Exploring the relationship between fatigue and circulating levels of the pro-inflammatory biomarkers interleukin-6 and C-reactive protein in the chronic stage of stroke recovery: A cross-sectional study

Prajwal Gyawali; Madeleine Hinwood; Wei Zhen Chow; Murielle Kluge; Lin Kooi Ong; Michael Nilsson; Frederick Rohan Walker

Brain, Behavior, & Immunity - Health (Dec 2020)

Exploring the relationship between fatigue and circulating levels of the pro-inflammatory biomarkers interleukin-6 and C-reactive protein in the chronic stage of stroke recovery: A cross-sectional study

Prajwal Gyawali,
Madeleine Hinwood,
Wei Zhen Chow,
Murielle Kluge,
Lin Kooi Ong,
Michael Nilsson,
Frederick Rohan Walker

Affiliations

Prajwal Gyawali: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia; School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Australia
Madeleine Hinwood: School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
Wei Zhen Chow: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
Murielle Kluge: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
Lin Kooi Ong: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia; School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
Michael Nilsson: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia; Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
Frederick Rohan Walker: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia; Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia; Corresponding author. School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia.

Journal volume & issue: Vol. 9
p. 100157

Abstract

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Background: The precise mechanisms underlying the aetiology of post-stroke fatigue remain poorly understood. Inflammation has been associated with clinically significant fatigue across a number of neurological disorders; however, at present there is a lack of evidence regarding the association of fatigue and inflammation in the chronic phase of stroke recovery. Aims: The aim of this study was to examine fatigue in a cohort of stroke survivors in the chronic phase of stroke, compared with matched controls, and to explore associations between the pro-inflammatory cytokine interleukin-6, high-sensitivity C-reactive Protein and fatigue. Methods: We performed an exploratory cross-sectional study of 70 people in the chronic phase of stroke recovery, and 70 age matched controls. Fatigue was assessed using the Fatigue Assessment Scale. Interleukin-6 was measured in serum using a commercially available enzyme immunoassay kit. Both outcome measures were assessed contemporaneously. Results: Clinically significant fatigue, defined as a score ≥24 on the Fatigue Assessment Scale, was reported by 60% of stroke survivors, and 15.7% of controls. The odds of experiencing clinically significant fatigue was 8.04 times higher among stroke survivors compared to control participants (odds ratio 8.045; 95% CI: 3.608, 17.939; P < 0.001). The fatigue score was significantly correlated with the level of both interleukin-6 and high-sensitivity c-reactive protein, however once entered into a linear regression model with cardiovascular covariables, this relationship was no longer statistically significant. Conclusions: This study shows that fatigue may be associated with systemic inflammation in the chronic phase of stroke. The pathological mechanisms underlying post-stroke fatigue and its clinical implications require further study.

Published in Brain, Behavior, & Immunity - Health

ISSN: 2666-3546 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/brain-behavior-and-immunity-health

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