Post-stroke depression and lesion location: A hospital based cross-sectional study

Abstract

Background:Depression is a common neuro-psychiatric consequence of stroke, affecting approximately 40% of the patients. Many studies show that in addition to the psychosocial stress, neurobiological factors such as site of infarct and brain atrophy may also be related to Post Stroke Depression (PSD). There are conflicting results in this area of research and paucity of such data in Indian literature. Thus the aim of this study is to weigh the importance of lesion location in PSD.Materials and Methods:Sixty two subjects with their first ever stroke were interviewed using a semi-structured proforma and PSD diagnosed using MINI Plus interview. Scales of Beck Depression Inventory and Montgomery Asberg Depression Rating Scale were used to assess severity of depression. Mini mental state examination was used to assess cognitive impairment and Barthel Index to measure Activities of Daily Living. Neuro-imaging provided information on site and side of lesion. Collected data was analysed using SPSS version 15.0.Results:PSD was diagnosed in 28 subjects, amongst who 19 had left sided lesions. Left sided cortical infarcts and sub cortical infarcts showed statistically significant association with PSD.Conclusion:Results are in keeping with previous landmark studies. Differences in emotional reactions depending on hemisphere and site of the infarct as shown in this study suggest organic biological basis for post stroke depression. Understanding the etiological basis would allow clinicians to monitor patients at risk of developing PSD, enabling early detection and treatment thus improving their quality of life and rehabilitation.

The association between lesion location, sex and poststroke depression: Meta‐analysis

“…According to the criteria outlined above after screening based on their abstracts, we initially excluded 3,758 citations. After we screened their full texts, we found that 31 original reports included categorical data on both depression and gender and were included in the meta-analysis (Folstein, Maiberger, & McHugh, 1977;Andersen, Vestergaard, Ingemann-Nielsen, & Lauritzen, 1995;Herrmann, Bartels, Schumacher, & Wallesch, 1995;Bjerg Bendsen, Bjerg Bendsen, Lauritzen, Vilmar, & Bech, 1997;Kase et al, 1998;Gainotti, Antonucci, Marra, & Paolucci, 2001;Singh et al, 2000;Desmond et al, 2003;Hsieh & Kao, 2005;Nys et al, 2005;Tang et al, 2005;Glodzik-Sobanska et al, 2006;Caeiro, Ferro, Santos, & Figueira, 2006;Brodaty, Withall, Altendorf, & Sachdev, 2007;Fuentes, Ortiz, Sanjose, Frank, & Diez-Tejedor, 2009;Nidhinandana et al, 2010;Nishiyama et al, 2010;Tennen et al, 2011;Shi et al, 2015;Choi-Kwon et al, 2012;Zhang, Pan, Wang, & Zhao, 2013;Rajashekaran, Pai, Thunga, & Unnikrishnan, 2013;Angeleri et al, 1997;Finklestein et al, 1982;Grasso et al, 1994;Ng, Chan, & Straughan, 1995;Sun et al, 2014;Jiang, Lin, & Li, 2014;Saxena & Suman, 2015;Wei et al, 2016;Metoki et al, 2016). The study characteristics and demographics are provided in Table 1.…”

Depressive signs and cognitive performance in patients with a right hemisphere stroke

“…Besides generating a negative impact on functional rehabilitation, it represents one of the most prominent causes to increase mortality in this population (1) . Depression has been detected in between 20 and 60% of stroke patients, this rate ranging in accordance with the evaluation criteria established (by means of scales or semi-structured interviews, for instance), as well as to the population investigated (such as ischemic and/or hemorrhagic, chronic and/or acute stroke) (2) and lesion location.…”

Depression, anxiety, and cognitive functioning after intracerebral hemorrhage

“…Multiprofessional rehabilitation is often necessary among those survivors as most of them have significant disabilities. Post‐stroke depression (PSD) is a common neuropsychiatric complication and has been reported to occur more often in the young stroke patients, females, and those with more severe symptoms . Depressed mood has been reported to be present in 20% of ICH survivors .…”