[HN Gopher] Researchers seeking better measures of cognitive fat...
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       Researchers seeking better measures of cognitive fatigue
        
       Author : bikenaga
       Score  : 92 points
       Date   : 2025-12-10 19:13 UTC (3 days ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | TurkishPoptart wrote:
       | Long Covid is really not new. It is virtually indistinguishable
       | from the condition long known in the medical lexicon as post-
       | infectious syndrome or myalgic encephalomyelitis/chronic fatigue
       | syndrome (ME/CFS). Although some have recognized and studied
       | their similarities, it seems no one has made the simplifying
       | observation that they are essentially the same condition.[1]
       | 
       | [1]: https://www.statnews.com/2023/09/14/long-covid-me-cfs-
       | myalgi...
        
         | tick_tock_tick wrote:
         | Because COVID got political if you drop COVID from the name
         | your ability to get funding and attention to study it falls off
         | a cliff.
        
         | MLgulabio wrote:
         | I really don't understand this comment? Its quite commonly
         | known that this is the same/related?
         | 
         | Your 'source' is btw. from 2023 and as far as i understand it,
         | the main issue is, that due to covid, a lot more people got it
         | but because it was already ignored or played down before, it
         | still is and the people in need just don't get help.
         | 
         | Covid apparently triggered it in more people than before.
         | 
         | I also have the feeling that someone else posted this
         | missconception a few weeks ago on hn. Or was that you too?
        
         | amelius wrote:
         | Is this a scientific fact or a hypothesis?
        
           | wizzwizz4 wrote:
           | In the limit, there's no difference between a scientific fact
           | and an unfalsified hypothesis. I'm not aware of anyone
           | falsifying this one, and it's over five years old, so I'm
           | going to say "scientific fact".
           | 
           | At this point, even if it _is_ falsified, that falsification
           | will probably take the form  "here is an exception to the
           | general rule", like how we still use Newton's law of
           | gravitation even though it was falsified by Urbain Le
           | Verrier's 1859 observations of Mercury.
        
             | amelius wrote:
             | If a hypothesis has not been falsified that does not mean
             | there is consensus around it in the scientific community.
             | 
             | Your statement can also be applied to the inverse of the
             | hypothesis, after all.
        
               | wizzwizz4 wrote:
               | I'll put it another way: long COVID has been studied
               | quite a lot over the past 5 years, and I'm not aware of
               | anyone being able to distinguish it from ME/CFS (except
               | by definition). People appear to have stopped _trying_ to
               | draw a distinction, by and large, in favour of trying to
               | identify better category boundaries to use instead. See
               | https://doi.org/10.3390/biomedicines13112797 for a Nov
               | 2025 literature review, which basically says "except for
               | long COVID being caused by SARS-CoV-2, it's _very_
               | difficult to tell ME /CFS-like long COVID and ME/CFS
               | apart" in excruciating detail. Some things have been
               | found to occur in long COVID but not found to occur in
               | ME/CFS, and vice versa, but afaik there's nothing found
               | to occur in ME/CFS-like long COVID that's been found to
               | _not_ occur in ME /CFS.
               | 
               | ( _Technically_ , long COVID is a broader diagnosis,
               | encompassing some long-term conditions caused by a
               | COVID-19 infection that are distinct from ME/CFS, but I
               | consider that a "by definition" distinction rather than
               | anything _real_. This is what you 'd expect if ME/CFS had
               | multiple causes, and COVID-19 infection could cause
               | multiple chronic conditions, and most long COVID is
               | actually ME/CFS.)
               | 
               | The ME Association came to this conclusion a couple of
               | years ago: https://meassociation.org.uk/2023/05/updated-
               | booklet-long-co...
               | 
               | > The ME Association (MEA) takes the view that Long Covid
               | and ME/CFS are both examples of a serious and
               | debilitating condition that can follow any type of viral
               | infection.
        
           | tbrownaw wrote:
           | Not sure about the ME/CFS thing, but "post-infectious
           | syndrome" is literally what its name says it is which makes
           | it a larger category that "long covid" would taxonomize
           | under.
        
