title: Subcortical white matter infarcts predict 1-year outcome of fatigue in stroke.
abstract: BACKGROUND
  Fatigue is common in stroke survivors. Lesion location may influence the risk of poststroke fatigue (PSF) but it is uncertain whether location has an impact on the prognosis of PSF. This study examined the association between PSF outcome and infarct location.
  
  
  METHODS
  The study sample comprised 435 Chinese patients with acute ischemic stroke admitted to the acute stroke unit of a university affiliated regional hospital in Hong Kong. Three and fifteen months after the onset of the index stroke a research assistant administered the Fatigue Severity Scale (FSS). PSF was defined as a FSS score of 4.0 or above. Of the 139 patients with PSF three months poststroke, 97 (69.8%) attended the 15-month follow-up, when 50 (51.5%) patients still had PSF ('non-remitters') and 47 (48.5%) did not report fatigue ('remitters'). The presence and location of infarcts were evaluated with magnetic resonance imaging.
  
  
  RESULTS
  In comparison with the remitters, the non-remitters were more likely to have subcortical white matter infarcts (40.0% vs 21.3%, p = 0.046). These infarcts remained an independent predictor of non-remission of PSF in the multivariate analysis, with an odds ratio of 4.208 (p = 0.011).
  
  
  CONCLUSIONS
  The results suggest that subcortical white matter infarcts may influence the outcome of PSF. Further investigations are needed to explore whether infarcts have any impact on the response of PSF to pharmacological or psychological interventions.
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China. tangwk@cuhk.edu.hk.|Department of Psychiatry, Shatin Hospital, Shatin, NT, Hong Kong, SAR, China. tangwk@cuhk.edu.hk.
authors.forename: Wai Kwong
authors.initials: WK
authors.lastname: Tang
authors.affiliation: Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong, PR China. davis78@cuhk.edu.hk.
authors.forename: Yang Kun
authors.initials: YK
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China. hedy.huajunliang@gmail.com.
authors.forename: Hua Jun
authors.initials: HJ
authors.lastname: Liang
authors.affiliation: Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, SAR, China. winnie@med.cuhk.edu.hk.
authors.forename: Winnie Chiu Wing
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China. vctmok@cuhk.edu.hk.
authors.forename: Vincent Chung Tony
authors.initials: VC
authors.lastname: Mok
authors.affiliation: The University of Notre Dame Australia/Marian Centre, Perth, Australia. sungvari@e.cuhk.edu.hk.|School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia. sungvari@e.cuhk.edu.hk.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China. ks-wong@cuhk.edu.hk.
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology*; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D020521:Stroke / Q000150:complications / Q000473:pathology*; D066127:White Matter / Q000473:pathology*