Influence of Medication on Fatigue Six Months after Stroke

Ponchel, Amélie; Labreuche, Julien; Bombois, Stéphanie; Delmaire, Christine; Bordet, Régis; Hénon, Hilde

doi:10.1155/2016/2410921

Cited by 21 publications

(21 citation statements)

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“…Our results support the feasibility and clinical utility of the MoCA within the first week after stroke despite practical challenges. 20,21 The MoCA has retained validity even the first days after stroke, 12,13 takes <10 minutes to complete, 46 and is feasible in the majority of patients with stroke. 12,13 It has high sensitivity for mild cognitive impairment in stroke patients, 11 is especially sensitive to executive deficits that are common in vascular cognitive impairment, 10 and better reflects underlying vascular pathology than the widely used Mini-Mental State Examination.…”

Section: Discussionmentioning

confidence: 99%

“…Details of the study designs have previously been described. 19,20 In brief, we recruited adult patients presenting with an acute stroke defined by a focal neurologic deficit in combination with a corresponding infarct on brain MRI. We excluded patients with a diagnosis of dementia or a summed score of >64 in the short version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), 21 known diseases of the CNS other than stroke, a condition interfering with follow-up such as end-stage malignancy, or missing language skills.…”

Section: Methodsmentioning

confidence: 99%

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Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke

et al. 2018

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ObjectiveTo examine whether the Montreal Cognitive Assessment (MoCA) administered within 7 days after stroke predicts long-term cognitive impairment, functional impairment, and mortality.MethodsMoCA was administered to 274 patients from 2 prospective hospital-based cohort studies in Germany (n = 125) and France (n = 149). Cognitive and functional outcomes were assessed at 6, 12, and 36 months after stroke by comprehensive neuropsychological testing, the Clinical Dementia Rating (CDR) scale, the modified Rankin Scale (mRS), and Instrumental Activities of Daily Living (IADL) and analyzed with generalized estimating equations. All-cause mortality was investigated by Cox proportional hazard models. Analyses were adjusted for demographic variables, education, vascular risk factors, premorbid cognitive status, and NIH Stroke Scale scores. The additive predictive value of MoCA was examined with receiver operating characteristic curves.ResultsIn pooled analyses, a baseline MoCA score <26 was associated with cognitive impairment, defined by neuropsychological testing (odds ratio [OR] 5.30, 95% confidence interval [CI] 2.75–10.22) and by CDR score ≥0.5 (OR 2.53, 95% CI 1.53–4.18); functional impairment, defined by mRS score >2 (OR 5.03, 95% CI 2.20–11.51) and by IADL score <8 (OR 2.48, 95% CI 1.40–4.38); and mortality (hazard ratio 7.24, 95% CI 1.99–26.35) across the 3-year follow-up. Patients with MoCA score <26 performed worse across all prespecified cognitive domains (executive function/attention, memory, language, visuospatial ability). MoCA increased the area under the curve for predicting cognitive impairment (neuropsychological testing 0.81 vs 0.72, p = 0.01) and functional impairment (mRS score >2, 0.88 vs 0.84, p = 0.047).ConclusionEarly cognitive testing by MoCA predicts long-term cognitive outcome, functional outcome, and mortality after stroke. Our results support routine use of the MoCA in stroke patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke

et al. 2018

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“…Twelve studies assessed anxiety within the first 2 weeks post-stroke (26-28, 35, 39-41, 46, 47, 52, 53, 59), 17 studies between 2 weeks and 3 months poststroke (7, 14, 29-32, 36, 37, 42, 44, 45, 49-51, 54, 55, 60) and 8 studies assessed between 3 months and 1 year post-stroke (33,34,38,43,48,(56)(57)(58).…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

Anxiety after stroke: A systematic review and meta-analysis

Rafsten¹,

Danielsson²,

Sunnerhagen³

2018

J Rehabil Med

181

120

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“…В останні роки доведено, що ПІВ не є однорідним явищем, її етіопатогенетичні особливості залежать від часу виникнення після ГПМК та термінів подальшого існування [4]. З іншого боку, серед можливих факторів ризику ПІВ, з досить суперечливими даними, розглядаються побічні ефекти фармакотерапії [4,5,6]. Зокрема, нами показано (робота в друці), що поліфармакотерапія під час стаціонарного лікування в гос-трому періоді ГПМК прямо асоціюється з ризиком персистування ПІВ протягом наступного року.…”

