1
|
Röttgering JG, Taylor JW, Brie M, Luks T, Hervey-Jumper SL, Phan S, Bracci PM, Smith E, De Witt Hamer PC, Douw L, Weyer-Jamora C, Klein M. Understanding the association between fatigue and neurocognitive functioning in patients with glioma: A cross-sectional multinational study. Neurooncol Pract 2024; 11:284-295. [PMID: 38737609 PMCID: PMC11085845 DOI: 10.1093/nop/npae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Fatigue and neurocognitive impairment are highly prevalent in patients with glioma, significantly impacting health-related quality of life. Despite the presumed association between these two factors, evidence remains sparse. Therefore, we aimed to investigate this relationship using multinational data. Methods We analyzed data on self-reported fatigue and neurocognitive outcomes from postoperative patients with glioma from the University of California San Francisco (n = 100, UCSF) and Amsterdam University Medical Center (n = 127, Amsterdam UMC). We used multiple linear regression models to assess associations between fatigue and seven (sub)domains of neurocognitive functioning and latent profile analysis to identify distinct patterns of fatigue and neurocognitive functioning. Results UCSF patients were older (median age 49 vs. 43 years, P = .002), had a higher proportion of grade 4 tumors (32% vs. 18%, P = .03), and had more neurocognitive deficits (P = .01). While the number of clinically fatigued patients was similar between sites (64% vs. 58%, P = .12), fatigue and the number of impaired neurocognitive domains were not correlated (P = .16-.72). At UCSF, neurocognitive domains were not related to fatigue, and at Amsterdam UMC attention and semantic fluency explained only 4-7% of variance in fatigue. Across institutions, we identified four distinct patterns of neurocognitive functioning, which were not consistently associated with fatigue. Conclusions Although individual patients might experience both fatigue and neurocognitive impairment, the relationship between the two is weak. Consequently, both fatigue and neurocognitive functioning should be independently assessed and treated with targeted therapies.
Collapse
Affiliation(s)
- Jantine G Röttgering
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, The Netherlands
| | - Jennie W Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Melissa Brie
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, California, USA
| | - Tracy Luks
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Shawn L Hervey-Jumper
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Stephanie Phan
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Ellen Smith
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Philip C De Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Neurosurgery, Amsterdam, The Netherlands
| | - Linda Douw
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam, The Netherlands
| | - Christina Weyer-Jamora
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Department of Psychiatry, Zuckerberg San Francisco General Hospital, California, USA
| | - Martin Klein
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, The Netherlands
| |
Collapse
|
2
|
Zeng H, Yang J, Wu J, Ding Y, Yuan S, Wang R, Zhao W, Zeng X. The impact of post-stroke fatigue on inpatient rehabilitation outcomes: An observational study. PLoS One 2024; 19:e0302574. [PMID: 38820361 PMCID: PMC11142535 DOI: 10.1371/journal.pone.0302574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/08/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Post-stroke fatigue is a typical complication following stroke. However, existing research primarily focused on its underlying mechanisms, and its impact on rehabilitation outcomes has yet to be uncovered. OBJECTIVE This study aims to explore the impact of post-stroke fatigue on rehabilitation outcomes during hospitalization. METHOD This was a prospective multicenter observational study including 46 stroke patients receiving comprehensive rehabilitation treatment. Patients' basic information was recorded upon admission and patients' functional independence was assessed with Functional Independence Measure (FIM) both upon admission and discharge. One week after rehabilitation treatment, fatigue, positivity in daily activity, attention, and memory were assessed. Serum biochemical indicators and levels of C-reactive protein (CRP) were assessed weekly following admission. The pain scores were assessed during the first week of hospitalization to calculate the average. Correlation analysis, linear regression and propensity score matching (PSM) were used to analyze the impact of fatigue on FIM scores at discharge and length of hospital stay. RESULT The proportion of patients with low fatigue was 39.13% and significant improvement was revealed in FIM scores upon admissions and discharge [(50.67±18.61) vs. (75.13±21.04), P<0.05]. Positivity in daily activity, attention, and age are factors that influence post-stroke fatigue. After PSM, low-fatigue group (Fatigue score< 3) showed significant higher motor function independence at discharge [(54.39 ± 15.42) vs. (41.89 ± 14.90), P<0.05] and shorter hospital stay [(28.54±9.13)d vs. (37.32 ± 9.81)d, P<0.05] than high-fatigue group. There was a significant difference (P<0.05) in level of CRP between the first inpatient week and the third week, with declining trend. CONCLUSION Post-stroke fatigue can affect the rehabilitation outcomes regarding motor function independence and length of hospital stay.
Collapse
Affiliation(s)
- Hongji Zeng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jiaying Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfa Wu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Yu Ding
- Department of Neurology, The Second Medical Center, PLA General Hospital, Beijing, China
| | - Shuya Yuan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Wang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weijia Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xi Zeng
- School of Public Health, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| |
Collapse
|
3
|
Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2024; 39:178-189. [PMID: 38278413 DOI: 10.1016/j.nrleng.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/28/2024] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
Collapse
Affiliation(s)
- A Juárez-Belaúnde
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España.
