Chronic post-stroke fatigue: It may no longer be about the stroke itself.


OBJECTIVE:Post-stroke fatigue (PSF) is a debilitating complication of stroke recovery. Contributing risk factors, whether they are modifiable, and if they change over time remain understudied. We determine factors associated with PSF and how they evolve from the subacute through chronic phases of recovery. PATIENTS AND METHODS:A consecutive series of patients presenting to our comprehensive stroke center with acute stroke were seen in follow-up within 6 months of infarct and administered the Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale to evaluate for PSF. It was re-administered >6 months post-infarct. Demographics, stroke characteristics (NIH Stroke Scale [NIHSS], infarct size and location), medical comorbidities, and outcomes (modified Rankin Scale [mRS]) were also recorded. Regression analyses were used to determine factors associated with FACIT scores and PSF at each time point. RESULTS:203 patients were administered the FACIT a mean 1.6 months post-stroke; 128 underwent re-administration (mean 13.9 months post-event). In adjusted models, stroke severity (follow-up NIHSS [p < 0.001], mRS [p = 0.005]) and posterior circulation localization (p = 0.012) were associated with lower FACIT scores (increased fatigue) in the subacute setting, while medical comorbidities (hypertension [p = 0.024], obstructive sleep apnea [p = 0.020]) and medication use (anticonvulsants [p = 0.021]) were associated with lower scores chronically. Baseline depression (p < 0.001, p = 0.029) was associated with lower scores at both time points. CONCLUSION:Early PSF appears to be largely attributable to stroke severity, while chronic fatigue occurs in the setting of medical comorbidities and medication use. This has significant clinical implications when considering management strategies at different stages of recovery.


Clin Neurol Neurosurg


Chen K,Marsh EB




Has Abstract


2018-11-01 00:00:00












  • Association of early inflammatory parameters after subarachnoid hemorrhage with functional outcome: A prospective cohort study.

    abstract:OBJECTIVE:Early brain injury after aneurysmal subarachnoid hemorrhage (aSAH) comprises a pronounced neuroinflammatory reaction. Nevertheless, its relevance for functional outcome and its role as outcome predictor remains uncertain. We evaluated the relationship of various early inflammatory parameters regarding functio...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Höllig A,Remmel D,Stoffel-Wagner B,Schubert GA,Coburn M,Clusmann H

    更新日期:2015-11-01 00:00:00

  • Sensibility testing after nerve grafting.

    abstract::This study attempts to establish which sensitivity test is to be preferred for final assessment of recovery of sensibility after nerve grafting. For this purpose seven sensibility tests were performed on patients who had been treated by median nerve transplantation. The findings revealed that the stereognosis test is ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Keunen RW,Slooff AC

    更新日期:1983-01-01 00:00:00

  • Hospital and demographic characteristics associated with inpatient neurological services in the United States.

    abstract:OBJECTIVE:To determine nationwide availability and factors associated with inpatient neurological services. PATIENTS AND METHODS:Using the 2011 American Hospital Association survey, we determined the proportion of hospitals that provided inpatient neurological services. Demographic and household data from the 2010 nat...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Fu KA,Razmara A,Cen SY,Towfighi A,Mack WJ,Sanossian N

    更新日期:2018-01-01 00:00:00

  • CT perfusion-guided versus time-guided mechanical recanalization in acute ischemic stroke patients.

    abstract:OBJECTIVE:Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke (AIS) patients. METHODS:A review was conducted on 132 patients, ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Chalouhi N,Ghobrial G,Tjoumakaris S,Dumont AS,Gonzalez LF,Witte S,Davanzo J,Starke RM,Randazzo C,Flanders AE,Hasan D,Chitale R,Rosenwasser R,Jabbour P

    更新日期:2013-12-01 00:00:00

  • Anatomical evaluation of the vertebral artery (V2) and its influence in cervical spine surgery.

    abstract:OBJECTIVE:The aim of this study was to quantitatively evaluate the surgical anatomy of the vertebral artery and the sub-axial spine to assess their influence on cervical spine surgery. PATIENTS AND METHODS:Retrospective data was evaluated from a total of 275 three-dimensional head and neck CT-angiograms. Vertebral art...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Lee HJ,Kim JH,Kim IS,Hong JT

    更新日期:2018-11-01 00:00:00

  • Trigeminal schwannomas: a report of 42 cases and review of the relevant surgical approaches.

