@article{ref1,
title="Factors Contributing to Chronic Fatigue After Traumatic Brain Injury",
journal="Journal of head trauma rehabilitation",
year="2012",
author="Schnieders, Jessica and Willemsen, Dennis and de Boer, Hans",
volume="27",
number="6",
pages="404-412",
abstract="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.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0b013e3182306341",
url="http://dx.doi.org/10.1097/HTR.0b013e3182306341"
}