title: Exploratory Cohort Study of Associations between Serum C - Reactive Protein and Fatigue after Stroke.
abstract: OBJECTIVE
  Post-stroke fatigue is a common and distressing problem but little is known about its biological mechanisms. This cohort study was to investigate associations between C-reactive protein (CRP) and fatigue after stroke.
  
  
  METHODS
  Patients were assessed at one, six and 12 months after their stroke onset, with the Fatigue Assessment Scale, a case definition of post-stroke fatigue, Hospital Anxiety and Depression Scale, and daily step counts. Blood samples were collected at each assessment and the CRP level was determined by a standard CRP immunoassay. Cross-sectional associations between CRP and fatigue at each time point were determined by Pearson correlation coefficient and independent-samples t-test. Whether CRP levels at one month predict fatigue scores at six and 12 months was explored by multiple linear regression, with anxiety, depression, and daily step counts as covariates.
  
  
  RESULTS
  Sixty-five patients (mean age 67 years, 65% men) were included: 61 at one month, 49 at six months, and 41 at 12 months. CRP levels and fatigue scores were not associated at one month (p = 0.88) or 12 months (p = 0.56), but weakly associated at six months (r = 0.27, p = 0.04); however, this association was no longer significant (p = 0.14) after controlling for the effects of covariates. The CRP level was not associated with the fulfilment of case definition of post-stroke fatigue at any time points (all p > 0.05). The CRP level at one month was not a significant predictor for fatigue levels at either six months (p = 0.93) or 12 months (p = 0.78).
  
  
  CONCLUSIONS
  There is insufficient evidence for the association between CRP and PSF in stroke patients. Future studies with larger sample sizes and controlling for potential confounders are needed to investigate whether this association exists.
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.|Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Simiao
authors.initials: S
authors.lastname: Wu
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Duncan
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Niall H
authors.initials: NH
authors.lastname: Anderson
authors.affiliation: Sobell Department of Motor Neuroscience, University of College London, London, United Kingdom.
authors.forename: Annapoorna
authors.initials: A
authors.lastname: Kuppuswamy
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Macloed
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Mead
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005221:Fatigue / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood*
chemical_list: D002097:C-Reactive Protein