| | - E Orcajo
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Consorci Sanitari Alt Penedès-Garraf, Departmento de Neurología, Cataluña, España
| | - P Davila-Pérez
- Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Universitario Rey Juan Carlos (HURJC), Departmento de Neurofisiología Clínica, Madrid, España; Health Research Institute - Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, España
| | - N León
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Nacional para Paraplégicos (SESCAM), Grupo FENNSI, Toledo, España
| |
Collapse
|
4
|
Dillon A, Casey J, Gaskell H, Drummond A, Demeyere N, Dawes H. Is there evidence for a relationship between cognitive impairment and fatigue after acquired brain injury: a systematic review and meta-analysis. Disabil Rehabil 2023; 45:4359-4372. [PMID: 36495110 DOI: 10.1080/09638288.2022.2152503] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Fatigue is a major symptom of ABI. Greater fatigue is associated with cognitive impairment. Our aim was to systematically review, describe and analyse the literature on the extent of this relationship. METHODS Five databases were searched from inception. Studies were included where: participants had a defined clinical diagnosis of ABI which included TBI, stroke or subarachnoid haemorrhage; a fatigue measure was included; at least one objective cognitive measure was used. Three reviewers individually identified studies and determined quality using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. RESULTS Sixteen of the 412 identified studies, investigating the relationship between cognitive dysfunction and fatigue, comprising a total of 1,745 participants, were included. Quality ranged from fair to good. Meta-analysis found fatigue was significantly associated with an overall pattern of cognitive slowing on tasks of sustained attention. A narrative synthesis found weak associations with fatigue and information processing, attention, memory and executive function. CONCLUSION Analysis found sustained attentional performance had stronger associations with fatigue after ABI. Whereas, weak associations were found between fatigue and information processing, attention and to some extent memory and executive function. More focused research on specific cognitive domains is needed to understand the mechanisms of fatigue.
Collapse
Affiliation(s)
- Avril Dillon
- Department of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Jackie Casey
- Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden
| | - Helen Gaskell
- Oxford Centre for Enablement, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Nele Demeyere
- Department of Experimental Psychology, Cognitive Neuropsychology Centre, University of Oxford, Oxford, UK
| | - Helen Dawes
- Exeter BRC, Exeter, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| |
Collapse
|
5
|
Bhimani R, Xiong J, Anderson L. Fatigue Experiences in People With Stroke. Rehabil Nurs 2023; 48:200-208. [PMID: 37733016 DOI: 10.1097/rnj.0000000000000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE Fatigue is a major symptom in patients with stroke. Because fatigue is an overarching multidimensional phenomenon, it is important to understand how the characteristics of fatigue change over time. The purpose of this study was to explore how fatigue characteristics change over time in patients with stroke. DESIGN This study used a mixed-method observational design. METHODS This study is a secondary analysis of data from a previous study, the results of which indicated fatigue to be a prominent symptom. Participants in that study were patients with stroke who met eligibility criteria and provided informed consent. This secondary analysis used data from numeric rating scale scores for fatigue, Functional Assessment of Chronic Illness Therapy-Fatigue Scale scores, fatigue descriptors, and participant comments about fatigue gleaned from transcribed interviews. RESULTS Twenty-two patients participated in the study. Thirteen characteristics of fatigue were evaluated. Seven characteristics showed significant improvement ( p < .05) from admission to 1 month follow-up, and six characteristics did not change significantly. CONCLUSIONS Fatigue experiences vary over time and have both physical and mental aspects to them. CLINICAL RELEVANCE TO REHABILITATION NURSING Nurses may consider providing a quiet environment for physical rest, which may allow the brain to not be distracted by multiple stimuli.
Collapse
Affiliation(s)
- Rozina Bhimani
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Jiayue Xiong
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Lisa Anderson
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
6
|
Lohaus T, Witt J, Schürmeyer A, Wolf OT, Thoma P. Fatigue and its relation to general cognition, social cognition and social activity in multiple sclerosis and stroke. Cogn Neuropsychiatry 2023; 28:165-180. [PMID: 36782396 DOI: 10.1080/13546805.2023.2178399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
INTRODUCTION The relationship between fatigue and (socio-)cognitive deficits in neurological diseases has sparked increasing research interest in the past years. So far, findings are inconsistent. Most studies focused on general cognitive functioning in specific disorders, particularly cancer or multiple sclerosis (MS). METHODS This study aims to examine the relationship between fatigue, social cognition and social activity, also taking into account general cognition, more closely, including a stroke patient group (n = 57), a MS patient group (n = 31) and a healthy control group (n = 20). The participants underwent a comprehensive (socio-)cognitive test battery and completed questionnaires on fatigue and psychopathology which, in addition to fatigue, can also affect (socio-)cognitive performance. RESULTS In both MS and stroke patients high fatigue scores were observed. Irrespective of aetiology, patients with high and low fatigue did not differ with regard to general cognition and social cognition. However, high fatigue scores were associated with a reduction of social activities in both patient groups. No other significant relationships were observed between fatigue and (socio-)cognitive measures. CONCLUSIONS Future studies ought to further explore the potentially complex nature of fatigue symptoms and their relationship with (socio-)cognitive performance and social activity in neurological populations.
Collapse
Affiliation(s)
- Tobias Lohaus
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Judith Witt
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Anne Schürmeyer
- Practice for Neuropsychology and Psychotherapy, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
7
|
Van Patten R, Iverson GL. Examining associations between concussion history, subjectively experienced memory problems, and general health factors in older men. Clin Neuropsychol 2023; 37:119-140. [PMID: 34668844 DOI: 10.1080/13854046.2021.1991481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Examine associations between subjective memory complaints (SMCs), concussion history, and cognitive, psychological, and physical health in older men from the general population. METHOD Participants were 504 men aged 50-79 who were recruited using an online labor market. Participants completed a survey assessing demographics, medication history, concussion history, recent memory problems, and additional aspects of recent cognitive, mental, and physical health. RESULTS Men with a lifetime history of ≥3 concussions also reported a lifetime history of being prescribed medication for anxiety (46.8%), depression (43.5%), chronic pain (79.0%), and high blood pressure (66.1%). When asked about symptoms experienced over the past year and the past week, they endorsed higher rates of cognitive and mental health problems, migraines, and difficulties with sleep and fatigue. The multivariable logistic regression model for predicting mild or greater memory problems was significant, χ2(8) = 168.97, p < .001. In unadjusted analyses, significant predictors, in order of magnitude (strongest to weakest), were fatigue (odds ratio [OR] = 3.21), back or neck pain (OR = 2.28), migraines (OR = 2.11), anxiety (OR = 2.07), depression (OR = 2.04), difficulty sleeping (OR = 1.98), and concussion history (OR = 1.49). In the multivariable model, only back or neck pain (OR = 1.51, p = .004) and fatigue (OR = 1.99, p = .004) were significant predictors. CONCLUSIONS A personal history of multiple concussions was associated with perceived memory problems, but to a lesser degree than fatigue, back or neck pain, and migraines.
