Factors Associated With Early and Late Post-stroke Fatigue in Patients With Mild Impairment. Results From the Stroke Cohort Study Augsburg

Kirchberger, Inge; Wallner, Florian; Linseisen, Jakob; Zickler, Philipp; Ertl, Michael; Naumann, Markus; Meisinger, Christine

doi:10.3389/fneur.2022.852486

Cited by 8 publications

(19 citation statements)

References 44 publications

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“…Furthermore, we found that lesion laterality, anxiety, and depression symptoms were significantly different between fatigue and non-fatigue groups at 6-month follow-up after the stroke onset. The right hemisphere is primarily responsible for emotional regulation and has also been reportedly related to PSF in the previous literature (Mutai et al, 2017); Moreover, psychological factors play an important role in the persistent fatigue, which is consistent with the previous study (Kirchberger et al, 2022) and Chalder's conceptual model of PSF (Wu et al, 2015).…”

Section: Discussionsupporting

confidence: 89%

Association of Lesion Location and Fatigue Symptoms After Ischemic Stroke: A VLSM Study

Wang

Xiao

et al. 2022

Front. Aging Neurosci.

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Background:Poststroke fatigue (PSF) is a common symptom in stroke survivors, yet its anatomical mechanism is unclear. Our study was aimed to identify which brain lesions are related to the PSF in patients with acute stroke.MethodPatients with first-ever acute ischemic stroke consecutively admitted from the first affiliated hospital of the University of Science and Technology of China (USTC) between January 2017 and June 2020. Fatigue was scored using the Fatigue Severity Scale. All the participants were assessed by 3.0 T brain MRI including diffusion-weighted imaging. The infarct lesions were delineated manually and transformed into a standard template. Voxel-based lesion-symptom mapping (VLSM) was applied to investigate the association between lesion location and the occurrence and severity of fatigue. The same analyses were carried out by flipping the left-sided lesions. Multivariate logistic regressions were applied to verify the associations.ResultsOf the 361 patients with acute stroke, 142 (39.3%) patients were diagnosed with fatigue in the acute phase and 116 (35.8%) at 6 months after the index stroke. VLSM analysis indicated clusters in the right thalamus which was significantly associated with the occurrence and severity of PSF at 6-month follow-up. In contrast, no significant cluster was found in the acute phase of stroke. The flipped analysis did not alter the results. Multivariate logistic regression verified that lesion load in the right thalamus (OR 2.67, 95% CI 1.46–4.88) was an independent predictor of 6-month PSF.ConclusionOur findings indicated that lesions in the right thalamus increased the risk of fatigue symptoms 6 months poststroke.

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Section: Discussionsupporting

confidence: 89%

Association of Lesion Location and Fatigue Symptoms After Ischemic Stroke: A VLSM Study

Wang

Xiao

et al. 2022

Front. Aging Neurosci.

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“…The sample sizes in the studies ranged from 13 participants 24 to 613 participants, 28 and the age of participants ranged from 18 to 94 years. 20 The studies were conducted in Canada, 4 China, 11,12,42 Croatia, 41 Finland, 35 France, 36 Ghana, 13 Germany, 33 Ireland, 29,32 Japan, 10 Korea, 25 the Netherlands, 3,38,40 Norway, 15,27,34 Hong Kong, 39 the United Kingdom, 7,20,24,30,43 Scotland, 26 Spain, 14 Switzerland, 31,37 and New Zealand. 28 Participants were recruited from different settings including hospital (inpatient), 12,35 clinic, 26 research center, 14 rehabilitation, 31 and research community.…”

Section: Resultsmentioning

confidence: 99%

“…28 Participants were recruited from different settings including hospital (inpatient), 12,35 clinic, 26 research center, 14 rehabilitation, 31 and research community. 4 The prevalence of PSF was investigated at 1 week, 12 2 weeks, 10,15,42 4 to 6 weeks, 7,26,31 2 months, 38 3 months, 4,11,14,20,25,27,[33][34][35]39,41 and 6 months post stroke. 3,26,[28][29][30]32,36,37,40,43 Twelve studies investigated ADLs, 41 and 5 studies investigated HRQoL at different points in time within 6 months post stroke.…”

Section: Resultsmentioning

confidence: 99%

“…23 Various instruments in Table 1 have been used to measure PSF including the Fatigue Severity Scale (FSS), 25 Chalder Fatigue Scale, 36,43 and Fatigue Assessment Scale (FAS). 14,26,33 Although studies have been published indicating that PSF can occur within the 2 weeks post stroke, the literature relating to the prevalence of PSF in the acute phase after stroke has not been systematically reviewed. Systematically investigating the prevalence of PSF will enable the development of evidence-based guidelines for the early assessment of PSF and the implementation of interventions to reduce the effect on ADLs and HRQoL for stroke survivors.…”

