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Neuropsychol Rehabil. 2017 Oct;27(7):1056-1070. doi: 10.1080/09602011.2016.1154875. Epub 2016 Mar 9.

Brain lesion correlates of fatigue in individuals with traumatic brain injury.

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a Department of Rehabilitation Psychology , Institute of Psychology, University of Freiburg , Freiburg , Germany.
b School of Psychological Sciences , Monash University Melbourne , Melbourne , Australia.
c Monash-Epworth Rehabilitation Research Centre , Epworth Hospital , Melbourne , Australia.
d Department of Medicine, Monash Medical Centre , Monash University Melbourne , Melbourne , Australia.
e Centre for Advanced Imaging , The University of Queensland , St Lucia , Australia.
f Murdoch Childrens Research Institute, Royal Children's Hospital , Melbourne , Australia.
g Symbion Imaging, Epworth Hospital , Melbourne , Australia.
h National Trauma Research Institute , Melbourne , Australia.


The purpose of this study was to investigate the neurological correlates of both subjective fatigue as well as objective fatigability in individuals with traumatic brain injury (TBI). The study has a cross-sectional design. Participants (N = 53) with TBI (77% male, mean age at injury 38 years, mean time since injury 1.8 years) underwent a structural magnetic resonance imaging (MRI) scan and completed the Fatigue Severity Scale (FSS), while a subsample (N = 36) was also tested with a vigilance task. While subjective fatigue (FSS) was not related to measures of brain lesions, multilevel analyses showed that a change in the participants' decision time was significantly predicted by grey matter (GM) lesions in the right frontal lobe. The time-dependent development of the participants' error rate was predicted by total brain white matter (WM) lesion volumes, as well as right temporal GM and WM lesion volumes. These findings could be explained by decreased functional connectivity of attentional networks, which results in accelerated exhaustion during cognitive task performance. The disparate nature of objectively measurable fatigability on the one hand and the subjective experience of fatigue on the other needs further investigation.


Traumatic brain injury; fatigability; fatigue; magnetic resonance imaging; vigilance

[Indexed for MEDLINE]

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