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脑外伤后疲劳与抑郁、损伤部位和病因的关系:康复环境中的探索性研究。

Relationship between fatigue after acquired brain injury and depression, injury localization and aetiology: An explorative study in a rehabilitation setting.

机构信息

Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, , 18288 Stockholm, Sweden.

出版信息

J Rehabil Med. 2018 Aug 22;50(8):725-731. doi: 10.2340/16501977-2365.

Abstract

OBJECTIVE

Fatigue after acquired brain injury may be related to the subcortico-frontal attention network. Depression is also strongly related to fatigue. This study investigates whether injury localization, diagnosis and depression are related to self-rated mental fatigue in patients with an acquired brain injury.

DESIGN

Retrospective cross-sectional cohort study.

SUBJECTS

Sixty-one patients diagnosed with stroke, subarachnoidal haemorrhage, traumatic brain injury, or brain tumour were included in the study.

METHODS

Patients who underwent a multidisciplinary team assessment during September 2011 to June 2012, and who were assessed with the Mental Fatigue Scale, were included in the study.

RESULTS

A significantly higher number of patients with posterior and non-specific lesions experienced fatigue compared with those with subcortical/frontal injuries. Fewer stroke patients experienced fatigue compared with the other patient groups. How-ever, after logistic regression, only depression remained as an explanatory variable for self-rated fatigue. Nevertheless, although all patients with depression were fatigued, not all fatigued patients were depressed.

CONCLUSION

Although depression explains a high degree of fatigue after an acquired brain injury, mental fatigue after brain injury should be viewed as a condition partly separate from depression. Future extensive comparative studies are required, preferably including neuropsychological measures.

摘要

目的

获得性脑损伤后的疲劳可能与皮质下额注意网络有关。抑郁与疲劳也有很强的相关性。本研究旨在探讨损伤定位、诊断和抑郁是否与获得性脑损伤患者的自我评估精神疲劳有关。

设计

回顾性横断面队列研究。

受试者

纳入 61 例经多学科团队评估诊断为卒中、蛛网膜下腔出血、创伤性脑损伤或脑肿瘤的患者。

方法

本研究纳入了 2011 年 9 月至 2012 年 6 月期间接受多学科团队评估且使用精神疲劳量表评估的患者。

结果

与皮质下/额叶损伤患者相比,后颅窝和非特异性病变患者疲劳的发生率显著更高。与其他患者组相比,卒中患者疲劳的发生率较低。然而,经过逻辑回归分析,只有抑郁仍然是自我评估疲劳的一个解释变量。尽管所有抑郁患者都有疲劳感,但并非所有疲劳患者都有抑郁。

结论

尽管抑郁解释了获得性脑损伤后高程度的疲劳,但脑损伤后的精神疲劳应被视为一种与抑郁部分独立的状况。需要进一步进行广泛的比较研究,最好包括神经心理学测量。

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