Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 34,245 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
Will your competent? doctor and hospital ensure research is completed to determine WHAT WILL CURE POST STROKE FATIGUE? Not manage or anything less than a FULL CURE!
This prediction crapola is COMPLETELY FUCKING USELESS!
Let's see how long everyone in stroke has been incompetent at this problem!
1. Department of Neurology, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan, China
2. Department of Neurology, The Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan, China
Abstract
Background and purpose:
Post-stroke fatigue (PSF) is a common and disabling complication after stroke, yet its pathophysiological mechanisms remain unclear and reliable prediction tools are lacking. This study aimed to identify risk factors for PSF and develop a visualized nomogram for early prediction based on clinical and laboratory data.
Methods:
We conducted a retrospective cohort study of stroke patients hospitalized in the Department of Neurology at the First Affiliated Hospital of Chongqing Medical University were randomly split into training (n = 592) and internal validation (n = 254) sets. An independent cohort of 440 patients from Nanchong Central Hospital was used as the external validation cohort. Fatigue was assessed at week 4 after admission using the Fatigue Severity Scale (FSS) and Fatigue Assessment Scale (FAS). Demographic, clinical, imaging, and laboratory data were collected. LASSO regression was used for variable selection, followed by multivariate logistic regression to construct a nomogram. Model performance was assessed using the area under the curve (AUC), calibration curves, and decision curve analysis (DCA), with internal and external validation via bootstrapping.
Results:
A total of 846 stroke patients were enrolled and randomly split into training (n = 592), internal validation (n = 254) and external validation (n = 440) sets. Eight independent predictors of PSF were identified: brainstem, basal ganglia, and thalamic lesions, female sex, older age, modified Rankin Scale (mRS) score, white blood cell (WBC) count, and C-reactive protein (CRP) level (all p < 0.05). The nomogram showed good discrimination (AUC: 0.870, 0.862, and 0.672 for training, internal, and external validation sets, respectively), calibration, and clinical utility.
Conclusion:
We developed a clinically applicable nomogram based on routinely available data for early prediction of PSF. The model demonstrated good accuracy and may aid in identifying high-risk patients to guide timely intervention.
What is your doctor's EXACT PRESCRIPTION TO PREVENT POST STROKE FATIGUE? Doesn't have one? That is complete fucking incompetence! Your doctor has known of the problem since medical school and HAS DONE NOTHING!
There are a number of reasons you might be feeling fatigued lately—poor sleep, stress, an active toddler perhaps? But one sneaky culprit behind fatigue you may not have considered is a mineral deficiency.
Namely, not getting enough magnesium is associated with a host of undesirable side effects. Here's what to know.
How a magnesium deficiency can contribute to fatigue
Magnesium is an essential mineral that helps keep our bodies functioning at their best, and when you aren't getting enough of it, you'll definitely notice a difference (even if you don't realize it's the lack of magnesium behind your symptoms).
As registered dietitian nutritionist, Natalie Butler, RDN, L.D., previously wrote for mindbodygreen, fatigue and exhaustion are generalized symptoms of a magnesium deficiency. "You may attribute your tiredness to stress, poor sleep, or a host of other reasons and not realize just how much nutrition is playing a role," she says, adding, "This is because magnesium is required for the production of energy. If the body has inadequate access to magnesium, then energy production suffers, leaving you prone to fatigue."
To that end, chronic inflammation is associated with fatigue as well, furthering the importance of making sure your magnesium levels are adequate to keep both inflammation and fatigue in check.
What to do about it
If you think you could be deficient in magnesium, the only way to know for sure is to test your levels with either a blood or urine sample.
But as Butler explains, "While you'll need formal testing to know if you're clinically deficient, you can also add more magnesium-rich foods to your diet or try a magnesium supplement to see if your symptoms improve." After all, she notes, research on chronic fatigue syndrome2 has indicated that magnesium actually provides nutritional support to combat fatigue.
