Study on fatigue symptoms after acute stroke based on voxel lesion mapping
Objective To determine the relationship between functional brain damage and post-stroke fatigue(PSF)in pa-tients with acute stroke.Methods The clinical data of patients with the first-ever acute ischemic stroke admitted to the First Affiliat-ed Hospital of the University of Science and Technology of China(Anhui Provincial Hospital)from January 2019 to June 2022 were retrospectively analyzed.Post-stroke fatigue was scored using the Fatigue Severity Scale.All participants were evaluated by three se-nior neurologists.All patients underwent a 3.0T magnetic resonance whole brain scan,including diffusion-weighted imaging.The cere-bral infarction lesion area was manually delineated,and the corre-sponding image template was made.Voxel-based lesion symptom map-ping(VLSM)was used to investigate the relationship between lesion location and the occurrence and severity of PSF.The same analysis was performed by flipping the contralateral lesion,and multivariate lo-gistic regression analysis was used to verify the correlation between functional brain damage and PSF.Results Among 361 patients with acute stroke,142(39.3％)patients were diagnosed with fatigue in the acute phase,and 116(35.8％)patients were diagnosed with fa-tigue 6 months after stroke.VLSM analysis showed that clustered le-sions in the right thalamus were significantly associated with the occurrence and severity of PSF at 6-month follow-up(P＜0.05).In con-trast to contralateral lesion inversion analysis,no significant clustering of disease was found during the acute phase of stroke.The re-sults of the flip analysis were not statistically significant(P=0.311).Multivariable logistic regression confirmed that right thalamic le-sion burden(OR=2.67,95％CI 1.46-4.88)was an independent predictor of 6-month PSF.Conclusion Right thalamic lesions in-crease the risk of poststroke fatigue symptoms 6 months after stroke.
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