Factors associated with multidimensional aspect of post-stroke fatigue in acute stroke period

Mutai, Hitoshi; Furukawa, Tomomi; Houri, Ayumi; Suzuki, Akihito; Hanihara, Tokiji

doi:10.1016/j.ajp.2016.12.015

Cited by 40 publications

(47 citation statements)

References 29 publications

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“…the incidence of PSF is higher when lesions are located in the adjacent basal ganglia, corona radiata and internal capsule [34]. Nevertheless, in our hands the relationship was not significant between PSF and lesion location, which is inconsistent with previous studies [35,36]. One possible explanation is the small sample size of our study; another explanation is that the redistribution of neurotransmitters may take some time after stroke.…”

Section: Discussioncontrasting

confidence: 99%

Elevated plasma high‐sensitivity C‐reactive protein at admission predicts the occurrence of post‐stroke fatigue at 6 months after ischaemic stroke

Liu

Wang

et al. 2020

Euro J of Neurology

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Background and purpose Post‐stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High‐sensitivity C‐reactive protein (hs‐CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs‐CRP and PSF after acute ischaemic stroke. Methods In all, 212 acute ischaemic stroke patients were consecutively recruited within the first 14 days after stroke onset and followed up for 6 months. Plasma hs‐CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score ≥ 43 is defined as PSF. Results Sixty‐eight stroke patients (32.1%) were diagnosed with PSF at 6 months’ follow‐up. In the patients with PSF, plasma hs‐CRP levels were significantly higher compared with those in non‐PSF patients (t = −8.524, P ≤ 0.001). In multivariate analyses, plasma levels of hs‐CRP were independently associated with PSF at 6 months (odds ratio 3.435, 95% confidence interval 2.222–5.309; P ≤ 0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut‐off value of plasma hs‐CRP levels as an indicator for the prediction of PSF was projected to be 0.52 mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725–0.864; P ≤ 0.001). Conclusion Elevated plasma hs‐CRP levels at admission were associated with PSF 6 months after stroke, suggesting that these alterations might predict the development of PSF in stroke patients.

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Section: Discussioncontrasting

confidence: 99%

Elevated plasma high‐sensitivity C‐reactive protein at admission predicts the occurrence of post‐stroke fatigue at 6 months after ischaemic stroke

Liu

Wang

et al. 2020

Euro J of Neurology

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“…Just a few earlier studies have investigated associations between separate dimensions of fatigue and depression. The authors are aware of just one study in an ABI population, conducted by Mutai, Furukawa, Houri, Suzuki, and Hanihara (2017) Compared to the present study, the study sample characteristics and methodology differed considerably in time since injury (inpatients vs. outpatients), age (mean: 74.4 vs. 23.7 years), aetiology (stroke vs. ABI in general), and applied measure of depression (HADS-D vs. MDI). Furthermore, Mutai et al (2017) did not include the remaining subscales of MFI-20 as predictors in the multiple regression analyses.…”

Section: Independent Associations Between Dimensions Of Fatigue and Dmentioning

confidence: 92%

On the relation between dimensions of fatigue and depression in adolescents and young adults with acquired brain injury

Cour

Forchhammer

Mogensen

et al. 2018

Neuropsychological Rehabilitation

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Complaints of fatigue following acquired brain injury (ABI) are often associated with depression. However, the nature of this relationship is unclear; furthermore, research among young people with ABI is limited. The objective of this cross-sectional study was (1) to investigate levels of depression in young outpatients with ABI (15-30 years old) and (2) to determine how different dimensions of fatigue relate to depression. Five dimensions of fatigue were assessed with the Multidimensional Fatigue Inventory (MFI-20), and depression was assessed with the Major Depression Inventory (MDI). Mann-Whitney U-tests and multiple regression analyses were conducted. The ABI group (n = 105), on average 23.7 years old (SD = 4.2) and 31 months post-injury (SD = 61), had elevated levels of fatigue and depression compared to a convenience sample of 160 healthy controls, all p's < .001. In multivariate analyses, the predominantly mental dimensions of fatigue, General Fatigue, Mental Fatigue, and Reduced Motivation, were independently associated with MDI, all p's < .01, while the physical dimensions, Physical Fatigue and Reduced Activity, were not. Distinctions within the concept of fatigue may be important in relation to depression, and future research could benefit from adopting a multidimensional approach in the development of more targeted and effective treatments of fatigue and depression following ABI.

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“…The specific role for thalamus in the pathogenesis of fatigue has been confirmed in both healthy subjects, 54 and patients with different (and more focal) neurological diseases (e.g., stroke, traumatic brain injury). 55,56 Indeed, a relatively-small damage to the thalamic network, independently from the extent of diffuse brain involvement, could generate fatigue. Accordingly, in MS, microstructural abnormalities and atrophy in strategic brain regions (e.g., thalamus) have stronger associations with fatigue, than measures of global brain damage, such as atrophy and lesion load.…”

Section: Towards a Unifying Theorymentioning

confidence: 99%

“…stroke and traumatic brain injury). 56,57 Indeed, a relatively small damage to the thalamic network, independently from the extent of diffuse brain involvement, could generate fatigue. Accordingly, in MS, microstructural abnormalities and atrophy in strategic brain regions (e.g.…”

Section: Toward a Unifying Theorymentioning

confidence: 99%

Fatigue in multiple sclerosis: The role of thalamus

et al. 2019

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Fatigue is very common in multiple sclerosis (MS) and is often considered as its most disabling symptom. Over the last 20 years, an increasing number of studies have evaluated the pathogenetic bases of MS-related fatigue. Converging evidence from neurophysiology and neuroimaging research suggests that a dysfunction in a cortico-subcortical pathway, centered on thalamus, is involved in the pathogenesis of fatigue. However, type and significance of such dysfunction remain unknown, and some studies reported an increase in the activity and connectivity within the thalamic network, whereas others suggested its reduction. Hereby, we review the results of neuroimaging studies supporting the different hypotheses about the role of thalamic network in the pathophysiology of MS-related fatigue and discuss limitations and shortcomings of available data, highlighting the key challenges in the field and the directions for future research.

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Factors associated with multidimensional aspect of post-stroke fatigue in acute stroke period

Cited by 40 publications

References 29 publications

Elevated plasma high‐sensitivity C‐reactive protein at admission predicts the occurrence of post‐stroke fatigue at 6 months after ischaemic stroke

Elevated plasma high‐sensitivity C‐reactive protein at admission predicts the occurrence of post‐stroke fatigue at 6 months after ischaemic stroke

On the relation between dimensions of fatigue and depression in adolescents and young adults with acquired brain injury

Fatigue in multiple sclerosis: The role of thalamus

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