Research Reports - Predictors of cognitive and physical fatigue in post-acute mild-moderate traumatic brain injury

Neuropsychol Rehabil. 2016 Aug 18:1-16. [Epub ahead of print]

Schiehser DM(1,)(2,)(3), Delano-Wood L(1,)(2,)(3), Jak AJ(1,)(2,)(3), Hanson
KL(1,)(2,)(3), Sorg SF(1), Orff H(1,)(2,)(3), Clark AL(4).

Post-traumatic fatigue (PTF) is a common, disabling, and often chronic symptom
following traumatic brain injury (TBI). Yet, the impact of chronic cognitive and
physical fatigue and their associations with psychiatric, sleep, cognitive, and
psychosocial sequelae in mild-moderate TBI remain poorly understood. Sixty
Veterans with a history of mild-moderate TBI and 40 Veteran controls (VC) were
administered the Modified Fatigue Impact Scale, a validated measure of
TBI-related cognitive and physical fatigue as well as measures of
neuropsychiatric, psychosocial, sleep, and objective cognitive functioning.
Compared to VC, TBI Veterans endorsed significantly greater levels of cognitive
and physical fatigue. In TBI, psychiatric symptoms, sleep disturbance, and
post-traumatic amnesia (PTA) were associated with both cognitive and physical
fatigue, while loss of consciousness (LOC) and poor attention/processing speed
were related to elevations in cognitive fatigue only. In regression analyses,
anxiety, sleep disturbance, and LOC significantly predicted cognitive fatigue,
while only post-traumatic stress symptoms and PTA contributed to physical
fatigue. Cognitive and physical fatigue are problematic symptoms following
mild-moderate TBI that are differentially associated with specific injury and
psychiatric sequelae. Findings provide potential symptom targets for
interventions aimed at ameliorating fatigue, and further underscore the
importance of assessing and treating fatigue as a multi-dimensional symptom
following TBI. 

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