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Predicting Fatigue 12 Months after Child Traumatic Brain Injury: Child Factors and Postinjury Symptoms
Alison Crichton1, Ed Oakley1, Franz E Babl1
11Murdoch Childrens Research Institute,Melbourne,Australia.
Insights
Preinjury fatigue and psychological symptoms predict long-term fatigue after childhood brain injury. Postinjury physical, sleep, and mood symptoms also contribute to persistent fatigue in children.
Area of Science:
- Pediatric neurology
- Neuroscience
- Rehabilitation medicine
Background:
- Fatigue is a prevalent and persistent symptom following pediatric brain injury.
- Understanding predictors of fatigue is crucial for effective intervention and management.
Purpose of the Study:
- To investigate preinjury and postinjury factors predicting fatigue at 12 months after childhood brain injury.
- To identify specific predictors for general, sleep/rest, and cognitive fatigue domains.
Main Methods:
- A cohort of 79 children (0-18 years) with traumatic brain injury (TBI) was studied.
- Parents reported on fatigue, pain, sleep, mood, and inattention at baseline and 6 months postinjury.
- Hierarchical regression analyses examined predictors of fatigue at 12 months postinjury, differentiating between mild and moderate/severe TBI.
Main Results:
- Preinjury fatigue predicted 7% of variance in sleep/rest fatigue, while preinjury psychological symptoms predicted 10%.
- Postinjury physical/motor symptoms, sleep, and mood symptoms predicted general fatigue (27%, 10%, 9% variance).
- Physical/motor, sleep, and mood symptoms at 6 months postinjury predicted sleep/rest fatigue (10%, 13%, 9% variance), and physical/motor symptoms predicted cognitive fatigue (17% variance).
Conclusions:
- Preinjury fatigue and psychological status are key indicators for children at high risk of persistent fatigue post-TBI.
- Predictors for specific fatigue types vary, but postinjury physical/motor, sleep, and mood symptoms are consistently implicated.
Objectives:
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.
Methods:
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.
Results:
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.
Conclusions:
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).
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