Cerebral Microbleeds and Fatigue in Stroke

Abstract

Background and Purpose: Poststroke fatigue (PSF) is a frequent and persistent problem in stroke survivors. The neuroanatomical model of PSF remains unclear. This study examined the association between PSF and cerebral microbleeds (CMBs). Methods: The sample comprised 199 patients with acute ischemic stroke. A psychiatrist who was blind to the subjects' radiological data administered the Chinese version of the Fatigue Severity Scale. PSF was defined as a Fatigue Severity Scale score of 4.0 or more. The locations of CMBs were evaluated with magnetic resonance imaging within 7 days of admission. Results: Of the 199 patients screened, 47 (23.6%) had PSF. The PSF group had a higher Geriatric Depression Scale score (p < 0.001) and a trend for a higher age (p = 0.074). The proportion of patients with deep CMBs was significantly higher in the PSF group (66.0 vs. 48.7%; p = 0.038). The presence of deep CMBs was a significant independent predictor of PSF with an odds ratio of 2.68 (p = 0.016). Conclusion: The results suggest that deep CMBs are associated with a higher risk of PSF. Further studies are needed to clarify whether CMBs affect the clinical presentation, treatment response and outcome of PSF.

Mechanisms of poststroke fatigue

“…Some authors investigated the difference in incidence of fatigue based on type of lesion. Patients with large vessel stroke experienced greater fatigue than small vessel involvement,59 while other studies report an association with cerebral microbleeds 60. Those with stroke reported greater fatigue than transient ischaemic attack (TIA) despite minimal impairment 14.…”

Factors Associated with Poststroke Fatigue: A Systematic Review

“…Twenty-five studies found that PSF was associated with greater disability and dependency [ 20 , 22 , 24 , 25 , 29 , 32 , 33 , 36 , 38 , 43 – 45 , 48 , 52 – 54 , 57 , 60 , 62 , 64 , 65 , 68 , 71 – 73 ], even though the association seems to be mediated by depression [ 74 ] and was not detected in 15 studies [ 5 , 19 , 21 , 23 , 31 , 42 , 46 , 48 – 50 , 56 , 61 , 67 , 69 , 75 ]. PSF was associated with less return to work (and particularly to a return to full-time work) soon or long after the stroke in seven studies [ 22 , 29 , 43 , 44 , 46 , 76 , 77 ] but not in another study [ 64 ].…”

Fatigue and its Related Factors in Patients with Epilepsy and Psychogenic Non-epileptic Seizure: a Cross-Sectional Study

“…Fatigue affects patients both physically and emotionally and is considered the most important bio-alert in human health [1]. Fatigue is associated with various types of neurological diseases such as multiple sclerosis (MS) [2,3], Parkinson's disease [3,4], stroke [3,5,6], and epilepsy [3,7,8]. Epilepsy is a common neurological disease and is the second most commonly reported disorder of the central nervous system in the world [9].…”

“…Epilepsy affects all aspects of daily life and uncontrolled seizures can lead to irreversible brain damage [10]. Studies have shown that patients with epilepsy experience a lower quality of life than patients with other chronic diseases such as asthma or diabetes [6,11]. According to the current literature, the frequency of fatigue in patients with PNES is higher than that in normal individuals, which can lead to a low quality of life in these patients [12,13].…”