Fatigue in patients with acquired brain damage

Area of Science:

• Neuroscience
• Rehabilitation Medicine

Background:

• Fatigue is a prevalent and complex syndrome following acquired brain injury (ABI).
• It significantly impedes neurorehabilitation outcomes and can persist long-term.
• Prevalence varies widely across stroke (29-77%), traumatic brain injury (18-75%), and brain tumors (47-97%).

Purpose of the Study:

• To review modifiable factors contributing to fatigue in ABI patients.
• To describe current and emerging treatments for managing fatigue in neurorehabilitation.

Main Methods:

• Literature review focusing on fatigue in acquired brain injury.
• Analysis of prevalence, associated factors, assessment tools, and treatment modalities.
• Inclusion of recent advances in diagnostic imaging like functional MRI.

Main Results:

• Fatigue is associated with demographic (female sex, age), psychosocial (family dynamics), and clinical factors (comorbidities, mood, prior fatigue).
• The Fatigue Severity Scale (FSS) is a primary assessment tool; functional MRI shows diagnostic promise.
• Conventional neurorehabilitation therapies, including bright light therapy, neurofeedback, electrical stimulation, and TMS, show positive results.

Conclusions:

• Understanding modifiable factors is crucial for effective fatigue management in neurorehabilitation.
• A multi-faceted approach integrating assessment and targeted therapies is recommended.
• Further research into novel treatments and diagnostic tools for post-ABI fatigue is warranted.