That tiredness is one of the most common symptoms in contemporary societies nobody doubts. Indeed, since the turn of the millennium it has become even more prevalent as it is associated with new diseases such as burnout and chronic fatigue syndrome.
In an analysis of the most frequent explanations for chronic fatigue syndrome (CFS) given in scientific articles published between 1990 and 2009, researchers from the Institute of Social Medicine at the Rio de Janeiro State University (UERJ) found a preponderance if not a consensus of explanations that related fatigue to the functioning of the brain. So is fatigue the outcome of a physiologically altered brain? Many of the symptoms of CFS, such as difficulty concentrating, lack of attention and poor memory, would indeed suggest the involvement of the central nervous system. Starting out with this notion, investigations have been made into the subject using neuroimaging methods.
Stating that most of the research tries to demonstrate a link between the brain and overtiredness does not mean, however, that such a link has actually been confirmed empirically, and this is what the authors have noted. From the many contributions made by neuroscience to studies of fatigue, they hone in on those from the late 1990s onwards that use neuroimaging to try and identify in brain scans a blood flow pattern that is particular to patients with fatigue.
However, the current status of research into the disease is still at an incipient stage. The images produced are considered to be preliminary, showing what are called “unidentified bright objects” (UBOs): bright dots of an undefined clinical significance. Also, given the nature of the technologies involved, the final image produced in these studies is a synthesis of many cases and not the image of one person’s brain. What one sees is a leap from the incontestably shaky results of neuroimaging studies to the deterministic language in which their findings have been couched by laypersons, lawyers, patients and even specialists. The authors suggest that this could be induced by the persuasive power of brain images which, despite whatever they actually show, seem to reveal “disease in 3D”.
Why, despite the scant reliable data for drawing a causal link between fatigue and the state of the brain, is it that this is given such precedence in research into chronic fatigue syndrome? The authors note that the fact that the disease has no identified cause gives room for the rise of certain hypotheses motivated primarily by patients’ struggle to get their disease recognized and given legitimacy, based on a quest for organic facts that might justify their condition. After all, in the absence of any concrete proof of a physical origin, CFS could be understood as complacency and lack of willpower.
There is also a strong cultural factor that contributes to this overview. Since the Decade of the Brain (the 1990s), the brain has become a major object of study. As a result of this new status, the realm of neuroscience has started to include research into moral and social behavior. Many studies addressing topics previously covered by the social sciences and humanities such as guilt, shame and religious feeling are being investigated using neuroscientific methods, especially brain imaging. Since the mid 1900s, explanations for mental disturbances and human behavior that stress biological aspects have become increasingly persuasive. The advances made in neuroimaging and cellular biology techniques have contributed to this process, as never before has there been so much access to how the brain works using techniques such as magnetic resonance tomography and positron emission tomography. What the authors stress from the trend they identify for research to associate fatigue with the brain is that in the case of such a rich and complex symptom, reducing its cause to a putative brain-related finding or anything else leads to a very limited understanding of the pathology. In view of the level of demands common in labor relations and the “excess of lifestyle-like activities”, any investigation of CFS that fails to address the patient’s psychological and social conditions will surely be the poorer for this. The elements that the authors highlight force us to question the understanding of CFS based on purely somatic findings.
