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Post-stroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia

  • Seiji Hama
  • Hidehisa Yamashita
  • Masaya Shigenobu
  • Atsuko Watanabe
  • Kaoru Kurisu
  • Shigeto Yamawaki
  • Tamotsu Kitaoka
ORIGINAL PAPER

Abstract

This study was designed to examine the correlation between damage to the basal ganglia or frontal lobe and depression status (both affective and apathetic dimensions) in 243 stroke patients. We assessed the affective dimension in post-stroke depression (PSD) using the Zung Self-rating Depression Scale (SDS) and the apathetic dimension in PSD using the apathy scale (AS). We classified basal ganglia or frontal lobe damage into four groups: no damage, damage to the left side only, damage to the right side only, and damage to both sides. Affective and/or apathetic PSD was found in 126 patients (51.9%). The severity of affective depression (SDS score) was associated with left frontal lobe (but not basal ganglia) damage, and that of apathetic depression (AS score) was related to damage to the bilateral basal ganglia (but not to the frontal lobe). The anatomical correlates of PSD differ depending on the PSD dimension (affective or apathetic) and may explain interstudy differences regarding the association between lesion location and type of PSD.

Keywords

basal ganglia frontal lobe stroke apathy Zung Self-rating Depression Scale 

Notes

Acknowledgment

This study was supported by the Ministry of Health, Labour and Welfare, Japan.

References

  1. Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M (1997) ‘Vascular depression’ hypothesis. Arch Gen Psychiatry 54:915–922PubMedGoogle Scholar
  2. Bielau H, Trübner K, Krell D, Agelink MW, Bernstein HG, Stauch R, Mawrin C, Danos P, Gerhard L, Bogerts B, Baumann B (2005) Volume deficits of subcortical nuclei in mood disorders: A postmortem study. Eur Arch Psychiatry Clin Neurosci 255:401–412PubMedCrossRefGoogle Scholar
  3. Biringer E, Lundervold A, Stordal K, Mykletun A, Egeland J, Bottlender R, Lund A (2005) Executive function improvement upon remission of recurrent unipolar depression. Eur Arch Psychiatry Clin Neurosci 255:373–380PubMedCrossRefGoogle Scholar
  4. Frodl T, Meisenzahl EM, Zetzsche T, Hohne T, Banac S, Schorr C, Jager M, Leinsinger G, Bottlender R, Reiser M, Moller HJ (2004) Hippocampal and amygdala changes in patients with major depressive disorder and healthy controls during a 1-year follow-up. J Clin Psychiatry 65:492–499PubMedCrossRefGoogle Scholar
  5. Kitamura T, Hirano H, Chen Z, Hirata M (2004) Factor structure of the Zung Self-rating Depression Scale in first-year university students in Japan. Psychiatry Res 128:281–287PubMedCrossRefGoogle Scholar
  6. Montaner J, Alvarez-Sabín J, Molina C, Anglés A, Abilleira S, Arenillas J, González MA, Monasterio J (2001) Matrix metalloproteinase expression after human cardioembolic stroke: temporal profile and relation to neurological impairment. Stroke 32:1759–1766PubMedGoogle Scholar
  7. Nys GM, van Zandvoort MJ, van der Worp HB, de Haan EH, de Kort PL, Kappelle LJ (2005) Early depressive symptoms after stroke: neuropsychological correlates and lesion characteristics. J Neurol Sci 228:27–33PubMedCrossRefGoogle Scholar
  8. Robinson RG, Kubos KL, Starr LB, Rao K, Price TR (1984) Mood disorders in stroke patients. Importance of location of lesion. Brain 107:81–93PubMedCrossRefGoogle Scholar
  9. Sheline YI, Wang PW, Gado MH, Csernansky JG, Vannier MW (1996) Hippocampal atrophy in recurrent major depression. Proc Natl Acad Sci USA 93:3908–3913PubMedCrossRefGoogle Scholar
  10. Soares JC, Mann JJ (1997) The anatomy of mood disorders-review of structural neuroimaging studies. Biol Psychiatry 41:86–106PubMedCrossRefGoogle Scholar
  11. Starkstein SE, Robinson RG, Price TR (1987) Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 110(Pt 4):1045–1059PubMedCrossRefGoogle Scholar
  12. Starkstein SE, Fedoroff JP, Price TR, Leiguarda R, Robinson RG (1993) Apathy following cerebrovascular lesions. Stroke 24:1625–1630PubMedGoogle Scholar
  13. Yamagata S, Yamaguchi S, Kobayashi S (2004) Impaired novelty processing in apathy after subcortical stroke. Stroke 35:1935–1940PubMedCrossRefGoogle Scholar
  14. Yamaguchi S, Kobayashi S, Koide H, Tsunematsu T (1992) Longitudinal study of regional cerebral blood flow changes in depression after stroke. Stroke 23:1716–1722PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Seiji Hama
    • 1
    • 4
  • Hidehisa Yamashita
    • 2
  • Masaya Shigenobu
    • 1
  • Atsuko Watanabe
    • 1
  • Kaoru Kurisu
    • 3
  • Shigeto Yamawaki
    • 2
  • Tamotsu Kitaoka
    • 1
  1. 1.Department of RehabilitationNishi-Hiroshima Rehabilitation HospitalHiroshimaJapan
  2. 2.Department of Psychiatry and NeuroscienceGraduate School of Biomedical Science, Hiroshima UniversityHiroshimaJapan
  3. 3.Department of NeurosurgeryGraduate School of Biomedical Science, Hiroshima UniversityHiroshimaJapan
  4. 4.Nishi-Hiroshima Rehabilitation HospitalHiroshimaJapan

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