Frontal Infarcts and Anxiety in Stroke

Abstract

Background and Purpose— This study examined the association between poststroke anxiety symptoms (PSA) and frontal lobe infarcts. Methods— A cohort of 693 patients was recruited. PSA was defined as an anxiety subscale of the Hospital Anxiety and Depression Scale score of 8 or above. The presence and location of infarcts were evaluated with MRI. Results— Compared with the non-PSA group, PSA patients were more likely to have right frontal acute infarcts. Right frontal infarcts remained independent predictors of PSA in the multivariate analysis, with an odds ratio of 4.44 ( P =0.002). Conclusions— The results suggest that right frontal acute infarcts may play a role in the development of PSA.

Factors Associated with Poststroke Anxiety: A Systematic Review and Meta-Analysis

“…The proportion of females ranged from 20.8% to 59.3% with one study not reporting this data [22]. Six studies had participants with ischaemic stroke [25, 26, 29, 31, 32, 36], nine had both ischaemic and haemorrhagic stroke [18, 19, 21, 23, 27, 28, 30, 35, 37], and nine did not specify the type of stroke [9–11, 17, 20, 22, 24, 33, 34]. 13 studies recruited participants from hospital [9, 10, 21, 25–31, 34–36], four from rehabilitation centres [18, 23, 33, 37], three from the community (including outpatient clinics) [11, 19, 20], and four from the population (such as stroke registers) [17, 22, 24, 32].…”

“…To assess the presence of anxiety, 13 studies used the Hospital Anxiety and Depression Scale (HADS-A) [17–19, 21, 22, 24, 26, 28, 29, 33–36], three studies used the Hamilton Anxiety Scale (HAM-A) [25, 27, 31], one used the Beck Anxiety Inventory (BAI) [23], two used the DSM-IV criteria [10, 32], one used the Irritability Depression and Anxiety scale (IDA) [30], one used the two-item Generalized Anxiety Disorder questionnaire (GAD-2) [20], two used the Posttraumatic Diagnostic Scale (PDS) [9, 37], and one used the PTSD Checklist Specific for a stressor (PCL-S) [11]. The percentage of participants deemed to have PSA using these scales ranged from 6.06% to 56.4%.…”

“…Seven used a cut-off of ≥8 [21, 22, 26, 29, 33, 35, 36], one study used a cut-off of ≥4 [18], one study used a cut-off of ≥5 [28], two studies used a score of 8–10 as possible caseness and a score of ≥11 as probable caseness [17, 24] and two did not specify a cut-off [19, 34]. …”

Prevalence of anxiety in people with aphasia after stroke

“…The association of anxiety with younger age may indicate a risk factor to be considered in this population, though results from studies that have considered this in the whole stroke population are inconsistent, with some studies supporting it (Broomfield, Scoular, Welsh, Walters, & Evans, 2013;Castellanos-Pinedo et al, 2011) and others not (Lincoln et al, 2013;Tang et al, 2012).…”

Right frontal lobe encephalomalacia in an adult propionic acidemia patient with neuropsychiatric manifestations

“…The possibility of a complex partial seizure was considered but his EEG was not suggestive, neither was there a response to anticonvulsants. It may have been precipitated by the frontal lobe encephalomalacia as right frontal lobe lesions are associated with disorganized behavior and anxiety [1], [2]. However, encephalomalacia is most likely a result of previous metabolic stroke and may not explain acute symptoms.…”