Collapse
Affiliation(s)
- Ryan Van Patten
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.,Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.,Spaulding Rehabilitation Hospital, Charlestown, MA, USA.,Spaulding Research Institute, Charlestown, MA, USA.,MassGeneral Hospital for Children Sports Concussion Program, Boston, MA, USA.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
| |
Collapse
|
8
|
Kliem E, Labberton AS, Barra M, Olsen A, Thommessen B, Thomas O, Gjestad E, Indredavik B, Grambaite R. Self-reported cognitive and psychiatric symptoms at 3 months predict single-item measures of fatigue and daytime sleep 12 months after ischemic stroke. Front Neurol 2022; 13:944586. [DOI: 10.3389/fneur.2022.944586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
IntroductionPost-stroke fatigue and increased need for daytime sleep are multidimensional and insufficiently understood sequelae. Our aim was to study the relationships of self-reported cognitive and psychiatric symptoms at 3 months with fatigue and daytime sleep at 12 months post-stroke.MethodsIschemic stroke patients without reported history of dementia or depression completed postal surveys 3- and 12-months post-stroke. At 3 months, psychiatric symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS), and self-reported changes in cognitive symptoms (concentration and memory) compared to pre-stroke were assessed using single-item measures. At 12 months, single-item questions about changes in self-reported difficulties sleeping at night, fatigue and daytime sleep were included. First, we studied whether self-reported cognitive and/or psychiatric symptoms at 3 months were associated with daytime sleep and fatigue at 12 months using multiple logistic regression. Second, we fitted 2 structural equation models (SEMs) predicting fatigue and 2 models predicting daytime sleep. We compared a model where only age, sex, stroke severity (National Institutes of Health Stroke Scale; NIHSS), and difficulties sleeping at night predicted fatigue and daytime sleep at 12 months to a model where mental distress (i.e., a latent variable built of cognitive and psychiatric symptoms) was included as an additional predictor of fatigue and daytime sleep at 12 months.ResultsOf 156 patients (NIHSS within 24 hours after admission (mean ± SD) = 3.6 ± 4.3, age = 73.0 ± 10.8, 41% female) 37.9% reported increased daytime sleep and 50.0% fatigue at 12 months. Increased psychiatric symptoms and worsened cognitive symptoms were associated with fatigue and daytime sleep at 12 months, after controlling for NIHSS, age, sex, and difficulties sleeping at night. SEM models including mental distress as predictor showed adequate model fit across 3 fit measures (highest RMSEA = 0.063, lowest CFI and TLI, both 0.975). Models without mental distress were not supported.ConclusionSelf-reported cognitive and psychiatric symptoms at 3 months predict increased daytime sleep and fatigue at 12 months. This highlights the relevance of monitoring cognitive and psychiatric symptoms in the subacute phase post-stroke. However, future research using validated measures of self-reported symptoms are needed to further explore these relationships.
Collapse
|
9
|
Wild CJ, Norton L, Menon DK, Ripsman DA, Swartz RH, Owen AM. Disentangling the cognitive, physical, and mental health sequelae of COVID-19. Cell Rep Med 2022; 3:100750. [PMID: 36103880 PMCID: PMC9448696 DOI: 10.1016/j.xcrm.2022.100750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/03/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022]
Abstract
As COVID-19 cases exceed hundreds of millions globally, many survivors face cognitive challenges and prolonged symptoms. However, important questions about the cognitive effects of COVID-19 remain unresolved. In this cross-sectional online study, 478 adult volunteers who self-reported a positive test for COVID-19 (mean = 30 days since most recent test) perform significantly worse than pre-pandemic norms on cognitive measures of processing speed, reasoning, verbal, and overall performance, but not short-term memory, suggesting domain-specific deficits. Cognitive differences are even observed in participants who did not require hospitalization. Factor analysis of health- and COVID-related questionnaires reveals two clusters of symptoms—one that varies mostly with physical symptoms and illness severity, and one with mental health. Cognitive performance is positively correlated with the global measure encompassing physical symptoms, but not the one that broadly describes mental health, suggesting that the subjective experience of “long COVID” relates to physical symptoms and cognitive deficits, especially executive dysfunction. Survivors of COVID-19 exhibit cognitive differences in specific domains Speed of processing, verbal, and reasoning are affected, but not memory function Performance in affected domains is linked to physical but not mental health These effects are observed in mild and hospitalized cases of COVID-19
Collapse
Affiliation(s)
- Conor J Wild
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada; Department of Physiology and Pharmacology, Western University, London, ON N6A 3K7, Canada.
| | - Loretta Norton
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada; Department of Psychology, King's University College, Western University, London, ON N6A 3K7, Canada
| | - David K Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge CB2 2QQ, UK
| | - David A Ripsman
- Faculty of Medicine, Department of Neurology, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Richard H Swartz
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Adrian M Owen
- Western Institute for Neuroscience, Western University, London, ON N6A 3K7, Canada; Department of Physiology and Pharmacology, Western University, London, ON N6A 3K7, Canada; Department of Psychology, Western University, London, ON N6A 3K7, Canada
| |
Collapse
|
10
|
Dornonville de la Cour FL, Bærentzen MB, Forchhammer B, Tibæk S, Norup A. Reducing fatigue following acquired brain injury: A feasibility study of high intensity interval training for young adults. Dev Neurorehabil 2022; 25:349-360. [PMID: 35343359 DOI: 10.1080/17518423.2022.2052374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim was to evaluate feasibility of high-intensity interval training (HIIT) in fatigued adults (20-40 years old) with acquired brain injury (ABI). A prospective pre-post single-arm intervention trial was conducted, including 6-8 months follow-up assessment and interview. Intervention was 18 sessions of intermittent exercise on a cycle ergometer over six weeks. Six out of ten participants without motor impairments completed the intervention (all females, mean age = 30.2 years, months post-injury = 22). On average, participants attended 88% of sessions and achieved high intensity (93% of max heart rate). VO2max improved by 0.53 l/min (SD = 0.29), and participants continued exercising post-intervention. All participants were satisfied with HIIT, were more inclined to exercise, and reported positive effects of exercising for self-management of fatigue. Three sessions a week were demanding to some participants. Findings support feasibility of HIIT as a promising intervention for young adults with post-ABI fatigue.
