In this paper, we propose a set of unifying definitions that are useful in all areas of fatigue research while remaining neutral to the various theories about fatigue. We first set up two criteria and four desiderata that a definition for interdisciplinary use needs to fulfill: (i) non-circularity, (ii) finiteness, (iii) broadness, (iv) precision, (v) neutrality, and (vi) phenomenon-focus. We argue that other existing attempts to unify definitions within fatigue research do not fulfill all of these criteria and desiderata. Instead, we argue for a set of stipulative definitions, centered around performance measures and subjective estimations, is required in order to maximize clarity. In total, a set of 13 distinct definitions of fatigue and fatigue-related phenomena is presented. These definitions will help facilitate communication between different researchers, link phenomena from divergent research fields together, facilitate application and knowledge production, and increase the specificity for hypothesis testing.

Pathological mental fatigue after mild traumatic brain injury (TBI-MF) is characterized by pronounced mental fatigue after cognitive activity. The neurological origin is unknown, and we aimed in the present study to investigate how prolonged mental activity affects cognitive performance and its neural correlates in individuals with TBI-MF. We recruited individuals with TBI-MF ( n = 20) at least 5 months after injury, and age-matched healthy controls ( n = 20). We used functional near-infrared spectroscopy (fNIRS) to assess hemodynamic changes in the frontal cortex. The self-assessed mental energy level was measured with a visual analog scale (VAS) before and after the experimental procedure. A battery of six neuropsychological tests including Stroop–Simon, Symbol Search, Digit Span, Parallel Serial Mental Operation (PaSMO), Sustained Attention and Working Memory test, and Digit Symbol Coding (DSC) were used. The sequence was repeated once after an 8 min sustained-attention test. The test procedure lasted 2½ h. The experimental procedure resulted in a decrease in mental energy in the TBI-MF group, compared to controls (interaction, p < 0.001, η p 2 = 0.331). The TBI-MF group performed at a similar level on both DSC tests, whereas the controls improved their performance in the second session (interaction, p < 0.01, η p 2 = 0.268). During the Stroop–Simon test, the fNIRS event-related response showed no time effect. However, the TBI-MF group exhibited lower oxygenated hemoglobin (oxy-Hb) concentrations in the frontal polar area (FPA), ventrolateral motor cortex, and dorsolateral prefrontal cortex (DLPFC) from the beginning of the test session. A Stroop and Group interaction was found in the left ventrolateral prefrontal cortex showing that the TBI-MF group did have the same oxy-Hb concentration for both congruent and incongruent trials, whereas the controls had more oxy-Hb in the incongruent trial compared to the congruent trial (interaction, p < 0.01, η p 2 = 0.227). In sum these results indicate that individuals with TBI-MF have a reduced ability to recruit the frontal cortex, which is correlated with self-reported mental fatigue. This may result both in deterioration of cognitive function and the experience of a mental fatigue after extended mental activity.

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Background Neuropsychiatric symptoms are common features of Graves' disease (GD), in hyperthyroidism and after treatment. The mechanism behind these symptoms is unknown, but reduced hippocampal volumes have been observed in association with increased thyroid hormone levels. Methods Sixty-two women with newly diagnosed GD underwent assessment including magnetic resonance (MR) imaging in hyperthyroidism and 48 of them were followed up after a mean of 16.4 ± 4.2 SD months of treatment. Matched thyroid-healthy controls were also assessed twice at a 15-month interval. MR images were automatically segmented using multi-atlas propagation with enhanced registration. Regional medial temporal lobe (MTL) volumes for amygdalae and hippocampi were compared with clinical data and data from symptom questionnaires and neuropsychological tests. Results Patients had smaller MTL regions than controls at inclusion. At follow-up, all four MTL regions had increased volumes and only the volume of the left amygdala remained reduced compared to controls. There were significant correlations between the level of TSH receptor antibodies (TRAb) and MTL volumes at inclusion and also between the longitudinal difference in the levels of fT3 and TRAb and the difference in MTL volumes. There were no significant correlations between symptom or test scores and any of the four MTL volumes. Conclusion Dynamic alterations in the amygdalae and hippocampi in GD reflect a previously unknown level of brain involvement both in the hyperthyroid state of the condition and after treatment. The clinical significance, as well as the mechanisms behind these novel findings, warrant further study of neurological consequences of GD.