Research Reports - Predicting fatigue 12 months after child traumatic brain injury

 J Int Neuropsychol Soc. 2017 Oct 4:1-13. doi: 10.1017/S1355617717000893. [Epub
ahead of print]

Crichton A(1), Oakley E(1), Babl FE(1), Greenham M(1), Hearps S(1), Delzoppo
C(1), Beauchamp MH(2), Hutchison JS(3), Guerguerian AM(3), Boutis K(3), Anderson
V(1).

OBJECTIVES: Fatigue is a common and persisting symptom after childhood brain
injury. This study examined whether child characteristics and symptomatology
preinjury or 6 months postinjury (pain, sleep, and mood, inattention) predicted
fatigue at 12months postinjury.
METHODS: Parents of 79 children (0-18 years) rated fatigue at 12 months after
injury on a multidimensional scale (general, sleep/rest, and cognitive).
Demographic and clinical data were collected at injury. Parents rated child
sleep, pain, physical/motor function, mood, and inattention at injury (preinjury
description), and 6 months postinjury. Children were divided into two traumatic
brain injury severity groups: mild TBI (n=57) and moderate/severe TBI (n=27).
Hierarchical regression models were used to examine (i) preinjury factors and
(ii) symptoms 6 months postinjury predictive of fatigue (general, sleep/rest, and
cognitive) at 12 months postinjury.
RESULTS: Sleep/rest fatigue was predicted by preinjury fatigue (7% of variance)
and psychological symptoms preinjury (10% of variance). General fatigue was
predicted by physical/motor symptoms (27%), sleep (10%) and mood symptoms (9%) 6
months postinjury. Sleep/rest fatigue was predicted by physical/motor symptoms
(10%), sleep symptoms (13%) and mood symptoms (9%) 6 months postinjury. Cognitive
fatigue was predicted by physical/motor symptoms (17%) 6 months postinjury.
CONCLUSIONS: Preinjury fatigue and psychological functioning identified those at
greatest risk of fatigue 12 months post-TBI. Predictors of specific fatigue
domains at 12 months differed across each of the domains, although consistently
included physical/motor function as well as sleep and mood symptoms postinjury. 

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