Vigilance and fatigue following traumatic brain injury

Abstract

Research findings have suggested that individuals with traumatic brain injury (TBI) show greater psychophysiological and subjective costs associated with performing vigilance tasks, but have not examined relationships with fatigue. The present study aimed to investigate vigilance and its relationship with subjective and objective fatigue measures. Forty-six TBI participants and 46 controls completed a 45-minute vigilance task. They also completed a subjective fatigue scale (the VAS-F) and a selective attention task before and after the vigilance task, and had their blood pressure (BP) monitored. TBI participants performed at a lower level on the vigilance task, but performed at a similar level across the duration of the task. Higher subjective fatigue ratings on the VAS-F were associated with more misses on the vigilance task for TBI participants. TBI participants showed greater increases in diastolic BP, and these were associated with greater increases in subjective fatigue ratings on the VAS-F. A subgroup of TBI participants showed a decline in performance on the vigilance task and also showed disproportionate increases in subjective fatigue. Findings provide support for the coping hypothesis, suggesting that TBI individuals expend greater psychophysiological costs in order to maintain stable performance over time, and that these costs are also associated with subjective increases in fatigue.

Mental fatigue and impaired cognitive function after an acquired brain injury

“…This finding is in accordance with other studies proposing that subjective fatigue after TBI and stroke correlates with poor performance on single tests for attention and processing speed (Ziino and Ponsford, 2006a,b; Belmont et al., 2009; Azouvi et al., 2004; Ashman et al., 2008; Johansson et al., 2009; Park et al., 1999; Ponsford et al., 2011; Johansson & Rönnbäck, 2012). However, it is difficult to determine whether the impairment in cognitive function is due to fatigue or the injury per se or a combination of the two.…”

“…The coping hypothesis has been supported by several authors (Belmont, Agar, Hugeron, Gallais, & Azouvi, 2006; Ziino and Ponsford, 2006a,b; Belmont, Agar, & Azouvi, 2009). Azouvi and co‐authors proposed that mentally‐tiring activities after brain injury are attributable to reduced resources and that patients who have sustained a brain injury also describe mental activity as more energy demanding than healthy people (Azouvi et al., 2004).…”

“…Azouvi and co‐authors proposed that mentally‐tiring activities after brain injury are attributable to reduced resources and that patients who have sustained a brain injury also describe mental activity as more energy demanding than healthy people (Azouvi et al., 2004). In an assessment of decreased cognitive function combined with mental fatigue, it has been proposed that subjective fatigue after TBI or mild TBI correlates with poor performance in attention tests and reduced processing speed (Ziino and Ponsford, 2006a,b; Belmont et al., 2009; Azouvi et al., 2004; Ashman et al., 2008; Johansson, Berglund, & Rönnbäck, 2009; Park, Moscovich, & Robertson, 1999; Ponsford, Cameron, Fitzgerald, Grant, & Mikocka‐Walus, 2011). A group of individuals who had sustained a TBI performed more slowly on a complex attention test, made more errors, and reported a higher level of subjective fatigue (Ziino and Ponsford, 2006a).…”

“…A group of individuals who had sustained a TBI performed more slowly on a complex attention test, made more errors, and reported a higher level of subjective fatigue (Ziino and Ponsford, 2006a). Their performance was slower, but remained on the same level during a vigilance test (Ziino and Ponsford, 2006b). Moreover, a simultaneous load on working memory requiring total control of the situation was more tiring for TBI subjects than an automatic activity (Park et al., 1999).…”

Evaluation of the Mental Fatigue Scale and its relation to Cognitive and Emotional Functioning after Traumatic Brain Injury or Stroke

“…TBI subjects also performed slower on a complex attention test, made more errors and reported a higher level of subjective fatigue [44]. Their performance was slower, but remained on the same level during a vigilance test, and a higher fatigue rating was attributed to more errors [45]. Furthermore, practice increased the response speed over time for controls, while this was not the case for subjects with mental fatigue after TBI [46].…”