Abstract
The neurophysiological mechanism of cancer-related fatigue (CRF) remains poorly understood. EEG was examined during a sustained submaximal contraction (SC) task to further understand our prior research findings of greater central contribution to early fatigue during SC in CRF. Advanced cancer patients and matched healthy controls performed an elbow flexor SC until task failure while undergoing neuromuscular testing and EEG recording. EEG power changes over left and right sensorimotor cortices were analyzed and correlated with brief fatigue inventory (BFI) score and evoked muscle force, a measure of central fatigue. Brain electrical activity changes during the SC differed in CRF from healthy subjects mainly in the theta (4-8 Hz) and beta (12-30 Hz) bands in the contralateral (to the fatigued limb) hemisphere; changes were correlated with the evoked force. Also, the gamma band (30-50 Hz) power decrease during the SC did not return to baseline after 2 min of rest in CRF, an effect correlated with BFI score. In conclusion, altered brain electrical activity during a fatigue task in patients is associated with central fatigue during SC or fatigue symptoms, suggesting its potential contribution to CRF during motor performance. This information should guide the development and use of rehabilitative interventions that target the central nervous system to maximize function recovery.
Highlights
Cancer-related fatigue (CRF) is defined as “a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer and/or cancer treatment that is not proportional to recent activity and interferes with usual functioning” [1]
cancer-related fatigue (CRF) is accompanied by abnormal brain activities and modulations before and during a sustained fatiguing muscle contraction, which fail to fully recover right after the task
Some of those abnormal brain changes correlate with measure of subjective (BFI) and objective fatigue
Summary
Cancer-related fatigue (CRF) is defined as “a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer and/or cancer treatment that is not proportional to recent activity and interferes with usual functioning” [1]. CRF is the most frequently reported (30%-90%) and undertreated symptom while having the greatest adverse influence on quality of life (both during and following treatment) of all cancer symptoms [1,2,3,4]. Fatigue in cancer patients is multifactorial and may be influenced by several demographic, medical, psychosocial, behavioral, and biological factors [3, 5]. Fatigue can still persist after ruling out comorbid, environmental, or social contributing factors, pointing to an intrinsic biological mechanism of CRF [5]. The biological etiology of CRF is not fully understood and is still the subject of active research
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