Role of carbohydrate in central fatigue: a systematic review.

Carbohydrate (CHO) depletion is linked to neuromuscular fatigue during exercise. While its role at peripheral level is relatively well understood, less is known about its impact centrally. The aim of this systematic review was to critically analyze the effects of CHO on central fatigue (CF) assessed by various neurophysiological techniques. Four databases were searched using PRISMA guidelines through February 2016. The inclusion criteria were: CHO as intervention against a placebo control, fatigue induced by prolonged exercise and assessed using neurophysiological measures [voluntary activation (VA), superimposed twitch (SIT), M-wave, electromyography], alongside maximal voluntary contraction (MVC). Seven papers were reviewed, where exercise duration lasted between 115 and 180 min. CHO improved exercise performance in three studies, whereby two of them attributed it to CF via attenuation of VA and SIT reductions, while the other indicated peripheral involvement via attenuation of M-wave reduction. Although a few studies suggest that CHO attenuates CF, data on its direct effects on neurophysiological outcome measures are limited and mixed. Generally, measures employed in these studies were inadequate to conclude central contribution to fatigue. Factors including the techniques used and the lack of controls render additional confounding factors to make definitive deductions. Future studies should employ consistent techniques and appropriate neurophysiological controls to distinguish CHO effect at central level. The use of pharmacological intervention should be incorporated to elucidate involvement of central mechanisms.

Neural adaptations to strength training: moving beyond transcranial magnetic stimulation and reflex studies.

It has long been believed that training for increased strength not only affects muscle tissue, but also results in adaptive changes in the central nervous system. However, only in the last 10 years has the use of methods to study the neurophysiological details of putative neural adaptations to training become widespread. There are now many published reports that have used single motor unit recordings, electrical stimulation of peripheral nerves, and non-invasive stimulation of the human brain [i.e. transcranial magnetic stimulation (TMS)] to study neural responses to strength training. In this review, we aim to summarize what has been learned from single motor unit, reflex and TMS studies, and identify the most promising avenues to advance our conceptual understanding with these methods. We also consider the few strength training studies that have employed alternative neurophysiological techniques such as functional magnetic resonance imaging and electroencephalography. The nature of the information that these techniques can provide, as well as their major technical and conceptual pitfalls, are briefly described. The overall conclusion of the review is that the current evidence regarding neural adaptations to strength training is inconsistent and incomplete. In order to move forward in our understanding, it will be necessary to design studies that are based on a rigorous consideration of the limitations of the available techniques, and that are specifically targeted to address important conceptual questions.