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Fatigue after spontaneous intracerebral haemorrhage: prevalence and associated factors

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Abstract

Background

Fatigue is a major complaint in stroke survivors, but data focusing on intracerebral haemorrhage (ICH) survivors are scarce. In a cohort of spontaneous ICH survivors, we assessed the long-term prevalence of fatigue and its associated factors.

Methods

We included consecutive 1-year ICH survivors from the prospective, observational, single-centre Prognosis of Intracerebral Haemorrhage (PITCH) study. We evaluated fatigue (defined as a score ≥ 4 in Chalder Fatigue Scale); the severity of neurological, depressive, and anxiety symptoms; and functional disability 1, 3, and 6 years after ICH. We performed univariable and multivariable models to evaluate clinical factors and brain magnetic resonance imaging (MRI) small vessel disease (SVD) markers associated with fatigue.

Results

Of 255 1-year ICH survivors, 153 (60%) underwent fatigue screening and were included in this study. Seventy-eight patients (51%) reported fatigue at 1-year, 56/110 (51%) at 3-year, and 27/67 (40%) at 6-year follow-up. Patients with fatigue exhibited more severe concomitant depressive/anxiety symptoms, but the severity of depressive symptoms was the only clinical factor significantly associated with 1-year fatigue in multivariable analysis (adjusted odds ratio 1.4 for one-point increase; 95% confidence interval 1.2–1.6). Patients with severe cortical atrophy at baseline had increased risk of fatigue at 1-year follow-up compared to patients with mild/no cortical atrophy (adjusted odds ratio 2.5; 95% confidence interval 1.1–5.8).

Conclusions

Fatigue after ICH is frequent and long-lasting, and it is associated with cortical atrophy (but not with other MRI markers of cerebral SVD). The link between fatigue and depressive symptoms may represent a potential therapeutic target.

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Data availability

Data are available from the authors upon reasonable request and with permission of the Internal Review Board.

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Acknowledgements

CC is a member of Institut Universitaire de France.

Funding

Inserm-U1172, Adrinord.

Author information

Authors and Affiliations

  1. Department of Neurology, Inserm, U1172–LilNCog–Lille Neuroscience & Cognition, CHU-Lille, Univ. Lille, F-59000, Lille, France

    Giuseppe Scopelliti, Costanza Rossi, Charlotte Cordonnier, Hilde Hénon & Barbara Casolla

  2. Neurology and Stroke Unit, Luigi Sacco Hospital, Milan, Italy

    Giuseppe Scopelliti

  3. Department of Neuroradiology, Inserm, U1172–Lille Neuroscience & Cognition, CHU-Lille, Univ. Lille, F-59000, Lille, France

    Grégory Kuchcinski

  4. Diagnostic and Interventional Neuroradiology Department, INSERM U1253 iBrain, University Hospital of Tours, Centre Val de Loire, Tours, France

    Grégoire Boulouis

  5. Department of Neurology, CHU-Reims, Reims, France

    Solène Moulin

  6. UR2CA-URRIS, Stroke Unit, CHU Pasteur 2, Nice Cote d’Azur University, Nice, France

    Barbara Casolla

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  1. Giuseppe Scopelliti
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  8. Barbara Casolla
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Contributions

GS designed and conceptualized the study, analyzed and interpreted all data, and drafted the manuscript. BC, HH, and CC designed and conceptualized the study, analyzed and interpreted all data, and drafted and reviewed the manuscript. CR and SM contributed to data collection and revised the manuscript. GB and GK contributed to data collection, analyzed imaging data, and revised the manuscript.

Corresponding author

Correspondence to Charlotte Cordonnier.

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Ethics approval

The study protocol was regarded as observational by the Internal Review Board of the Lille University Hospital, which granted ethics approval for this study (no approval number/reference was given). Patients, or their relatives or primary caregiver, gave oral informed consent for follow-up. The study conforms with the World Medical Association Declaration of Helsinki.

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The authors declare no competing interests.

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Scopelliti, G., Rossi, C., Kuchcinski, G. et al. Fatigue after spontaneous intracerebral haemorrhage: prevalence and associated factors. Neurol Sci 45, 2127–2135 (2024). https://doi.org/10.1007/s10072-023-07196-8

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