Fatigue and Fatigability in patients with Mild Traumatic Brain Injury: a combined neurophysiological and fMRI study

Prak, R. (Roeland) (2015) Fatigue and Fatigability in patients with Mild Traumatic Brain Injury: a combined neurophysiological and fMRI study. thesis, Medicine.

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Abstract

Introduction: Fatigue is a common symptom in patients with mild traumatic brain injury (MTBI) and can cause long-lasting impairment in functioning. Two dimensions of fatigue can be distinguished: perceptions of fatigue (i.e. fatigue as it is perceived by individuals) and performance fatigability (i.e. impaired performance that results from fatigue). Muscle fatigability belongs to the latter dimension and can be due to both central and peripheral factors. Methods: To explore fatigue in patients with MTBI, we recorded the force decline during a fatiguing motor task in MTBI- and control subjects. To determine the contribution of central and peripheral factors, electrical stimulation was applied to the ulnar nerve to evoke superimposed twitches. Functional MRI (fMRI) was used to investigate changes in cortical activation during the task. Results: No differences were observed in the force recordings across MTBI- and control subjects indicating no difference in muscle fatigability. However, fMRI findings showed increased activation of the ipsilateral precentral gyrus and inferior parietal lobule in MTBI subjects at the start of the contraction. A larger decline in activation of frontal areas was found in MTBI- compared to control subjects. Conclusion: We observed no changes in performance fatigability after MTBI. The increased activation at the start of the contraction is a sign of increased effort. The stronger decline in activation of frontal areas suggests MTBI subjects experience increased mental effort during the task. Both point to changes in perceptions of fatigue.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor: and Zijdewind, Dr Inge and Department: UMCG, Neuroscience
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1594

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