To determine the prevalence of fatigue, and whether there is a relationship between specific baseline neurologic impairments and post-stroke fatigue in an urban, minority population.

Fatigue is a frequently reported sequela of stroke, affecting 38-77% of stroke survivors. Post-stroke fatigue (PSF) is characterized as hidden dysfunction with symptoms of mental fatigability, difficulty concentrating, and decreased stress tolerance. PSF is associated with poor outcome: prolonged institutionalization, functional dependency, and fatality. The cause of PSF is not well understood. Data suggest that the etiology of PSF is likely multifactorial with physical, emotional, and cognitive dimensions. There is some evidence that neurologic impairments resulting from stroke are associated with fatigue, but an equal number of studies showing no correlation. Most of these studies were conducted in European, Caucasian populations.

Of 78 patients with a history of ischemic stroke, 32 (41%) were fatigued, as defined as ≥22 on the FAS. There was no association between PSF and baseline NIHSS (Spearman correlation 0.03, p=0.776), visual field impairment (-0.05, p=0.671), facial palsy (0.13, p=0.256), or sensory deficit (0.00, p=0.988).

In this minority, urban population, the prevalence of fatigue was 41% in ischemic stroke survivors.  We could not ascertain a relationship of total NIHSS or specific baseline neurologic impairment with PSF in this population. Fatigue is a complex sequela of stroke. Its cause is likely multifactorial.