Clinical characteristics and metabolic therapy of fatigue in the acute and early recovery periods of ischemic stroke

Abstract

To reveal clinical characteristics of asthenic syndrome with subsequent estimation of Meldonium therapy efficacy in patients in acute and early recovery periods of ischemic stroke. The study included 94 patients diagnosed with ischemic stroke, mean age being 65.6±9.5 years. Psychoemotional status was assessed on the 10th day of hospitalization with the use of the Asthenic Disorders Inventory (MFI-20), Hospital Anxiety and Depression Scale (HADS), Apathy Evaluation Scale (AES). Patients with verified asthenic syndrome were added Mildronate in a daily dose of 1000 mg (500 mg 2 times a day) for one month to baseline therapy in a real outpatient setting, followed by an assessment of treatment efficacy. The presence of asthenic syndrome in patients in the acute period of ischemic stroke was detected on all subscales of MFI-20. A high level of general and physical asthenia was found in patients with subcortical localization stroke, with decreased motivation corresponding to lesions in the frontotemporal and decreased activity in the parieto-occipital lobes. Close correlations between the MFI-20 parameters and the level of depression, anxiety, apathy, and the degree of neurological deficit were found. The dynamic evaluation of the severity of main manifestations of psychoemotional dysfunction during treatment with Mildronate showed a decrease in the level of depression, general and mental asthenia, and decreased activity during the period of observation. The high prevalence and multifactorial character of asthenia in early ischemic stroke make it urgent to optimize the early treatment of asthenic syndrome. The results of assessment of Mildronate application in a daily dose of 1000mg for a month have shown therapy efficacy concerning affective and asthenic disorders, which allows recommending its inclusion in the complex therapy of ischemic stroke.