Collapse
Affiliation(s)
| | | | | | - Sigrid Tibæk
- Department of Occupation Therapy and Physiotherapy, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
11
|
Smetheram T, Amiama ME, Hébert D, Law G, Dawson DR. Occupational Therapy Interventions for Poststroke Fatigue: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:182-188. [DOI: 10.1177/15394492221087968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Fatigue after stroke can negatively affect the survivors’ well-being. Despite the high prevalence and consequences of poststroke fatigue (PSF), there is no specific guidance for occupational therapy practitioners (OTPs) to address this symptom. Objectives: The objectives of the study were to identify and describe the research on potential occupational therapy (OT) interventions for PSF. Method: Three databases were searched using scoping review methodology. Two authors completed a title and abstract and full-text review. Study characteristics, participant characteristics, qualities of interventions, and outcome measures were extracted and synthesized. Results: Eight studies met selection criteria. Studies were conducted with stroke and traumatic brain injury patients in outpatient, inpatient, and community settings. Interventions included psychoeducation and behavior change, multicomponent programs, and mindfulness-based stress reduction therapies. The Fatigue Severity Scale and the Mental Fatigue Scale were commonly used. Conclusion: Evidence for OT interventions targeting PSF is limited. Recommendations for future research are provided.
Collapse
Affiliation(s)
| | | | | | - Geoff Law
- University Health Network, Toronto, Ontario, Canada
| | - Deirdre R. Dawson
- University of Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
| |
Collapse
|
12
|
Redwine LS, Hong S, Kohn J, Martinez C, Hurwitz BE, Pung MA, Wilson K, Pruitt C, Greenberg BH, Mills PJ. Systemic Inflammation and Cognitive Decrements in Patients With Stage B Heart Failure. Psychosom Med 2022; 84:133-140. [PMID: 34654027 DOI: 10.1097/psy.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the role of systemic inflammation in reduced cognitive functioning in patients with early-stage heart failure (HF) while determining associations with other cardiovascular risk factors. METHODS Patients with stage B HF (n = 270; mean [standard deviation] age = 66.1 [10.1] years) were examined cross-sectionally for relationships among cardiovascular disease (CVD) and psychological risk factors, C-reactive protein (CRP), and Montreal Cognitive Assessment (MoCA) scores. A subsample (n = 83) at high risk for stage C HF (B-type natriuretic peptide levels ≥65 pg/ml) were followed up for 12 months for relationships between CRP levels and cognitive function. RESULTS Baseline smoking (χ2 = 6.33), unmarried (χ2 = 12.0), hypertension (χ2 = 5.72), greater body mass index (d = 0.45), and physical fatigue (d = 0.25) were related to higher CRP levels (p values < .05). Cross-sectionally, CRP levels were negatively related to MoCA scores, beyond CVD (ΔR2 = 0.022, β = -0.170, p < .010) and psychological risk factors (ΔR2 = 0.016, β = 0.145, p < .027), and related to mild cognitive impairment criteria (odds ratio = 1.35, 95% confidence interval [CI] = 1.00-1.81, p = .046). Across 12 months, B-type natriuretic peptide high-risk patients with CRP levels ≥3 mg/L had lower MoCA scores (23.6; 95% CI = 22.4-24.8) than did patients with CRP levels <3 mg/L (25.4; 95% CI = 24.4-26.5; p = .024). CONCLUSIONS Patients with stage B HF and heightened CRP levels had greater cognitive impairment at baseline and follow-up, independent of CVD and potentially psychological risk factors. Low-grade systemic inflammation may be one mechanism involved in cognitive dysfunction at early stages of HF.
Collapse
Affiliation(s)
- Laura S Redwine
- From the College of Behavioral and Community Sciences (Redwine), University of South Florida, Tampa, Florida; Departments of Psychiatry (Hong, Kohn) and Family Medicine and Public Health (Hong, Kohn, Pung, Pruitt, Mills), University of California School of Medicine, San Diego, California; Division of Cardiology (Martinez), University of Miami Miller School of Medicine; Behavioral Medicine Research Center (Hurwitz), University of Miami, Miami; Department of Psychology (Hurwitz), University of Miami, Coral Gables; Division of Endocrinology, Diabetes and Metabolism (Hurwitz), Miller School of Medicine, University of Miami, Miami, Florida; Department of Medicine (Greenberg), University of California School of Medicine, San Diego, California; and Department of Public Health Sciences (Redwine), University of Miami Miller School of Medicine, Miami, Florida
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Pulyk O, Hyryavets M, Studeniak T. POSTSTROKE FATIGUE AND MOTOR RECOVERY AFTER ISCHEMIC STROKE. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1328-1330. [PMID: 35758453 DOI: 10.36740/wlek202205218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To determine the effect of post-stroke fatigue on the motor recovery after ischemic stroke. PATIENTS AND METHODS Materials and methods: The study was conducted on the basis of the department of vascular neurology of the Uzhhorod Central City Clinical Hospital during the six months of 2020. We examined 92 patients who suffered a hemispheric ischemic stroke in the early recovery period. RESULTS Results: At the end of therapy, improvement of motor function was observed in patients in both groups. We received a significant improvement(p<0,05) in the patients of the main group on the SSS and 6-point scale of muscle strength. We found that a high score on the FAS showed a significant correlation with the worst dynamics of recovery on the NIHSS, Scandinavian scale of stroke and 6-point scale of muscle strength (p <0,05). CONCLUSION Conclusions: According to the results of the study, it was found that the presence of post-stroke fatigue significantly impairs the improvement of motor functions in patients with hemispheric ischemic stroke, patients who had more severe fatigue had worse recovery rates after stroke.
