Differential Impact of Lacunes and Microvascular Lesions on Poststroke Depression

Santos, Micaela; Gold, Gabriel; Kovari, Eniko Veronika; Herrmann, Françoís; Bozikas, Vasilis P.; Bouras, Constantin; Giannakopoulos, Pantéleimon

doi:10.1161/strokeaha.109.548545

Cited by 83 publications

(68 citation statements)

References 54 publications

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“…Six studies reported on a combination of people with and without dementia described as a single group. Two studies assessed patients with stroke (Esiri et al, 1997;Santos et al, 2009), one study elderly without describing their cognitive status (Longstreth et al, 2009). Three papers concerned patients with cerebral amyloid angiopathy (CAA) (Olichney et al, 1997;Soontornniyomkij et al, 2010;De Reuck et al, 2011a).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000) was used most frequently, followed by the Cognitive Assessment Screening Instrument (Teng et al, 1994). Four studies based their diagnosis on a combination of neuropathology (cerebrovascular disease, AD, stroke, CAA) and clinical examination (dementia, depression) (Lee et al, 2000;Ballard et al, 2000;Santos et al, 2009;Soontornniyomkij et al, 2010) ( Table 1). …”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Age at death was most often used, which varied between a mean of 69 and 95 years of age. One paper reported age at onset of dementia (Ballard et al, 2000), another the age at which stroke occurred (Santos et al, 2009) (Table 1).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…The remaining studies had a more limited brain coverage, that is, only the four lobes (Okamoto et al, 2009) or the temporal, parietal and frontal lobes combined with deep gray matter (Olichney et al, 1997;Gold et al, 2007;Kö vari et al, 2007;Santos et al, 2009). One study focused on the watershed areas (Suter et al, 2002), another study only on one midtemporal, and one midparietal section (Haglund et al, 2006) (see Supplementary Table 2).…”

Section: Review On Cerebral Microinfarctsmentioning

confidence: 99%

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Cerebral Microinfarcts: A Systematic Review of Neuropathological Studies

Brundel

Bresser

Dillen

et al. 2012

J Cereb Blood Flow Metab

239

207

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Vascular cognitive impairment is an umbrella term for cognitive dysfunction associated with and presumed to be caused by vascular brain damage. Autopsy studies have identified microinfarcts as an important neuropathological correlate of vascular cognitive impairment that escapes detection by conventional magnetic resonance imaging (MRI). As a frame of reference for future highresolution MRI studies, we systematically reviewed the literature on neuropathological studies on cerebral microinfarcts in the context of vascular disease, vascular risk factors, cognitive decline and dementia. We identified 32 original patient studies involving 10,515 people. The overall picture is that microinfarcts are common, particularly in patients with vascular dementia (weighted average 62%), Alzheimer's disease (43%), and demented patients with both Alzheimer-type and cerebrovascular pathology (33%) compared with nondemented older individuals (24%). In many patients, multiple microinfarcts were detected. Microinfarcts are described as minute foci with neuronal loss, gliosis, pallor, or more cystic lesions. They are found in all brain regions, possibly more so in the cerebral cortex, particularly in watershed areas. Reported sizes vary from 50 lm to a few mm, which is within the detection limit of current high-resolution MRI. Detection of these lesions in vivo would have a high potential for future pathophysiological studies in vascular cognitive impairment.

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Review On Cerebral Microinfarctsmentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Microinfarcts: A Systematic Review of Neuropathological Studies

Brundel

Bresser

Dillen

et al. 2012

J Cereb Blood Flow Metab

239

207

View full text Add to dashboard Cite

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“…12 A recent autopsy study suggested that lacunar infarcts may predict PSD. 13 There is a lack of large-scale studies on PSD in lacunar stroke. The aim of this study was to determine the relationship between CMB and PSD in lacunar stroke survivors.…”

mentioning

confidence: 99%

Cerebral Microbleeds and Depression in Lacunar Stroke

Tang

Chen

et al. 2011

Stroke

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Background and Purpose-Cerebral microbleeds (CMB) are common in stroke survivors and the community-dwelling elderly. The clinical significance of CMB in the development of depression after a stroke is unknown. This study examined the association between poststroke depression (PSD) and CMB. Methods-A cohort of 235 patients with acute lacunar stroke admitted to the stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. Three months after the onset of the index stroke, a research assistant administered the locally validated 15-item Geriatric Depression Scale. PSD was defined as a Genetic Depression Scale score of Ն7.The presence and location of CMB were evaluated with MRI. Results-In comparison with the non-PSD group, PSD patients were more likely to have lobar CMB (33.3% versus 19.9%; Pϭ0.022). Lobar CMB remained an independent predictor of PSD in the multivariate analysis, with an odds ratio of 2.08 (Pϭ0.032). Conclusions-The

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References

2011

Psychological Management of Stroke

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Differential Impact of Lacunes and Microvascular Lesions on Poststroke Depression

Abstract: The cumulative vascular burden resulting from chronic accumulation of lacunar infarcts within the thalamus, basal ganglia, and deep white matter may be more important than single infarcts in the prediction of PSD.

Cited by 83 publications

References 54 publications

Cerebral Microinfarcts: A Systematic Review of Neuropathological Studies

Cerebral Microinfarcts: A Systematic Review of Neuropathological Studies

Cerebral Microbleeds and Depression in Lacunar Stroke

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