[Asthenia in the acute period of ischemic stroke]

To analyze the clinical and pathogenetic correlates of post-stroke asthenia (PSA) subtypes.

The study included 103 patients with ischemic stroke. PSA was assessed using the Multidimensional Fatigue Inventory-20 (MFI-20). A standard set of laboratory and instrumental tests, as well as examinations for neurological deficits, cognitive functions, symptoms of apathy, depression, anxiety, and daytime sleepiness, were conducted. Linear regression analysis was performed to identify predictors of the severity of the different PSA subtypes.

Asthenia was reported in 79 (76.7%) of the examined patients. The frequency of general asthenia, physical asthenia, and decreased activity ranged from 60-73%. Mental asthenia and decreased motivation were reported in about 31-37% of patients. A decrease in the fibrinogen/albumin ratio and the severity of cognitive impairment were predictors of the severity of general asthenia. The severity of physical asthenia was associated with the severity of the neurological deficit and the blood levels of hemoglobin and potassium. The blood hemoglobin level and the severity of depressive symptoms determined the decrease in activity. The severity of decreased motivation and mental asthenia were associated with various symptoms of apathy and depression.

The analysis of correlates of various asthenia subtypes made it possible to distinguish two main PSA phenotypes: «physical» associated with the severity of the neurological deficit, as well as somatogenic factors, and «mental» associated with affective-behavioral disorders. The data obtained confirm the heterogeneity of the PSA phenomenon, which must be considered when developing methods of its treatment and prevention.