Abstract
<jats:p>Asthenic disorder in children and adolescents is a polyetiological condition characterized by a varied clinical picture with the dominant complaint of increased fatigue and rapid exhaustion, both mental and physical, which are persistent and last for a long period of time. It is reported that medical aid appealability rates due to asthenic symptoms achieve up to 64%. The prevalence of asthenic disorder in children and adolescents is extremely difficult to determine, as the numerous clinical symptoms are often viewed within the context of other diseases rather than as a single, hallmark pathology. The development of this condition is driven by challenging-to-differentiate functional and organic disorders that arise secondary to other, diverse pathologies. Dysfunction of the reticular activating system (RAS) is one of the primary mechanisms underlying asthenic syndrome. Severe manifestations of asthenic disorder which result in the significant impairment of daily activities and considerable deterioration of the patient's quality of life for more than 6 months are considered as a separate nosological entity — chronic fatigue syndrome (CFS). Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis that is the body's main way of responding to stress are believed to be involved in the development of CFS. A single component failure can disrupt the entire system and contribute to the development of increased fatigue. Asthenic disorders are one of the common symptoms in patients who have suffered a traumatic brain injury (TBI). N-acetylaspartate (NAA) is seen as one of the markers of nerve tissue damage and repair in traumatic brain injury. Research on the role of NAA in the development of asthenic disorders is of great interest. Brain magnetic resonance spectroscopy (MRS) has found specific neurochemical abnormalities that can potentially be treated with agents targeting metabolic disturbances identified in the central nervous system. The search for new physiological and biochemical markers of asthenic syndrome will expand our understanding of the pathogenesis and treatment options for these disorders.</jats:p>