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Association of Frontal Subcortical Circuits Infarcts in Poststroke Depression: A Magnetic Resonance Imaging Study of 591 Chinese Patients With Ischemic Stroke
- Source :
- Journal of Geriatric Psychiatry and Neurology. 24:44-49
- Publication Year :
- 2010
- Publisher :
- SAGE Publications, 2010.
-
Abstract
- Despite extensive research into poststroke depression (PSD), the role played by lesion location in the pathogenesis of PSD remains uncertain. The aim of this study was to estimate the magnetic resonance imaging (MRI) correlates of PSD in Chinese patients with first or recurrent stroke. A total of 591 patients with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong were recruited. A psychiatrist assessed all the patients 3 months after the stroke. The psychiatrist used the Structured Clinical Interview for Diagnostic and Statistical Manual, fourth edition (DSM-IV) to confirm whether the patients met the criteria of a depressive disorder. In addition, a host of demographic, clinical, and radiological variables were examined. A tota; of 475 and 116 patients had first and recurrent strokes, respectively. In all, 75 (12.7%) patients received a diagnosis of PSD. In univariate analysis of the MRI findings, the presence of infarcts in the frontal subcortical circuits ([FSC], 66.7% vs 53.3%) was significantly associated with PSD (P = .03) compared to the patients without PSD. The FSC infarct-PSD association remained significant (odds ratio = 2.6) in subsequent logistic regression analysis after adjusting for gender, history of depression, neurological impairment, level of social support, and major life events. In conclusion, FSC infarcts are independent predictors of PSD. Further work is needed to clarify whether these infarcts have an impact on the clinical presentation, treatment responses, and prognosis of PSD.
- Subjects :
- Male
medicine.medical_specialty
Neurology
Brain Ischemia
Central nervous system disease
Internal medicine
mental disorders
medicine
Humans
Stroke
Depression (differential diagnoses)
Depressive Disorder
Univariate analysis
medicine.diagnostic_test
business.industry
Cerebral infarction
Magnetic resonance imaging
Odds ratio
Prognosis
medicine.disease
Magnetic Resonance Imaging
Frontal Lobe
Surgery
Psychiatry and Mental health
Logistic Models
nervous system
Hong Kong
Female
Neurology (clinical)
Geriatrics and Gerontology
business
Subjects
Details
- ISSN :
- 15525708 and 08919887
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Journal of Geriatric Psychiatry and Neurology
- Accession number :
- edsair.doi.dedup.....6f6e07ed4452000814b6412b672e8e71
- Full Text :
- https://doi.org/10.1177/0891988710392375