Abstract
The aim of the present study was to investigate the relationships between poststroke depression (PSD), lesion location and cognitive deficits after stroke. We studied 20 patients within the first month after clinical onset (T1), and one year later (T2). PSD was observed in 55% of patients at T1 and 35% of patients at T2. At T1, depression was reliably correlated with dorsal lesions in the right-hemisphere and anterior lesions in the left hemisphere. Lesion location was no longer a significant factor determining PSD at T2. Changes in PSD, from T1 to T2, were inversely correlated with the performances in cognitive tests exploring the domains of attention, visuospatial learning, executive/motor functions, and with the global composite cognitive score. Our data suggest that: 1) in the mix of influences that may produce PSD, lesion location is the main factor determining mood changes after stroke in the first month; 2) PSD produces deficits in attention, learning, and executive/motor functions, without affecting language and other cognitive domains.
Sommario
Scopo di questo studio sono i rapporti tra la depressione post-stroke (PSD), la localizzazione della lesione cerebrovascolare e i disturbi cognitivi conseguenti alla lesione. Abbiamo studiato 20 pazienti entro il primo mese dall'episodio ictale (T1) ed un anno dopo (T2). La PSD era osservabile nel 55% dei pazienti a T1 e nel 35% dei pazienti a T2. A T1, la PSD era significativamente correlata con lesioni dorsali nell'emisfero di destra e con lesioni anteriori nell'emisfero di sinistra. Queste correlazioni non erano più significative a T2. Le variazioni della PSD da T1 a T2 erano inversamente correlate con le prestazioni dei pazienti a compiti cognitivi di attenzione, apprendimento visuospaziale, funzioni esecutivo/motorie, e con un punteggio cognitivo composito.
Questi dati suggeriscono che: 1) tra le numerose cause che possono produrre la PSD, la localizzazione della lesione sembra essere il fattore principale nel primo mese dopo l'episodio cerebrovascolare; 2) la PSD produce disturbi attentivi, di apprendimento visuospaziale ed esecutivi/motori senza determinare disturbi nella sfera del linguaggio e di altre funzioni cognitive.
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References
Bolla-Wilson K., Robinson R.G., Starkstein S.E., Boston J., Price T.R.:Lateralization of dementia of depression in stroke patients. Am. J. Psychiatry., 146:627–634, 1989.
Bear D.M.:Hemispheric specialization and the neurology of emotion. Arch. Neurol., 40:195–202, 1983.
Brumback R.A., Staton R.D., Wilson H.:Neuropsychological study of children during and after remission of endogenous depressive episodes. Percept. Mot. Skills, 50:1163–1167, 1980.
Damasio H., Damasio A.R.:Lesion analysis in neuropsychology. New York, NY: Oxford University Press, 1989.
Ebrahim S., Barer D. Nouri F.:Affective illness after stroke. Br. J. Psychiatry, 151:52–56, 1987.
Foote S.L., Morrison J.H., Bloom F.E., O'Conner D.:Laminar and regional distribution of norepinephrine fibers in squirrel monkey neocortex as revealed by immunochemistry. Soc. Neurosci. Abs., 7:792, 1981.
Freeman R.L., Galaburda A.M., Cabal R.D., Geschwind N.:The neurology of depression. Arch. Neurol., 42:289–291, 1985.
Hier D.B., Mondlock J., Caplan L.R.:Recovery of behavioral abnormalities after right hemisphere stroke. Neurology, 33:345–350, 1983.
House A., Dennis M., Warlow C., Hawton K., Molyneaux A.:Mood disorders after stroke and their relation to lesion location. Brain., 113:1113–1129, 1990.
Lezak M.D.:Neuropsychological assessment. New York, NY: Oxford University Press, 1976.
Liotti M., Tucker D.M.:Right hemisphere sensitivity to arousal and depression. Brain. Cogn., 18:138–151, 1992.
Mayberg H.S., Robinson R.G., Wong D.F. et al.:PET imaging of cortical S2 serotonin receptors after stroke: lateralized changes and relationship to depression. Am. J. Psychiatry, 145:937–943, 1988.
Morrison J.H., Molliver M.E., Grzanna R.:Noradrenergic innervation of cerebral cortex: widespread effects of local cortical lesions. Science, 205:313–316, 1979.
Pancheri P., Carilli L.:Standardizzazione e validazione di una nuova self rating-scale per la valutazione della sintomatologia depressiva. Rivista di Psichiatria, 17:22–37, 1982.
