M.A. KUTLUBAEV^1,2, V.D. MENDELEVICH³, L.R. AKHMADEEVA²

¹Republican Clinical Hospital named after G.G. Kuvatova, 132 Dostoevskiy St., Ufa, Russian Federation, 450005

²Bashkir State Medical University, 3 Lenin St., Ufa, Russian Federation, 450000

³Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012

Kutlubaev M.A. — Cand. Med. Sc., physician of a Neurology Department, Assistant of the Department of Neurology with courses of Neurosurgery and Medical Genetics, tel. (347) 228-75-00, e-mail: mansur.kutlubaev@yahoo.com

Mendelevich V.D. — D. Med. Sc., Professor, Head of the Department of Medical and General Psychology, tel. (843) 238-60-74, e-mail: mend@tbit.ru

Akhmadeeva L.R. — D. Med. Sc., Professor at the Department of Neurology with courses of Neurosurgery and Medical Genetics, tel. (347) 272-56-64, email: la@ufaneuro.org

Within one month after stroke 227 people were examined for post-stroke fatigue phenomenon (PSF), had a comparative assessment of the frequency and correlations of PSF and similar phenomena (apathy, depression). Symptoms of PSF have been identified in 46.7% of patients, while the frequency of depression and apathy was approximately 20%. In 21% of patients PSF developed independently, in other cases — in conjunction with apathy and / or depression. Development of PSF was associated with strokes in the vertebrobasilar system, female sex, and the presence of acute or uncompensated chronic somatic pathology. Development of apathy is correlated with signs of chronic structural brain damage and depression — with the severity of neurologic deficit. Therefore, PSF is low-specific, heterogeneous phenomenon which may occur in connection with lesions of certain cerebral structures, as well as in other neuropsychiatric and somatic stroke complications. On this basis, it is proposed to divide PSF on primary, secondary and associated with abnormal fatigue.

Key words: psychoneurological disorders, fatigue, asthenia, apathy, depression, stroke.

REFERENCES

1. Kutlubaev M.A., Akhmadeeva L.R. Post-stroke fatigue. Zhurnal nevrologii i psikhiatrii, 2010, no. 110 (4), suppl. 2, pp. 60-6 (in Russ.).
2. Duncan F., Wu S., Mead G.E. Frequency and natural history of fatigue after stroke: a systematic review of longitudinal studies. J Psychosom Res. 2012, vol. 73, rr. 18-27.
3. Wu S., Barugh A., Macleod M., Mead G. Psychological associations of poststroke fatigue: a systematic review and meta-analysis. Stroke, 2014, vol. 45, rr. 1778-83.
4. Kutlubaev M.A., Duncan F.H., Mead G.E. Biological correlates of post-stroke fatigue: a systematic review. Acta Neurol Scand, 2012, vol. 125, rr. 219-27.
5. Wu S., Kutlubaev M.A., Chun H.Y.Y. et al. Interventions for post-stroke fatigue. Cochrane Database of Systematic Reviews, 2015, issue 7, art. no.: CD007030. DOI: 10.1002/14651858.CD007030.pub3.
6. Skvortsova V.I., Kontsevoy V.A., Petrova E.A., Savina M.A. Depression and paradepressivnye disorder in cerebral stroke: epidemiology, pathogenesis and risk factors. Zhurnal nevrologii i psikhiatrii, 2009, no. 109, pp. 4-10 (in Russ.).
7. Bogousslavsky J. William Feinberg lecture 2002: emotions, mood, and behavior after stroke. Stroke, 2003, vol. 34, rr. 1046-50.
8. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ, 1976, vol. 54, rr. 541-53.
9. Spilker J., Kongable G., Barch C. et al. Using the NIH Stroke Scale to assess stroke patients. The NINDS rt-PA Stroke Study Group. J Neurosci Nurs, 1997, vol. 29, rr. 384-92.
10. Rankin J Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scott Med J. 1957, vol. 2, rr. 200-15.
11. Kutlubaev M.A., Saitgraeeva A.R., Akhmadeeva L.R. Cognitive impairment in acute cerebral stroke: a comparative analysis of Mini-Mental State Examination, Montreal cognitive assessment scale and clock drawing test. Rossiyskie meditsinskie vesti, 2014, no. 2, pp. 63-7 (in Russ.).
12. De Vries J., Michielsen H., Van Heck G.L., Drent M. Measuring fatigue in sarcoidosis: the Fatigue Assessment Scale (FAS). Br J Health Psychol, 2004, vol. 9, rr. 279-91.
13. Kutlubaev M.A., Akhmadeeva L.R. Post-stroke apathy. Zhurnal nevrologii i psikhiatrii, 2012, no. 112, 4, pp. 99-102 (in Russ.).
14. Zigmond A.S., Snaith R.P. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand, 1983, vol. 67, rr. 361-370.
15. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa programm Statistica [Statistical analysis of medical data. Application software package Statistica]. Moscow: MediaSfera, 2006. 312 p.