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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2024; 39:178-189. [PMID: 38278413 DOI: 10.1016/j.nrleng.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/28/2024] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España.
| | - E Orcajo
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Consorci Sanitari Alt Penedès-Garraf, Departmento de Neurología, Cataluña, España
| | - P Davila-Pérez
- Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Universitario Rey Juan Carlos (HURJC), Departmento de Neurofisiología Clínica, Madrid, España; Health Research Institute - Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, España
| | - N León
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Nacional para Paraplégicos (SESCAM), Grupo FENNSI, Toledo, España
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Allonsius F, van Markus-Doornbosch F, de Kloet A, Lambregts S, Vliet Vlieland T, van der Holst M. Fatigue in young patients with acquired brain injury in the rehabilitation setting: Categorizing and interpreting fatigue severity levels. Dev Neurorehabil 2022; 25:542-553. [PMID: 35881762 DOI: 10.1080/17518423.2022.2099994] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Fatigue in patients with acquired brain injury (ABI) is common. However, to better target fatigue, clear ways to categorize/interpret fatigue-severity in individual patients are lacking. This study aims to determine/categorize fatigue severity among children, adolescents, and young adults with ABI. METHODS This cross-sectional study included young patients admitted to outpatient rehabilitation and their parents. To determine fatigue, the PedsQL™Multidimensional-Fatigue-Scale was used (MFS, scores 0-100, lower scores = higher fatigue, patient-/parent-reported). Based on scores from a reference population, four categories were formed: "1 = no/little fatigued" to "4 = severely-more fatigued." RESULTS All scores were lower than those from the reference population, with comparisons in the adolescent and young adult groups reaching statistical significance (p < .05). The proportions of patients in category 4 were: 9%/50%/58% among children/adolescents/young adults, showing that many patients were "severely-more fatigued"-than the reference population. CONCLUSIONS Measuring fatigue and categorizing fatigue severity looks promising for clinical practice and could help to better target fatigue.
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Affiliation(s)
- Florian Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands.,Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Arend de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands
| | - Suzanne Lambregts
- Department of Rehabilitation Medicine, Revant Rehabilitation Center, Breda, The Netherlands
| | - Thea Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands.,Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Menno van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, The Hague, The Netherlands.,Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2021:S0213-4853(21)00111-0. [PMID: 34538507 DOI: 10.1016/j.nrl.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/05/2023] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España.
| | - E Orcajo
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - P Davila-Pérez
- Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España
| | - N León
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España; Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España; Grupo FENNSI, Hospital Nacional de Parapléjicos, SESCAM, Toledo, España
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Sullivan KA, Blaine H, Kaye SA, Theadom A, Haden C, Smith SS. A Systematic Review of Psychological Interventions for Sleep and Fatigue after Mild Traumatic Brain Injury. J Neurotrauma 2018; 35:195-209. [DOI: 10.1089/neu.2016.4958] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Karen A. Sullivan
- School of Psychology and Counseling, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Hannah Blaine
- School of Psychology and Counseling, Queensland University of Technology, Brisbane, Australia
| | - Sherrie-Anne Kaye
- School of Psychology and Counseling, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Alice Theadom
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
- National Institute for Stroke and Applied Neurosciences, Auckland, New Zealand
| | - Catherine Haden
- Division of Information and Library Services, Queensland University of Technology, Brisbane, Australia
| | - Simon S. Smith
- Recover Injury Research Center, University of Queensland, Brisbane, Australia
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Ulrichsen KM, Kaufmann T, Dørum ES, Kolskår KK, Richard G, Alnæs D, Arneberg TJ, Westlye LT, Nordvik JE. Clinical Utility of Mindfulness Training in the Treatment of Fatigue After Stroke, Traumatic Brain Injury and Multiple Sclerosis: A Systematic Literature Review and Meta-analysis. Front Psychol 2016; 7:912. [PMID: 27445888 PMCID: PMC4917545 DOI: 10.3389/fpsyg.2016.00912] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/02/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fatigue is a common symptom following neurological illnesses and injuries, and is rated as one of the most debilitating sequela in conditions such as stroke, traumatic brain injury (TBI), and multiple sclerosis (MS). Yet effective treatments are lacking, suggesting a pressing need for a better understanding of its etiology and mechanisms that may alleviate the symptoms. Recently mindfulness-based interventions have demonstrated promising results for fatigue symptom relief. OBJECTIVE Investigate the efficacy of mindfulness-based interventions for fatigue across neurological conditions and acquired brain injuries. MATERIALS AND METHODS Systematic literature searches were conducted in PubMed, Medline, Web of Science, and PsycINFO. We included randomized controlled trials applying mindfulness-based interventions in patients with neurological conditions or acquired brain injuries. Four studies (N = 257) were retained for meta-analysis. The studies included patients diagnosed with MS, TBI, and stroke. RESULTS The estimated effect size for the total sample was -0.37 (95% CI: -0.58, -0.17). CONCLUSION The results indicate that mindfulness-based interventions may relieve fatigue in neurological conditions such as stroke, TBI, and MS. However, the effect size is moderate, and further research is needed in order to determine the effect and improve our understanding of how mindfulness-based interventions affect fatigue symptom perception in patients with neurological conditions.
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Affiliation(s)
| | - Tobias Kaufmann
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
| | - Erlend S. Dørum
- Sunnaas Rehabilitation Hospital HT, NesoddenNorway
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
- Department of Psychology, University of Oslo, OsloNorway
| | - Knut K. Kolskår
- Sunnaas Rehabilitation Hospital HT, NesoddenNorway
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
- Department of Psychology, University of Oslo, OsloNorway
| | - Geneviève Richard
- Sunnaas Rehabilitation Hospital HT, NesoddenNorway
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
- Department of Psychology, University of Oslo, OsloNorway
| | - Dag Alnæs
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
| | - Tone J. Arneberg
- Department of Behavioural Sciences, Oslo and Akershus University College of Applied Sciences, OsloNorway
| | - Lars T. Westlye
- KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, NORMENT: Norwegian Centre for Mental Disorders Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, OsloNorway
- Department of Psychology, University of Oslo, OsloNorway
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Gagner C, Landry-Roy C, Lainé F, Beauchamp MH. Sleep-Wake Disturbances and Fatigue after Pediatric Traumatic Brain Injury: A Systematic Review of the Literature. J Neurotrauma 2015; 32:1539-52. [DOI: 10.1089/neu.2014.3753] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Charlotte Gagner
- Department of Psychology, University of Montreal, Quebec, Canada
- Ste-Justine Hospital Research Center, Montreal, Quebec, Canada
| | | | - France Lainé
- Institut Universitaire de Gériatrie de Montréal Research Center, Montreal, Quebec, Canada
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Quebec, Canada
- Ste-Justine Hospital Research Center, Montreal, Quebec, Canada
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