Relation between cognitive and motor fatigue in patients with a functional stroke mimic or acute ischemic infarction’

fatigue ischemic stroke Functional stroke mimic

Dr. C.A.T. Zijdewind

Nature of the research:
Intervention study into fatigue in functional stroke mimics and ischemic stroke.

Fields of study:
movement sciences medical physiology neurology

Background / introduction
In functional neurologic disorders the function of the nervous system is disturbed without structural damage. Patients with functional disorders can present with acute stroke-like symptoms, this is called a functional stroke mimic (FSM). Fatigue is a major problem in functional neurologic disorders and in acute ischemic stroke (AIS). In this study we want to gain more insight into the interaction between motor and cognitive fatigue. Studies in healthy controls have shown that during a dual-task (DT), a cognitive task combined with a fatiguing motor task, the performance on a cognitive task declines over time (with fatigue). We hypothesise that in patients with a functional stroke mimic and patients with AIS this interaction is stronger compared to healthy controls. We also want to study whether the symptoms and the interaction between cognitive and motor fatigue recover with time. Our group has already performed this dual-task in patients with MS.
Research question / problem definition
Does performance on a fatiguing motor task in patients with FSM decline more compared to patients with AIS? What are the differences in cognitive functioning and motor fatigue between FSM, AIS and healthy controls? What is the relation between fatigue questionnaire scores and performance on the cognitive and motor tasks?
The study design is a mono-centre intervention study. Subjects perform a cognitive task: a two choice reaction time task (CRT). The CRT is performed on its own, and simultaneously with a motor task (i.e. the dual-task). Patients and controls will be measured 6 weeks after admission to the hospital. The investigation comprises two sessions of one and a half hour, on two separate days. Force and muscle activity (EMG) of the first dorsal interosseous muscle (FDI) are measured during every session.
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