title: Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study.
abstract: Post-traumatic brain injury fatigue (PTBIF) is a major problem in the years after traumatic brain injury (TBI), yet little is known about its persistence and resolution. The objective of the study was to identify factors related to PTBIF remission and resolution. TBI Model System registrants at five centres participated in interviews at either one and two years post-injury (Y1-2 Cohort), or two and five years post-injury (Y2-5 Cohort). Characteristics of participants with PTBIF remission were compared to those with PTBIF persistence. Variables studied included the presence of and changes in disability, sleep dysfunction, mood, and community participation. The Functional Independence Measure did not differ significantly between groups or over time. In the Y1-2 Cohort the Fatigue Resolved group scored significantly better on the Disability Rating Scale and Pittsburgh Sleep Quality Index. In the Y2-5 Cohort the Fatigue Resolved group scored significantly higher on a measure of community participation. It was concluded that fewer than half of the sample in each cohort experienced a remission of PTBIF between time points. Persistence of PTBIF 1-2 years post-injury is associated with disability, sleep disturbance, and depression while persistence of fatigue beyond 2 years post-injury appears to be related to participation level, underscoring the potential impact of effective surveillance, assessment, and treatment of this condition in optimising life after TBI. Differences in fatigue progression may point to the presence of different types of PTBIF.
authors.affiliation: a Kessler Foundation , West Orange , NJ , USA.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Lequerica
authors.affiliation: a Kessler Foundation , West Orange , NJ , USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Botticello
authors.affiliation: a Kessler Foundation , West Orange , NJ , USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Lengenfelder
authors.affiliation: a Kessler Foundation , West Orange , NJ , USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Chiaravalloti
authors.affiliation: b Rusk Rehabilitation , New York , USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Bushnik
authors.affiliation: c Department of Rehabilitation Medicine , Mount Sinai School of Medicine , New York , USA.
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.affiliation: d Department of Physical Medicine and Rehabilitation , Indiana University School of Medicine , Indianapolis , IN , USA.
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.affiliation: e Stanford University - Concussion and Brain Performance Center , Palo Alto , CA , USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Kolakowsky-Hayner
authors.affiliation: f Department of Physical Medicine and Rehabilitation , Ohio State University, Wexer Medical Center , Columbus , OH , USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000534:rehabilitation*; D003256:Community Participation; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D000066530:Neurological Rehabilitation / Q000379:methods*; D012074:Remission Induction; D012893:Sleep Wake Disorders / Q000209:etiology; D055815:Young Adult
keywords: Fatigue; brain injury