Académique Documents
Professionnel Documents
Culture Documents
Amerigo Rossuello
Exercise induced fatigue has been defined as an inability to sustain a given level of power
output during repetitive or continuous muscular contractions . The failure to maintain power
output during exercise is most likely multifactorial and may be caused by central factors, which
decrease the body’s ability to maximally stimulate the muscle, or peripheral factors, which
decrease the ability of the muscle to produce maximal force . The relative contributions of
central and peripheral factors to exercise induced fatigue are still a cause for debate . Several
studies have attempted to answer this question via the twitch interpolation technique, whereby
the motor nerve is artificially stimulated while the subject is maximally contracting the
innervated muscle. If the force increases during the twitch interpolation, than the central drive
was insufficient and central fatigue is likely a cause of the fatigue; if no increase in force occurs,
then the fatigue is likely completely peripheral. Recent advances have allowed researchers to
also use targeted transcranial magnetic stimulation during muscle contractions to also asses
These types of studies are typically done using isometric contractions to enable optimal
assessment of force and EMG, and the results generally indicate that central fatigue accounts for
10-25% of total fatigue . The goal of this paper will be to explain the most probable supraspinal
and spinal changes that occur during exercise to cause a reduction in neural drive. Some
particular attention will also be given to any relative changes in central fatigability that may
This paper will also attempt to differentiate and find commonalities between the various
causes of fatigue due to the three primary modes of fatiguing exercise; 1. Repeated or sustained
maximal contractions in which EMG remains relatively constant while force decreases. 2.
2
Repeated or sustained submaximal muscle contractions in which force is maintained as long as
possible while EMG gradually increases until failure. 3. Dynamic whole body endurance
Supraspinal fatigue
Supraspinal fatigue can be quantified by administering TMS to the motor cortex with a
simultaneous maximal voluntary effort. The difference between the last maximal voluntary
contraction and the subsequent contraction with TMS supplementation is considered to be the
amount of fatigue that is due to supraspinal processes. Supraspinal fatigue has been
demonstrated to be approximately ¼ of the total central fatigue during repeated maximal exercise
Preventing the recovery of a newly fatigued muscle by limiting blood flow does not
affect the recovery of excitability in the motor cortex from central fatigue, as evidenced by TMS
activation. However, supraspinal fatigue remains evident until blood flow is restored to the
fatigued muscle due to maintained activation of group III and IV muscle afferents , suggesting
that these neurons inhibit maximal motor cortical output when metabolic factors indicate muscle
fatigue. This evidence should somewhat moderate the weight of the conclusions achieved in
fatigue studies that use sustained contractions, maximal or sub-maximal, of a small muscle group
because of the potential for the exercise to unnaturally occlude blood flow.
The actual changes in neurotransmitter release, reuptake and breakdown during fatiguing
exercise are still mostly theoretical because it has been difficult to assess brain neurotransmitter
activity in vivo. However, based on the recent advances using the microdialysis technique and
3
support, primarily focused on exercise induced changes in the dopaminergic, noradrenergic and
serotonergic systems .
The neurotransmitter implicated in the predominant central fatigue theory has been
serotonin. The theory is based on research showing that free tryptophan and branched chain
amino acids (BCAA) compete for a transporter to cross the blood brain barrier . During
endurance exercise, the human body progressively utilizes more BCAAs, allowing more
tryptophan to cross the blood brain barrier. Because tryptophan is a precursor to serotonin, this
sequence leads to higher than normal concentrations of serotonin in the brain, causing fatigue
symptoms like irritability and increased level of perceived exertion. However, if the process
were this simple, then BCAA supplementation, which elevates blood BCAA concentration would
improve exercise performance by delaying fatigue; but the results have been equivocal .
Furthermore, because studies that were able to selectively increase brain serotonin concentration
did not consistently improve exercise , it is more likely that the interactions between several
A revised central fatigue hypothesis contends that, because of the well-known properties
of dopamine in feeling motivated, the ratio between brain serotonin and dopamine is probably a
better indicator of fatigue . High ratios (serotonin to dopamine) are associated with fatigue, and
low ratios are associated with motivation. Because mood and exercise tolerance are strongly
based on brain neurotransmitter activity, it is more likely that central fatigue is caused by
changes in serotonin and dopamine concentration than by serotonin alone. More research needs
to be done to determine the exact changes in neurotransmitter activity in the brain during
4
Endurance exercise in a hot and humid environment, when body temperature cannot be
controlled, causes fatigue more quickly than in cooler temperatures, which may indicate a
thermal limit (~40˚C) to exercise performance, although the mechanism is unclear . Though
some of the fatigue associated with high body heat may be due to reduced blood volume
associated with dehydration, part of it can be attributed to central fatigue based on the activity of
changes in the serotonergic and catecholaminergic projections to the hypothalamus may alter its
function. Seven out of 9 subjects who were administered bupropion, a norepinephrine and
dopamine reuptake inhibitor, were able to achieve core temperatures above 40˚C, while only 2
out of 9 in the placebo trial . Furthermore, endurance performance was significantly better in the
experimental trail, indicating that neurotransmitter activity at high temperatures affects the
Another possible cause of the reduced supraspinal capacity during maximal repeated
evidence suggests a much more complex system of inhibition and excitation controlled by both
GABAA and GABAB receptor activation . It is still unclear, however, exactly how this
Spinal fatigue
One of the most well known causes of central fatigue during maximal sustained or
repeated exercise and repeated submaximal contractions is the slowing of motor unit firing rates .
