Depression after minor stroke: prevalence and predictors

Altieri, Marta; Maestrini, Ilaria; Mercurio, Arthur M.; Troisi, P.; Sgarlata, Eleonora; Rea, V.; Piero, Vittorio Di; Lenzi, Gian Luigi

doi:10.1111/j.1468-1331.2011.03583.x

Cited by 78 publications

(69 citation statements)

References 21 publications

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“…19,20 Last, depression has been reported after transient ischemic attack and minor stroke (National Institutes of Health Stroke Scale score ≤5 at discharge). 21,22 Proposed biological factors contributing to PSD include lesion location, genetic susceptibility, inflammation, PSD and functional outcomes PSD is associated with poorer functional outcomes after stroke. Treatment with fluoxetine was associated with lower PSD occurrence rates and improvement in motor recovery in 1 RCT.…”

Section: February 2017mentioning

confidence: 99%

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Towfighi¹,

Ovbiagele²,

Husseini³

et al. 2017

Stroke

536

506

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Abstract-Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion. This multispecialty statement provides a comprehensive review of the current evidence and gaps in current knowledge of the epidemiology, pathophysiology, outcomes, management, and prevention of PSD, and provides implications for clinical practice. (Stroke. 2017;48:e30-e43.

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Section: February 2017mentioning

confidence: 99%

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Towfighi¹,

Ovbiagele²,

Husseini³

et al. 2017

Stroke

536

506

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“…Voxel × voxel t tests were applied in standard brain coordinates using Statistical Parametric Mapping 8 (SPM8, Wellcome Department of Cognitive Neurology). Because they have been linked to depression in previous studies, 18,19 we included age, sex, years of education, lesion size, MMSE score and NIHSS score as covariates to control for confounding factors. We considered results to be significant at p < 0.05, family-wise error (FWE)-corrected, with a cluster size > 100.…”

Section: Whole Brain Statistical Parametric Mappingmentioning

confidence: 99%

A significant risk factor for poststroke depression: the depression-related subnetwork

Yang

Hua

Shang

et al. 2015

jpn

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IntroductionPoststroke depression (PSD) is one of the most common emotional disorders afflicting those who experience stroke. A meta-analysis has indicated that the prevalence of major or mild depression is approximately 18% (range 8%-46%), 1 with the presence of PSD being associated with increased mortality.2 Converging evidence has implicated particular neural networks in the pathophysiology of mood disorders.3 However, despite being one of the direct causes of depression, whether stroke-induced neuroanatomical deterioration actually plays an important role in the onset of PSD is still controversial. Previous neuroimaging studies have focused mainly on regional differences and severity of local brain lesions. 4 In addition, an often-cited meta-analysis that reported no clear association between PSD and any specific lesion location or hemisphere 4 has fueled intense debate. Recently, although statistical parametric mapping linked affective depression to lesions centred in the left basal ganglia and left frontal cortex, the conclusions remain in doubt because results were not corrected for multiple comparisons. 5,6 Diffusion tensor imaging (DTI) is a noninvasive technique that assesses white matter connectivity, particularly fibre density and myelination. In addition, structural brain network interactions can be quantified using brain graphs 7,8 in which neuroanatomical regions are defined as a set of nodes and DTI-derived white matter connections act as interconnecting edges.7 Using this approach, a disruption of neural topology has been shown in several brain diseases, 9-11 including those occurring in chronic stroke patients. 12 Here, we evaluated 3 markers of brain-damage severity: lesion index, fractional anisotropy (FA) reduction and brain structural networks. We hypothesized that a specific brain subnetwork is associated with PSD and that the damage to it might serve as a predictor of poststroke major depression. We constructed a depression-related subnetwork based on Background: Despite being one of the direct causes of depression, whether stroke-induced neuroanatomical deterioration actually plays an important role in the onset of poststroke depression (PSD) is controversial. We assessed the structural basis of PSD, particularly with regard to white matter connectivity. Methods: We evaluated lesion index, fractional anisotropy (FA) reduction and brain structural networks and then analyzed whole brain voxel-based lesions and FA maps. To understand brain damage in the context of brain connectivity, we used a graph theoretical approach. We selected nodes whose degree correlated with the Hamilton Rating Scale for Depression score (p < 0.05, false discovery rate-corrected), after controlling for age, sex, years of education, lesion size, Mini Mental State Examination score and National Institutes of Health Stroke Scale score. We used Poisson regression with robust standard errors to assess the contribution of the identified network toward poststroke major depression. Results: We included 116 stroke patients ...

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“…oststroke depression (PSD) is the most common neuropsychiatric disorder exhibited after stroke, affecting about a third of the growing stroke population (Altieri et al, 2012;Chemerinski & Robinson, 2000;Roger et al, 2012). Even low levels of PSD among patients with stroke are posited to coincide with diminished levels of function (Carod-Artal, Egido, González, & Varela de Seijas, 2000;Ellis, Zhao, & Egede, 2010;House, Knapp, Bamford, & Vail, 2001;Pohjasvaara, Vataja, Leppävuori, Kaste, & Erkinjuntti, 2001).…”

mentioning

confidence: 99%

Minimal Depression: How Does It Relate to Upper-Extremity Impairment and Function in Stroke?

Weaver

Page

Sheffler

et al. 2013

The American Journal of Occupational Therapy

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OBJECTIVE. We sought to determine the association between minimal depression, upper-extremity (UE) impairment, and UE motor function in a cohort of participants with subacute stroke. METHOD. We conducted a retrospective, secondary analysis of an interventional study. Correlational analyses were performed using the following outcome measures: the UE section of the Fugl-Meyer Assessment (FM), the functional ability section of the Arm Motor Ability Test (AMAT), and the Beck Depression Inventory (BDI–II). RESULTS. We found a negative correlation between BDI–II and both the FM (−.120, p = .196) and the AMAT (−.110, p = .275); however, this correlation was not statistically significant. Women exhibited higher depression scores (8.75 ± 0.78) than men (6.29 ± 0.46; p = .008). CONCLUSION. Low levels of depression are not associated with UE motor impairment and function in people with minimal to moderate UE disability levels. Poststroke depression occurs more frequently in women, warranting additional research on sex-specific differences. Given the proliferation of UE therapies targeting this group, this information is important for effective therapy planning and implementation.

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Depression after minor stroke: prevalence and predictors

Abstract: Post-stroke depression is frequent even in patients with minor stroke. Early detection of DSs might help to predict long-term development of PSD. No correlation was observed between lesion site or side and the development of PSD.

Cited by 78 publications

References 21 publications

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

A significant risk factor for poststroke depression: the depression-related subnetwork

Minimal Depression: How Does It Relate to Upper-Extremity Impairment and Function in Stroke?

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