Fatigue is certainly no fun, especially when you can't figure out why you're feeling exhausted. If that sounds all too familiar, including more magnesium in your routine could be the missing link you're looking for.
WHAT FUCKING STUPIDITY! We've known of post stroke fatigue a long time. SOLVE THE FUCKING PROBLEM! Instead of this waste of time. And your mentors and senior researchers were so incompetent, they didn't know of all this earlier research?
This did absolutely nothing to help survivors recover. I'd fire the mentors and senior researchers involved! A lot of dead wood needs to be removed in stroke so we can actually get around to solving stroke to 100% recovery!
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
Background: Effective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors.
Method: A comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health’s quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes.
Results: Chronic PSF was found to have significant negative correlations with mobility (meta r = −0.106, p < 0.001), balance performance (meta r = −0.172; 95%; p = 0.004), and quality of life (meta r = −0.647; p < 0.001). It also showed significant positive correlations with stroke impairment (meta r = 0.144, p < 0.001) and disability (meta r = 0.480, p < 0.001). Additionally, exertion/acute PSF had significantly negative correlations with walking economy (meta r = −0.627, p < 0.001) and walking endurance (meta r = −0.421, p = 0.022). The certainty of evidence was deemed moderate for these relationships.
Conclusion: Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlle
Conclusion: Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlled trials, are warranted to substantiate our findings.
There are few reported studies on post-stroke fatigue (PSF) in young and middle-aged stroke patients, however, PSF plays a key role in the patient’s disease regression. Exploring the level of PSF and the influencing factors in young and middle-aged stroke patients is crucial for determining how to reduce the level of PSF and improve the patients’ motivation for rehabilitation treatment. Therefore, this study investigated the level of PSF in young and middle-aged stroke patients and analyzed the factors influencing PSF to provide a reference or basis for healthcare professionals to develop effective and targeted PSF intervention programs. The purpose of this study was to investigate the incidence of fatigue and its related influencing factors in young and middle-aged stroke patients. A total of 300 young and middle-aged stroke patients hospitalized in the Neurology Department of a tertiary hospital in Xi’an, China, from June 13 to December 31, 2024 were consecutively recruited by convenience sampling method. According to the Fatigue Severity scale (FSS), the patients were divided into a fatigue group (FSS ≥ 36 points, 187 cases) and a non-fatigue group (FSS < 36 points, 113 cases). The general situation questionnaire, Modified Rankin Scale (mRS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and Stroke Specific Quality of Life Scale (SS-QOL), Chronic Disease Self-efficacy Scale (CDSES) were used to investigate and study them. A logistic regression model was established and stratified analysis was conducted to explore the factors influencing PSF in young and middle-aged patients. The incidence of PSF among 300 young and middle-aged stroke patients was 62.3%, Univariate analysis showed that Pre-Stroke Fatigue (PrSF), mRS score, SAS score, SDS score, PSQI score, SS-QOL score, CDSES score, marital status and occupation were related to PSF (P < 0.05). Multivariate regression analysis revealed that marital status (OR = 8.908, 95%CI 1.776–44.674), PrSF( OR = 2.909, 95%CI 1.555–5.443), SDS score (OR = 1.099, 95%CI 1.046–1.154) and SS-QOL score (OR = 0.985, 95%CI 0.972–0.998) were associated with the occurrence of PSF. Stratified analysis showed that in the group of patients with PrSF, Be married (OR = 0.438, 95%CI 0.046–4.203), SDS score (OR = 1.052, 95%CI 0.965–1.146), SS-QOL score (OR = 0.960, 95%CI 0.937–0.984), among which the SS-QOL score was associated with the risk of PSF (P < 0.001); In the group of patients without PrSF, SDS score (OR = 1.086, 95%CI 1.033–1.142) was associated with a high risk of PSF (P < 0.001), Be married (OR = 0.060, 95% CI 0.007–0.490) and SS-QOL score (OR = 0.984, 95% CI 0.974–0.995) were associated with a low risk of PSF (P < 0.05). The fatigue status of young and middle-aged stroke patients is more serious. Clinically, we should strengthen the protection of high-risk patients with the above risk factors, and corresponding intervention programs should be formulated in time to reduce the incidence of PSF, alleviate the fatigue symptoms of patients, and enhance their quality of life.
