Department of Neurology, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
Eur J Neurol. 2011 Apr;18(4):611-7. doi: 10.1111/j.1468-1331.2010.03217.x. Epub 2010 Sep 27.
Post-stroke fatigue (PSF) often occurs after stroke and has a negative impact on the rehabilitation process. Several studies focused either on short- or on long-term PSF and their relations with stroke characteristics. However, possible pre-stroke risk factors such as history of depression, pre-existent white matter lesions or brain atrophy were usually not taken into account. Therefore, the precise mechanisms underlying PSF remain still unclear. This study was aimed at assessing the possible contributions of (pre-)stroke factors to both short-term PSF and its course over time.
This study pertains to 108 patients with an acute cerebral infarction. PSF was rated by the Checklist Individual Strength at 2 months and 1.5 year post-stroke. The relation between (pre-)stroke factors and PSF was assessed with multivariate regression analysis.
The prevalence of baseline PSF was 35% and at follow-up 33%. Older age had a protective effect on PSF at baseline (OR 0.95; 95% CI 0.91-0.98), whereas post-stroke depressive symptoms and infratentorial infarctions were related to an increased risk for PSF (OR 1.40; 95% CI 1.21-1.63 and OR 4.69; 95% CI 1.03-21.47, respectively). Baseline fatigue was related to an increased risk of PSF at follow-up (OR 1.15; 95% CI 1.09-1.22).
Predictors for baseline fatigue were younger age, post-stroke depressive symptoms, and infratentorial infarctions. Baseline fatigue did predict fatigue outcome over time, suggesting that early interventions might be useful to prevent deteriorated PSF.
中风后常发生中风后疲劳（PSF），对康复过程有负面影响。有几项研究侧重于 PSF 的短期或长期影响及其与中风特征的关系。然而，通常没有考虑到可能的中风前危险因素，如抑郁史、预先存在的白质病变或脑萎缩。因此，PSF 的确切机制仍不清楚。本研究旨在评估（中风前）因素对短期 PSF 及其随时间变化的过程的可能贡献。
本研究涉及 108 例急性脑梗死患者。PSF 采用个体力量检查表在中风后 2 个月和 1.5 年进行评定。采用多元回归分析评估（中风前）因素与 PSF 之间的关系。
基线 PSF 的患病率为 35%，随访时为 33%。年龄较大对基线 PSF 有保护作用（OR0.95；95%CI0.91-0.98），而中风后抑郁症状和幕下梗死与 PSF 的风险增加有关（OR1.40；95%CI1.21-1.63 和 OR4.69；95%CI1.03-21.47）。基线疲劳与随访时 PSF 的风险增加有关（OR1.15；95%CI1.09-1.22）。
基线疲劳的预测因素是年龄较小、中风后抑郁症状和幕下梗死。基线疲劳确实预测了随时间推移的疲劳结果，这表明早期干预可能有助于预防 PSF 恶化。
