Mild traumatic brain injury and fatigue: a prospective longitudinal study
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Updated: Jun 6, 2026
Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
Published on: April 11, 2025
Joan Norrie1, Marcus Heitger, Janet Leathem
1Department of Psychology, Massey University, Palmerston North, New Zealand. j.m.norrie@massey.ac.
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.
