Post-stroke fatigue is associated with resting state posterior hypoactivity and prefrontal hyperactivity

Area of Science:

• Neuroscience
• Stroke Research
• Medical Imaging

Background:

• Post-stroke fatigue significantly impacts patient recovery and quality of life.
• Understanding the neural underpinnings of post-stroke fatigue is crucial for developing effective interventions.
• Current research has yet to fully elucidate the specific brain mechanisms driving fatigue after stroke.

Purpose of the Study:

• To identify resting-state brain activity patterns associated with post-stroke fatigue.
• To explore potential neural markers for fatigue in stroke survivors.
• To investigate whole-brain functional connectivity differences between fatigued and non-fatigued stroke survivors.

Main Methods:

• Observational study of 63 ischemic stroke survivors (mean age 67.5 years).
• Resting-state functional magnetic resonance imaging (fMRI) conducted three months post-stroke.
• Analysis of fractional amplitude of low-frequency fluctuations (fALFF) to measure spontaneous neural activity.

Main Results:

• Forty-five participants reported experiencing post-stroke fatigue.
• Fatigued individuals showed significantly lower resting-state activity in the calcarine cortex and lingual gyrus.
• Higher resting-state activity was observed in the medial prefrontal cortex of fatigued participants compared to non-fatigued ones.

Conclusions:

• Post-stroke fatigue is associated with hypoactivity in posterior brain regions and hyperactivity in the medial prefrontal cortex.
• These findings suggest dysfunction in large-scale brain networks, potentially linking fatigue to executive and visual processing deficits.
• This study offers novel targets for investigating post-stroke fatigue beyond lesion-focused approaches.