1Murdoch Childrens Research Institute,Melbourne,Australia.
6Department of Psychology,University of Montreal,Montreal,Canada.
J Int Neuropsychol Soc. 2018 Mar;24(3):224-236. doi: 10.1017/S1355617717000893. Epub 2017 Oct 4.
Fatigue is a common and persisting symptom after childhood brain injury. This study examined whether child characteristics and symptomatology preinjury or 6 months postinjury (pain, sleep, and mood, inattention) predicted fatigue at 12months postinjury.
Parents of 79 children (0-18 years) rated fatigue at 12 months after injury on a multidimensional scale (general, sleep/rest, and cognitive). Demographic and clinical data were collected at injury. Parents rated child sleep, pain, physical/motor function, mood, and inattention at injury (preinjury description), and 6 months postinjury. Children were divided into two traumatic brain injury severity groups: mild TBI (n=57) and moderate/severe TBI (n=27). Hierarchical regression models were used to examine (i) preinjury factors and (ii) symptoms 6 months postinjury predictive of fatigue (general, sleep/rest, and cognitive) at 12 months postinjury.
Sleep/rest fatigue was predicted by preinjury fatigue (7% of variance) and psychological symptoms preinjury (10% of variance). General fatigue was predicted by physical/motor symptoms (27%), sleep (10%) and mood symptoms (9%) 6 months postinjury. Sleep/rest fatigue was predicted by physical/motor symptoms (10%), sleep symptoms (13%) and mood symptoms (9%) 6 months postinjury. Cognitive fatigue was predicted by physical/motor symptoms (17%) 6 months postinjury.
Preinjury fatigue and psychological functioning identified those at greatest risk of fatigue 12 months post-TBI. Predictors of specific fatigue domains at 12 months differed across each of the domains, although consistently included physical/motor function as well as sleep and mood symptoms postinjury. (JINS, 2018, 24, 224-236).
疲劳是儿童脑损伤后常见且持续存在的症状。本研究旨在探讨儿童在受伤前或受伤后 6 个月（疼痛、睡眠和情绪、注意力不集中）的特征和症状是否能预测受伤后 12 个月的疲劳。
79 名（0-18 岁）儿童的家长在受伤后 12 个月时使用多维量表（一般、睡眠/休息和认知）对疲劳进行评分。在受伤时收集人口统计学和临床数据。父母在受伤时（受伤前描述）和受伤后 6 个月时评估儿童的睡眠、疼痛、身体/运动功能、情绪和注意力。将儿童分为轻度颅脑损伤（mild TBI，n=57）和中重度颅脑损伤（moderate/severe TBI，n=27）两组。采用分层回归模型来检验（i）受伤前的因素和（ii）受伤后 6 个月的症状对受伤后 12 个月的疲劳（一般、睡眠/休息和认知）的预测作用。
睡眠/休息疲劳由受伤前的疲劳（7%的方差）和受伤前的心理症状（10%的方差）预测。一般疲劳由受伤后 6 个月的身体/运动症状（27%）、睡眠（10%）和情绪症状（9%）预测。睡眠/休息疲劳由受伤后 6 个月的身体/运动症状（10%）、睡眠症状（13%）和情绪症状（9%）预测。认知疲劳由受伤后 6 个月的身体/运动症状（17%）预测。
受伤前的疲劳和心理功能可以确定那些在颅脑损伤后 12 个月时最易出现疲劳的人。12 个月时各疲劳领域的特定预测因素各不相同，但都包括受伤后身体/运动功能以及睡眠和情绪症状。
