Prevalence and biopsychosocial predictors of post-stroke fatigue in patients with minor strokes.

The sample size was small (n=72), limiting statistical power and making the findings hypothesis-generating rather than conclusive. The study excluded patients with severe language or cognitive dysfunctions, which may bias the sample toward higher-functioning individuals. There was no consensus on the cut-off for clinically significant fatigue; using a lower cut-off (4 instead of 5) would have increased the prevalence to 29.4%. The study did not measure pre-stroke cognitive function, so it is unclear if self-reported cognitive symptoms represent new deficits or pre-existing conditions. Multiple comparisons were made, increasing the risk of Type I error, although the significance level was adjusted to p ≤ 0.01 for primary analyses.

Do not assume that normal neuropsychological test scores rule out cognitive issues contributing to fatigue. Patients often report subjective cognitive symptoms like forgetfulness and slow thinking that are strongly linked to fatigue, even when objective tests are unremarkable.