Parikh R.M., Robinson R.G., Lipsey J.R., Starstein S.E., Fedoroff J.P., Price T.R.:The impact of poststroke depression on recovery in activities of daily living over a 2-year follow up. Arch. Neurol., 47:785–789, 1990.
Pearlson G.D., Robinson R.G.:Suction lesions of the frontal cerebral cortex in the rat induce asymmetrical behavioral and catecholaminergic responses. Brain. Res., 218:233–242, 1981.
Pickel V.M., Segal M., Bloom F.E.:A radioautographic study of the efferent pathways of the nucleus locus coeruleus. J. Comp. Neurol., 155:15–42, 1974.
Robinson R.G.:Differential behavioral and biochemical effects of right and left hemispheric cerebral infarction in the rat. Science, 205:707–710, 1979.
Robinson R.G., Bolla-Wilson K., Kaplan E., Lipsey J.R., Price T.R.:Depression influences intellectual impairment in stroke patients. Br. J. Psychiatry, 148:541–547, 1986.
Robinson R.G., Boston J.D., Starkstein S.E. et al.:Comparison of mania with depression following brain injury: causal factors. Am. J. Psychiatry, 145:172–178, 1988.
Robinson R.G., Coyle J.T.:The differential effect of right versus left hemispheric cerebral infarction on catecholamines and behavior in the rat. Brain. Res., 188:63–78, 1980.
Robinson R.G., Kubos K.L., Starr L.B., Rao K., Price T.R.:Mood changes in stroke patients: relationship to lesion location. Compreh. Psychiat., 24:555–566, 1983.
Robinson R.G., Kubos K.L., Starr L.B., Rao K., Price T.R.:Mood disorders in stroke patients: importance of location of lesion. Brain., 107:81–93, 1984.
Robinson R.G., Price T.R.:Post-stroke depressive disorders: a follow up study of 103 patients. Stroke, 13:635–641, 1982.
Robinson R.G., Starr L.B., Kubos K.L., Rao K., Price T.R.:A two-year longitudinal study of poststroke mood disorders: findings during the initial evaluation. Stroke, 14:736–741, 1983.
Ross E.D., Rush A.J.: Diagnosis and neuroanatomical correlates of depression in brain-damaged patients. Arch. Gen. Psychiatry, 38:1344–1354, 1981.
Sinyor D., Jacques P., Kaloupek D.G., Becker R., Goldenberg M., Coopersmith H.:Poststroke depression and lesion location: an attempted replication. Brain, 109:537–546, 1986.
Starkstein S.E., Bolla K.I., Robinson R.G.:Dementia syndrome of depression in patients with stroke. In: Bornstein R.A., Brown G. eds.Neurobehavioral aspects of cerebrovascular disease. New York: Oxford University Press, 150–164, 1990.
Starkstein S.E., Robinson R.G.:Affective disorders and cerebrovascular disease. Br. J. Psychiatry, 154:170–182, 1989.
Starkstein S.E., Robinson R.G., Honig M.A., Parikh R.M., Joselyn John, Price T.R.:Mood changes after right hemisphere lesions. Br. J. Psychiatry, 155:79–85, 1989.
Starkstein S.E., Robinson R.G., Price T.R.:Comparison of patients with and without poststroke major depression matched for size and location of lesion. Arch. Gen. Psychiatry, 45:247–252, 1988.
Stern R.A., Bachman D.L.:Depressive symptoms following stroke. Am. J. Psychiatry, 148:351–356, 1991.
Sweeney J.A., Wetzler S., Stokes P., Kocsis J.:Cognitive functioning in depression. J. Clin. Psychol., 45:836–842, 1989.
Ungerstedt U.:Stereotaxic mapping of monoamine pathways in the rat brain. Acta Psysiol. Scand., 367 (Suppl.): 1–48, 367.
Wade D.T., Legh-Smith J.E., Hewer R.A.:Depressed mood after stroke: a community study of its frequency. Br. J. Psychiatry, 151:200–205, 1987.
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Iacoboni, M., Padovani, A., Di Piero, V. et al. Post-stroke depression: Relationships with morphological damage and cognition over time. Ital J Neuro Sci 16, 209–216 (1995). https://doi.org/10.1007/BF02282991
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DOI: https://doi.org/10.1007/BF02282991