Collapse
|
14
|
Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2021:S0213-4853(21)00111-0. [PMID: 34538507 DOI: 10.1016/j.nrl.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/05/2023] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
Collapse
Affiliation(s)
- A Juárez-Belaúnde
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España.
| | - E Orcajo
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - P Davila-Pérez
- Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España
| | - N León
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España; Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España; Grupo FENNSI, Hospital Nacional de Parapléjicos, SESCAM, Toledo, España
| |
Collapse
|
15
|
Gu M, Xiao L, Wang J, Cai Q, Liu Y, Xu P, Liu Y, Huang X, Hu W, Sun W. Obesity and Poststroke Fatigue: A 2-Year Longitudinal Study. Neurol Ther 2021; 10:955-969. [PMID: 34436757 PMCID: PMC8571443 DOI: 10.1007/s40120-021-00276-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Obesity is associated with fatigue in many diseases, but the correlation between obesity and poststroke fatigue (PSF) is unclear. The study aimed to investigate the relationship between body mass index (BMI) and the occurrence of and recovery from PSF. Methods Within 3 days of the onset of ischemic stroke, patients were consecutively recruited. We assessed PSF at admission and at 6, 12, and 24 months with the Fatigue Severity Scale (FSS). Multivariable logistic regression and restricted cubic spline function were used to explore the relationships between baseline BMI and the risk of PSF at different time points. The correlation between baseline BMI and the dynamic changes in the natural logarithm transformation of the FSS (lnFSS) score during the follow-up period was analyzed by the piecewise linear mixed-effects model. Results A total of 1026 stroke patients were included. Multivariable analyses indicated that obesity was associated with a decreased risk of early PSF (fatigue diagnosed at baseline) [odds ratio (OR) 0.61, 95% confidence interval (CI) 0.41–0.93] but an increased risk of late PSF (fatigue diagnosed 6 months after the index stroke) (OR 1.63, 95% CI 1.06–2.50 for 6 months; OR 1.87, 95% CI 1.18–2.96 for 12 months; OR 2.11, 95% CI 1.28–3.49 for 24 months). Longitudinal analyses indicated that in the late stage of fatigue, the higher the BMI category, the slower the rate of decrease was for the FSS score. Conclusion Obese patients are less likely to develop fatigue in the acute stage of ischemic stroke. However, they are more prone to late fatigue and exhibit a slower decline in the FSS score in the long term. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00276-x.
Collapse
Affiliation(s)
- Mengmeng Gu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lulu Xiao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiankun Cai
- Department of Neurology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yujing Liu
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Pengfei Xu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yuanlu Liu
- Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, China
| | - Xianjun Huang
- Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui Province, China
| | - Wei Hu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Wen Sun
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| |
Collapse
|
16
|
Zhang X, Fang H, Ma D, Duan Y, Wang Z, Zhang N, Wang C. Risk Factors and Imaging Mechanisms of Fatigue After Mild Ischemic Stroke: An Exploratory Study From a Single Chinese Center. Front Neurol 2021; 12:649021. [PMID: 34113307 PMCID: PMC8185271 DOI: 10.3389/fneur.2021.649021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the biochemical risk factors and imaging mechanisms of post fatigue after mild ischemic stroke among a Chinese population. Methods: Forty consecutive patients with mild ischemic stroke within onset of 14 ± 2 days were enrolled between March and June 2018. The clinical information, scale data, biomarkers in peripheral venous blood, and imaging data during hospitalization and follow-up period were collected. Results: Patient age (range 34-78) was positively correlated with the prevalence of fatigue (p = 0.009). Both blood norepinephrine and serotonin levels during hospitalization were negatively correlated to the prevalence of post-stroke fatigue (model 1 p = 0.009 and model 2 P = 0.043, respectively). Infarct of right cerebral hemisphere is positively correlated with the occurrence of fatigue after mild ischemic stroke (p = 0.020). Compared to non-fatigue patients, amplitude of low-frequency fluctuation (ALFF) was lower in several areas of brain in stroke patients with fatigue, including the right orbital inferior frontal, right inner orbital frontal, right frontal, right triangular frontal inferior, right anterior and lateral cingulate, and right medial frontal gyruses. Analysis of the difference in functional connectivity between the fatigue and non-fatigue groups found no cluster. Conclusions: Frontal lobe-related neural pathways may play an essential role in the regulation of fatigue after mild ischemic stroke. Abnormal neural circuits may reduce the levels of neurotransmitters such as serotonin and norepinephrine and lead to post-stroke fatigue.
Collapse
Affiliation(s)
- Xiaoxiao Zhang
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ding Ma
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhaozhao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunxue Wang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| |
Collapse
|
17
|
Brief Psychosocial Intervention to Address Poststroke Depression May Also Benefit Fatigue and Sleep-Wake Disturbance. Rehabil Nurs 2021; 46:222-231. [PMID: 33443981 DOI: 10.1097/rnj.0000000000000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine if brief psychosocial/behavioral therapy directed to reduce poststroke depression would decrease fatigue and improve sleep-wake disturbance. DESIGN A preplanned secondary data analysis from a completed clinical trial was conducted. METHODS One hundred participants received usual care, in-person intervention, or telephone intervention. Depression, fatigue, and sleep-wake disturbance were measured at entry, 8 weeks, 21 weeks, and 12 months following the intervention. FINDINGS Fatigue (within: p = .042, between: p = .394), sleep disturbance (within: p = .024, between: p = .102), and wake disturbance (within: p = .004, between: p = .508) decreased over the 12 months in the intervention groups, but not in the control group. This difference was clinically meaningful for wake disturbance and approached the clinically important difference for fatigue. CONCLUSIONS/CLINICAL RELEVANCE Reduction in wake disturbance was consistent with clinically meaningful difference standards for patient-reported outcomes, warranting further research in larger samples.
