my personal edition > depression > news


  E-Mail this DGReview to a colleague

DGReview

Brain Lesions Correlates of Depression in Stroke Patients

Lesions that affect the prefrontosubcortical circuits, especially on the left side of the brain, relate to a higher risk of depression in ischemic stroke patients.

"This finding might be important in understanding the pathophysiology of depressive disorders," Finnish researchers state.

"In multivariate analysis, the independent correlates of depression after stroke were number of infarcts in the genu of internal capsule on the left side and the number of lesions in the pallidum of any side.

"Our results support the idea that lesions affecting the prefrontosubcortical circuit relate to a higher risk of depression after stroke."

Researchers from Helsinki University Central Hospital and the University of Kuopio concluded: "An infarct located in these critical locations should make the clinician alert in diagnosis and treatment of eventual depression after stroke, an independent correlate of stroke-related independence."

They note theirs was the first large magnetic resonance imaging (MRI) study to explore radiologic correlates of depression after stroke.

"Depression affects up to 40 percent of patients with ischemic stroke," they point out. "The relationship between site and size of brain infarcts and post-stroke depression (had not been) well characterized.

"Further possible contribution and interaction of white matter lesions and brain atrophy had not been studied previously."

Investigators used modified Diagnostic & Statistical Manual of Mental Disorders criteria to diagnosis depressive disorders three to four months after ischemic stroke. Participants included 275 people in a series of 486 consecutive patients aged from 55 to 85 years.

A standardised MRI protocol detailed side, site, type and extent of brain infarcts and the extent of white matter lesions and brain atrophy.

"Depressive disorders were diagnosed in 109 patients (40 percent)," the researchers say. "Extent of white matter lesions and atrophy did not differ in patients with and without depression.

"Independent correlates of post-stroke depression in a logistic regression model were mean frequency of infarcts in the genu of internal capsule on the left side (odds ratio [OR], 3.2), mean frequency of infarcts in the pallidum of any side (OR, 1.6) and mean volume of infarcts in the right occipital lobe (OR, 0.98)."
Archives of General Psychiatry, 2001; 58: 925-931.

E-Mail this DGReview to a colleague

To print, use this version