Department of Neurology, University of Fribourg, Fribourg, Switzerland.
Neurology. 2012 Oct 2;79(14):1422-7. doi: 10.1212/WNL.0b013e31826d5f3a. Epub 2012 Sep 5.
To explore the potential relationship between fatigue following strokes and poststroke mood, cognitive dysfunction, disability, and infarct site and to determine the predictive factors in the development of poststroke fatigue (PSF) following minor infarcts.
Ninety-nine functionally active patients aged less than 70 years with a first, nondisabling stroke (NIH Stroke Scale score ≤6 in acute phase and ≤3 after 6 months, modified Rankin Scale score ≤1 at 6 months) were assessed during the acute phase and then at 6 (T1) and 12 months (T2) after their stroke. Scores in the Fatigue Assessment Inventory were described and correlated to age, gender, neurologic and functional impairment, lesion site, mood scores, neuropsychological data, laboratory data, and quality of life at T1 and T2 using a multivariate logistic regression analysis in order to determine which variables recorded at T1 best predicted fatigue at T2.
As many as 30.5% of the patients at T1 and 34.7% at T2 (11.6% new cases between T1 and T2) reported fatigue. At both 6 and 12 months, there was a significant association between fatigue and a reduction in professional activity. Attentional-executive impairment, depression, and anxiety levels remained associated with PSF throughout this time period, underlining the critical role of these variables in the genesis of PSF. There was no significant association between the lesion site and PSF.
This study suggests that attentional and executive impairment, as well as depression and anxiety, may play a critical role in the development of PSF.
探讨脑卒中后疲劳与卒中后情绪、认知功能障碍、残疾和梗死部位的潜在关系,并确定小梗死后发生卒中后疲劳(PSF)的预测因素。
99 例年龄小于 70 岁的首次非致残性卒中患者(急性期 NIH 卒中量表评分≤6 分,6 个月后评分≤3 分,6 个月时改良 Rankin 量表评分≤1 分)在急性期进行评估,然后在卒中后 6 个月(T1)和 12 个月(T2)进行评估。在 T1 和 T2 时使用多元逻辑回归分析描述疲劳评估量表的评分,并将其与年龄、性别、神经和功能障碍、病变部位、情绪评分、神经心理学数据、实验室数据和生活质量相关联,以确定在 T1 记录的哪些变量能最好地预测 T2 时的疲劳。
T1 时有 30.5%的患者,T2 时有 34.7%的患者(T1 和 T2 之间有 11.6%的新病例)报告疲劳。在 6 个月和 12 个月时,疲劳与职业活动减少均存在显著相关性。在此期间,注意力-执行功能障碍、抑郁和焦虑水平与 PSF 仍存在显著相关性,这突显了这些变量在 PSF 发生中的关键作用。病变部位与 PSF 之间无显著相关性。
本研究表明,注意力和执行功能障碍以及抑郁和焦虑可能在 PSF 的发展中起关键作用。