Fatigue in patients following traumatic brain injury and stroke

Abstract

Fatigue may be defined as an experience of long-term or recurrent tiredness and reduced capacity for mental and/or physical activity, and is common following acquired brain injury. This article provides an overview of the status of knowledge on fatigue following stroke and traumatic brain injury. An assessment of the existing literature, including a literature search, as well as the authors' own clinical experience form the basis for the content of this article. Existing studies use varying definitions of fatigue and apply different survey tools. The prevalence of fatigue following stroke or traumatic brain injury is uncertain due to varying inclusion criteria and survey methods, and because different times of measurement can result in different prevalence figures. Several studies estimate the prevalence to be between 50 and 70%. Our knowledge of the pathologic mechanisms is very limited; premorbid, sociodemographic, stroke/trauma-related and comorbid factors all play a role in the experience of fatigue. Therapeutic interventions include psychoeducation, regulation of activity, physical exercise and treatment of comorbid conditions. Trials have also been conducted on drug treatment, so far without convincing results. Fatigue occurs frequently in stroke patients and patients with traumatic brain injuries, and often significantly restricts daily functioning for these patients. Our knowledge of pathologic mechanisms and evidence with regard to therapeutic interventions is deficient, and the patient population is heterogeneous. The treatment is adapted to the individual and its objective is to enable individuals to use their limited capacity in the most appropriate way possible.