This week, Bobbi Conner talks with Dr. Parneet Grewal about post-stroke apathy, and engaging patients in rehab after stroke. Dr. Grewal is a stroke neurologist and researcher in the Comprehensive Stroke Center at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Many individuals who have had a stroke struggle with apathy or loss of motivation that can interfere significantly with their recovery. Doctor Parneet Grewal is here to talk about addressing these issues to improve engagement in rehabilitation after stroke. Doctor Grewal is a stroke neurologist and a researcher in the Comprehensive Stroke Center at MUSC. Doctor Grewal, tell us more about post-stroke apathy.
Dr. Grewal: Apathy, it’s a clinical syndrome that is marked by loss of motivation and a noticeable drop in goal directed behaviors in persons emotional, cognitive, and social lives. We see it in about one third of stroke survivors. What's interesting is that the symptoms can begin as early as four days after stroke, and can last for quite some time, even years.
Conner: How does this sort of loss of motivation really interfere, then, with rehabilitation after stroke?
Dr. Grewal: When somebody has loss of motivation, it's actually associated with functional disability, including reductions in basic activities of daily living, such as eating or dressing, impairments in tasks that require planning and slower functional recovery over time. Survivors who suffer from apathy, they actually tend to have a harder time recovering after a stroke, and they do tend to require more support from caregivers because they do have those lower levels of initiation.
Conner: What can be done to address these mental health or mood issues to get more participation in rehabilitation after a stroke?
Dr. Grewal: I think the first thing would actually be increasing awareness in recognition of the personality changes and the neuropsychiatric or mood disorders that can happen in stroke survivors. They are very common, but often missed. Apart from apathy, it can include post-stroke depression, anxiety, and so forth. Early screening is one involving family and caregivers in the process also makes a big difference.
Conner: And what are the treatment options then in this scenario?
Dr. Grewal: Once recognized, specific interventions can actually be started. Behavioral therapy is one. It can help people process what they are going through. We can also try cognitive therapy. And in some cases medications can actually help improve mood. The bottom line is, along with physical side of stroke recovery, we should focus on the emotional side of the recovery. People are much more likely to engage in rehab and make real progress if they are motivated to take part in their rehabilitation.
Conner: Tell us about the research study you're involved in related to exploring new treatment options for post-stroke apathy.
Dr. Grewal: In collaboration with the MUSC Brain Stimulation Lab, I'm investigating whether transcranial magnetic stimulation or TMS could help stroke survivors who struggle with loss of motivation. TMS is already used for depression patients, so we're looking at a different indication. The ultimate goal of my research is to find effective ways to reengage patients in their recovery journey.
Conner: Doctor Grewal, thanks for this information about post-stroke apathy.
Dr. Grewal: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
