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Sandstrom G Journal article: NEUROMUSCULAR DISORDERS

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The main causes of fatigue are: accumulation of protons in the muscle cell, depletion of energy sources (e.g., phosphocreatine and glycogen), accumulation of ammonia in the blood and tissues [2,3,4], oxidative stress, muscle damage [1] and changes in neurotransmitter synthesis, such as the increase in serotonin and the decrease in dopamine [5]