Trial registration: Registration number of China Clinical Trials Registration Center ChiCTR2500099037.
With your massive brain fatigue post stroke will your competent? doctor get testing going in stroke patients to provide a protocol to cure the fatigue?
Summary: A new study reveals how the brain responds
to mental exhaustion, identifying two key regions—the right insula and
the dorsolateral prefrontal cortex—that become more active as cognitive
fatigue builds. Using functional MRI, researchers observed how
volunteers responded to demanding memory tasks and how their willingness
to continue changed based on internal fatigue and external rewards.
The
more mentally drained participants felt, the more activity these brain
regions showed—yet higher financial incentives still pushed them to keep
going. These insights could help guide treatments for fatigue-related
conditions like depression and PTSD by offering a measurable, biological
view of mental effort.
Key Facts:
Fatigue Circuits Identified: The right insula and dorsolateral prefrontal cortex show heightened activity during cognitive fatigue.
Effort vs. Incentive: Higher monetary rewards increased participants’ willingness to exert mental effort, even when fatigued.
Clinical Potential: Findings may inform treatments for mental exhaustion in PTSD, depression, and related conditions.
Source: Johns Hopkins Medicine
In
experiments with healthy volunteers undergoing functional MRI imaging,
scientists have found increased activity in two areas of the brain that
work together to react to, and possibly regulate, the brain when it’s
“feeling” tired and either quits or continues exerting mental effort.
The experiments, designed to help detect various aspects of brain
fatigue, may provide a way for physicians to better evaluate and treat
people who experience overwhelming mental exhaustion, including those
with depression and post-traumatic stress disorder (PTSD), the
scientists say.
The
tests of their working memory, which took place while undergoing
subsequent MRI scans of their brains, included looking at a series of
letters, in sequence, on a screen and recalling the position of certain
letters. Credit: Neuroscience News
A report on the NIH-funded study was published online June 11 in the Journal of Neuroscience, detailing results on 18 female and 10 male healthy adult volunteers given tasks to exercise their memory.
“Our
lab focuses on how [our minds] generate value for effort,” says Vikram
Chib, Ph.D., associate professor of biomedical engineering at the Johns
Hopkins University School of Medicine and a research scientist at
Kennedy Krieger Institute.
“We understand less about the biology
of cognitive tasks, including memory and recall, than we do about
physical tasks, even though both involve a lot of effort.” Anecdotally,
Chib says, scientists know cognitive tasks are tiring, and relatively
less about why and how such fatigue develops and plays out in the
brain.
The 28 study participants, who ranged in age from 21 to
29, were paid $50 to participate in the study, and were told they could
receive additional payments based on their performance and choices. All
participants received a baseline MRI scan before the experiments began.
The
tests of their working memory, which took place while undergoing
subsequent MRI scans of their brains, included looking at a series of
letters, in sequence, on a screen and recalling the position of certain
letters. The farther back a letter was in the series of letters, the
harder it was to recall its position, increasing the cognitive effort
expended.
The participants were given feedback on their
performance after each test and opportunities to receive increasing
payments ($1–$8) with more difficult recall exercises. The participants
also were asked before and after each test to self-rate their level of
cognitive fatigue.
Overall, the test results found increased
activity and connectivity in two brain areas when participants reported
cognitive fatigue: the right insula, an area deep in the brain that has
been associated with feelings of fatigue, and the dorsal lateral
prefrontal cortex, areas on both sides of the brain that control working
memory.
