The duality of asthenia and cognitive impairments in cerebral diseases

Asthenia is a pathological condition characterized by abnormal, spontaneous fatigue that occurs without exercise, continues for a long time and does not go away after rest. With asthenia, performance decreases, and difficulties arise in maintaining prolonged mental  and physical stress. The presence of these  disorders  is associated with a decrease in quality of life, an increase  in morbidity and mortality  in general. In general,  we can say that  complaints  of weakness,  tiredness and fatigue are the most common  when visiting a primary care doctor. The article  presents various clinical manifestations of asthenia, classification  and features  of these  disorders. In clinical practice, it is important to distinguish  between idiopathic  chronic fatigue  (primary or functional  asthenia)  and  chronic fatigue  syndrome  (CFS). The publication presents modern  diagnostic criteria for this syndrome. It has been  shown that  CFS should be distinguished from nonspecific  chronic fatigue, which can be observed  in various pathological conditions. The article  discusses  the classification,  as well as the features  and criteria for diagnosing of asthenic  disorders  (AD). The close  relationship and  common  pathogenetic mechanisms of the  development  of asthenia and cognitive  impairments (CI) in cerebral  diseases  are reflected. Issues of management of patients with asthenia and  concomitant CI are  discussed,  which  should  be  comprehensive and  include  non-drug  and  drug  treatment methods.  Non-drug  methods,  including  methods of cognitive  stimulation and  cognitive  training,  are  coming  to  the  fore in the treatment of various manifestations of AD. The possibilities  of therapy  with phenylpiracetam for asthenic  syndrome of various origins, including  those  with concomitant anxiety-depressive disorders  and CI, have been  shown.

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