Central nervous system fatigue

Central nervous system fatigue, or central fatigue, is a form of fatigue that is associated with changes in the synaptic concentration of neurotransmitters within the central nervous system (CNS; including the brain and spinal cord) which affects exercise performance and muscle function and cannot be explained by peripheral factors that affect muscle function. In healthy individuals, central fatigue can occur from prolonged exercise and is associated with neurochemical changes in the brain, primarily involving serotonin (5-HT), noradrenaline, and dopamine. Central fatigue plays an important role in endurance sports and also highlights the importance of proper nutrition in endurance athletes. Existing experimental methods have provided enough evidence to suggest that variations in synaptic serotonin, noradrenaline, and dopamine are significant drivers of central nervous system fatigue. An increased synaptic dopamine concentration in the CNS is strongly ergogenic (promotes exercise performance). An increased synaptic serotonin or noradrenaline concentration in the CNS impairs exercise performance. Manipulation of norepinephrine suggests it may actually play a role in creating a feeling of fatigue. Reboxetine, an NRI inhibitor, decreased time to fatigue and increased subjective feelings of fatigue. This may be explained by a paradoxical decrease in adrenergic activity lead by feedback mechanisms. In the brain, serotonin is a neurotransmitter and regulates arousal, behavior, sleep, and mood, among other things. During prolonged exercise where central nervous system fatigue is present, serotonin levels in the brain are higher than normal physiological conditions; these higher levels can increase perceptions of effort and peripheral muscle fatigue. The increased synthesis of brain serotonin occurs because of a higher level of tryptophan, the serotonin precursor, in the blood and which results in larger amounts of tryptophan crossing the blood-brain barrier. An important factor of serotonin synthesis is the transport mechanism of tryptophan across the blood-brain barrier. The transport mechanism for tryptophan is shared with the branched chain amino acids (BCAAs), leucine, isoleucine, and valine. During extended exercise, BCAAs are consumed for skeletal muscle contraction, allowing for greater transport of tryptophan across the blood-brain barrier. None of the components of the serotonin synthesis reaction are saturated under normal physiological conditions, allowing for the increased production of the neurotransmitter. However the failure of BCAAs to decrease time to fatigue consistently limit this hypothesis. Dopamine is a neurotransmitter that regulates arousal, motivation, muscular coordination, and endurance performance, among other things. Dopamine levels have been found to be lower after prolonged exercise. A decrease in dopamine can decrease athletic performance as well as mental motivation. Dopamine itself cannot cross the blood brain barrier and must be synthesized within the brain. In rats bred for running, increased activity of the ventral tegmental area have been observed, and VTA activity correlates with voluntary wheel running. As the VTA is an area dense in dopaminergic neurons that project to many areas of the brain, this suggests that dopaminergic neurotransmission drives physical performance. Further supporting this theory is the fact that dopamine reuptake inhibitors as well as norepinephrine dopamine reuptake inhibitors are able to increase exercise performance, especially in the heat. Acetylcholine is required for the generation of muscular force. In the central nervous system, acetylcholine modulates arousal and temperature regulation. It also may play a role in central fatigue. During exercise, levels of acetylcholine drop. This is due to a decrease in plasma choline levels. However, there have been conflicting results in studies about the effect of acetylcholine on fatigue. One study found that plasma choline levels had dropped 40% after the subjects ran the Boston Marathon. Another study found that choline supplementation did not improve time to exhaustion. This study also found that plasma choline levels had not changed in either the placebo or the choline supplemented groups. More research is needed to investigate acetylcholine's effects on fatigue. Cytokines can manipulate neurotransmissions creating sickness behavior, characterized by malaise and fatigue. In animal models, IL-1b stimulates serotonin release and increases activity of GABA. Lipopolysaccharide challenges also inhibit activity of histaminergic and dopaminergic neurons. Increased circulating levels of ammonia may alter brain function and result in fatigue. One hypothesized reason that BCAAs fail to increase exercise performance is due to increased oxidation of BCAAs in supplementation that results in increased fatigue, canceling out the effects on 5-HT.