This Article Full Text (PDF) All Versions of this Article: 1545968309340327v1 23/9/939    most recent References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Belmont, A. Articles by Azouvi, P. PubMed PubMed Citation Articles by Belmont, A. Articles by Azouvi, P. Social Bookmarking                         What's this?

Subjective Fatigue, Mental Effort, and Attention Deficits After Severe Traumatic Brain Injury

AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France, INSERM U731, Paris, France, UPMC, Faculté de Médecine, Laboratoire de Physiologie et Physiopathologie de la Motricité, Paris, France

Nathalie Agar, MA

AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France

Philippe Azouvi, MD, PhD

AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation, Garches, France, INSERM U731, Paris, France, UPMC, Faculté de Médecine, Laboratoire de Physiologie et Physiopathologie de la Motricité, Paris, France, Université de Versailles Saint Quentin, France, philippe.azouvi{at}rpc.aphp.fr

Objective. Although fatigue is one of the most frequent complaints of individuals with traumatic brain injury (TBI), its mechanisms remain poorly understood. The objective of this study was to assess the relationships between subjective mental fatigue, mental effort, attention deficits, and mood after severe TBI. Methods and participants. A total of 27 patients with subacute/chronic severe TBI were compared with matched controls. Patients first rated their baseline subjective fatigue on the Fatigue Severity Scale (FSS) and on the Visual Analog Scale for Fatigue (VAS-F). Mood was assessed with the Montgomery and Asberg Depression Rating Scale (MADRS). Then, they performed a long-duration selective attention task, separated in 2 parts. Fatigue on the VAS-F was assessed again between the 2 parts and at the end of the attention task. Patients were also asked to rate on the VAS the level of subjective mental effort devoted to the task. Results. Patients reported a higher baseline fatigue than controls. They performed significantly poorer on the selective attention task. Significant correlations were found in the group with TBI between attention performance, mental effort, and subjective fatigue. Depression did not significantly correlate with fatigue. Discussion and conclusions. These findings suggest that patients with more severe attention deficits have to produce higher levels of mental effort to manage a complex task, which may increase subjective fatigue, in line with the coping hypothesis.

Key Words: Traumatic brain injury • Mental fatigue • Attention deficits

This version was published on November 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 9, 939-944 (2009)
DOI: 10.1177/1545968309340327


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?