Article

Fatigue is one of the most frequent sequelae of traumatic brain injury
(TBI), although its causes are poorly understood. This study investigated the
interrelationships between fatigue and sleepiness, vigilance performance,
depression, and anxiety, using a structural equation modeling approach. METHODS:
Seventy-two participants with moderate to severe TBI (78% males) were recruited a
median of 305 days postinjury. They completed the Fatigue Severity Scale, a
vigilance task, the Epworth Sleepiness Scale, and Hospital Anxiety and Depression
Scale. A model of the interrelationships between the study variables was
developed, tested, and modified with path analysis. RESULTS: The modified model
had a good overall fit (chi2 = 1.3, P = .54; comparative fit index = 1.0;
root-mean square error of approximation = 0.0; standardized root-mean square
residual = 0.02). Most paths in this model were significant (P < .05). Fatigue
predicted anxiety, depression, and daytime sleepiness. Depression predicted
daytime sleepiness and poor vigilance, whereas anxiety tended to predict reduced
daytime sleepiness. CONCLUSIONS: This model confirms the complexity of fatigue
experience. It supports the hypothesis that fatigue after TBI is a cause, not a
consequence, of anxiety, depression, and daytime sleepiness, which, in turn
(especially depression), may exacerbate fatigue by affecting cognitive
functioning. These findings suggest that to alleviate fatigue, it is important to
address each of these factors. However, the findings need to be confirmed with a
longitudinal research design.

Langue : ANGLAIS