Delva M, Delva I
Ukrainian Medical Stomatological Academy, Poltava, Ukraine.
Georgian Med News. 2017 Oct(271):91-95.
Aim - identify neuroimaging characteristics associated with different post-stroke fatigue (PSF) domains within first 6 months after ischemic strokes. There were enrolled in the study 107 patients with acute ischemic strokes. General PSF and certain PSF domains (global, physical, mental, motivational, activity-related) were measured by multidimensional fatigue inventory-20 (MFI-20) scale at hospital stay, in 1, 3 and 6 months after stroke occurrence. Brain MRI studies included cerebral infarct localization, planimetric measurements of infarct volumes, measurement of brain atrophy indexes (bifrontal, bicaudate, cortical atrophy indexes, width of third ventricle) and evaluation of leukoaraiosis severity, according to Fazekas scale. In univariate logistic regression analysis infarcts volumes as well as brain atrophy indexes were not significantly associated with risk of any PSF domain at any time points within first 6 months after ischemic strokes. On the other hand, it had been found reliable associations between subcortical infarcts and increased risk of PSF domains which are related just to physical activity (physical PSF, activity-related PSF) in 1 month after stroke onset and later, as well as reliable associations between infratentorial infarcts and risk of global PSF domain in 3 months after stroke and later. Moreover, it have been revealed significant direct associations between severity of white matter lesions and risk of mental PSF in 3 months after stroke onset and later. Subcortical infarcts may be risk factors for development of physical PSF domain, infratentorial infarcts - risk factors for development of global PSF domain, leukoaraiosis extension - risk factor for development of mental PSF domain but not early than 1 month after stroke occurrence.
目的——确定缺血性卒中后6个月内与不同中风后疲劳（PSF）领域相关的神经影像学特征。本研究纳入了107例急性缺血性卒中患者。在住院期间、卒中发生后1个月、3个月和6个月，采用多维疲劳量表-20（MFI-20）对一般PSF和特定PSF领域（整体、身体、精神、动机、活动相关）进行测量。脑部MRI研究包括脑梗死定位、梗死体积的平面测量、脑萎缩指数（双侧额叶、双侧尾状核、皮质萎缩指数、第三脑室宽度）的测量以及根据 Fazekas 量表对白质疏松严重程度的评估。在单因素逻辑回归分析中，梗死体积以及脑萎缩指数在缺血性卒中后6个月内的任何时间点与任何PSF领域的风险均无显著相关性。另一方面，研究发现，皮质下梗死与卒中发作后1个月及以后仅与身体活动相关的PSF领域（身体PSF、活动相关PSF）风险增加之间存在可靠关联，幕下梗死与卒中后3个月及以后整体PSF领域风险之间也存在可靠关联。此外，研究还揭示了卒中发作后3个月及以后白质病变严重程度与精神PSF风险之间存在显著的直接关联。皮质下梗死可能是身体PSF领域发展的危险因素，幕下梗死是整体PSF领域发展的危险因素，白质疏松扩展是精神PSF领域发展的危险因素，但不早于卒中发生后1个月。