Section: постинсультная усталость и особенности амбулаторной фармакотunclassified

“…У питанні ж «бета-адреноблокатори -ПІВ» наявні достатньо суперечливі літературні дані. В двох роботах виявлені закономірності між прийомом бета-адреноблокаторів та інтенсивністю ПІВ: пацієнти з ПІВ мали тенденцію до більш частого прийому бета-адреноблокаторів через 6 місяців після ішемічного інсульту (р = 0,086) [6], прийом бета-адреноблокаторів асоціювався зі збільшенням інтенсивності ПІВ через 6 місяців та пізніше після розвитку ГПМК [4], однак, в обох дослідженнях, після врахування інших чинників (демографічних, клінічних, тощо) ці закономірності повністю нівелювалися. В ще одній роботі не було знайдено взагалі будь-яких асоціацій між прийомом бета-адреноблокаторів та ПІВ [16].…”

Section: постинсультная усталость и особенности амбулаторной фармакотunclassified

Post-Stroke Fatigue and Ambulatory Pharmacotherapy After Acute Cerebrovascular Events

Delva

2019

EUMJ

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Introduction. Post-stroke fatigue (PSF) is a common complication of acute cerebrovascular events (ACE) that occurs in about 50% of patients within the first post-stroke year. It is well-known that PSF has multiple negative influences on post-stroke rehabilitation, life quality, mortality rates and so on. Purpose: find possible associations between ambulatory pharmacotherapy since hospital discharge and regularities of PSF onset and PSF clinical course within the first year after ACE occurrence. Material and methods. The study included 318 patients with ACE (217 had ischemic strokes, 39hemorrhagic strokes and 62transient ischemic attacks). Exclusion criteria were major medical illness that could cause secondary fatigue (oncological, hematological diseases, cardiac, liver, kidney and respiratory insufficiency, progressive angina pectoris, acute myocardial infarction), alcohol abuse, consciousness impairments, insufficient cognitive ability (Mini-Mental State Examination scores less than 24), depressive and anxious disorders (Hospital Anxiety and Depression Scale scores more than 10 for both pathologies), impaired speech function to participate (severe dysphasia or dysarthria), impaired language or written ability to complete the study questionnaires, severe functional disabilities (modified Rankin scale scores ≥ 4). Patients' characteristics were evaluated at definite time points: in 1, 3, 6, 9 and 12 months after ACE occurrence. PSF and its components were measured by three self-report questionnaires: fatigue assessment scale (FAS), fatigue severity scale (FSS) and multidimensional fatigue inventory-20 (MFI-20). PSF characteristics included time of occurrence, time of disappearance, duration, intensity. Characteristics of hospital pharmacotherapy (groups of used drugs, number of drugs prescribed for patient) were analyzed using a special algorithm. Results and discussion. There were no associations between any drug group prescriptions as well as between number of used drugs and PSF characteristics (rates and intensities) according to all used scales within the whole one-year observation period. There were no association between the number of used drugs and number of new PSF cases that were diagnosed in 1 month and in 3 months after ACE occurrence. Also, we didn't find any significant correlation between number of used drugs and risk of PSF prolongation during one year observation period. None of the drug groups (with the exception of beta-blockers) was associated with a significant change of PSF intensity during the first post-stroke year. Finally, betablockers usage during the first post-stroke year was associated with statistically significant increase of PSF intensity (according to FAS) in 1, 3

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Influence of Medication on Fatigue Six Months after Stroke

Cited by 21 publications

References 61 publications

Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke

Early MoCA predicts long-term cognitive and functional outcome and mortality after stroke

Anxiety after stroke: A systematic review and meta-analysis

Post-Stroke Fatigue and Ambulatory Pharmacotherapy After Acute Cerebrovascular Events

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