Member May 2026: The Hidden Side of Stroke: Cognition, Mood, and Fatigue (On-Demand)-Session Recording

Video Transcription

Video Summary

This Member May session focused on the “hidden side of stroke”: cognitive impairment, mood disorders, fatigue, and sleep problems that often accompany stroke but are less visible than motor deficits.<br /><br />The first section covered post-stroke cognitive impairment (PSCI), emphasizing that it is common, underdiagnosed, and linked to higher disability and mortality. Speakers reviewed terminology, prevalence, risk factors, affected brain regions, biomarkers, and treatment options. Management strategies included early neuropsychological testing, rehabilitation therapies, aerobic exercise, digital interventions, and in some cases medications or transcranial magnetic stimulation.<br /><br />The mood section highlighted post-stroke depression as frequent, serious, and often missed—especially in patients with mild strokes or those discharged home. Risk factors include prior depression, stroke severity, cognitive impairment, functional dependence, and social isolation. Screening with validated tools was strongly recommended. Treatment approaches included counseling, cognitive behavioral therapy, exercise, and SSRIs or mirtazapine when needed.<br /><br />The sleep section distinguished fatigue from sleepiness and reviewed common post-stroke sleep disorders such as insomnia, circadian rhythm disruption, sleep apnea, and restless legs/periodic limb movements. The speakers stressed sleep hygiene, sleep history, screening tools, and targeted treatment such as CPAP or behavioral interventions.<br /><br />A case discussion tied the topics together, focusing on a woman with post-stroke brain fog, fatigue, low motivation, mood symptoms, and sleep difficulty. The panel discussed prioritizing mood and sleep treatment, therapy optimization, functional safety, medical workup for fatigue, diet, supplements, and when to consider tapering medications after recovery. The overall message: screen early, treat holistically, and integrate mood, cognition, sleep, and fatigue into stroke rehabilitation.

Keywords

stroke

post-stroke cognitive impairment

post-stroke depression

fatigue

sleep disorders

insomnia

sleep apnea

neuropsychological testing

cognitive behavioral therapy

rehabilitation

screening tools