title: Objective measurement of fatigue following traumatic brain injury.
abstract: OBJECTIVE
  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-to-day fatigue.
  
  
  METHODS
  The study included 202 community-dwelling individuals with mild-severe TBI and 73 noninjured controls.
  
  
  METHODS
  Measures included Cambridge Neuropsychological Test Automated Battery, Global Fatigue Index, and situational fatigue rating.
  
  
  METHODS
  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-to-day 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.
authors.affiliation: Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. teresa.ashman@mssm.edu
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Ashman
authors.forename: Joshua B
authors.initials: JB
authors.lastname: Cantor
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Gordon
authors.forename: Lisa
authors.initials: L
authors.lastname: Spielman
authors.forename: Matthew
authors.initials: M
authors.lastname: Egan
authors.forename: Annika
authors.initials: A
authors.lastname: Ginsberg
authors.forename: Clara
authors.initials: C
authors.lastname: Engmann
authors.forename: Marcel
authors.initials: M
authors.lastname: Dijkers
authors.forename: Steven
authors.initials: S
authors.lastname: Flanagan
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D005222:Mental Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests