Transient ischemic attacks occur when there is a temporary blockage to the brain’s blood supply.

Transient ischemic attacksTrusted Source — sometimes referred to as “ministrokes” — involve a temporary blockage to the brain’s blood supply. People who experience a transient ischemic attack may go on to experience a stroke later on.

Due to such health-related concerns, doctors and other medical experts are interested in the long-term struggles people may face after a transient ischemic attack.

A recent study published in Neurology, the medical journal of the American Academy of Neurology, examined fatigue following a transient ischemic attack. The Danish Physiotherapy Association funded this research.

Over half of the participants experienced general fatigue 1 year after their transient ischemic attack.

The results suggest that addressing fatigue in individuals who experience transient ischemic attacks may be important.

How do transient ischemic attacks relate to fatigue?

This research was a prospective cohort study exploring fatigue after a transient ischemic attack.

All participants had experienced a transient ischemic attack, were at least 18, and had started experiencing symptoms within the previous 30 days.

Researchers excluded certain individuals, such as those with terminal illnesses or those who were unable to fill out questionnaires. All participants received treatment for transient ischemic attack at Aalborg University Hospital’s stroke unit.

Researchers used two questionnaires to evaluate the participants’ fatigue levels. The first assessed fatigue in five different domains, and the second measured fatigue severity.

Participants answered these questionnaires via email or letter. One domain of fatigue was general fatigue, where a score of 12 points or more indicated pathologic fatigue.

The initial baseline assessment happened an average of around 20 days after participants experienced their transient ischemic attack symptoms. Researchers then followed up with participants at 3 months, 6 months, and 12 months.

Participants underwent MRI scans to see if they had acute infarction, which refers to injury or death of brain tissue resulting from the blockage in blood flow.

Researchers collected other participant data as well, such as age, the type and duration of transient ischemic attack symptoms, and previous history of anxiety or depression.

High proportion of people experience fatigue 1 year after a ministroke

In all, 287 participants filled out the study’s baseline questionnaires, and 250 participants filled out the final questionnaire 12 months later.

Overall, there was a high likelihood of fatigue among participants. At baseline, just over 61% of participants had pathologic fatigue. At the 12-month mark, 53.8% of participants reported pathologic fatigue.

Over 60% of participants who experienced pathologic fatigue at baseline reported pathologic fatigue 12 months later. In contrast, only 22.5% of participants who did not have a score indicating pathologic fatigue at baseline reported pathologic fatigue at the 12-month mark.

The proportion of participants who experienced acute infarction was lower among those who experienced fatigue compared with those who did not experience fatigue. Among participants who had fatigue at baseline, 13.1% had acute infarction compared to 19.8% in the participant group who did not report fatigue at baseline.

Researchers further suggested that looking for acute ischemic lesions alone is not enough to predict who will experience fatigue after a transient ischemic attack. Previous anxiety or depression was twice as common in the group that reported baseline fatigue.

The results suggest a potential long-term impact following transient ischemic attacks. Christopher Yi, MD, a board-certified vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, noted the following to Medical News Today:

“Very little is known about the impact of [transient ischemic attacks], as traditional approaches to [such events] are catered around stroke prevention (i.e. hypertension control, antiplatelets, anticoagulation, or surgery)… This study offers a new perspective on the lingering effects of transient ischemic attacks, which were traditionally thought to have no long-term consequences. This may add a new dimension to our approach to the management and workup of chronic fatigue.”

Fatigue prevalence may be ‘underestimated’

This study does have a few limitations. For one, it was conducted out of one stroke unit in one hospital in Denmark. This could indicate the need for more diverse research in the future and a lack of generalizability.

Then, the researchers acknowledged the possibility that relatives of the participants assisted with questionnaire responses, which could have affected their accuracy.

Furthermore, some participants were excluded because they declined participation due to a lack of energy, which would indicate they also had fatigue. Researchers suggest that this could have led to selection bias, leading to “an underestimation of fatigue prevalence.” Thus, even more research into fatigue may be warranted in the future.

Continued research should look at why people develop fatigue after transient ischemic attacks, as the current study could not determine this.