Self- and Parent-Reported Fatigue 7 Years After Severe Childhood Traumatic Brain Injury: Results of the Traumatisme Grave de l'Enfant Prospective Longitudinal Study

Câmara-Costa, Hugo; Francillette, Leila; Opatowski, Marion; Touré, Hanna; Brugel, Dominique; Laurent-Vannier, A.; Meyer, Philippe; Dellatolas, Georges; Watier, Laurence; Chevignard, Mathilde

doi:10.1097/htr.0000000000000502

Cited by 21 publications

(31 citation statements)

References 51 publications

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“…The burden of increased effort may also result in stress by creating an imbalance between perceived demands and resources, which, in turn, may reinforce the experience of being fatigued (Ponsford et al, 2014). Interestingly, there were no significant effects of age in the HC-group (Câmara-Costa et al, 2019;van Markus-Doornbosch et al, 2016). This may reflect a specific vulnerability in adolescents with pABI to experience fatigue complications when responding to the increased demands and expectations (i.e., elevated cognitive load) in the late teenage years (as reported by parents), compared to healthy peers.…”

Section: Aim 2: Fatigue and Demographic Variables Related To Injury Type Age At Injury And Intervention Time Since Injury And Iq In The Pmentioning

confidence: 89%

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Fatigue following pediatric acquired brain injury: Interplay with associated factors in a clinical trial population compared to healthy controls.

Hypher¹,

Andersson²,

Finnanger³

et al. 2021

Neuropsychology

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Objective. The aims of the present study were to compare fatigue levels in children with pABI with healthy controls (HCs), and examine the interplay of fatigue with associated factors. Method. We used baseline data from a preregistered randomized controlled trial.Seventy-six children aged 10 to 17 (median 13y) with pABI in the chronic phase (88% with confirmatory cerebral imaging findings) and executive function (EF) complaints were included, most with moderate disability according to The Glasgow Outcome Scale Extended (GOSE-E) categorization. HCs consisted of 60 children aged 10 to 17 (median 13y). All 127 participants completed measures of fatigue and IQ. pABI participants were also assessed for behavioral problems, health-related quality of life (HRQoL) and EF. Nonparametric statistics were employed, in addition to a network analysis to model the unique associations between parent-reported fatigue and related factors. Results. Parents reported significantly more fatigue in the pABI-group (75% of scores in clinical range; <70) compared to HCs (11.7% of scores in clinical range). No strong associations were found between fatigue and injury characteristics, but findings indicated more fatigue in the older than younger age-group for pABI participants. Network modeling revealed a central role for HRQoL, behavioral and EF symptoms in relation to fatigue. Conclusions. Fatigue is reported to be highly prevalent in the chronic phase of pABI. When addressing fatigue, our findings demonstrate the advantage of including multidimensional measures of fatigue and examining associated psychological and cognitive constructs, such as HRQoL, behavioral problems and EF.

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Section: Aim 2: Fatigue and Demographic Variables Related To Injury Type Age At Injury And Intervention Time Since Injury And Iq In The Pmentioning

confidence: 89%

“…Measuring fatigue in the pediatric population involves some additional issues, relating to respondent types and developmental factors (Câmara-Costa et al, 2019;Haines et al, 2005).…”

mentioning

confidence: 99%

Fatigue following pediatric acquired brain injury: Interplay with associated factors in a clinical trial population compared to healthy controls.

Hypher¹,

Andersson²,

Finnanger³

et al. 2021

Neuropsychology

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“…First, our findings must be considered cautiously given the small sample size, which decreased statistical power and might have prevented assessment of associations of some variables with memory function, such as pre-injury school difficulties, age at injury and parental education. Although a matched control group was included in the 7-year follow-up study (see for example [10,12,19,51,52]), this group did not perform the memory assessments, in order to reduce the burden of assessment length, and, thus, we opted not to include in the present analyses. Therefore, we relied on the robustness of the age-and gender-standardized norms of the memory assessment battery.…”

Section: Discussionmentioning

confidence: 99%

“…The present work is part of a larger prospective longitudinal study (TGE cohort), aiming at determining overall and specific outcomes following severe childhood TBI [10,12,19,47,[51][52][53][54].…”

