Toward the unity of pathological and exertional fatigue: a predictive processing model

Greenhouse-Tucknott, A, Butterworth, J B, Wrightson, J G, Smeeton, N J, Critchley, H D, Dekerle, J and Harrison, N A (2022) Toward the unity of pathological and exertional fatigue: a predictive processing model. Cognitive, Affective and Behavioral Neuroscience, 22. pp. 215-228. ISSN 1530-7026

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Fatigue is a common experience in both health and disease. Yet, pathological (i.e., prolonged or chronic) and transient (i.e., exertional) fatigue symptoms are traditionally considered distinct, compounding a separation between interested research fields within the study of fatigue. Within the clinical neurosciences, nascent frameworks position pathological fatigue as a product of inference derived through hierarchical predictive processing. The metacognitive theory of dyshomeostasis (Stephan et al., 2016) states that pathological fatigue emerges from the metacognitive mechanism in which the detection of persistent mismatches between prior interoceptive predictions and ascending sensory evidence (i.e., prediction error) signals low evidence for internal generative models, which undermine an agent’s feeling of mastery over the body and is thus experienced phenomenologically as fatigue. Although acute, transient subjective symptoms of exertional fatigue have also been associated with increasing interoceptive prediction error, the dynamic computations that underlie its development have not been clearly defined. Here, drawing on the metacognitive theory of dyshomeostasis, we extend this account to offer an explicit description of the development of fatigue during extended periods of (physical) exertion. Accordingly, it is proposed that a loss of certainty or confidence in control predictions in response to persistent detection of prediction error features as a common foundation for the conscious experience of both pathological and nonpathological fatigue.

Item Type: Article
Keywords: Allostasis, Exercise, Fatigue, Interoception, Metacognition, Predictive processing;Consciousness;Emotions;Fatigue;Humans;Interoception;Metacognition
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 15 Jun 2022 08:19
Last Modified: 15 Jun 2022 08:30

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