           | smj-edison wrote:
           | https://pubmed.ncbi.nlm.nih.gov/40627388/#&gid=article-
           | figur... (figure one)
        
         | PaulKeeble wrote:
         | Symptom wise and quite a lot of the biology they definitely
         | appear similar. The problem is the genetics studies show some
         | overlap, about 80 combined SNPs for ME/CFS out of 270 and out
         | of around 150 for Long Covid.
         | 
         | There is more to it than just different genetic mappings
         | because while both conditions share mitochondria differences
         | which compartments are different. Depending on how deep you dig
         | into the biology they appear the same or quite different and a
         | number of multiple point blood, urine and saliva tests can
         | distinguish the diseases from each other.
         | 
         | I think at this point its more accurate to say they are
         | overlapping conditions, they have similarities but they are
         | different conditions. Sister diseases much in the same way
         | there is overlap in Fibromylgia and Gulf War syndrome with
         | ME/CFS and each other. Long Covid is another post infection
         | Neurological and immune disease with unknown biomarker/core
         | pathology. There are clearly a lot of measurable changes that
         | are dysfunctional so its every bit as real biological disease
         | as the others. What they definitely share is a high amount of
         | debilitation, severe disability and patient reduction in
         | quality of life on the same set of 280 symptoms in a very
         | similar patter of prevalence.
         | 
         | Its also now a disease with very little research funding world
         | wide as well so the situation is unlikely to improve for the
         | 400m+ sufferers world wide.
        
           | aswegs8 wrote:
           | Is that from GWAS/MR Studies?
        
             | PaulKeeble wrote:
             | There has been a couple of GWAS and also a few SNP
             | combination studies that I have seen, could have been a few
             | more I missed. Nothing full genome yet so that might
             | increase or decrease the overlap.
        
       | pitched wrote:
       | https://archive.is/5Ty0K
        
       | PaulKeeble wrote:
       | Truth is we are no closer to having a biomarker for fatigue.
       | There is no particular reason why the normal fatigue that people
       | get from working hard has anything to do with the chronic fatigue
       | that ME/CFS and other chronic diseases face. ME/CFS is unique in
       | its payback where a sufferers pushes through the fatigue and ends
       | up with symptoms worsening and new symptoms 12-72 hours later
       | that can last a day to the rest of their lives. That isn't just
       | fatigue and the UK doctors have been trying to make ME/CFS all
       | about fatigue since the 1980s and it caused immense harm. It
       | actually has about 280 symptoms, of which fatigue is just one and
       | not even the most debilitating or important one.
        
         | pitched wrote:
         | Something important to keep in mind is that cognitive fatigue
         | is a protective system meant to protect our cells from harm.
         | Pushing through anyways would be unlikely to cause harm in a
         | healthy system. Post-covid is an extremely stressed one though.
         | Would be like going to the gym after tearing a muscle and being
         | surprised it got worse.
        
       | arjie wrote:
       | > _To better understand fatigue, Pessiglione, Chib and other
       | researchers are trying to bridge an understanding of its
       | biochemical workings with how it affects motivation4. The current
       | hypothesis: cognitive fatigue arises from metabolic changes in
       | parts of the brain that are responsible for cognitive control_
       | 
       | This will be interesting to see because for a long time there's
       | been a lot of work saying that "ego depletion" isn't a thing[0]
       | and I swear I have tried to believe this but my own personal
       | experience is completely different. Later in the night, and when
       | I'm mentally tired I do experience this: poor impulse control,
       | lowered emotion regulation, the whole shebang. It'll be
       | interesting to see what the basis is for this, because despite
       | taking all that research at face-value I have to say that now
       | after all these years, I can't help but think it must be wrong.
       | 
       | 0: though some have claimed that it is a thing if you believe
       | that it's a thing, i.e. it happens to those who believe in it.
        
         | aswegs8 wrote:
         | Ego depletion isn't a thing if you don't believe in it? Who
         | said that? Dr. Goggins?
        
           | arjie wrote:
           | Haha! Listen, the "you can do it if you believe in yourself"
           | stuff always sounds bogus. But there was some stuff around
           | ten years ago about this. Here's an example:
           | https://www.pnas.org/doi/full/10.1073/pnas.1313475110#F1
        
             | DiscourseFan wrote:
             | I don't think its _completely_ bogus. There are lots of
             | things you can do that you don't realize you can. But 40-50
             | hours of work a week, even if you don't even leave your
             | house, still takes a lot out of you.
        
