Content » Vol 50, Issue 8

Original report

Relationship between fatigue after acquired brain injury and depression, injury localization and aetiology: An explorative study in a rehabilitation setting

Anna Holmqvist, Märta Berthold Lindstedt, Marika C. Möller
Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, 18288 Stockholm, Sweden. E-mail:
DOI: 10.2340/16501977-2365


Objective: Fatigue after acquired brain injury may be related to the subcortico-frontal attention network. Depression is also strongly related to fatigue. This study investigates whether injury localization, diagnosis and depression are related to self-rated mental fatigue in patients with an acquired brain injury.
Design: Retrospective cross-sectional cohort study.
Subjects: Sixty-one patients diagnosed with stroke, subarachnoidal haemorrhage, traumatic brain injury, or brain tumour were included in the study.
Methods: Patients who underwent a multidisciplinary team assessment during September 2011 to June 2012, and who were assessed with the Mental Fatigue Scale, were included in the study.
Results: A significantly higher number of patients with posterior and non-specific lesions experienced fatigue compared with those with subcortical/frontal injuries. Fewer stroke patients experienced fatigue compared with the other patient groups. How-ever, after logistic regression, only depression remained as an explanatory variable for self-rated fatigue. Nevertheless, although all patients with depression were fatigued, not all fatigued patients were depressed.
Conclusion: Although depression explains a high degree of fatigue after an acquired brain injury, mental fatigue after brain injury should be viewed as a condition partly separate from depression. Future extensive comparative studies are required, preferably including neuropsychological measures.

Lay Abstract

Fatigue is a common complaint following brain injury. This study investigated the impact of injury localization, diagnosis and depression on subjective fatigue experience in a group of patients in a rehabilitation unit. Patients with posterior and non-specific lesions were more fatigued than those with subcortical and frontal injuries. Stroke patients were less likely to experience fatigue than patients with other diagnoses. However, the differences in fatigue between injury localization and diagnostic groups were overshadowed by the strong relationship between depression and fatigue.


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