Neuroimmune Mechanisms and Emerging Intervention Strategies for Post-Stroke Fatigue: A Narrative Review

03 February 2026 : Review article

Zekai Hu

^{ABCDEF 1}, Qingui Sun

^{F 2}, Xieyun Jin

^{BCD 3}, Jie Zhuang

^{BCD 1}, Jun Hu^{AG 1*}

DOI: 10.12659/MSM.951361

Med Sci Monit 2026; 32:e951361

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Introduction Mechanisms and Interventions for Post-Stroke Fatigue Future Research Directions Conclusions References

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Table 2 Intervention strategies for post-stroke fatigue.

Intervention type	Intervention strategy	Level of evidence	Current status
Pharmacological	SSRIs (eg, fluoxetine), modafinil	Moderate	Clinical use for mood-related fatigue; PSF-specific benefit remains under investigation
Non-pharmacological	Exercise therapy (aerobic, resistance), CBT	Moderate to high	Clinical; exercise reduces fatigue and improves rehabilitation outcomes
Neuromodulation	rTMS, tDCS	Low to moderate	Experimental; evidence supports modulation of cortical excitability and reduction of fatigue
CBT – cognitive behavioral therapy; PSF – post-stroke fatigue; rTMS – repetitive transcranial magnetic stimulation; SSRIs – selective serotonin reuptake inhibitors; tDCS – transcranial direct current stimulation.

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