Collapse
|
18
|
Almhdawi KA, Jaber HB, Khalil HW, Kanaan SF, Shyyab AA, Mansour ZM, Alazrai AH. Post-stroke fatigue level is significantly associated with mental health component of health-related quality of life: a cross-sectional study. Qual Life Res 2021; 30:1165-1172. [PMID: 33387289 DOI: 10.1007/s11136-020-02714-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE Individuals post-stroke might have high levels of post-stroke fatigue (PSF) which might affect their quality of life. This study aimed to investigate the prevalence of post-stroke fatigue in Jordan and to comprehensively identify its possible associated factors. METHODS A cross-sectional design was implemented through one-hour face-to-face assessment sessions. The modified fatigue impact scale, 12-item Short-Form Health Survey, Montreal Cognitive Assessment, Motor Assessment Log, Upper Extremity Fugl Meyer assessment, Nine Hole Peg Test, 10 Meter Walk Testing, active and passive goniometry, Hand-held dynamometry, and modified Ashworth scale were used as outcome measures. Prevalence of post-stroke fatigue and levels of quality of life were reported using descriptive analyses. Multiple variable linear regression analysis was used to identify PSF associated factors of post-stroke fatigue. P < 0.05 was considered significant for all statistical tests. RESULTS 153 individuals with stroke participated in the study. A total of 117 participants (69.9%, 95% CI = 62.0-77.1%) were fatigued. Fatigue was significantly predicted by mental component of quality of life (β -0.42 [95% CI -0.53--0.31]; p < 0.001), cognition (β -0.69 [95% CI -1.08--0.29], p = 0.001), weekly sport hours (β -0.94 [95% CI -1.73--0.14], p = 0.022), and shoulder abduction spasticity (β -1.81 [95% CI -3.38--0.24], p = 0.024. The model explained 51% of the variation in the fatigue (F = 29.006, p < 0.001). CONCLUSION Jordanian individuals with stroke have a high prevalence of fatigue. Mental related quality of life was significantly associated with PSF levels. Other factors significantly associated with PSF included cognition status, sport participation, and spasticity. Healthcare practitioners working in neurorehabilitation should take PSF and its significant correlates into consideration when treating individuals with stroke.
Collapse
Affiliation(s)
- Khader A Almhdawi
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.
| | - Hanan B Jaber
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan W Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam F Kanaan
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Awni A Shyyab
- Department of Neurology, King Hussein Centre, Amman, Jordan
| | - Zaid M Mansour
- Department of Physical and Occupational Therapy, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Alza H Alazrai
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
19
|
Ulrichsen KM, Alnaes D, Kolskår KK, Richard G, Sanders AM, Dørum ES, Ihle-Hansen H, Pedersen ML, Tornås S, Nordvik JE, Westlye LT. Dissecting the cognitive phenotype of post-stroke fatigue using computerized assessment and computational modeling of sustained attention. Eur J Neurosci 2020; 52:3828-3845. [PMID: 32530498 DOI: 10.1111/ejn.14861] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/18/2022]
Abstract
Post-stroke fatigue (PSF) is prevalent among stroke patients, but its mechanisms are poorly understood. Many patients with PSF experience cognitive difficulties, but studies aiming to identify cognitive correlates of PSF have been largely inconclusive. With the aim of characterizing the relationship between subjective fatigue and attentional function, we collected behavioral data using the attention network test (ANT) and self-reported fatigue scores using the fatigue severity scale (FSS) from 53 stroke patients. In order to evaluate the utility and added value of computational modeling for delineating specific underpinnings of response time (RT) distributions, we fitted a hierarchical drift diffusion model (hDDM) to the ANT data. Results revealed a relationship between fatigue and RT distributions. Specifically, there was a positive interaction between FSS score and elapsed time on RT. Group analyses suggested that patients without PSF increased speed during the course of the session, while patients with PSF did not. In line with the conventional analyses based on observed RT, the best fitting hDD model identified an interaction between elapsed time and fatigue on non-decision time, suggesting an increase in time needed for stimulus encoding and response execution rather than cognitive information processing and evidence accumulation. These novel results demonstrate the significance of considering the sustained nature of effort when defining the cognitive phenotype of PSF, intuitively indicating that the cognitive phenotype of fatigue entails an increased vulnerability to sustained effort, and suggest that the use of computational approaches offers a further characterization of specific processes underlying behavioral differences.
Collapse
Affiliation(s)
- Kristine M Ulrichsen
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
| | - Dag Alnaes
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Knut K Kolskår
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
| | - Geneviève Richard
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
| | - Anne-Marthe Sanders
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
| | - Erlend S Dørum
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital HF, Nesodden, Norway
| | | | - Mads L Pedersen
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Cognitive, Linguistic & Psychological Sciences, Brown University, Providence, RI, USA
| | | | | | - Lars T Westlye
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,K.G. Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| |
Collapse
|
20
|
Poststroke Fatigue Is Related to Motor and Cognitive Performance: A Secondary Analysis. J Neurol Phys Ther 2020; 43:233-239. [PMID: 31436613 PMCID: PMC8130858 DOI: 10.1097/npt.0000000000000290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Poststroke fatigue (PSF) is a common debilitating and persistent symptom after stroke. The relationship between PSF and motor and cognitive function remains inconclusive partly due to lack of control for effects of depression and use of insensitive measures. We examined the relationship between PSF and motor and cognitive performance using a comprehensive set of behavioral measures and excluding individuals with depression. METHODS Fifty-three individuals poststroke (16 female) were included (median age: 63 years, median months poststroke: 20 months). Poststroke fatigue was quantified using the Fatigue Severity Scale (FSS) and cognitive performance was measured with the Montreal Cognitive Assessment, simple and choice reaction time (SRT and CRT) tasks. Lower extremity motor performance included Fugl-Meyer Motor Assessment, 5 times sit-to-stand test (5 × STS), Berg Balance Scale, Functional Ambulation Category, and gait speed. Upper extremity motor performance was indexed with Fugl-Meyer, grip strength, and Box and Block test. Spearman correlation and stepwise linear regression analyses were performed to examine relationships. RESULTS Two motor performance measures, Berg Balance Scale and Functional Ambulation Category, were significantly correlated with FSS (ρ = -0.31 and -0.27, respectively) while all cognitive measures were significantly correlated with FSS (ρ = -0.28 for Montreal Cognitive Assessment, 0.29 for SRT, and 0.29 for CRT). Regression analysis showed that Berg Balance Scale was the only significant determinant for FSS (R = 0.11). DISCUSSION AND CONCLUSIONS Functional gait, balance, and cognitive performance are associated with PSF. Fatigue should be considered when planning and delivering interventions for individuals with stroke. Future studies are needed to explore the potential efficacy of balance and cognitive training in PSF management.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A287).
