Article

Poststroke fatigue following minor infarcts A prospective study

From the Department of Neurology (N.R., J.-M.A.), University of Fribourg, Fribourg
Neurology (Impact Factor: 8.29). 09/2012; 79(14):1422-7. DOI: 10.1212/WNL.0b013e31826d5f3a
Source: PubMed

ABSTRACT

To explore the potential relationship between fatigue following strokes and poststroke mood, cognitive dysfunction, disability, and infarct site and to determine the predictive factors in the development of poststroke fatigue (PSF) following minor infarcts.
Ninety-nine functionally active patients aged less than 70 years with a first, nondisabling stroke (NIH Stroke Scale score ≤6 in acute phase and ≤3 after 6 months, modified Rankin Scale score ≤1 at 6 months) were assessed during the acute phase and then at 6 (T1) and 12 months (T2) after their stroke. Scores in the Fatigue Assessment Inventory were described and correlated to age, gender, neurologic and functional impairment, lesion site, mood scores, neuropsychological data, laboratory data, and quality of life at T1 and T2 using a multivariate logistic regression analysis in order to determine which variables recorded at T1 best predicted fatigue at T2.
As many as 30.5% of the patients at T1 and 34.7% at T2 (11.6% new cases between T1 and T2) reported fatigue. At both 6 and 12 months, there was a significant association between fatigue and a reduction in professional activity. Attentional-executive impairment, depression, and anxiety levels remained associated with PSF throughout this time period, underlining the critical role of these variables in the genesis of PSF. There was no significant association between the lesion site and PSF.
This study suggests that attentional and executive impairment, as well as depression and anxiety, may play a critical role in the development of PSF.

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Available from: Jean-Marie Annoni, Mar 28, 2015
    • "Our current understanding and assessment of fatigue encompasses two dimensions , psychological fatigue (fatigue during a cognitive process) and physiological fatigue (fatigue during a physical process) (Choi- Kwon and Kim, 2011; Zwarts et al., 2008). Fatigue is frequently described as one of the most difficult symptoms to cope with following stroke (Lerdal et al., 2011; Zwarts et al., 2008) and has negative implications in terms of rehabilitation and the patient's family, social and occupational life (De Groot et al., 2003; Radman et al., 2012). The onset and maintenance of fatigue is likely to involve a dynamic interaction of biological, psychosocial and behavioural phenomena; however, little is known about the exact nature of the relationships between these phenomena (Choi- Kwon and Kim, 2011; Ingles et al., 1999). "
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    ABSTRACT: Both psychological distress and fatigue are common post stroke. Although there is recognition that the phenomena are related, the nature of the relationship is unclear.Cross-sectional study of 98 independently functioning participants within 2 years of stroke. Significant relationships were observed between fatigue and general anxiety, health-related anxiety and stroke-specific anxiety (r range from .31 to .37). In the final regression model, depression, pain and stroke-specific anxiety were significant, accounting for 32 per cent of the variance in fatigue scores (p < .001). The findings provide insight into the importance of anxiety-related factors post stroke, their relevance to our understanding of post-stroke fatigue and their implications for post-stroke intervention. © The Author(s) 2015.
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    ABSTRACT: Pathologic fatigue is common in neurologic disorders and can be defined as "a state of weariness unrelated to previous exertion levels which is usually not ameliorated by rest."(1) A case definition for poststroke fatigue (PSF) has been developed,(2) based on this definition,(1) to identify clinically important fatigue in stroke survivors.(2).
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