Ashman Teresa A, Cantor Joshua B, Gordon Wayne A, Spielman Lisa, Egan Matthew, Ginsberg Annika, Engmann Clara, Dijkers Marcel, Flanagan Steven
Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
J Head Trauma Rehabil. 2008 Jan-Feb;23(1):33-40. doi: 10.1097/01.HTR.0000308719.70288.22.
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.
The study included 202 community-dwelling individuals with mild-severe TBI and 73 noninjured controls.
Measures included Cambridge Neuropsychological Test Automated Battery, Global Fatigue Index, and situational fatigue rating.
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.
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.
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.
通过记录因持续脑力劳动导致的神经心理测试表现变化，客观量化创伤性脑损伤（TBI后）的精神疲劳，并检验客观测量的精神疲劳与自我报告的情境疲劳和日常疲劳之间的关系。
该研究纳入了202名社区居住的轻-重度TBI患者和73名未受伤的对照者。
测量方法包括剑桥神经心理测试自动成套系统、总体疲劳指数和情境疲劳评分。
对受试者进行3次时长30分钟的计算机化神经心理测试。第二次和第三次测试之间间隔约2小时的访谈和自我报告测量。
对神经心理测试分数进行因子分析，得出3个分量表：速度、准确性和执行功能。TBI患者组的情境疲劳和日常疲劳显著高于未患TBI的个体，且与速度分量表分数相关。TBI患者在准确性分量表分数上的表现显著下降。这些与持续脑力劳动相关的表现下降与TBI组的主观疲劳无关。虽然在未患脑损伤的个体中观察到了对速度和准确性分数的练习效应，但在TBI患者中未观察到。
研究结果在很大程度上与先前的文献一致，表明虽然主观疲劳与TBI患者的不良表现相关，但与脑力任务表现的客观下降无关。