    abstract::This study aims to achieve the complete removal of trigeminal schwannoma (TS) while preserving cranial nerve function. We focused on the outcomes of different surgical approaches and address the contributions of different operative techniques. Forty-two TS cases, treated surgically in Qilu Hospital during a 12-year pe...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Zhang L,Yang Y,Xu S,Wang J,Liu Y,Zhu S

    更新日期:2009-04-01 00:00:00

  • Electroencephalographic abnormalities in homocystinuria due to cystathionine synthase deficiency.

    abstract::Nineteen homocystinuric patients--13 children and 6 adults--were identified in the course of a selective screening for homocystinuria due to cystathionine synthase deficiency. Treatment with high doses (300-1200 mg/day) of pyridoxine was carried out in 17 patients, of whom 15 were completely responsive. In 10 patients...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Del Giudice E,Striano S,Andria G

    更新日期:1983-01-01 00:00:00

  • Indication-based analysis of patient outcomes following deep brain stimulation surgery.

    abstract:BACKGROUND:While considered a safe operation, deep brain stimulation (DBS) has been associated with various morbidities. We assessed differences in postsurgical complication rates in patients undergoing the most common types of neurostimulation surgery. METHODS:The National Readmission Database (NRD) was queried to id...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Tafreshi AR,Shahrestani S,Lien BV,Ransom S,Brown NJ,Ransom RC,Ballatori AM,Ton A,Chen XT,Sahyouni R,Lee B

    更新日期:2021-01-01 00:00:00

  • Successful treatment for giant pituitary adenomas through diverse transcranial approaches in a series of 15 consecutive patients.

    abstract:OBJECT:Giant pituitary adenomas (GPAs) remain a therapeutic challenge with high mortality and morbidity. We described our experience in a consecutive series of GPAs with extensive suprasellar extension. METHODS:A series of 15 consecutive patients with maximum dimension of more than 4cm was enrolled in present study. T...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Guo F,Song L,Bai J,Zhao P,Sun H,Liu X,Yang B,Wang S

    更新日期:2012-09-01 00:00:00

  • Clinical characteristics of headache or facial pain prior to the development of acute herpes zoster of the head.

    abstract:OBJECTIVES:When physicians encounter patients with headache or facial pain (preeruptive pain) associated with acute herpes zoster of the head, especially before the appearance of characteristic skin eruptions (preeruptive phase), they typically find it difficult to make clinical impressions and apply appropriate diagno...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Lee HL,Yeo M,Choi GH,Lee JY,Kim JS,Shin DI,Lee SS,Lee SH

    更新日期:2017-01-01 00:00:00

  • Early decompressive surgery after combined intra-venous thrombolysis and endovascular stroke treatment.

    abstract:BACKGROUND AND PURPOSE:The prognosis of malignant middle cerebral artery infarctions (MCA) is poor. The poor prognosis is attributable to the severe cerebral edema that causes a brain herniation and death. Decompressive surgery reduces mortality and may further improve patient outcomes. However, the safety and effectiv...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Ozdemir O,Ozbek Z,Vural M,Durmaz R,Cosan E,Arslantas A,Atasoy MA

    更新日期:2014-07-01 00:00:00

  • Intracerebral cyst associated with meningioma.

    abstract::A 27-year-old male had experienced an episode of severe headache and nausea, sometimes accompanied by an inability to name objects. Magnetic resonance imaging showed a huge cyst within the left temporal lobe and a high degree of brain shift by it. A small round mass, which appeared to be a mural nodule, was located in...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Ueno Y,Tanaka A,Nakayama Y,Nomoto Y

    更新日期:1999-12-01 00:00:00

  • Magnetic resonance imaging of idiopathic carpal tunnel syndrome: correlation with clinical findings and electrophysiological investigation.

    abstract:OBJECTIVE:To compare clinical evaluation, electrophysiological investigation and magnetic resonance findings in assessing the severity of idiopathic carpal tunnel syndrome. PATIENTS AND METHODS:Seventy-four patients with idiopathic carpal tunnel syndrome were prospectively recruited. Clinical evaluation included sympt...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Martins RS,Siqueira MG,Simplício H,Agapito D,Medeiros M

    更新日期:2008-01-01 00:00:00

  • Combined approaches to the skull base for intracranial extension of tumors via perineural spread can improve patient outcomes.

