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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

Authors :
Yang Kun Chen
Jin Yan Lu
Winnie C.W. Chu
Ka Sing Wong
Gabor S. Ungvari
Vincent Mok
Wai Kwong Tang
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.

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