Chronic post-stroke fatigue: It may no longer be about the stroke itself

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Post-stroke fatigue (PSF) is a common and severe complication impacting stroke recovery.
• The risk factors for PSF and their evolution over time are not well understood.
• Identifying modifiable factors is crucial for effective management strategies.

Purpose of the Study:

• To determine the factors associated with PSF.
• To investigate how these factors change from the subacute to the chronic phase of stroke recovery.

Main Methods:

• A cohort of acute stroke patients were assessed for fatigue using the FACIT scale at two time points: subacute (<6 months) and chronic (>6 months) post-stroke.
• Regression analyses were performed to identify associations between fatigue scores and demographic, clinical, and comorbidity data.
• Stroke characteristics (NIHSS, infarct location), comorbidities (hypertension, OSA), medication use, and depression were recorded.

Main Results:

• In the subacute phase, higher stroke severity (NIHSS, mRS) and posterior circulation infarcts were associated with increased fatigue.
• In the chronic phase, medical comorbidities (hypertension, OSA) and anticonvulsant medication use were linked to persistent fatigue.
• Baseline depression was a significant predictor of fatigue in both subacute and chronic phases.

Conclusions:

• Early PSF is primarily associated with stroke severity.
• Chronic PSF is linked to the presence of medical comorbidities and the use of certain medications.
• These findings highlight the need for stage-specific management approaches for post-stroke fatigue.