Collapse
|
21
|
Abstract
Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1 st March 2016 and the search date (19 th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.
Collapse
Affiliation(s)
- Ghazaleh Aali
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Farhad Shokraneh
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- King's Technology Evaluation Centre (KiTEC), London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| |
Collapse
|
22
|
Abstract
Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1 st March 2016 and the search date (19 th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.
Collapse
Affiliation(s)
- Ghazaleh Aali
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Farhad Shokraneh
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- King's Technology Evaluation Centre (KiTEC), London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| |
Collapse
|
23
|
Ho LYW, Lai CKY, Ng SSM. Measuring fatigue following stroke: the Chinese version of the Fatigue Assessment Scale. Disabil Rehabil 2020; 43:3234-3241. [PMID: 32142618 DOI: 10.1080/09638288.2020.1730455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: The aim of this study was to translate and adapt the Fatigue Assessment Scale into Chinese, examine its psychometric properties, determine the levels of physical and mental fatigue, and compare the fatigue scores in stroke survivors with and without depressive symptoms.Methods: The translation was conducted according to established guidelines and psychometric properties were examined in 112 stroke survivors. Physical and mental fatigue scores and between-group difference were compared.Results: Content validity was good. Internal consistency (Cronbach's α = 0.71-0.82) and test-retest reliability (intraclass correlation coefficient = 0.77-0.95; κ = 0.38-0.83) were satisfactory. Minimal detectable change was good. The scale had two factors without ceiling and floor effects. Significant correlations were found between the Chinese version of the Fatigue Assessment Scale and the Mental Fatigue Scale (rs = 0.68), Fatigue Severity Scale (rs = 0.57), Epworth Sleepiness Scale (rs = 0.36), and Fugl-Meyer Assessment of upper (rs = 0.24) and lower extremities (rs = 0.24). Physical fatigue score was higher than mental fatigue score (12.00 vs. 10.00). Participants with depressive symptoms had higher fatigue sum, physical, and mental scores than those without.Conclusion: The Chinese version of the Fatigue Assessment Scale is reliable and valid for assessing fatigue. The level of physical fatigue was higher than that of mental fatigue. Participants with depressive symptoms had higher fatigue scores than those without.Implications for rehabilitationThe Fatigue Assessment Scale has been translated and culturally adapted into Chinese. It is reliable and valid for evaluating fatigue in stroke survivors in both clinical and research settings.The Chinese version of the Fatigue Assessment Scale significantly correlated with the Mental Fatigue Scale, Fatigue Severity Scale, Epworth Sleepiness Scale, and Fugl-Meyer Assessment of upper and lower extremities.The level of physical fatigue was higher than that of mental fatigue in community-dwelling stroke survivors so interventions could target physical fatigue.More attention should be paid to stroke survivors with depressive symptoms as their level of fatigue was higher than those without.
Collapse
Affiliation(s)
- Lily Y W Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| |
Collapse
|
24
|
Chen HJ, Wang YF, Wen J, Xu Q, Lu GM, Zhang LJ. Functional-structural relationship in large-scale brain networks of patients with end stage renal disease after kidney transplantation: A longitudinal study. Hum Brain Mapp 2020; 41:328-341. [PMID: 31571368 PMCID: PMC7268055 DOI: 10.1002/hbm.24804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
It is unclear how the brain network changed after kidney transplantation (KT). We explored the patterns of large‐scale complex network after KT in end‐stage renal disease (ESRD) patients with resting‐state functional MRI (rs‐fMRI) and diffusion tensor imaging (DTI). Twenty‐one ESRD patients (14 men; mean age, 31.5 ± 9.9 years) scheduled for KT and 17 age‐ and gender‐matched healthy controls (HC) (8 men; mean age, 28.9 ± 7.2 years) were enrolled in this study. Each participant underwent rs‐fMRI and DTI scans in three time points (pre‐KT, 1 and 6 months after KT [for ESRD]). Graph theory analysis was used to characterize the topological properties by using functional and structural network connectivities intergroup correlation analysis was performed between functional/structural MR indexes and clinical markers. Compared with HC, pre‐KT ESRD patients showed an altered topological organization in both functional and structural networks. Compared with pre‐KT, increased node degree and node efficiency were observed for both functional and structural networks at 1 month after KT (all p < .05), which were further increased at 6 months after KT (p < .05). Both functional and structural networks did not recover completely at 6 months after KT (all p < .05). The patients showed an increased functional–structural connectivity coupling at 1 month after KT compared with HC (p = .041). A trend of progressive recovery of functional and structural connectivity networks was observed in ERSD patients after KT, which did not recover to the normal levels even in 6 months after KT. The study results underlie cognitive function recovery in ESRD patients following KT in the neuropathophysiological perspective.