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confidence: 99%

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Prevalence and Impact of Poststroke Fatigue on Patient Outcomes in the First 6 Months After Stroke: A Systematic Review and Meta-analysis

Paudel

Rolls

Green

et al. 2023

Journal of Neuroscience Nursing

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BACKGROUND: Post-stroke fatigue (PSF) is one of the most pervasive and debilitating symptoms after stroke and has a negative impact on activities of daily living (ADLs) and health-related quality of life (HRQoL) of stroke survivors. However, to date, no study has systematically reviewed the prevalence of PSF at different points in time after stroke. OBJECTIVE: The aim of this study was to investigate the prevalence of PSF and its impact on ADLs and HRQoL in the first 6 months post stroke. METHOD: CINAHL, MEDLINE, Scopus, Google Scholar, and Index to Theses were searched from 1983 to August 2022 for studies published in English. Studies were included if they were conducted on adults 18 years and older, and were observational, correlational, and quantitative components of mixed methods reporting on PSF, ADLs, and HRQoL post stroke. RESULTS: Thirty studies were included in this review, and all had a high methodological quality. The pooled prevalence of PSF at 1 to 6 weeks was 49.5%; at 3 months, it was 41.9%; and at 6 months, it was 43.4%. A negative correlation between PSF and ADLs was observed at 1, 2, and 4 to 6 weeks, and at 3 and 6 months post stroke. A significant negative correlation between PSF and HRQoL was observed within the first week (r = −0.40, P < .05) and at 3 and 6 months post stroke. The results at 3 and 6 months post stroke were inclusive. CONCLUSION: The prevalence of PSF in the first 6 weeks, particularly in the first 2 weeks after stroke, is high and has a significant negative impact on stroke survivors' ADLs and HRQoL. Only a limited number of studies assessed PSF within the first 2 weeks after stroke.

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“…Large studies reported that fatigue is present in about 29%−68% of stroke survivors within the first 2 years after the acute event ( 1 – 3 ). A recent study by our group found a fatigue frequency of about 30% in patients with mild impairment 3 and 12 months after the acute stroke event ( 4 ). Fatigue is a condition causing distress and loss of functioning due to a lack of energy.…”

Section: Introductionmentioning

confidence: 95%

Association between fatigue and cytokine profiles in patients with ischemic stroke

et al. 2023

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BackgroundChronic fatigue is a common symptom after a stroke. Studies suggested that chronic fatigue is caused by inflammatory or immunological processes but data are limited and contradictory. Thus, the present study aimed to identify specific biomarkers associated with fatigue in post-stroke patients and replicated the findings in a population-based study.MethodsWe investigated associations between 39 circulating biomarkers of inflammation and fatigue in 327 patients after an ischemic stroke included in the Stroke Cohort Augsburg (SCHANA) study and the “Metabolism, Nutrition and Immune System in Augsburg” (MEIA) study (n = 140). The Fatigue Assessment Scale (FAS) was used to assess the severity of fatigue. The serum concentrations of the biomarkers were measured using the Bio-Plex Pro™ Human Cytokine Screening Panel (Bio-Rad, USA). Multiple linear regression models adjusted for possible confounders were used to examine associations.ResultsIn patients with stroke, SCGFb was inversely associated [−1.67, 95% confidence interval (CI) (−3.05; −0.29) p = 0.018], and in healthy subjects, G-CSF was positively associated [1.56, 95% CI (0.26; 2.87), p = 0.020] with an increasing FAS-score, while SCF was positively related in both samples [1.84, 95% CI (0.27; 3.42), p = 0.022 and 1.40, 95% CI (0.29; 2.52), p = 0.015]. However, after correction for multiple testing, all of these associations lost statistical significance.ConclusionThe present findings suggested an association between the growth factor SCF and fatigue. Future research on cytokines as possible markers of fatigue should focus on a longitudinal design including a sufficiently large number of study participants to enable testing associations between certain cytokines and sub-groups of chronic fatigue.

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Factors Associated With Early and Late Post-stroke Fatigue in Patients With Mild Impairment. Results From the Stroke Cohort Study Augsburg

Cited by 8 publications

References 44 publications

Association of Lesion Location and Fatigue Symptoms After Ischemic Stroke: A VLSM Study

Association of Lesion Location and Fatigue Symptoms After Ischemic Stroke: A VLSM Study

Prevalence and Impact of Poststroke Fatigue on Patient Outcomes in the First 6 Months After Stroke: A Systematic Review and Meta-analysis

Association between fatigue and cytokine profiles in patients with ischemic stroke

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