Task-induced subjective fatigue and resting-state striatal connectivity following traumatic brain injury

J. Bruijel*, C. W. E. M. Quaedflieg, T. Otto, V. van de Ven, S. Z. Stapert, C. van Heugten, A. Vermeeren

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: People with traumatic brain injury (TBI) often experience fatigue, but an understanding of the neural underpinnings of fatigue following TBI is still lacking. This study used resting-state functional magnetic resonance imaging (rs-fMRI) to examine associations between functional connectivity (FC) changes and task-induced changes in subjective fatigue in people with moderate-severe TBI.

METHODS: Sixteen people with moderate-severe TBI and 17 matched healthy controls (HC) performed an adaptive N-back task (working memory task) to induce cognitive fatigue. Before and after the task they rated their state fatigue level and underwent rs-fMRI. Seed-to-voxel analyses with seeds in areas involved in cognitive fatigue, namely the striatum and default mode network (DMN) including, medial prefrontal cortex and posterior cingulate cortex, were performed.

RESULTS: The adaptive N-back task was effective in inducing fatigue in both groups. Subjective task-induced fatigue was positively associated with FC between striatum and precuneus in people with TBI, while there was a negative association in HC. In contrast, subjective task-induced fatigue was negatively associated with FC between striatum and cerebellum in the TBI group, while there was no association in HC. Similar associations between task-induced subjective fatigue and DMN FC were found across the groups.

CONCLUSIONS: Our results suggest that the subjective experience of fatigue was linked to DMN connectivity in both groups and was differently associated with striatal connectivity in people with moderate-severe TBI compared to HC. Defining fatigue-induced neuronal network changes is pertinent to the development of treatments that target abnormal neuronal activity after TBI.

Original languageEnglish
Article number102936
Number of pages9
JournalNeuroImage: Clinical
Early online date4 Jan 2022
Publication statusPublished - 2022


  • Default mode network (DMN)
  • Fatigue
  • Functional connectivity
  • Resting-state fMRI
  • Striatum
  • Traumatic brain injury (TBI)

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