The influence of mental fatigue on brain activity: Evidence from a systematic review with meta-analyses.

The occurrence of mental fatigue during tasks like driving a vehicle increases risk of injury or death. Changes in electroencephalographic (EEG) activity associated with mental fatigue has been frequently studied and considered a promising biomarker of mental fatigue. This is despite differences in methodologies and outcomes in prior research. A systematic review with meta-analyses was conducted to establish the influence of mental fatigue on EEG activity spectral bands, and to determine in which regions fatigue-related EEG spectral changes are likely to occur. A high-yield search strategy identified 21 studies meeting inclusion criteria for investigating the change in EEG spectral activity in non-diseased adults engaged in mentally fatiguing tasks. A medium effect size (using Cohen's g) of 0.68 (95%CI: 0.24-1.13) was found for increase in overall EEG activity following mental fatigue. Further examination of individual EEG spectral bands and regions using network meta-analyses indicated large increases in theta (g = 1.03; 95%CI: 0.79-1.60) and alpha bands (g = 0.85; 95%CI: 0.47-1.43), with small to moderate changes found in delta and beta bands. Central regions of the scalp showed largest change (g = 0.80; 95%CI: 0.46-1.21). Sub-group analyses indicated large increases in theta activity in frontal, central and posterior sites (all g > 1), with moderate changes in alpha activity in central and posterior sites. Findings have implications for fatigue monitoring and countermeasures with support for change in theta activity in frontal, central and posterior sites as a robust biomarker of mental fatigue and change in alpha wave activity considered a second line biomarker to account for individual variability.