Abstract
Objective
The caudate nucleus may be involved in the pathogenesis of the fatigue observed in
neurological disorders. However, the significance of caudate lesions in poststroke
fatigue (PSF) is unknown. This study examined the association between caudate infarcts
and PSF.
Methods
Five hundred Chinese patients with acute ischemic stroke admitted to the acute stroke
unit of a university-affiliated regional hospital in Hong Kong participated in the
study. All participants were assessed for PSF with the Fatigue Severity Scale (FSS)
three months after their index stroke. PSF was defined as a mean FSS score of 4.0
or more. Physical functioning and depressive symptoms were measured by the Barthel
Index (BI) and the Geriatric Depression Scale (GDS).
Results
One hundred and twenty-five (25.0%) of the patients had PSF. Compared to the non-fatigue
group, the PSF patients were more likely to be women and had hyperlipidemia, lower
BI and higher GDS scores. Caudate (8.0% versus 1.3%, p=0.001) and putamen (19.2% versus 12.0%, p=0.043) acute infarcts were more common in the PSF group, whereas pons infarcts (13.6%
versus 22.2%, p=0.038) were less common. Acute caudate infarcts remained an independent predictor
of PSF in the multivariate analysis, with an odds ratio of 6.4.
Conclusions
The results suggest that patients with PSF are more likely to have caudate infarcts.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study.J Neurol Neurosurg Psychiatry. 2002; 72: 179-183
- Fatigue and basal ganglia.J Neurol Sci. 2000; 179: S34-S42
- Fatigue after stroke.Arch Phys Med Rehabil. 1999; 80: 173-178
- Fatigue after stroke: a major but neglected issue.Cerebrovasc Dis. 2001; 12: 75-81
- Experience of severe fatigue long after stroke and its relation to depressive symptoms and disease characteristics.Eur Neurol. 2001; 45: 28-33
- Decreased capacity for mental effort after single supratentorial lacunar infarct may affect performance in everyday life.J Neurol Neurosurg Psychiatry. 1998; 65: 697-702
- Consequences of mild stroke in persons <75 years—a 1-year follow-up.Cerebrovasc Dis. 2000; 16: 383-388
- Fatigue in neurological disorders.Lancet. 2004; 363: 978-988
- Poststroke fatigue: a 2-year follow-up study of stroke patients in Sweden.Stroke. 2002; 33: 1327-1333
- Sleep apnea, delirium, depressed mood, cognition, and ADL ability after stroke.J Am Geriatr Soc. 2001; 49: 391-397
- Major depression in stroke patients. A 3-year longitudinal study.Stroke. 1993; 24: 976-982
- Diffuse cerebral symptoms in convalescents from cerebral infarction and myocardial infarction.Acta Neurol Scand. 1983; 67: 348-355
- Time course and risk factors of post-stroke fatigue: a prospective cohort study.Eur J Neurol. 2011; 18: 611-617
- Biological correlates of post-stroke fatigue: a systematic review.Acta Neurol Scand. 2012; 125: 219-227
- Central and peripheral fatigue: exemplified by multiple sclerosis and myasthenia gravis.PM R. 2010; 2: 399-405
- Regional brain atrophy in primary fatigued patients with multiple sclerosis.Neuroimage. 2010; 50: 608-615
- Fatigue in Parkinson's disease is linked to striatal and limbic serotonergic dysfunction.Brain. 2010; 133: 3434-3443
- Measurements of acute cerebral infarction: a clinical examination scale.Stroke. 1989; 20: 864-870
- Reliability and validity of the Cantonese version of the mini-mental state examination: a preliminary study.Hong Kong J Psychiatry. 1994; 4: 25-28
- The triad of pain, fatigue and depression in ischemic stroke patients: the Bergen Stroke Study.Cerebrovasc Dis. 2012; 33: 461-465
- Development of the bilingual (Chinese/English) SCID-I (Structured Clinical Interview for DSM-IV Axis I disorder): a study of its reliability and validity in an in-patient population.Hong Kong College of Psychiatrist, Hong Kong2000
- The measurement of fatigue: a new instrument.J Psychosom Res. 1993; 37: 753-762
- Syndrome differentiation and treatment of post-stroke fatigue.J Pract Tradit Chin Int Med. 2008; 22: 17-19
- Functional evaluation: the Barthel Index.Md State Med J. 1965; 14: 61-65
- Validation and comparison of three brief depression scales in an elderly Chinese population.Int J Geriatr Psychiatry. 2000; 15: 824-830
- Cognitive impairment and functional outcome after stroke associated with small vessel Disease.J Neurol Neurosurg Psychiatry. 2004; 5: 560-566
- MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging.Am J Roentgenol. 1987; 149: 351-356
- The cognitive functions of the caudate nucleus.Prog Neurobiol. 2008; 86: 141-155
- Why do we have a caudate nucleus?.Acta Neurobiol Exp (Wars). 2010; 70: 95-105
- Parallel organization of functionally segregated circuits linking basal ganglia and cortex.Annu Rev Neurosci. 1986; 9: 357-381
- Basal ganglia lesions and the theory of fronto-subcortical loops: neuropsychological findings in two patients with left caudate lesions.Neurocase. 2003; 9: 70-85
- Motivation-dependent responses in the human caudate nucleus.Cereb Cortex. 2004; 14: 1022-1030
- Reward-predicting activity of dopamine and caudate neurons—a possible mechanism of motivational control of saccadic eye movement.J Neurophysiol. 2004; 91: 1013-1024
- Acute basal ganglia infarcts in poststroke fatigue: an MRI study.J Neurol Neurosurg Psychiatry. 2010; 257: 178-182
- Basal ganglia functional connectivity based on a meta-analysis of 126 positron emission tomography and functional magnetic resonance imaging publications.Cereb Cortex. 2006; 16: 1508-1521
- Repetitive transcranial magnetic stimulation of the human prefrontal cortex induces dopamine release in the caudate nucleus.J Neurosci. 2001; 21: RC157
- Lateralized and frequency-dependent effects of prefrontal rTMS on regional cerebral blood flow.Neuroimage. 2006; 31: 641-648
- Preferential loss of serotonin markers in caudate versus putamen in Parkinson's disease.Brain. 2008; 131: 120-131
- Neurobehavioral changes associated with bilateral caudate nucleus infarctions.Psychiatry Clin Neurosci. 2005; 59: 109-110
- Physiopathology of fatigue in multiple sclerosis.Neurol Sci. 2008; 29: S241-S243
- The neuroanatomy of post-polio fatigue.Arch Phys Med Rehabil. 1994; 75: 498-504
Article info
Publication history
Published online: November 12, 2012
Accepted:
October 23,
2012
Received in revised form:
October 22,
2012
Received:
September 6,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