    abstract::Many neoplasms of the head and neck extend centripetally, gaining access to the central nervous system via nerves through the skull base foramina. Often patients with perineural spread have been excluded from aggressive interventions given the overall poor prognosis and technical difficulty when addressing the perineu...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Palejwala SK,Barry JY,Rodriguez CN,Parikh CA,Goldstein SA,Lemole GM Jr

    更新日期:2016-11-01 00:00:00

  • Treatment of ruptured internal carotid artery trunk aneurysms: feasibility of endovascular trapping or proximal obliteration of the ICA.

    abstract:OBJECTIVE:Ruptured aneurysms arising from non-branching sites of the internal carotid artery (ICA) are often difficult to treat by neck clipping or endosaccular coiling. We discuss the feasibility of simple endovascular ICA ligation or trapping to treat aneurysms. METHODS:Data from eleven patients were retrospectively...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Hoya K,Tanaka Y,Uchida T,Takano I,Nagaishi M,Kowata K,Hyodo A,Yoshimoto Y

    更新日期:2011-05-01 00:00:00

  • Elevated expression of Notch-1 and EGFR induced apoptosis in glioblastoma multiforme patients.

    abstract:OBJECTIVE:The Notch signaling pathway has been well recognized as important adjuster in glioma tumorigenesis and could regulate the glioma cell proliferation through downstream factors such as epidermal growth factor receptor (EGFR). Our current study was aim to investigate the clinical association between Notch-1 gene...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Xing ZY,Sun LG,Guo WJ

    更新日期:2015-04-01 00:00:00

  • Cysticercosis mimicking brain tumor: the role of albendazole as a diagnostic tool.

    abstract::We report a patient with seizures and a single ringlike enhancing lesion on MRI that resembled a low-grade glioma. The patient received a diagnostic trial with albendazole on the assumption that this lesion could be a cysticercus. Follow-up showed resolution of the brain lesion in 4 weeks. Albendazole administration t...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Del Brutto OH,Quintero LA

    更新日期:1995-08-01 00:00:00

  • Culture positive tuberculous meningitis: clinical indicators of poor prognosis.

    abstract::Few studies have evaluated culture positive tuberculous meningitis (TBM) as a group. We evaluated certain clinical factors in culture positive TBM which could be associated with a poorer outcome. Out of 40 consecutive TBM patients seen over a period of 4 years in a tertiary referral hospital, 18 culture positive and n...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Tan EK,Chee MW,Chan LL,Lee YL

    更新日期:1999-09-01 00:00:00

  • An investigation on the effect of improved X-rays-guided radiofrequency thermocoagulation denervation on lumbar facet joint syndrome.

    abstract:OBJECTIVES:This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS). PATIENTS AND METHODS:Eighty LFJS patients were randomly assigned into two groups: the denervatio...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Zhou Q,Zhou F,Wang L,Liu K

    更新日期:2016-09-01 00:00:00

  • Coiling of the vertebral artery presenting with neuralgic pain.

    abstract::A rare case of radicular pain in the arm due to compression of the C6 nerve root by coiling of the vertebral artery is reported; the diagnosis was confirmed by computed tomography (CT), magnetic resonance (MR) angiography and echocolordoppler. Although the enlargement of an intervertebral foramen by a tortuous vertebr...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Maiuri F,Iaconetta G,Gallicchio B,Briganti F

    更新日期:1997-02-01 00:00:00

  • Hemorrhage rates of external ventricular drain (EVD), intracranial pressure gauge (ICP) or combined EVD and ICP gauge placement within 48 h of endovascular coil embolization of cerebral aneurysms.

    abstract:OBJECT:In single patients with a cerebral aneurysm an external ventricular drain (EVD), an intracranial pressure (ICP) gauge or a combined EVD and ICP gauge placement is necessary after coil embolization and initiation of postprocedural anticoagulation. The aim of this study was to examine the hemorrhage rates of drain...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Scholz C,Hubbe U,Deininger M,Deininger MH

    更新日期:2013-08-01 00:00:00

  • The role of diffusion tensor imaging and dynamic susceptibility perfusion MRI in the evaluation of meningioma grade and subtype.

    abstract:PURPOSE:We prospectively investigated the relationship between diffusion tensor imaging (DTI), dynamic susceptibility perfusion (DSP) MRI metrics and grade, subtype and Ki-67 labelling index of meningiomas. MATERIALS AND ΜETHODS: Thirty-nine patients operated for meningioma were included in the study. DTI and DSP were ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Zikou A,Alexiou GA,Goussia A,Kosta P,Xydis V,Voulgaris S,Kyritsis AP,Argyropoulou MI

