Mild traumatic brain injury and fatigue: A prospective longitudinal study

Abstract

Primary objective: To examine fatigue prevalence, severity, predictors and co-variates over 6 months post-mild traumatic brain injury (MTBI).

Research design: Longitudinal prospective study including 263 adults with MTBI.

Procedures: Participants completed the Fatigue Severity Scale (FSS), Rivermead Post-concussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence—RPSQ Item 6: severity—FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates.

Main outcomes and results: Post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months, respectively. There was a strong effect for time over the first 3 months and moderate-to-high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue; depression, but not anxiety was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases.

Conclusions: Post-MTBI fatigue is a persistent post-concussion symptom, exacerbated by depression but not anxiety. It diminishes in the first 3 months and then becomes relatively stable, suggesting the optimum intervention placement is at 3 months or more post-MTBI.

• Fatigue
• mild traumatic brain injury
• concussion
• depression
• anxiety
• FSS
• FAS
• RPSQ
• HADS
• SF-36v2