Endurance exercise and central fatigue

Abstract

Background: Endurance exercise, characterized by sustained low-to-moderate intensity training, enhances physiological performance during prolonged physical activity and is widely used in sports training and the rehabilitation of chronic diseases. Central fatigue, a key issue in endurance sports, arises from fatigue mechanisms within the central nervous system, affecting both performance and emotional well-being. Although endurance training can improve performance and mood by modulating neurotransmitter balance, the onset and exacerbation of central fatigue remain unresolved challenges. Methods: A bibliometric approach was employed, using the Web of Science Core Collection (WoSCC) database to retrieve literature published between 2005 and 2024 on endurance exercise and central fatigue. Data analysis and visualization were conducted using CiteSpace, VOSviewer, and the R-Bibliometrix tool to explore research trends, hotspots, and future directions. Results: The study reveals a year-on-year increase in publications on endurance exercise and central fatigue, especially since 2014. Research has progressively focused on exercise performance, fatigue mechanisms, and neurotransmitter regulation. Keyword analysis highlights growing interest in the impact of prolonged exercise on central fatigue and the rising focus on psychological fatigue and cognitive function. Increasing interdisciplinary collaboration, international cooperation, and citation bursts from seminal works in exercise neurobiology and psychology are evident. Conclusion: The mechanistic literature mapped in this analysis suggests that endurance exercise may influence performance and emotional well-being via neurotransmitter modulation; however, as a bibliometric study, the present analysis cannot itself establish causal biological mechanisms, and this interpretation should be corroborated by dedicated experimental and clinical research. The onset and progression of central fatigue remain significant challenges. Future research should focus on the neurobiological mechanisms of endurance exercise, particularly neurotransmitter regulation and neuroprotection, and explore its clinical potential in treating chronic fatigue syndrome, mental health disorders, and cognitive impairments.

The authors' abstract, as published at the source. Medicine, 2026 · DOI ↗