Slowed motor unit firing rates may cause some muscle fibers to not fully contract, reducing the
force output and causing fatigue. Three general changes to the motor neuron are most likely
5
responsible for the slowing of motor neuron firing rate; increased inhibitory input, reduced
excitatory input, and decreased responsiveness to excitatory stimuli. It is likely that all three
contribute to central fatigue , but their relative contributions to the slowing of maximal motor
Nociceptive stimulation incurred during fatiguing exercise most likely stimulates the
activity of inhibitory interneurons which reduce the excitability of motor neurons . Furthermore,
group III and IV afferent nerves, which are sensitive to the accumulation of metabolites, increase
in heat, and mechanical stresses may also inhibit motor neuron activity during maximal exercises
. It has been shown that a sustained contraction as small as 5% of maximal voluntary contraction
can sufficiently increase the arteriovenous K+ difference to stimulate group IV afferent neurons
which many also slow neuron firing rate (spinal fatigue) and reduce motor cortical drive
(supraspinal fatigue).
Motor neuron firing rate may also decrease due to a reduction in muscle spindle firing,
causing a decrease in the muscle spindle contraction facilitation . Macefield, et al. observed a ½
reduction in muscle spindle activity after 1 minute of isometric contraction, likely leading to a
Andersen, et al. measured maximal force output following a fatiguing exercise of the
abductor digiti minimi muscle. They also measured the fatigued force output while
supplemented with TMS, and the force with simultaneous TMS and direct motor nerve
stimulation. The findings showed that TMS failed to activate all of the motor neurons following
the fatiguing exercise, indicating that a reduction in the motor neuron responsiveness to an
6
Older Adults and Aging
Although older adults produce less maximal force than their young counterparts, older
adults experience less fatigue during repetitive or sustained maximal contractions when the last
fatigability is apparently different between young and older adults, it can be supposed that the
mechanisms that cause central fatigue may be different or differentially influential in older
adults.
One of the mechanisms of central fatigue in young, healthy adults is a slowing of the
maximal firing rate of the motor neurons. Older adults have approximately 30-35% slower
maximal motor unit firing rates than young adults when unfatigued . Furthermore, it has been
well documented that older adults have a relatively higher percentage of slower, type I motor
neurons than young adults, and an increased threshold for motor cortex excitability . However, it
is unclear whether the slower baseline firing rates changes differently during fatiguing exercise.
Kent-Braun, et al. found no difference in the rate of force development between young and old
adults during repeated maximal contractions. Similarly, young and older adults are both able to
voluntarily activate more than 99% of their target muscle fibers at baseline and fatigue. A recent
fatiguing protocol (20% MVC) in older adults , although the difference was not present at 80%
MVC.
The motor neurons of older adults may have a lower concentration of acetylcholine , less
neuromuscular propagation should be lower in older adults. The M-wave amplitude is, in fact,
approximately 20-40% lower in older adults, depending on the muscle group, and progressively
7
declines with age . Although the older motor neurons are clearly functionally different, fatiguing
exercise has not had any consistent differential effects on M-wave characteristics in older adults
The results from the relatively few studies that have been done comparing the
mechanisms of central fatigue in young and older adults (or animals) have been inconclusive .
At this time, it does not appear that the causes of central fatigue change with age, but future
research may clarify whether the proportional influence of each aspect changes over time.
Conclusion
The central mechanisms of exercise induced fatigue remain relatively unknown because
of the inherent difficulties in assessing neural changes during exercise performance. However,
decades of arduous work and ingenuity have led the scientific field to a basic understanding of
several causes of a reduced capacity to maximally stimulate muscle during exhaustive exercise.
One of the most likely causes of supraspinal fatigue during exercise is the inhibitory
effect of afferent group III and IV neurons, which sense fatigue and may be a safety negative
feedback loop to make sure humans do not pass their limit of exercise tolerance. Endurance
exercise is also limited in the brain by the contrasting affects of serotonin and dopamine. High
serotonin concentration may lead to fatigue unless there is a concurrent increase in dopamine
stimulate the hypothalamus to disregard the exercise related increase in core temperature, which
There is a broad consensus that the most prominent portion of central fatigue is caused by
a decrease in the maximal firing rate of fatigued motor neurons. The reduction in firing rate is
8
caused by increased inhibitory input, reduced excitatory input and responsiveness to excitatory
input.
Older adults fatigue at a slower rate than young adults during maximal or submaximal
exercise protocols, but the mechanism causing the difference has yet to be discovered, although
9
References
10