    更新日期:2016-07-01 00:00:00

  • Molecular and clinical prognostic factors for favorable outcome following surgical resection of adult intramedullary spinal cord astrocytomas.

    abstract:OBJECTIVE:Intramedullary spinal cord astrocytomas are uncommon but important entities. Aggressive surgical resection is believed to be critical to prevent subsequent neurological deterioration; however, the prognostic significance of numerous patient and molecular variables remains unclear. We sought to investigate the...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Xiao R,Abdullah KG,Miller JA,Lubelski D,Steinmetz MP,Shin JH,Krishnaney AA,Mroz TE,Benzel EC

    更新日期:2016-05-01 00:00:00

  • Can vascular risk factors influence number and size of cerebral metastases? A 3D-MRI study in patients with different tumor entities.

    abstract:OBJECTIVE:There is increasing evidence that cerebral microangiopathy reduces number of brain metastases. Aim of this study was to analyse if vascular risk factors (arterial hypertension, diabetes mellitus, smoking, and hypercholesterolemia) or the presence of peripheral arterial occlusive disease (PAOD) can have an imp...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Nagel S,Berk BA,Kortmann RD,Hoffmann KT,Seidel C

    更新日期:2018-02-01 00:00:00

  • Socioeconomic and demographic disparities of moyamoya disease in the United States.

    abstract:OBJECTIVES:Although stroke incidence is inversely associated with socioeconomic status, whether similar disparities exist with moyamoya disease (MMD) is unknown. Determining the socioeconomic and demographic factors involved in MMD will provide better direction in elucidating the etiology or addressing healthcare inequ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Ghaffari-Rafi A,Ghaffari-Rafi S,Leon-Rojas J

    更新日期:2020-05-01 00:00:00

  • Intradural tumors of the cauda equina: a single institution review of clinical characteristics.

    abstract::A retrospective review of 106 cases of intradural tumors of the cauda equina are presented, subdivided into 5 groups according to their histological characteristics. For each group the clinical course and long-term postoperative results were analyzed: it emerged that differential diagnosis between neurinomas, meningio...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Cervoni L,Celli P,Cantore G,Fortuna A

    更新日期:1995-02-01 00:00:00

  • Cavernous malformations isolated from cranial nerves: Unexpected diagnosis?

    abstract:OBJECTIVES:Cranial nerves (CN) cavernous malformations (CMs) are lesions that are isolated from the CNs. The authors present three cases of CN CMs, for which MR was demonstrated to be critical for management, and surgical resection produced good outcomes for the patients. Surgical removal is the recommended course of a...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,评审


    authors: Rotondo M,Natale M,D'Avanzo R,Pascale M,Scuotto A

    更新日期:2014-11-01 00:00:00

  • Distribution characteristics of sweat gland nerve fibres in normal humans identified by acetylcholinesterase histochemical staining.

    abstract:OBJECTIVE:To quantitatively analyze distribution characteristics of sweat gland nerve fibres (SGNF) in normal Chinese individuals for obtaining a reference for early diagnosis of peripheral neuropathy. PATIENTS AND METHODS:Skin biopsy samples were collected from 192 normal Chinese individuals and divided into six, fou...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Ling L,Liu Y,Sun Y,Cai Y,Jiang Y,Chen L,He L,Xue J

    更新日期:2020-02-01 00:00:00

  • Neostigmine-induced fasciculations--a useful diagnostic test?

    abstract::Previous studies have concluded that provocation of fasciculations by neostigmine indicates a lesion of lower motor neurones. We performed 20 control experiments in 18 healthy volunteers. Ten subjects received an intramuscular injection of 1.0 mg neostigmine per 60 kg body weight. All showed fasciculations, most profu...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Heijnsbroek GJ,van Gijn J

    更新日期:1983-01-01 00:00:00

  • A single institutional outcome analysis of Gamma Knife radiosurgery for single or multiple brain metastases.

    abstract::Although Gamma Knife stereotactic radiosurgery (SRS) is widely used for metastatic brain tumors, optimal patient selection and treatment strategy continue to be investigated. The aim of this study was to provide treatment results with Gamma Knife SRS and to establish prognostic factors. Of the 54 patients treated from...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章


    authors: Nakagawa K,Tago M,Terahara A,Aoki Y,Sasaki T,Kurita H,Shin M,Kawamoto S,Kirino T,Otomo K

    更新日期:2000-12-01 00:00:00