Lequerica Anthony H, Botticello Amanda L, Lengenfelder Jean, Chiaravalloti Nancy, Bushnik Tamara, Dijkers Marcel P, Hammond Flora M, Kolakowsky-Hayner Stephanie A, Rosenthal Joseph
a Kessler Foundation , West Orange , NJ , USA.
b Rusk Rehabilitation , New York , USA.
Neuropsychol Rehabil. 2017 Oct;27(7):1019-1030. doi: 10.1080/09602011.2016.1231120. Epub 2016 Sep 16.
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.
创伤性脑损伤后疲劳（PTBIF）是创伤性脑损伤（TBI）后数年的一个主要问题，但对其持续存在和缓解情况知之甚少。本研究的目的是确定与PTBIF缓解和解决相关的因素。五个中心的TBI模型系统登记参与者在受伤后1年和2年（Y1 - 2队列）或受伤后2年和5年（Y2 - 5队列）参加了访谈。将PTBIF缓解的参与者特征与PTBIF持续存在的参与者特征进行比较。研究的变量包括残疾的存在及变化、睡眠功能障碍、情绪和社区参与情况。两组之间或随时间推移，功能独立性测量没有显著差异。在Y1 - 2队列中，疲劳缓解组在残疾评定量表和匹兹堡睡眠质量指数上得分显著更高。在Y2 - 5队列中，疲劳缓解组在社区参与度测量上得分显著更高。得出的结论是，每个队列中不到一半的样本在各时间点之间经历了PTBIF的缓解。受伤后1 - 2年PTBIF的持续存在与残疾、睡眠障碍和抑郁有关，而受伤后2年以上疲劳的持续存在似乎与参与水平有关，这突出了有效监测、评估和治疗这种情况对优化TBI后生活的潜在影响。疲劳进展的差异可能表明存在不同类型的PTBIF。
