Cognitive basis proposed for fatigue after stroke

This is closer to what I've always believed about stroke fatigue. Make sure you bring this up to your therapist/doctors when they tell you you need to exercise more to combat fatigue.
http://www.news-medical.net/news/20120917/Cognitive-basis-proposed-for-fatigue-after-stroke.aspx
Research shows that poststroke fatigue (PSF) in patients with nondisabling stroke is tied to a specific type of cognitive dysfunction.
The prospective study, published in Neurology, links impaired attentional and executive impairment, as well as depression and anxiety, to PSF. Rather than being predictive of PSF development, these types of cognitive dysfunction were associated with the presence of PSF at 6 and 12 months after stroke.
In an editorial accompanying the article, Mansur Kutlubaev (Kuvatov's Republican Clinical Hospital, Ufa, Russia) and Gillian Mead (University of Edinburgh, UK) say that it is not clear whether these cognitive deficits cause fatigue or vice versa.
But they note: "The study results are consistent with the hypothesis that a stroke lesion affecting the neural circuits involved in regulation of attention and executive function may contribute to the development of tiredness and aversion to effort, and subsequently to the development of the behavioral phenomenon of fatigue."
 Rest at the link.