The biologic basis of fatigue

Gutstein, Howard B.

doi:10.1002/1097-0142(20010915)92:6+<1678::aid-cncr1496>3.0.co;2-r

Cited by 116 publications

(77 citation statements)

References 24 publications

(24 reference statements)

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“…For example, human cognitive impairment often involves working memory rather than retentive/ consolidative memory, but the rodent memory models commonly used may not actually test working memory. Animal models representative of fatigue are particularly lacking 4 and require careful attention to distinguish motivational deficits from fatigue. Expert panels composed of clinical and basic scientists could help to specify the operational definitions of components of human cancer symptoms and could propose component animal behaviors that might parallel these definitions.…”

Section: Working Group Conclusion and Future Directionsmentioning

confidence: 99%

“…2,3 There is growing awareness that common biologic mechanisms may underlie or contribute to at least some of those symptoms simultaneously. 3,4 This is exemplified in the animal models of sickness behavior, which have symptoms in common with those of cancer patients. Sickness behavior refers to a constellation of physiologic and behavioral responses observed in animals after the administration of inflammatory agents or specific proinflammatory cytokines.…”

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confidence: 99%

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Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?

Cleeland

Bennett

Dantzer

et al. 2003

Cancer

468

340

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BACKGROUNDCancers and cancer treatments produce multiple symptoms that collectively cause a symptom burden for patients. These symptoms include pain, wasting, fatigue, cognitive impairment, anxiety, and depression, many of which co‐occur. There is growing recognition that at least some of these symptoms may share common biologic mechanisms.METHODSIn November 2001, basic and clinical scientists met to consider evidence for a cytokine‐immunologic model of symptom expression along with directions for future research.RESULTSThe characteristics of cytokine‐induced sickness behavior in animal models have much in common with those of symptomatic cancer patients. Sickness behavior refers to a set of physiologic and behavioral responses observed in animals after the administration of infectious or inflammatory agents or certain proinflammatory cytokines. In some cases, these responses can be prevented by cytokine antagonists. A combination of animal and human research suggests that several cancer‐related symptoms may involve the actions of proinflammatory cytokines.CONCLUSIONSBased on the similarities between cancer symptoms and sickness behavior, the authors discussed approaches to further test the implications of the relationship between inflammatory cytokines and symptoms for both symptom treatment and symptom prevention. Cancer 2003;97:2919–25. © 2003 American Cancer Society.DOI 10.1002/cncr.11382

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Section: Working Group Conclusion and Future Directionsmentioning

confidence: 99%

mentioning

confidence: 99%

Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?

Cleeland

Bennett

Dantzer

et al. 2003

Cancer

468

340

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“…The basic mechanisms in fatigue are generally divided into two major components: peripheral fatigue from neuromuscular dysfunction and mechanisms leading to energy imbalance and central fatigue that implies alteration in neurotransmitters in serotonergic and noradrenalin pathways and changes in the function of the hypothalamic-pituitary-adrenal axis (HPA), often coexistent with such psychological complaints as anxiety and depression (Swain, 2000, Gutstein, 2001). Other suggested mechanisms of fatigue include alteration in biochemistry with elevated levels of cytokines in plasma, resulting in immune activation.…”

Section: Fatiguementioning

confidence: 99%

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Falk

Swedberg

Gaston‐Johansson

et al. 2007

European Journal of Cardiovascular Nursing

101

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Although fatigue is a prevalent and distressing symptom in patients with chronic heart failure (CHF), it is an underestimated problem in the care of patients, and consequently, insuffi ciently investigated. The primary aim of this thesis was, therefore, to advance the knowledge from the patients' perspective by describing characteristics of the fatigue experience and its consequences in daily life in patients with CHF. A secondary aim was to investigate the relationships between fatigue and selected physiological and psychological factors associated with fatigue. Both quantitative and qualitative methods have been used and three samples of patients have been interviewed on different occasions. In two of the quantitative studies 93 patients, and in another study 112 patients, consecutively included, were interviewed at the hospital. Fifteen patients were included in the qualitative study. These 15 participants were enrolled when they visited an outpatient clinic and most of them were interviewed in their homes. These interviews were supplemented with the content of an Internet discussion with persons living with CHF.The results of the studies indicated that fatigue embraces the individual's body, emotions and cognitive abilities, forcing the person to physical restrictions that, in turn, perpetuate emotional discomfort. However, the physical sensation of fatigue followed by functional limitations seemed to be the most prevalent and distressing experience in patients with CHF. The patients described fatigue as lacking strength, which was associated in connection with physical efforts and lacking energy, viewed as an annoying sensation after both mental and physical strain. Another dimension of fatigue was described as being sleepy, often with a rapid and unforeseen onset. Consequences of fatigue, such as refraining from daily chores, denying oneself opportunities for rejoice and social isolation, further exaggerated the experience of fatigue. Restorative activities that engaged, absorbed or distracted the patients counteracted these negative consequences. Depressed mood was related to those fatigue dimensions that compromised functional ability and motivation to start any activities, whereas anxiety was associated with cognitive impairment. Feelings of uncertainty were related to physical tiredness, possibly infl icted by limitations in performing activities. Symptom distress that was caused by a number of reported symptoms other than fatigue had a diminutive infl uence on fatigue and separate symptoms that were associated with fatigue were, with the exception of breathlessness, not the fi rst and most pressing symptom reported by the patients. Anemic patients reported more fatigue compared with non-anemic patients and functional status, according to the New York Heart Association (NYHA) functional classifi cation criteria, was associated with those fatigue dimensions that encompassed physical tiredness and reduced functioning.The fi ndings provide new insights on the characteristics of fatigue and its con...

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“…The pathophysiology of fatigue is poorly understood and few basic research studies have been conducted to investigate the physiological mechanisms underlying cancer-related fatigue (Gutstein, 2001). Identifying the aetiological factors that contribute to fatigue often proves to be complicated, as multiple causes typically coexist and may have additive effects.…”

Section: Aetiology Of Cancer-related Fatiguementioning

confidence: 99%

Fatigue and cancer: causes, prevalence and treatment approaches

2004

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Fatigue is the most prevalent cancer-related symptom and has a significant adverse impact on patients' functional ability and quality of life. Hypotheses regarding the aetiology of cancer-related fatigue are discussed, and clinical practice guidelines for the evaluation and management of oncology patients with fatigue are reviewed. Both nonpharmacologic and pharmacologic strategies for the management of fatigue are summarised.

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The biologic basis of fatigue

Cited by 116 publications

References 24 publications

Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?

Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Fatigue and cancer: causes, prevalence and treatment approaches

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