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Depression and anxiety symptoms are associated to disruption of default mode network in subacute ischemic stroke

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Abstract

Depression and anxiety symptoms are common after stroke and associated to reduction in quality of life and poor physical and social outcomes. The Default Mode Network (DMN) plays an important role in the emotional processing. We investigated whether these symptoms are associated to a disruption of DMN functional connectivity in the first month after stroke. Thirty-four subacute ischemic stroke patients were submitted to: 1) behavioral assessment through Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Structured Clinical Interview for DSM Disorders; 2) neuropsychological assessment using Mini Mental State Examination and Montreal Cognitive Assessment; 3) resting state functional magnetic resonance imaging acquisition using a 3 T scanner (Philips Achieva). Patients with depression and/or anxiety symptoms showed an increased DMN functional connectivity in left inferior parietal gyrus and left basal nuclei, when compared to stroke controls. Specific correlation between BDI/BAI scores and DMN functional connectivity indicated that depression symptoms are correlated with increased functional connectivity in left inferior parietal gyrus, while anxiety symptoms are correlated with increased functional connectivity in cerebellum, brainstem and right middle frontal gyrus. Our study provides new insights into the underlying mechanisms of post stroke depression and anxiety, suggesting an alternate explanation other than regional structural damage following ischemic event, that these psychiatric symptoms are related to brain network dysfunction.

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Acknowledgments

This study is funded by Cepid-Brainn-Fapesp 2013/07559-3. Jéssica Elias Vicentini was recipient of Fapesp scholarship 2013/23183-3 and Marina Weiler is recipient of Fapesp scholarship 2015/06163-4.

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  1. Brazilian Institute of Neuroscience and Neurotechnology, Brainn, Campinas, SP, Brazil

    Jéssica Elias Vicentini, Marina Weiler PhD, Sara Regina Meira Almeida, Brunno Machado de Campos, Lenise Valler & Li Min Li

  2. Department of Neurology, School of Medical Sciences, University of Campinas (UNICAMP), Vital Brasil, 251, Zeferino Vaz, Campinas, SP, 13083-888, Brazil

    Jéssica Elias Vicentini, Marina Weiler PhD, Sara Regina Meira Almeida, Brunno Machado de Campos, Lenise Valler & Li Min Li

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  1. Jéssica Elias Vicentini
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Correspondence to Li Min Li.

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Jéssica Elias Vicentini, Marina Weiler, Sara Regina Meira Almeida, Brunno Machado de Campos, Lenise Valler and Li Min Li declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, and the applicable revisions at the time of the investigation. Informed consent was obtained from all patients for being included in the study. The study was approved by Ethics Committee number: 483.401.

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Vicentini, J.E., Weiler, M., Almeida, S.R.M. et al. Depression and anxiety symptoms are associated to disruption of default mode network in subacute ischemic stroke. Brain Imaging and Behavior 11, 1571–1580 (2017). https://doi.org/10.1007/s11682-016-9605-7

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