Relationship between fatigue after acquired brain injury and depression, injury localization and aetiology: An explorative study in a rehabilitation setting (original) (raw)
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Fatigue and traumatic brain injury
Annales de réadaptation et de médecine physique : revue scientifique de la Société française de rééducation fonctionnelle de réadaptation et de médecine physique, 2006
Fatigue is frequent and disabling in patients with traumatic brain injury (TBI). Its mechanisms are complex and multifactorial. We performed a literature review of reports of the condition using the following key words: brain injury, depression, neuroendocrine dysfunction, and treatment. Five scales have been used to evaluate fatigue in TBI patients: the Fatigue Severity Scale, the visual analog scale (VAS) for fatigue, the Fatigue Impact Scale, the Barrow Neurological Institute (BNI) Fatigue Scale and the Cause of Fatigue (COF) Questionnaire. The BNI Fatigue Scale and the COF Questionnaire have been designed specifically for brain-injured patients. Fatigue is present in 43-73% of patients and is one of the first symptoms for 7% of them. Fatigue does not seem to be significantly related to injury severity not to time since injury. It can be related to mental effort necessary to overcome attention deficit and slowed processing ("coping hypothesis"). It can also be related t...
Fatigue in patients with acquired brain damage
Fatigue in patients with acquired brain damage, 2024
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
Patterns of Fatigue and Its Correlates Over the First 2 Years After Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2008
This study used a prospective longitudinal design to quantify fatigue and associated factors during the first 2 years after traumatic brain injury (TBI). Fifty-one individuals were assessed at 3 time points: within the first 6, 12, and 18-24 months after TBI. Self-reported fatigue improved during the first year, as did pain, sleep quality, cognitive independence, and involvement in productive activity. Further changes up to 2 years after TBI were not observed. The subset of individuals who reported significant increases in fatigue over the first 2 years demonstrated poorer outcomes in cognition, motor symptoms, and general functioning than those with decreased or stable fatigue.
Journal of Head Trauma Rehabilitation, 2008
Fatigue is a well-recognized issue for individuals with traumatic brain injury (TBI). This prospective study examined the rate and types of fatigue that are experienced by a cohort of individuals with TBI within the first 2 years, using a multidimensional fatigue scale. The impact of factors such as demographics, injury severity indices, and concomitant psychosocial variables was also examined. Using 2 measures of overall fatigue, 16%-32% at Year 1 and 21%-34% at Year 2 reported significant levels of fatigue. Fatigue did not appear to change between 1 and 2 years post-TBI. Sleep quality was the most prevalent concomitant disturbance followed by depression and pain.
Objective Measurement of Fatigue Following Traumatic Brain Injury
Journal of Head Trauma Rehabilitation, 2008
Objectives: To quantify posttraumatic brain injury (post-TBI) mental fatigue objectively by documenting changes in performance on neuropsychological tests as a result of sustained mental effort and to examine the relationship between objectively measured mental fatigue and self-reported situational and day-today fatigue. Participants: The study included 202 community-dwelling individuals with mild-severe TBI and 73 noninjured controls. Measures: Measures included Cambridge Neuropsychological Test Automated Battery, Global Fatigue Index, and situational fatigue rating. Method: Subjects were administered a 30-minute computerized neuropsychological test battery 3 times. The second and third administrations of the battery were separated by approximately 2 hours of interviews and administration of self-report measures. Results: The neuropsychological test scores were factor analyzed, yielding 3 subscales: speed, accuracy, and executive function. Situational fatigue and day-today fatigue were significantly higher in individual with TBI group than in individuals without TBI and were associated with speed subscale scores. Individuals with TBI evidenced a significant decline in performance on the accuracy subscale score. These declines in performance related to sustained mental effort were not associated with subjective fatigue in the TBI group. While practice effects on the speed and accuracy scores were observed in non-brain-injured individuals, they were not evidenced in individuals with TBI. Conclusions: Findings were largely consistent with previous literature and indicated that while subjective fatigue is associated with poor performance in individuals with TBI, it is not associated with objective decline in performance of mental tasks.
Journal of Neurology
Background Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subjective fatigue was measured by single item on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), administered at baseline, three and 6 months postinjury. Patients were categorized by clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU). Injury severity, preinjury somatic- and psychiatric conditions, depressive and sleep problems were registered at baseline. For prediction of fatigue changes, descriptive statistics and mixed effect logistic reg...
Is Multidimensional Fatigue Inventory (MFI-20) adequate to measure brain injury related fatigue?
Disability and Health Journal, 2020
Background: Fatigue is a common symptom in patients with acquired brain injury (ABI) related disability while its multidimensionality has never been investigated, and specifically its relationship with patients' cognitive functioning. Objective: This study aimed to evaluate the validity of the Multidimensional Fatigue Inventory (MFI-20) in patients living with ABI-related disability. Methods: Four hundred twenty-six participants divided in three different groups (ABI-related disability, physical-related disability without an ABI, and healthy volunteers with no disability) were administered the French version of the Multidimensional Fatigue Inventory. We investigated the link between these fatigue measures and neuropsychological assessment in patients with ABI. Performance on this tool was compared according to the group and we calculated normative data for the Multidimensional Fatigue Inventory based on healthy volunteers' performance. Results: In patients with ABI, fatigue measures significantly correlated with neuropsychological measures of attention, memory and executive functions. We found higher scores on Mental Fatigue and Reduced Activities dimensions in patients with ABI in comparison with the patients with physical disability (p < 0.05) and healthy controls (p < 0.01). Conclusions: The Multidimensional Fatigue Inventory appeared to be a sensitive tool to detect ABIrelated fatigue, fatigue levels being higher than in patients with physical disability and in healthy volunteers. As fatigue appeared to be related to memory, executive and attentional functioning of patients with ABI-related disability who often face unemployment, its impact on vocational outcome following ABI should be further investigated.
2009
Acquired brain injury (ABI) can result in devastating and long-lasting disabilities in the physical, cognitive, psychological and social domains of life. The Department of Health (2005) estimates that, in the United Kingdom, there are 420,000 people aged between 16 and 65 years living with a traumatic brain injury (TBI) and that many more people are affected by non-traumatic types of brain injury. Fatigue is one of the most frequently reported symptoms, even among those with mild to moderate injuries . Significant numbers of people are affected by fatigue for many years following a TBI and it is a substantial but understudied issue for people with other types of ABI, such as stroke . found fatigue to be prevalent in 57% at 1 month, 61% at 3 months, 45% at 6 months and 45% at 12 months post mild-moderate TBI. Olver et al (1996) reported a rate of 73% of participants experiencing fatigue at 5 years following TBI.