Cognition, Emotion and Fatigue Post-stroke

Excerpt

After stroke, the less visible cognitive and emotional problems including fatigue are common and have a negative impact on the lives of patients as well as their caregivers. Given their prevalence, severity and impact, every stroke patient should at least be screened regularly for consequences in these areas of functioning. Cognitive complaints may not be related to cognitive deficits, and caregivers may have other experiences and consequences than the stroke patients themselves. Subjective cognitive functioning as experienced by both patients and their family members is therefore essential to assess as well. At the start of rehabilitation, and also when support is needed for community reintegration, an extensive neuropsychological assessment should be conducted. All patients and their caregivers need information and education about stroke and its neuro-psychological consequences because this knowledge has a positive influence on mood and quality of life. Further rehabilitation and support should be offered if community reintegration is delayed or stagnates. Cognitive rehabilitation should be combined with more holistic approaches including emotional, psychological and family support. Assistive technology can be helpful in compensating for lasting cognitive impairments. Restorative approaches, such as computerized brain training and non-invasive brain stimulation, can be used for improvement at impairment level, but have not shown effects on the long term nor on daily life functioning, but promising developments are anticipated.