Association Between Fatigue and

Cognitive Impairment at 6 Months in

Patients With Ischemic Stroke
Treated With Acute Revascularization
Therapy
dr. Andi

Supervisor : Dr. dr. Suherman, Sp. S

 TABLE OF CONTENTS

01 02
BACKGROUND METHODS

03 04
RESULTS DISCUSSION

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 01
BACKGROUND

BACKGROUND
Selama 20 tahun terakhir, fokus dan tujuan mayor terapi stroke
adalah survival dan outcome motorik saja.

Konsekuensinya, ada beberapa komplikasi stroke terabaikan,

padahal sangat mempengaruhi kualitas hidup pasien pasca
stroke.
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 01
BACKGROUND

29-77% Prevalence of
fatigue after
ischemic
stroke

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 01
BACKGROUND

Fatigue….
Subjective, multidimensional
experience, perceptual, Feeling of exhaustion,
motor, emotional and weakness, and
cognitive components aversion to effort

Decrease in performance
Impossible to perform
occurs during the repetition
routine activities
of a mental or physical
activity

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 - Investigate the prevalence of
fatigue 6 months after ischemic
Aims of this stroke
- Association with cognitive
study? performances in patients who
received acute revascularization
therapy
 02
METHODS

Design Place
Prospective cohort At Stroke Unit of the
study University Hospital of
Dijon, France

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 02
METHODS

Inclusion Criterias

Received
a revascularization therapy
(intravenous thrombolysis
Patients ≥18 years, suffffered and/or mechanical
hemispheric acute thrombectomy)
ischemic stroke

Between August 2017 and

May 2018.

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 02
METHODS
Exclusion Criterias
Major co-morbidities prior
to ischemic stroke that may be previous dementia
responsible for signifificant or aphasia,
fatigue,
1 2
Modifified Rankin scale
5 4 3 Persistence of severe
score > 3
aphasia

Severe disability

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 02
METHODS

Data we collected…

Demographic Stroke severity Functional handicap Fatigue

The National Institutes of The modifified Rankin Score The Fatigue Severity
Health Stroke Scale (mRS) Scale (FSS)
(NIHSS) score.

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 02
METHODS

Data we collected…

Global pain and quality of life Sleep assessment Several cognitive domains
The
Pittsburgh Sleep Quality Index
(PSQI)

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 02

Steps of this study METHODS

 03

Results
 03
RESULTS
Prevalence of Fatigue and Patients
Characteristics

Prevalence of fatigue Quality of life Factors of fatigue

Patients with fatigue History of
Twenty four patients hypercholesterolemia, the
had worse quality
(34.3%) have fatigue presence of depressive
of life (47–67) vs (65–
(FSS score >4) symptoms on the HAD scale,
80),
. mRS score ≥2.
P = 0.0005
.

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 03
RESULTS
Neuropsychological Evaluation and
Fatigue at 6 Months

MoCA Score Memory aspect Executive dysfunction

Patients with fatigue Patients with fatigue had Impairment of either working
have a low score on the memory impairment (60 vs. memory, processing speed,
MoCA (score <26) 30.6%, p=0.035) fluency or mental flexibility (65
(79.2 vs. 47.8% p = vs. 30.8%, p= 0.014)
0.015)

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 04

Discussion
 04
DISCUSSION
Correlation of fatigue and other neuropsycological
aspects

Fatigue is correlated with residual motor disability

Primary fatigue after stroke could be linked to damage in

neural networks, particularly reticular formation and
attention network

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 Fatigue after ischemic stroke
is a frequent symptom even
in patients treated with acute
revascularization
therapies

Conclusion Could be of interest in

developing further interventional
studies to define therapeutic
strategies
THANKS

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