New Research Links Mini-Strokes to Prolonged Fatigue in Patients

Persistent fatigue might be a symptom of poor sleep habits, but recent findings suggest it could also signal a lasting impact from mini-strokes.

This revelation comes from a comprehensive study conducted by researchers at Aalborg University Hospital in Denmark, published this week in the esteemed journal Neurology, which is associated with the American Academy of Neurology.

Understanding Mini-Strokes

Medically termed as transient ischemic attacks, mini-strokes are characterized by temporary interruptions of blood flow to the brain, resulting in a brief episode of symptoms. According to the Mayo Clinic, these symptoms can vary but typically do not last long, resolving within a day.

Study Overview

The Danish study revealed that individuals who have suffered a mini-stroke were significantly inclined to report extended fatigue, with effects lasting for up to a year.

Birgitte Hede Ebbesen, PT, PhD, the lead author of the study and a physiotherapist at Aalborg University Hospital, informed Fox News Digital that patients following such events reported fatigue levels similar to those who had experienced a full stroke.

Research Methodology

The study monitored 354 subjects, primarily averaging 70 years of age, who had recently endured a mini-stroke. Participants were asked to assess their fatigue across multiple domains, including overall tiredness, physical tiredness, reduced activity, diminished motivation, and mental fatigue via a structured questionnaire.

The fatigue levels were rated on a scale of 4 to 20, where 20 indicated extreme fatigue. Over time, participants reported diminishing fatigue levels: an average score of 12.3 two weeks post-event, decreasing to 11.9 at three months, 11.4 at six months, and finally reaching 11.1 after one year.

Prevalence of Fatigue

Two weeks following the mini-stroke, a startling 61% of participants indicated experiencing high fatigue levels. By three, six, and twelve months, this rate slightly declined to 54% but still revealed a significant prevalence of prolonged fatigue. Those affected also had a doubled risk of experiencing anxiety and depression.

Insights from Researchers

Ebbesen noted that clinical observations had previously identified fatigue among TIA patients, but the frequency observed in this study was unexpectedly high. Modrau further emphasized that persistent fatigue was common among participants, highlighting that if fatigue manifests within two weeks post-discharge from a hospital, it may persist for an extended period.

Implications for Patient Care

Based on the findings, researchers underscore the importance of monitoring patients diagnosed with a TIA for ongoing fatigue in the months that follow. This approach could enhance understanding of which individuals might struggle with long-term fatigue, leading to tailored care interventions.

Recognizing Stroke Symptoms

Common indications of a stroke include facial drooping, arm weakness, and slurred speech. While these symptoms typically improve within a day, the study found that some individuals also reported enduring cognitive difficulties following their strokes.

Expert Opinions on Fatigue

Bradley Serwer, an interventional cardiologist and chief medical officer at VitalSolution, underscored the prevalence of fatigue following both strokes and mini-strokes. He explained that fatigue is often multifaceted and challenging to attribute to a singular cause.

Potential Causes for Post-Stroke Fatigue

The Maryland-based cardiologist outlined several plausible factors contributing to fatigue experienced after mini-strokes:

Brain Healing: The brain’s recovery process demands energy, leaving patients fatigued as it works to rewire itself.
Increased Inflammation: An immune response can cause inflammation post-TIA, contributing to fatigue.
Decreased Neurotransmitter Levels: Lower levels of serotonin, dopamine, and norepinephrine can lead to fatigue and depression.
Sleep Disturbances: Common after strokes, sleep issues can significantly impair rest quality.
Medication Side Effects: Some drugs prescribed post-stroke, such as beta-blockers, may lead to fatigue.
Other Factors: Everyday tasks can seem more mentally taxing post-injury, and psychological factors like depression may exacerbate fatigue.

Limitations and Future Directions

Despite the study’s enlightening findings, researchers acknowledged certain limitations. The observational nature of the study prevents establishing direct causal relationships, and reliance on self-reported data may introduce biases.

Future studies could address these gaps by including comprehensive pre-TIA fatigue data, as past research indicates that such fatigue may be prevalent among mini-stroke patients.

Advocating for Patient Awareness

Modrau expressed hope that healthcare providers will increasingly recognize the significance of enduring fatigue following a TIA, advocating for structured care pathways for affected patients.

She concluded by stating that previous perceptions often sidelined patients as merely “lucky” individuals who had survived a TIA, rather than acknowledging the difficulties they face. Her goal is to amplify these patients’ voices and emphasize the importance of addressing their struggles.