How Changes in the Motor Cortex and Spinal Cord with Exercise Contribute to Fatigue in Humans

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Fatigue with exercise is a common experience in healthy people and can be a problem in many illnesses. With fatigue people are less able to produce force with their muscles. Much of this weakness occurs because of events in the muscles but some results from changes in the nervous system. The size of the contribution of the nervous system to fatigue is not known for the kinds of exercise that cause fatigue in everyday life e.g. prolonged weak contractions like holding the shopping or a plate of food, rhythmic contractions like walking or painting a wall, and more vigorous exercise that causes changes in breathing and body temperature. The behaviour of nerve cells in the brain and spinal cord is altered in fatigue but how and why many of these changes occur, and how they affect the control of movements, is poorly understood. Three approaches are planned. In the first set of studies, we will use brain and nerve stimulation to measure the impact of sustained low-level activities on people's ability to drive their muscles fully. We will identify whether such activities, as well as increased demands on other body systems, can cause fatigue in the nervous system. In the second set of studies, we will investigate whether changes in the motor areas of the brain can alter peoples' performance of fatiguing motor tasks or their perception of how much effort the tasks take. Finally, we will use stimulation of the spinal cord to work out why motor nerve cells in the spinal cord fire more slowly with fatigue. Fatigue is an important symptom which is not confined to diseases of any one system in the body. For example, it is a major complaint in multiple sclerosis, cardiac failure, chronic obstructive airway disease, depression and cancer, as well as after chemotherapy, surgery, and viral illness. The implications of better understanding of the contribution of the nervous system to fatigue range from targeting treatments in patients to improving the performance of athletes.