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Sleep Disorder, Pain and Depressive Symptoms as Predictors of Fatigue After Mild Traumatic Brain Injury Losoi H 1,2 , Wäljas M 1 , Helminen M 3 , Rosti-Otajärvi E 1 , Julkunen J 2 , Öhman J 1 1 Tampere University Hospital, Department of Neurosciences and Rehabilitation, Tampere, Finland

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METHODS

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  1. Sleep Disorder, Pain and Depressive Symptoms as Predictors of Fatigue After Mild Traumatic Brain Injury Losoi H 1,2, Wäljas M1, Helminen M3, Rosti-Otajärvi E1, Julkunen J2, Öhman J1 1 Tampere University Hospital, Department of Neurosciences and Rehabilitation, Tampere, Finland 2 University of Helsinki, Institute of Behavioural Sciences, Helsinki, Finland 3 University of Tampere, School of Public Health, Tampere, Finland RESULTS ► In separate analyses, sleep disorder predicted 45.5% (p ≤ 0.005), pain 40.4% (p ≤ 0.005) and depressive symptoms 30.4% (p ≤ 0.005) of the variance of post-MTBI fatigue. ► A combination of sleep disorder, pain and depressive symptoms accounted for 54.7% (adjusted R-square) of the variation of fatigue. ► In hierarchical analysis, pain (added after sleep disorder) contributed to the model 8.5% (p≤ 0.005) but the contribution of depressive symptoms was not significant (0.7%, p=0.208). ►When depressive symptoms were held constant sleep disorder (16.4%, p ≤ 0.005) and pain (7.9%, p ≤ 0.005) still significantly added to the model. OBJECTIVE To examine sleep disorder, pain and depressive symptoms as predictors of fatigue 1 month after mild traumatic brain injury (MTBI). METHODS ►Participants consisted of 50 consecutively enrolled patients with MTBI from the Emergency Department of Tampere University Hospital (Age in years: M= 36.0, SD=12.4; Education in years: M= 13.5, SD=2.7; Gender: Male 52%/Female 48%). ►The patients were assessed for self-reported fatigue (Barrow Neurological Institute Fatigue Scale; BNI-FS), pain (Pain Scale from Ruff Neurobehavioral Inventory), sleep disorder (Insomnia Severity Index) and depressive symptoms (Beck Depression Inventory; BDI-II) 1 month after MTBI. ►The statistical significance of sleep disorder, pain and depressive symptoms as predictors of fatigue was assessed by separate linear regression analyses adjusted to age, gender and education. ►Since the predictors have considerable overlap and association with each other, hierarchical linear regression analysis was then conducted to examine the simultaneous and unique effect of them. CONCLUSION Our results suggest that sleep disorder and pain are significant individual predictors of post-MTBI fatigue, even when depressive symptoms are taken into account. ► The results emphasize the identification and treatment of sleep disorder and pain in association with fatigue after MTBI. • Presented at the International Brain Injury Association Ninth World Congress on Brain Injury • Edinburgh, Scotland, March 2012 • Contact information: • Heidi Losoi, M. A. (Psych.) • Department of Neurosciences and Rehabilitation • Tampere University Hospital • Email: heidi.losoi@pshp.fi • Tel. +358 3 311 65116 • Address: Teiskontie 35, P. O. Box 2000, FI-33521 Tampere, Finland

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