         | IsTom wrote:
         | I feel there is more than one type of mental fatigue. Some of
         | them can be forced through (e.g. the emotional kind that
         | happens when you have to do something you don't want to do) and
         | some can't (e.g. not having enough sleep for prolonged time).
        
         | pitched wrote:
         | Physical fatigue is lack of ATP and happens through the day as
         | oxidation builds up. Cognitive fatigue is a build-up of used
         | neurotransmitters that also build up over the day. These two
         | processes interact with each other though where
         | neurotransmitter reuptake uses a lot of ATP. I see that
         | connection between them as ego depletion. If true, the best
         | solution to it is a nap because that will help clear the junk
         | out.
        
       | j45 wrote:
       | I'm sharing this more for folks who might have looked in a lot of
       | places and are still seeking answers.
       | 
       | There has been a lot more science in this area it seems in the
       | last 5 years, maybe it's just me, and the attention to do with
       | long covid, or other things that cross the blood/brain barrier.
       | 
       | It's encouraging to see articles like this, since there is no
       | single measure or signal of this, its really about considering
       | brain health in general, and doing everything that is possible to
       | eliminate neuroinflammation that can be.
       | 
       | The challenge for folks suffering with symptoms that includes a
       | neurological thing like brain fog is the challenge of usually
       | having to be the Quarterback integrating between specialists,
       | because specialists don't necessarily integrate. For someone with
       | cognitive fatigue, since it's differnet for everyone on different
       | tasks, it can be a lot.
       | 
       | It's been eye opening to learn how many specialists first
       | overlook proper neck posture and position since it can have a
       | direct effect on what's getting into/out of the brain and
       | downstream symptoms. Advocating for the basic inputs first before
       | trying things is critical.
       | 
       | Additionally, tools like QEEG and FMRI are promising, not super
       | mainstream yet but appear to have decent information it can
       | provide of what is happening in the brain. In addition to this,
       | the area of neurofeedback (devices like mendi, bellabee, etc seem
       | to have some promise to help in some cases).
       | 
       | Another thing that too often gets missed is first ensuring things
       | are OK physiologically. A simple xray of the neck and where
       | nerves, blood and more go up into the brain is too often a step
       | that's missed, and quite often there might be some compression,
       | tightness or pinches there limiting the brain to recieve what it
       | normally may have - and instead effort is spent trying to figure
       | out how to get the brain operating better with a garden hose
       | that's been slightly pinched.
       | 
       | Fatigue to the extent I understand it neurologically seems to at
       | least two sided dice: energy and nutrition being available when
       | and where it's needed on one side, and the things needed in place
       | to use that energy effectively.
       | 
       | Chronic depletion or deficiencies in certain vitamins, amino
       | acids, etc can also build up over time. Doing what we can for
       | nutrition is critical, including any research backed
       | neuroinflammation reducing supplements (magnesium threonate,
       | saffron, omega 3, tumeric, etc).
        
       | gnosis67 wrote:
       | BURN IT!
       | 
       | You are working against yourself in this problem.
       | 
       | To master cognitive capacity is similar to physical labor. There
       | are those who do not resist the efficiency of over achieving and
       | there are those who have no idea what that means.
       | 
       | Rathering a more convenient less exhaustive measure is where you
       | short yourself.
       | 
       | Burn it. Do the work. The exhaustive measures will make you more
       | complete than the banal need which drives you.
       | 
       | Your lazy delegation is the seed of your hypocrisy and it shall
       | blossom into the fatigue of your self reliance.
       | 
       | Only you can bear the terrible burden of free will. And that
       | comes at the cost of your determination to resolve.
        
       | matt3210 wrote:
       | I start to go blind when programming for too long. Does that
       | count?
        
         | pitched wrote:
         | You should probably talk to ChatGPT about that. ...or see a
         | doctor, if that's still a thing people do?
        
       | bdbdbdb wrote:
       | I wonder when they get tired thinking about the problem, do they
       | get more motivated?
        
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