Mood Changes After Right-Hemisphere Lesions

Starkstein, Sergio E.; Robinson, Robert G.; Honig, Marc A.; Parikh, Rajesh M.; Joselyn, John; Price, Thomas R.

doi:10.1192/bjp.155.1.79

“…42 Five studies did not provide frequency counts of the number of depressed and nondepressed patients with either left or right hemisphere strokes. 10,32,33,38,47 As shown in Figure 1, the 95% CIs for individual studies were wide, and the test of heterogeneity was highly significant ( 2 ϭ75.45, PϽ0.00001), indicating substantial variation in OR among studies. As noted earlier, much of this variation is believed to reflect the methodological differences of the literature.…”

Section: Resultsmentioning

confidence: 97%

Lesion Location and Poststroke Depression

Bhogal

¹

,

Teasell

²

,

Foley

³

et al. 2004

Stroke

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Background-It has been hypothesized that poststroke depression (PSD) results from left hemisphere lesions. However, attempts to systematically review the data investigating lesion location and PSD have yielded conflicting results. We sought to investigate the methodological differences across the literature studying the relationship between lesion location and PSD. Summary of Review-A MEDLINE literature search to retrieve articles investigating the association between PSD and lesion location was performed. Information sought included source population of samples, definition of depression, standardized measurement of stroke and depression, blinding, time since stroke onset, and study design. Odds ratios (ORs) and 95% CIs were calculated with the use of Review Manager and MetaView statistical software. Twenty-six original articles were reviewed. Much of the heterogeneity across studies reflected differences in methodology. The direction of association between left hemisphere lesion location and PSD varied depending on whether patients were sampled as inpatients (OR, 1.36; 95% CI, 1.05 to 1.76) or from the community (OR, 0.60; 95% CI, 0.39 to 0.92). Change in the direction of association was also observed across assessment interval from the acute stroke (OR, 2.14; 95% CI, 1.50 to 3.04) to the chronic stroke (OR, 0.53; 95% CI, 0.30 to 0.93) phase. Differences in the measurement of depression, study design, and presentations of results also may have contributed to the heterogeneity of the findings. Conclusions-Several key initiatives should be addressed before future research is undertaken, including the development of a comprehensive measure of PSD, optimal poststroke assessment intervals, and determination of a representative population reference.

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“…Normalized CBF values in the mesial ). Counts in ROIs belonging to the same anatomicofunctional area were averaged, obtaining 11 regions, as follows: basal temporal (T) region (1); basal frontal (F) region (2); lateral temporal cortex (3,7,14); mesial temporal cortex (4); prefrontal region (5,12,16); motor areas (6,13,17,20); parietal (P) cortex (18,21); occipital (O) cortex (8,15,19); caudate nucleus (9); lenticular nucleus (10); and thalamus (11).…”

Section: Resultsmentioning

confidence: 99%

Mesial temporal cortex hypoperfusion is associated with depression in subcortical stroke.

Grasso

¹

,

Pantano

²

,

Ricci

³

et al. 1994

Stroke

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Background and Purpose This study was conducted to evaluate local cerebral blood flow changes in patients with depression after a subcortical stroke.Methods Clinical and neuropsychological assessments were performed in 15 patients with a single subcortical lesion. Depression was assessed by DSM-III-R. In addition, the Hamilton Rating Scale for depression, the Zung Self-Rating Depression Scale, and the Beck scale were administered to each patient. Single-photon emission-computed tomography study was performed with " T C hexamethylpropyleneamine oxime.Results In all patients cortical regions ipsilateral to subcortical lesions were significantly less perfused than the contra-

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“…10,32,33,38,47 As shown in Figure 1, the 95% CIs for individual studies were wide, and the test of heterogeneity was highly significant ( 2 ϭ75.45, PϽ0.00001), indicating substantial variation in OR among studies. As noted earlier, much of this variation is believed to reflect the methodological differences of the literature.…”

Section: Bhogal Et Al Lesion Location and Poststroke Depressionmentioning

confidence: 98%

Lesion location and poststroke depression

Morris

¹

,

Robinson²,

Raphael³

et al. 1996

JNP

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Background-It has been hypothesized that poststroke depression (PSD) results from left hemisphere lesions. However, attempts to systematically review the data investigating lesion location and PSD have yielded conflicting results. We sought to investigate the methodological differences across the literature studying the relationship between lesion location and PSD. Summary of Review-A MEDLINE literature search to retrieve articles investigating the association between PSD and lesion location was performed. Information sought included source population of samples, definition of depression, standardized measurement of stroke and depression, blinding, time since stroke onset, and study design. Odds ratios (ORs) and 95% CIs were calculated with the use of Review Manager and MetaView statistical software. Twenty-six original articles were reviewed. Much of the heterogeneity across studies reflected differences in methodology. The direction of association between left hemisphere lesion location and PSD varied depending on whether patients were sampled as inpatients (OR, 1.36; 95% CI, 1.05 to 1.76) or from the community (OR, 0.60; 95% CI, 0.39 to 0.92). Change in the direction of association was also observed across assessment interval from the acute stroke (OR, 2.14; 95% CI, 1.50 to 3.04) to the chronic stroke (OR, 0.53; 95% CI, 0.30 to 0.93) phase. Differences in the measurement of depression, study design, and presentations of results also may have contributed to the heterogeneity of the findings. Conclusions-Several key initiatives should be addressed before future research is undertaken, including the development of a comprehensive measure of PSD, optimal poststroke assessment intervals, and determination of a representative population reference.

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Mood Changes After Right-Hemisphere Lesions

Cited by 154 publications

References 27 publications

Lesion Location and Poststroke Depression

Lesion Location and Poststroke Depression

Mesial temporal cortex hypoperfusion is associated with depression in subcortical stroke.

Lesion location and poststroke depression

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