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

• Published in: Neuropsychological rehabilitation Vol. 27; no. 7; pp. 1031 - 1046
• Main Authors: Schiehser, Dawn M., Delano-Wood, Lisa, Jak, Amy J., Hanson, Karen L., Sorg, Scott F., Orff, Henry, Clark, Alexandra L.
• Format: Journal Article
• Language: English
• Published: England Routledge 03-10-2017; Taylor & Francis Ltd
• Subjects: Adult; Amnesia; Anxiety; Anxiety Disorders - diagnosis; Anxiety Disorders - etiology; Anxiety Disorders - physiopathology; Attention; Brain Concussion - complications; Brain Concussion - diagnosis; Brain Concussion - physiopathology; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - diagnosis; Brain Injuries, Traumatic - physiopathology; cognition; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Cognitive functioning; Complications; Consciousness; Depressive Disorder - diagnosis; Depressive Disorder - etiology; Depressive Disorder - physiopathology; Fatigue; Fatigue - diagnosis; Fatigue - etiology; Fatigue - physiopathology; Female; Fishing industry; Humans; Male; Mental Fatigue - diagnosis; Mental Fatigue - etiology; Mental Fatigue - physiopathology; Middle Aged; Occupational hazards; Physical symptoms; Post traumatic stress disorder; Post-traumatic fatigue; Prognosis; Psychiatric symptoms; Psychological trauma; Psychosocial factors; Sleep; Sleep disorders; sleep quality; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - etiology; Sleep Wake Disorders - physiopathology; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - physiopathology; Traumatic brain injury; United States; Veterans; Post-traumatic fatigue; traumatic brain injury; psychiatric symptoms; cognition; sleep quality
• ISSN: 0960-2011; 1464-0694
• DOI: 10.1080/09602011.2016.1215999

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.