{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:20:54Z","timestamp":1792095654082,"version":"4.4.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following traumatic brain injury (TBI) some patients develop lingering comorbid symptoms of fatigue and cognitive impairment. The mild cognitive impairment self-reported by patients is often not detected with neurocognitive tests making it difficult to determine how common and severe these symptoms are in individuals with a history of TBI. This study was conducted to determine the relative prevalence of fatigue and cognitive impairment in individuals with a history of TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Fatigue and Altered Cognition Scale (FACs) digital questionnaire was used to assess self-reported fatigue and cognitive impairment. Adults aged 18\u201370 were digitally recruited for the online anonymous study. Eligible participants provided online consent, demographic data, information about lifetime TBI history, and completed the 20 item FACs questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 519 qualifying participants completed the online digital study which included 204 participants with a history of TBI of varied cause and severity and 315 with no history of TBI. FACs Total Score was significantly higher in the TBI group (57.7 \u00b1 22.2) compared to non-TBI (39.5 \u00b1 23.9; p&lt;0.0001) indicating more fatigue and cognitive impairment. When stratified by TBI severity, FACs score was significantly higher for all severity including mild (53.9 \u00b1 21.9, p&lt;0.0001), moderate (54.8 \u00b1 24.4, p&lt;0.0001), and severe (59.7 \u00b1 20.9, p&lt;0.0001) TBI. Correlation analysis indicated that more severe TBI was associated with greater symptom severity (p&lt;0.0001, r = 0.3165). Ancillary analysis also suggested that FACs scores may be elevated in participants with prior COVID-19 infection but no history of TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adults with a history of even mild TBI report significantly greater fatigue and cognitive impairment than those with no history of TBI, and symptoms are more profound with greater TBI severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0300910","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T13:34:55Z","timestamp":1711114495000},"page":"e0300910","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of fatigue and cognitive impairment after traumatic brain injury"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-930X","authenticated-orcid":true,"given":"Traver J.","family":"Wright","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6608-7714","authenticated-orcid":true,"given":"Timothy R.","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Randolph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Pyles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5955-1534","authenticated-orcid":true,"given":"Brent E.","family":"Masel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall J.","family":"Urban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Sheffield-Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"pone.0300910.ref001","volume-title":"Central nervous system injury surveillance data submission standards\u20142002","author":"AL Marr","year":"2004"},{"key":"pone.0300910.ref002","author":"AB Peterson","year":"2019","journal-title":"Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths, United States, 2014"},{"key":"pone.0300910.ref003","doi-asserted-by":"crossref","first-page":"E55","DOI":"10.1097\/HTR.0000000000000140","article-title":"Prevalence of Self-Reported Lifetime History of Traumatic Brain Injury and Associated Disability: A Statewide Population-Based Survey","volume":"31","author":"GG Whiteneck","year":"2016","journal-title":"J Head Trauma Rehabil"},{"key":"pone.0300910.ref004","volume-title":"Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation","author":"Centers for Disease Control and Prevention","year":"2015"},{"key":"pone.0300910.ref005","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/B978-0-444-52892-6.00001-5","article-title":"Epidemiology of traumatic brain injury","volume":"127","author":"M Faul","year":"2015","journal-title":"Handb Clin Neurol"},{"key":"pone.0300910.ref006","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.15585\/mmwr.mm7048a3","article-title":"Incidence of Nonfatal Traumatic Brain Injury-Related Hospitalizations\u2014United States, 2018","volume":"70","author":"AB Peterson","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0300910.ref007","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1136\/jnnp.2006.111187","article-title":"Comparison of indices of traumatic brain injury severity: Glasgow Coma Scale, length of coma and post-traumatic amnesia","volume":"79","author":"M Sherer","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"pone.0300910.ref008","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0140-6736(74)91639-0","article-title":"Assessment of coma and impaired consciousness. 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