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Stroke survivors showed higher fatigue than healthy controls; the BG+ group had the highest levels and fastest fatigue accrual. fMRI findings linked fatigue ratings to fatigue-network activation only in BG−. Results suggest basal ganglia involvement accelerates CF development and engagement of the fatigue network may mitigate fatigue.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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does the pilot study address about post-stroke cognitive fatigue?","Question",{"text":62,"@type":63},"The study investigates the neural mechanisms underlying cognitive fatigue in stroke survivors, focusing on how basal ganglia damage influences its onset and progression.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How were participants grouped for the analysis?",{"text":67,"@type":63},"Sixteen participants were divided into BG+ (stroke survivors with basal ganglia lesions), BG− (stroke survivors with lesions elsewhere), and healthy controls.",{"name":69,"@type":60,"acceptedAnswer":70},"What did the fMRI analysis show about the relationship between cognitive fatigue and brain activation?",{"text":71,"@type":63},"Fatigue ratings correlated with task-evoked activation in the fatigue network only in the BG− group, while BG+ showed the highest fatigue levels and greatest increase over 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[homepage:](homepage: www.sciencedirect.com/journal/neuroimage-reports)[ www.sciencedirect.com/journal/neuroimage-reports](homepage: www.sciencedirect.com/journal/neuroimage-reports)  \n| The critical role of the basal ganglia in post-stroke fatigue: A pilot study Olga Boukrinaa,c,* , John DeLucaa,c,d , Glenn R. Wylie b,c,**\u003Cbr>a Stroke Rehabilitation Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA b Rocco Ortenzio Neuroimaging Center, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USAc Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ, 07103, USA d Department of Neurology, Rutgers, New Jersey Medical School, Newark, NJ, 07103, USA |  |\n| --- | --- |\n| A R T I C L E I N F O\u003Cbr>Keywords: Stroke Fatigue fMRI\u003Cbr>Basal ganglia | A B S T R A C T\u003Cbr>This pilot study aimed to explore the neural mechanisms underlying cognitive fatigue (CF) in stroke survivors, with a focus on the role of basal ganglia damage. Sixteen participants were recruited, including six stroke survivors with basal ganglia lesions (BG+), four with lesions elsewhere in the brain (BG − ), and six healthy controls (HC). Participants underwent neuropsychological assessments and an fMRI fatigue induction task, where CF was induced using a modified letter-comparison task under individually titrated response deadlines. CF was assessed using the Visual Analog Scale of Fatigue (VAS-F), and fMRI data were analyzed to identify task-evoked activation within the fatigue network. Stroke survivors reported higher levels of CF compared to healthy controls, with the BG+ group exhibiting the highest fatigue levels and the greatest increase in fatigue over time. The BG+ group also demonstrated the most pronounced disparity in reaction times between short and long response deadlines. Functional neuroimaging revealed that CF ratings correlated with task-evoked activation in the fatigue network, but only in the BG − group. Our findings suggest that while stroke presence generally may increase CF, damage specifically involving the basal ganglia accelerates its accrual. Moreover, the ability to engage the fatigue network may mitigate fatigue, as observed in the BG − group. These results underscore the importance of basal ganglia in understanding CF and highlight the need for future research in this area. |\n\n1. Introduction  \nNeurological deficits are a debilitating consequence of stroke, which affects 795,000 Americans annually. Among these is cognitive fatigue, defined as a sense of weariness, lack of energy, and aversion to effort during mental activity. Cognitive fatigue (CF) is common following stroke with prevalence estimates varying between 29 % and 78 % of stroke survivors, depending on time of assessment (acute, subacute, and chronic stroke), diagnosis (unilateral stroke, multiple strokes, and lacunar infarcts) and the instrument used (e.g., self-report instruments, cognitive assessment batteries) (Acciarresi et al., 2014; van Heugten and Wilson, 2021; Tang et al., 2010; Van Zandvoort et al., 1998). According to a recent systematic review, post-stroke CF has a negative impact on participation in therapeutic activities during rehabilitation. Post-stroke CF is also associated with increased prevalence of anxiety and depression (Mutai et al., 2017; Pedersen et al., 2022; S. et al., 2014; Tang et al., 2010, 2013). Patients with post-stroke fatigue have worse neurological recovery and greater mortality (Hinkle et al., 2017).  \nGiven the negative impact of CF on stroke outcomes, an improved understanding of the neural mechanisms ofCF is imperative in efforts to improve stroke recovery. However, the underlying causes of post-stroke CF are currently not well understood. Some studies have reported greater incidence of CF following basal ganglia infarcts, in particular, tho","cbCaigVh5kUb3NQr","https://ap.wps.com/l/cbCaigVh5kUb3NQr","pdf",3484884,"English","# Introduction\n## Cognitive fatigue after stroke\n## Evidence linking fatigue with basal ganglia lesions\n# Methods\n## Participants and group definitions\n## Neuropsychological assessments and fMRI task\n## Fatigue induction and outcome measures\n# Results\n## Group differences in cognitive fatigue\n## Reaction-time changes across deadlines\n## fMRI correlates of fatigue network activation\n# Discussion\n## Role of basal ganglia in fatigue accrual\n## Potential mitigation via fatigue-network engagement\n# Conclusions","[{\"question\":\"What question does the pilot study address about post-stroke cognitive fatigue?\",\"answer\":\"The study investigates the neural mechanisms underlying cognitive fatigue in stroke survivors, focusing on how basal ganglia damage influences its onset and progression.\"},{\"question\":\"How were participants grouped for the analysis?\",\"answer\":\"Sixteen participants were divided into BG+ (stroke survivors with basal ganglia lesions), BG− (stroke survivors with lesions elsewhere), and healthy controls.\"},{\"question\":\"What did the fMRI analysis show about the relationship between cognitive fatigue and brain activation?\",\"answer\":\"Fatigue ratings correlated with task-evoked activation in the fatigue network only in the BG− group, while BG+ showed the highest fatigue levels and greatest increase over time.\"}]","The critical role of the basal ganglia in post-stroke fatigue - A pilot study | PDF",1790706142,23]