Collapse
Affiliation(s)
- Hui J Chen
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.,Department of Radiology, Affiliated Hainan Hospital of Hainan Medical College, Hainan General Hospital, Haikou, Hainan, P.R. China
| | - Yun F Wang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Jiqiu Wen
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Qiang Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Guang M Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Long J Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| |
Collapse
|
25
|
Riley EA, Owora A, McCleary J, Anderson A. Sleepiness, Exertion Fatigue, Arousal, and Vigilant Attention in Persons With Chronic Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1491-1508. [PMID: 31437012 DOI: 10.1044/2019_ajslp-18-0301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Individuals in the acute and chronic stages of stroke recovery often report more daytime sleepiness (Sterr, Herron, Dijk, & Ellis, 2008) and fatigue that qualitatively differs from "normal" feelings of fatigue they experienced prestroke (De Doncker, Dantzer, Ormstad, & Kuppuswamy, 2018). Speech-language pathologists frequently observe signs of fatigue in their clients with aphasia and perceive that client fatigue impedes therapeutic interventions (Riley, 2017). The current study aimed to quantify daytime sleepiness, exertion fatigue, and physiologically measured arousal and vigilant attention in persons with aphasia. Method We measured sleepiness, exertion fatigue, arousal, and vigilant attention in 10 participants with aphasia and 10 neurologically healthy adults. Daytime sleepiness was measured using the Epworth Sleepiness Scale (Johns, 1991). Exertion fatigue was measured using the Visual Analog Fatigue Scale (B. Y. Tseng, Gajewski, & Kluding, 2010) before and after a 72-min computer-administered language task. Arousal was measured using heart rate and variability (Shaffer & Ginsberg, 2017). Vigilant attention was measured using electroencephalography and subsequently classified into 1 of 4 levels of vigilant attention using a classification algorithm (Berka et al., 2004). Results Persons with aphasia did not show significant differences from controls in reported amount of daytime sleepiness, exertion fatigue, or overall physiological arousal but demonstrated different patterns of electroencephalography-measured vigilant attention and error production as compared to controls. Conclusions Although overall sleepiness, exertion fatigue, and overall arousal did not differ between groups, physiological measures of vigilant attention may be more sensitive to differences and may explain feelings of fatigue that persons with chronic aphasia experience.
Collapse
Affiliation(s)
- Ellyn A Riley
- Aphasia Lab, Department of Communication Sciences and Disorders, College of Arts and Sciences, Syracuse University, NY
| | - Arthur Owora
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington
| | - Joshua McCleary
- Aphasia Lab, Department of Communication Sciences and Disorders, College of Arts and Sciences, Syracuse University, NY
| | - Alyssa Anderson
- Aphasia Lab, Department of Communication Sciences and Disorders, College of Arts and Sciences, Syracuse University, NY
| |
Collapse
|
26
|
Graber M, Garnier L, Duloquin G, Mohr S, Guillemin S, Ramaget O, Piver A, Tainturier C, Bret-Legrand C, Delpont B, Blanc-Labarre C, Guéniat J, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. Association Between Fatigue and Cognitive Impairment at 6 Months in Patients With Ischemic Stroke Treated With Acute Revascularization Therapy. Front Neurol 2019; 10:931. [PMID: 31555198 PMCID: PMC6724763 DOI: 10.3389/fneur.2019.00931] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Fatigue is a frequent symptom after stroke. We aimed to determine the association between fatigue and cognitive performance in patients with ischemic stroke who received acute revascularization therapy (IV thrombolysis and/or mechanical thrombectomy). Methods: Seventy patients were prospectively included in the stroke unit of the University Hospital of Dijon, France. A follow-up was performed at 6 months with clinical examination, fatigue assessment by the Fatigue Severity Scale (FSS), and a comprehensive neuropsychological evaluation. Patients with fatigue (FSS score >4) were compared with patients without fatigue. Neuropsychological factors associated with fatigue at 6 months were analyzed using multivariable logistic regression models. Results: Fatigue was reported by 34.3% of patients. Patients with fatigue were older, had more frequent residual handicap, depressive symptoms, and impaired quality of life. They had more frequently low score (<26) on the MoCA scale (79.2 vs. 47.8%, OR = 4.15; 95% CI: 1.32-13, p = 0.015), memory impairment (60 vs. 30.6%, OR = 3.41; 95% CI: 1.09-10.7, p = 0.035), and executive dysfunction (65 vs. 30.8%, OR = 4.18; 95% CI: 1.33-13.1, p = 0.014). In multivariable logistic regression analysis, only memory impairment was independently associated with fatigue (OR = 5.70; 95% CI: 1.09-29.6, p = 0.039). Further analyses restricted to non-depressed patients (n = 58, 84.1%) showed in multivariable models that a score < 26 on MoCA scale (OR 5.12; 95% CI: 1.00-26.2, p = 0.05), and a memory impairment (OR = 6.17; 95% CI: 1.06-35.9, p = 0.043) were associated with fatigue. There was also a non-significant trend toward an association between divided attention deficit and fatigue (OR = 6.79; 95% CI: 0.80-57.6, p = 0.079). Conclusion: The association between fatigue and subtle cognitive impairment including memory or attention deficits could be of interest in elaborating future interventional studies to evaluate the impact of therapeutic strategies, including cognitive rehabilitation, on fatigue.
Collapse
Affiliation(s)
- Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Guillemin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Océane Ramaget
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Ariane Piver
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Cécile Tainturier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Christine Bret-Legrand
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Benoit Delpont
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Christelle Blanc-Labarre
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Julien Guéniat
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Marie Hervieu-Bègue
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Guy-Victor Osseby
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| |
Collapse
|
27
|
Affiliation(s)
- Maurizio Paciaroni
- From the Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Italy
| | - Monica Acciarresi
- From the Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Italy
| |
Collapse
|
28
|
Aarnes R, Stubberud J, Lerdal A. A literature review of factors associated with fatigue after stroke and a proposal for a framework for clinical utility. Neuropsychol Rehabil 2019; 30:1449-1476. [DOI: 10.1080/09602011.2019.1589530] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Rannveig Aarnes
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jan Stubberud
- Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Lovisenberg Diaconal Hospital, Oslo, Norway
- Faculty of Medicine, Department of Health and Society, Institute of Nursing Science, University of Oslo, Oslo, Norway
| |
Collapse
|