Review Pathophysiological mechanisms of fatigue and multidisciplinary management strategies (Review) 2026 Lin et al

[Andy]

Abstract​

Fatigue is a common clinical symptom, and its complex pathophysiological mechanisms markedly affect the quality of life and social function of patients. With the advancement of omics technologies and artificial intelligence applications, the ability to understand the mechanisms of fatigue has been notably enhanced. Fatigue is a complex process involving the interaction of multiple systems and factors. The occurrence of fatigue involves multilevel regulation of energy metabolism, neuroendocrine and immune systems. Based on omics and molecular biology, abnormal energy metabolism, oxidative stress and mitochondrial dysfunction serve a central role in the pathogenesis of fatigue. Disorders in the neuro‑endocrine‑immune network and dysfunction of the microbiome‑gut‑brain axis constitute key systemic integration mechanisms. Clinically, numerous diseases, including chronic fatigue syndrome and endocrine, neurological and autoimmune disease, can manifest as fatigue symptoms. In terms of treatment, individualized, multidisciplinary collaborative comprehensive management models have become nursing standards. In addition, the application of telemedicine technology has markedly improved the accessibility and compliance of fatigue management.

The present review aimed to examine the conceptual framework, physiological mechanisms, clinical manifestations and management strategies of fatigue to provide reference for clinical diagnosis and treatment practice. Future research should focus on strengthening the exploration and translational application of molecular mechanisms, developing novel intervention targets, establishing effective fatigue assessment models and optimizing management strategies to provide strong evidence‑based support for clinical practice.

Open access

 

[Utsikt]

Yet another review demonstrating a substantial lack of understanding of basic scientific methods and principles for assessing evidence.

 

[Creekside]

"Exercise therapy (moderate-quality evidence, GRADE) is a key methods for treating CFS."

"Psychotherapy (high-quality evidence, GRADE) is a key component of the comprehensive management of CFS and can effectively improve fatigue symptoms,"

"Physiotherapy. Certain physical factors (low-quality evidence, GRADE) such as low-intensity laser and static magnetic field may alleviate CFS symptoms." Do people still buy magnet bracelets ... and pet rocks, mood rings, etc?

It was published in February, but it's in the April edition, which seems appropriate for an April Fool's joke.

Reviews of literature from people who don't understand how to judge quality of research aren't of much value. When I read reviews of books or items to buy, I mostly ignore the good reviews (possible shills?) and instead look for the bad reviews.

 

[Peter T]

I may be totally wrong, but it does seen that fatigue is approached very differently to other non specific symptoms.

Fatigue occurs in many medical conditions and in varied circumstances, which without further information is not necessarily helpful in diagnosing specific conditions. Fatigue is similar in this to a range of other such non specific symptoms like word finding difficulties, headaches, etc. It may be that I am more aware of research into fatigue because of ME/CFS, though word finding difficulties are relevant to my previous research and clinical work, but I certainly feel as though there is less interest in such as word finding difficulties independent of it clinical context.

 

[Creekside]

Fatigue occurs in many medical conditions and in varied circumstances

.. and probably via many unrelated mechanisms, all falling under the umbrella of the vaguely defined word: "fatigue". Maybe "swept under the rug of" fits better.