Original ArticlePoststroke Fatigue: Hints to a Biological Mechanism
Section snippets
Research Subjects
The parent–patient population is described elsewhere.10 Briefly, patients with ischemic stroke admitted to Harborview Medical Center from September 2005 through May 2009 who were at least 18 years of age were enrolled within 72 hours of symptom onset. Individuals with ongoing therapy for malignancy, known history of human immunodeficiency virus, hepatitis B or C, history of brain tumor, anemia (hematocrit <35 on admission), and those taking immunomodulatory drugs were excluded. All study
Results
Individual FAS scores over time are shown in Figure 1. Median FAS scores did not differ over time and were similar among those with good outcome (mRS <2) and those without. Among our 39 participants, 17 (44%) did not endorse fatigue (FAS, 10-21) at any time point after stroke, 14 (36%) had fatigue (FAS, 22-34) at one or more time points, and 8 (20%) felt extremely fatigued (FAS, 35-50) at one or more time points in the year after stroke. The clinical characteristics of these subjects are shown
Discussion
Fatigue is a common and disabling symptom that affects over half of stroke survivors. Few studies have addressed the biological basis of this symptom, and to our knowledge, this study is the first to evaluate a genetic contribution to PSF. Although this exploratory study is small, it indicates a potentially substantial role for genetic factors in PSF. Large studies found that individuals with one or more IL1RN rs4251961 C alleles (those with more fatigue in our study) had lower circulating
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2021, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :Interestingly, Radman et al. observed that PSF was also prevalent among ninety-nine patients with minor infarctions characterized based on neuroimaging.15 Other studies also indicate that PSF is “democratic” and does not correlate with stroke severity at all.16–18 In fact, it appears that other stroke characteristics such as the type, etiology, and acute management are not good predictors of PSF as well, which demonstrates the complexity of the condition.15
Global brain inflammation in stroke
2019, The Lancet NeurologyCitation Excerpt :Such results suggest that an immune modulatory treatment might improve global brain function in patients with acute ischaemic stroke, possibly through attenuation of global brain inflammation. Depression and fatigue develop commonly in patients who have had a stroke from months to years after disease onset, and some studies83–85 implicate inflammation in the pathogenesis. Anti-inflammatory medications such as aspirin or statins have been shown to reduce the likelihood of early depression (within 1 year) but conversely increase the risk of late depression,86 implying that global brain inflammation might play distinct roles during the different stages of stroke recovery.
Health-Related Quality of Life and Fatigue After Transient Ischemic Attack and Minor Stroke
2019, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :Although vascular risk factors might conceivably be involved in poststroke fatigue, the results tend to argue against this hypothesis.25 An association with hyperlipidemia was found in 1 study36 but not in others9 and smoking was associated with fatigue in 1 study9 but not in others.35,37 According to previous studies where fatigue was found equally common in patients with TIA as in patients with ischemic stroke,38 or was more frequent in patients with TIA,3 it appears that stroke characteristics (such as the type, severity, etiology, and infarct volume) are not predictive of fatigue.25
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This study was funded by NINDS R01NS049197.
None of the authors have anything to disclose.