Section: Methodsmentioning

confidence: 99%

Memory functioning 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de l’Enfant study

Câmara-Costa

Viot

Francillette

et al. 2021

Journal of Neuropsychology

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Objective: to explore memory functioning 7-years after severe pediatric TBI, associated factors, and relationships with other outcomes. Method:Children aged 0-15 years (n=65), consecutively admitted over a 3-year period in a single trauma center, who survived after severe non-inflicted TBI, were included in a prospective longitudinal study. Memory assessments were performed 7-years post-injury using the Children's Memory Scale (CMS) or the Wechsler Memory Scale (WMS IV), according to age. The General Memory Score (GMS-7) was the primary outcome.Results: Thirty-seven patients were available for assessment at 7-years post-injury. Mean GMS-7 was in the low average range (M=84.9, SD=12.1). Lower GMS-7 was significantly associated with markers of higher injury severity, such as length of coma. One-year post-injury functional and disability outcomes explained 74% of the variance of GMS-7. Concurrent intellectual ability and type of ongoing education correlated strongly with GMS-7. Age at injury and parental education were not associated with memory outcome. Conclusions:Memory functioning is variable but often strongly impaired several years after severe pediatric TBI, and is mostly related to injury severity, functional outcomes measured 1year post-injury, and concomitant cognitive and educational outcomes. GMS-7 was lower at 7years than one-year post-injury, supporting the importance of long term follow-up.

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“…Severity of injury, as classified by the Glasgow Coma Scale (GCS) (17), tends to covary with persisting symptoms, with severe (GCS ≤ 8) and moderate (GCS 9-12) injuries being associated with higher degree of disability and cognitive deficit, lower academic long-term performance, persistent social impairments, reduced quality of life, and reduced societal participation (9,(18)(19)(20)(21)(22)(23)(24). Furthermore, fatigue is reported to be a substantial problem for as many as 58% to 74.6% of children with pTBI and seems to be unrelated to cause of injury, but positively associated with injury severity (25).…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

et al. 2022

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Descriptions of clinical outcomes in pediatric traumatic brain injury (pTBI) in Scandinavia are sparse. The Oslo site of the European CENTER-TBI study has performed a pTBI outcome study in a hospitalized population. The main objective was to investigate neuropsychological outcomes, self- and parent-reported symptoms associated with brain injury, and quality of life in children aged 1–15 years, 5–8 months after injury. Fifty-two children were included, and 45 completed the assessments. The sample consisted of 15.4% severe, 21.2% moderate, and 63.4% mild TBI. Subjectively experienced problems with concentration and fatigue were reported by the parents of nearly half of the children. Higher brain injury symptom load was associated with lower quality of life, but was unrelated to injury severity. Group average scores of the sample on neuropsychological testing appeared unimpaired relative to normative means aside from lower performance in working memory. However, based on an impairment index (i.e., 2 or more tests being >1.5 SD below the normative mean), the presence of weak cognitive performance was evident in as many as 45.4% of the sample. Two-thirds of the sample also showed abnormally large intraindividual variability in cognitive functioning (i.e., significant WISC-IV index discrepancies). The findings highlight the need to look beyond group averages on neuropsychological testing. Utilizing an impairment index and considering intraindividual performance variability conveyed deficits that may warrant clinical follow-up. The association of brain injury symptoms with quality of life but not injury severity emphasizes the need to consider symptoms after TBI within a biopsychosocial framework.Clinical Trial Registration:ClinicalTrials.gov; identifier: NCT02210221.

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Self- and Parent-Reported Fatigue 7 Years After Severe Childhood Traumatic Brain Injury: Results of the Traumatisme Grave de l'Enfant Prospective Longitudinal Study

Cited by 21 publications

References 51 publications

Fatigue following pediatric acquired brain injury: Interplay with associated factors in a clinical trial population compared to healthy controls.

Fatigue following pediatric acquired brain injury: Interplay with associated factors in a clinical trial population compared to healthy controls.

Memory functioning 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de l’Enfant study

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

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