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La fatiga en los trastornos neurológicos

Abhijit Chaudhuri1, Peter O Behan

  • 1Division of Clinical Neurosciences, University of Glasgow, Glasgow G51 4TF, UK. ac54p@udcf.gla.ac.uk

Lancet (London, England)
|March 27, 2004
PubMed
Resumen

La fatiga crónica tiene un impacto significativo en condiciones neurológicas como la esclerosis múltiple. La fatiga central, caracterizada por un mayor esfuerzo percibido y una resistencia reducida, implica complejas interrupciones de las vías cerebrales.

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Área de la Ciencia:

  • Neurología Neurología.
  • La neurociencia es la neurociencia.
  • Fisiopatología Fisiopatología.

Sus antecedentes:

  • La fatiga crónica es un síntoma prevalente e incapacitante en varias enfermedades neurológicas, incluida la esclerosis múltiple, la pospoliomielitis, el post-accidente cerebrovascular y el síndrome de fatiga crónica.
  • La fatiga se manifiesta como fatiga periférica (fatigabilidad muscular) o fatiga central, que afecta la resistencia física y mental.
  • La fatiga central implica una mayor percepción del esfuerzo y una capacidad de actividad sostenida limitada.

Objetivo del estudio:

  • Aclarar los mecanismos fisiopatológicos subyacentes a la fatiga central en los trastornos neurológicos.
  • Explorar el papel del eje hipotálamo-hipófisis-adrenal en el desarrollo de la fatiga central persistente.

Principales métodos:

  • Revisión de la literatura existente sobre la fisiopatología de la fatiga central.
  • Análisis de lesiones metabólicas y estructurales que afectan a las vías neuronales.
  • Investigación de la hipocortisolaemia y la sensibilidad del eje hipotálamo-hipófisis-adrenal.

Principales resultados:

  • La fatiga central está relacionada con lesiones que interrumpen las vías que conectan los ganglios basales, el tálamo, el sistema límbico y los centros corticales.
  • La hipocortisolaemia preexistente puede predisponer a las personas a la fatiga central persistente después del estrés.
  • La interacción de factores fisiológicos, cognitivos y afectivos contribuye de manera variable a la fatiga.

Conclusiones:

  • La fatiga central es un síntoma neurológico complejo con orígenes multifactoriales.
  • Comprender la base fisiopatológica es crucial para desarrollar tratamientos dirigidos.
  • Las estrategias actuales de manejo de la fatiga son principalmente sintomáticas y de rehabilitación.