Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Towards the unity of pathological and exertional fatigue: a predictive processing model

Greenhouse-Tucknott, A., Butterworth, J. B., Wrightson, J. G., Smeeton, N. J., Critchley, H. D., Dekerle, J. and Harrison, N. A. ORCID: 2022. Towards the unity of pathological and exertional fatigue: a predictive processing model. Cognitive, Affective, and Behavioral Neuroscience 22 , pp. 215-228. 10.3758/s13415-021-00958-x

[thumbnail of Greenhouse-Tucknott2021_Article_TowardTheUnityOfPathologicalAn.pdf] PDF - Published Version
Available under License Creative Commons Attribution.

Download (918kB)


Fatigue is a common experience in both health and disease. Yet, pathological (i.e., prolonged or chronic) and transient (i.e., exertional) fatigue symptoms are traditionally considered distinct, compounding a separation between interested research fields within the study of fatigue. Within the clinical neurosciences, nascent frameworks position pathological fatigue as a product of inference derived through hierarchical predictive processing. The metacognitive theory of dyshomeostasis (Stephan et al., 2016) states that pathological fatigue emerges from the metacognitive mechanism in which the detection of persistent mismatches between prior interoceptive predictions and ascending sensory evidence (i.e., prediction error) signals low evidence for internal generative models, which undermine an agent’s feeling of mastery over the body and is thus experienced phenomenologically as fatigue. Although acute, transient subjective symptoms of exertional fatigue have also been associated with increasing interoceptive prediction error, the dynamic computations that underlie its development have not been clearly defined. Here, drawing on the metacognitive theory of dyshomeostasis, we extend this account to offer an explicit description of the development of fatigue during extended periods of (physical) exertion. Accordingly, it is proposed that a loss of certainty or confidence in control predictions in response to persistent detection of prediction error features as a common foundation for the conscious experience of both pathological and nonpathological fatigue.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License
Publisher: Psychonomic Society
ISSN: 1530-7026
Date of First Compliant Deposit: 28 October 2021
Date of Acceptance: 21 September 2021
Last Modified: 05 May 2023 22:52

Citation Data

Cited 8 times in Scopus. View in Scopus. Powered By Scopus® Data

Actions (repository staff only)

Edit Item Edit Item


Downloads per month over past year

View more statistics