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Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e3182306341
Original Articles

Factors Contributing to Chronic Fatigue After Traumatic Brain Injury

Schnieders, Jessica MD; Willemsen, Dennis MD; de Boer, Hans MD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

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Background: The annual incidence of traumatic brain injury in Europe amounts to 235 per 100 000 persons. About two-thirds will develop posttraumatic brain injury chronic fatigue (pTBI-CF).

Aim: To identify the reversible hormonal and nonhormonal causes of pTBI-CF.

Patients and Methods: Ninety patients with varying degrees of pTBI-CF underwent endocrine testing and an evaluation of sleep, attention, coping style, daily activity and dependency, physical performance, emotional well-being, and quality of life.

Results: Vitamin D deficiency was found in 65%, poor sleep quality in 54%, anxiety disorders in 36%, growth hormone deficiency in 16%, and gonadal hormone deficiencies in 9%. Fatigue severity was correlated with poor sleep (R = +0.65, P < .0001), serum 25-hydroxy vitamin D levels (R = −0.50, P < .0001), and anxiety (R = +0.50, P < .0001) but not with growth hormone deficiency or gonadal hormone deficiencies. The first 3 factors together explained 59% of the fatigue score variance.

Conclusions: Poor sleep, vitamin D deficiency, and anxiety were the most important factors associated with pTBI-CF. Appropriate treatment of these disorders may help to reduce fatigue in these patients.

© 2012 Lippincott Williams & Wilkins, Inc.


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