Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While much has been written about the importance of the experience of presence in simulation protocols, the role of "absence" deserves closer attention. The role of subjective experience and neurophysiologic processes involved in fluctuating states of consciousness is a key issue in developing assessment and treatment tools using interactive immersive simulator tasks. This paper proposes that when engaging in an interactive simulator task, there are fluctuations of consciousness that determine both motivational engagement and measured performance. Rather than expecting a continuous experience, both in terms of perceptual and motor output flow, factors such as circadian fluctuations, fatigue, and actual intrusion of sleep into waking consciousness are relevant in assessments and treatments using virtual environment-based tasks. These factors are particularly relevant in treatment populations with neurological and psychiatric disorders, where such disturbances are more common. To illustrate this construct, a series of experiments examining these phenomena in relation to a standardized driving-simulation protocol to detect psychomotor impairment developed for clinical and diagnostic testing in a sleep laboratory setting are reviewed.
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PMID:Neural correlates of "absence" in interactive simulator protocols. 1842 11

3,4-Methylenedioxymethamphetamine (MDMA, "ecstasy") is a unique drug, sharing properties of hallucinogens and stimulants. The acute effects of empathy, euphoria, and excitement for which it is used recreationally can make it overwhelmingly distracting for the user in the context of driving. This review considers the chemistry, synthesis, analysis, pharmacology, pharmacokinetics, and documented effects of MDMA on cognitive and psychomotor skills important to driving. Laboratory studies show that users do experience cognitive impairments, and may also act more impulsively while under the influence of the drug's sympathomimetic effects. Psychomotor impairment may occur with elevated doses or after repeated administration, and residual psychomotor impairment during the "coming-down" phase may be compounded by fatigue, dehydration, combined drug use, or other confounding factors. There is growing anecdotal information providing evidence of MDMA-impaired driving, and it is evident that many users recognize and attempt to mitigate the effects by delaying driving until the acute affects have dissipated. The drug inevitably may affect a subject's judgment and ability to properly assess their fitness to drive also. Blood concentrations in MDMA-impaired drivers suggest that this impairment can be caused by normal patterns of recreational use, and MDMA use should be considered inconsistent with safe driving immediately following ingestion, and for up to a day or longer following use.
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PMID:3,4-Methylenedioxymethamphetamine - Effects on Human Performance and Behavior. 2625 92

Depression is the most common comorbidity and neuropsychiatric complication in HIV. Estimates suggest that the prevalence rate for depression among HIV-infected individuals is three times that of the general population. The association between HIV and clinical depression is complex; however, chronic activation of inflammatory mechanisms, which disrupt central nervous system (CNS) function, may contribute to this association. Disruptions in CNS function can result in cognitive disorders, social withdrawal, fatigue, apathy, psychomotor impairment, and sleep disturbances, which are common manifestations in depression and HIV alike. Interestingly, the parasympathetic system-associated vagus nerve (VN) has primary homeostatic properties that restore CNS function following a stress or inflammatory response. Unfortunately, about 30% of adults with HIV are resistant to standard psychotherapeutic and psychopharmacological treatments for depression, thus suggesting the need for alternative treatment approaches. VN stimulation (VNS) and its benefits as a treatment for depression have been well documented, but remain unexplored in the HIV population. Historically, VNS has been delivered using a surgically implanted device; however, transcutanous VNS (tVNS) with nonsurgical auricular technology is now available. Although it currently lacks Food and Drug Administration approval in the US, evidence suggests several advantages of tVNS, including a reduced side-effect profile when compared to standard treatments and comparable results to implantable VNS in treating depression. Therefore, tVNS could offer an alternative for managing depression in HIV via regulating CNS function; moreover, tVNS may be useful for treatment of other symptoms common in HIV. From this, implications for nursing research and practice are provided.
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PMID:The potential role of vagus-nerve stimulation in the treatment of HIV-associated depression: a review of literature. 2872 Oct 49