Predicting Modafinil-Treatment Response in Poststroke Fatigue Using Brain Morphometry and Functional Connectivity.

Détails

ID Serval
serval:BIB_DDC0B7281DEE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Predicting Modafinil-Treatment Response in Poststroke Fatigue Using Brain Morphometry and Functional Connectivity.
Périodique
Stroke
Auteur(s)
Visser M.M., Maréchal B., Goodin P., Lillicrap T.P., Garcia-Esperon C., Spratt N.J., Parsons M.W., Levi C.R., Bivard A.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Statut éditorial
Publié
Date de publication
03/2019
Peer-reviewed
Oui
Volume
50
Numéro
3
Pages
602-609
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Background and Purpose- Poststroke fatigue affects a large proportion of stroke survivors and is associated with a poor quality of life. In a recent trial, modafinil was shown to be an effective agent in reducing poststroke fatigue; however, not all patients reported a significant decrease in fatigue with therapy. We sought to investigate clinical and radiological predictors of fatigue reduction with modafinil therapy in a stroke survivor cohort. Methods- Twenty-six participants with severe fatigue (multidimensional fatigue inventory-20 ≥60) underwent magnetic resonance imaging at baseline and during the last week of a 6-week treatment period of 200 mg modafinil taken daily. Resting-state functional magnetic resonance imaging and high-resolution structural imaging data were obtained, and functional connectivity and regional brain volumes within the fronto-striato-thalamic network were obtained. Linear regression analysis was used to identify predictors of modafinil-induced fatigue reduction. Results- Multiple regression analysis showed that baseline multidimensional fatigue inventory-20 score (β=0.576, P=0.006) and functional connectivity between the dorsolateral prefrontal cortex and the caudate nucleus (β=-0.424, P=0.008) were significant predictors of modafinil-associated decreases in poststroke fatigue (adjusted r <sup>2</sup> =0.52, area under the receiver operator characteristic curve=0.939). Conclusions- Fronto-striato-thalamic functional connectivity predicted modafinil response for poststroke fatigue. Fatigue in other neurological disease has been attributed to altered function of the fronto-striato-thalamic network and may indicate that poststroke fatigue has a similar mechanism to other neurological injury related fatigue. Self-reported fatigue in patients with normal fronto-striato-thalamic functional connectivity may have a different mechanism and require alternate therapeutic approaches. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000350527.
Mots-clé
caudate nucleus, fatigue, magnetic resonance imaging, modafinil, quality of life
Pubmed
Web of science
Création de la notice
31/03/2019 15:12
Dernière modification de la notice
20/08/2019 17:02
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