For each participant, activity in both brain locations
during cognitive fatigue increased by more than twice the level of
baseline measurements taken before starting the tests.
“Our
study was designed to induce cognitive fatigue and see how people’s
choices to exert effort change when they feel fatigue, as well as
identify locations in the brain where these decisions are made,” says
Chib.
Notably, Chib and his research team members Grace Steward and Vivian
Looi found that the financial incentives need to be high in order for
participants to exert increased cognitive effort, suggesting that
external incentives prompt such effort.
“That outcome wasn’t
entirely surprising, given our previous work finding the same need for
incentives in spurring physical effort,” says Chib.
“The two
areas of the brain may be working together to decide to avoid more
cognitive effort unless there are more incentives offered. However,
there may be a discrepancy between perceptions in cognitive fatigue and
what the human brain is actually capable of doing,” says Chib.
Fatigue is linked with many neurological conditions, including PTSD and depression, says Chib.
“Now
that we’ve likely identified some of the neural circuits for cognitive
effort in healthy people, we need to look at how fatigue manifests in
the brains of people with these conditions,” he adds.
Chib says
it may be possible to use medication or cognitive behavior therapy to
combat cognitive fatigue, and the current study using decision tasks and
functional MRI could be a framework for objectively classifying
cognitive fatigue.
Functional MRI uses blood flow to measure
broad areas of activity in the brain; however, it does not directly
measure neuron activation, nor more subtle nuances in brain activity.
“This
study was performed in an MRI scanner and with very specific cognitive
tasks. It will be important to see how these results generalize to other
cognitive effort and real-world tasks,” says Chib.
Funding: Funding for the research was provided by the National Institutes of Health (R01HD097619, R01MH119086).
About this neuroscience research news
Author: Vanessa Wasta Source: Johns Hopkins University Contact: Vanessa Wasta – Johns Hopkins University Image: The image is credited to Neuroscience News
Introduction Post-stroke fatigue (PSF) is highly prevalent and lacks of effective management. Recent evidence suggest the use of transcranial direct current stimulation (tDCS) to reduce PSF. However, the effect was not lasting and the working mechanisms was unclear. The purpose of this study is to determine the behavioral and neurophysiolog- ical effects of five daily sessions of tDCS on PSF.
Methods and analysis
This will be a double-blind randomized controlled trial targeting an enrollment of 32 participants with subacute-chronic stroke and significant fatigue (average Fatigue Severity Scale (FSS) > 4). Participants will be equally randomized to either anodal tDCS or sham tDCS groups. The anodal tDCS group will receive 20 minutes of 2-mA anodal tDCS applied to the ipsilesional primary motor cortex (M1) for five consecu- tive days. The sham tDCS group will receive the same protocol except there will be to randomization), immediately after the intervention, and at one-month follow-up. The primary behavioral outcome will be the FSS and the primary neurophysiological outcome will be an input-output curve of motor cortex excitability derived using tran- scranial magnetic stimulation. Secondary behavioral outcomes will include Fatigue Scale for Motor and Cognitive Function, Visual Analog Scale-Fatigue, Borg Rating of Perceived Exertion, and Paas Mental Effort Rating Scale. Secondary neurophys- iological outcome will be the functional connectivity of the fronto-striato-thalamic network acquired using resting state functional Magnetic Resonance Imaging (MRI).PLOS One|https://doi.org/10.1371/journal.pone.0324591June 6, 20252 / 12 Repeated measure ANOVA or ANCOVA will be conducted for all outcomes to com- pare the change between groups.
Discussion
Little is known about effective treatments for PSF and the underlying mechanisms of PSF. tDCS is a promising tool to provide targeted intervention to reduce PSF. The results of this clinical trial will offer critical information for PSF management and investigation.
Trial registration This trial was registered in February 1 2024 with ClinicalTrials.gov under the registra
Jibrin S. Usman
Thomson W. L. Wong
Shamay S. M. Ng