Poststroke Depression and Lesion Location

Sinyor, David; Jacques, Phyllis; Kaloupek, Danny G.; Becker, Rubin; Goldenberg, Marvin M.; Coopersmith, H

doi:10.1093/brain/109.3.537

Cited by 218 publications

(91 citation statements)

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“…In the end, 26 original reports were included in the review (Table). 10, Ten articles observed no significant association between lesion locations and the frequency or severity of PSD. * Two studies cited a significant association between right hemisphere strokes and PSD 33,45 ; 4 studies noted a significant association between left hemisphere strokes and PSD 7,28,30,41 ; 3 studies noted greater depression associated with left hemisphere basal ganglia lesions 31,39,40 ; and 7 studies noted changes in the association between lesion location and PSD over time.…”

Section: Resultsmentioning

confidence: 93%

“…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: 96%

“…Furthermore, differences in emotional reactions depending on hemisphere of the infarct suggested an organic basis of PSD. 10 The association between the location of brain lesion as a result of stroke and PSD has been the topic of much research.…”

mentioning

confidence: 99%

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Lesion location and poststroke depression

Morris

Robinson²,

Raphael³

et al. 1996

JNP

140

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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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Section: Resultsmentioning

confidence: 93%

Section: Bhogal Et Al Lesion Location and Poststroke Depressionmentioning

confidence: 96%

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Lesion location and poststroke depression

Morris

Robinson²,

Raphael³

et al. 1996

JNP

140

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“…(1986) have indicated that the sex differences in the frequency of PSD may be masked by the excluding patients, who had a history of psychiatric disorder. More especially, it is reported that there is a sex‐specific prevalence of PSD.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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BackgroundPoststroke depression (PSD) is a common form of stroke patients. Whether the risk of PSD is influenced by the stroke lesion location and sex remains a matter of debate. The objective of this study was to examine the association between the risk of PSD and the stroke lesion location and sex by performing a systematic meta‐analysis.MethodsSubgroup analyses were performed according to the time interval after stroke onset to assessment for PSD. A total of 31 reports involving 5,309 subjects (for lesion location analysis) and 5,489 subjects (for sex analysis) suffering from stroke were included in this meta‐analysis.ResultsThe pooled odds ratio (OR) of PSD after a left‐hemisphere stroke, compared with a right‐hemisphere stroke was 1.11 (95% confidence interval [CI] 0.82–1.49) and OR of PSD after a male stroke, compared with a female stroke was 0.68 (95% CI 0.58–0.81). Subacute poststroke subgroup (1–6 months) significantly favored PSD occurring after a left hemisphere stroke (OR = 1.50, 95% CI 1.21–1.87). Furthermore, there was a statistically significant association between PSD and female stroke for studies with acute poststroke group (OR = 0.73, 95% CI 0.62–0.86) and subacute poststroke stroke phase (OR = 0.69, 95% CI 0.56–0.86).ConclusionsThis systematic review suggests that patients with left hemisphere stroke may be more susceptible to PSD during subacute phase of stroke and female stroke may be more susceptible to PSD during acute and subacute phase of stroke.

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“…Alguns estudos não encontraram associação entre a lateralidade do AVC e a ocorrência de depressão em pacientes de centro de reabilitação 37 e da comunidade 38,39 .…”

Section: Depressão Pós-avcunclassified

Depressão pós-AVC: fatores de risco e terapêutica antidepressiva

Terroni¹,

Leite²,

Tinone³

et al. 2003

Rev. Assoc. Med. Bras.

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INTRODUÇÃOO acidente vascular cerebral (AVC) pode limitar de modo significativo o desempenho funcional, com conseqüências negativas nas relações pessoais, familiares, sociais e sobretudo na qualidade de vida. Essa limitação, entretanto, nem sempre se deve ao déficit neurológico em si. Complicações psiquiátricas têm sido indicadas como fatores determinantes da incapacitação do paciente após o AVC. Dentre as complicações psiquiátricas, a depressão é a mais prevalente e a que mais tem sido associada a um pior prognóstico.Conhecer a natureza desta depressão e seus fatores de risco torna-se essencial para aprimorar seu diagnóstico e tratamento.A participação de fatores psicológicos é difícil de ser questionada. Somente o impacto RESUMO -A depressão é a complicação psiquiátrica mais freqüen-te nos pacientes com acidente vascular cerebral (AVC). Vários aspectos têm sido detectados como fatores de risco para a sua ocorrência. Neste artigo faz-se uma revisão dos fatores envolvidos na depressão pós-AVC e o estado atual de seu tratamento, a fim de estimular sua detecção e adequado tratamento pelo médico não-psiquiatra.A prevalência da depressão maior pós-AVC é de 10% a 34%, variando conforme as diferenças dos métodos de pesquisa. O período do pós-AVC, o tipo de população avaliada e o tratamento recebido pelos pacientes, assim como o critério utilizado para o diagnóstico da depressão, podem influir a sua prevalência.Fatores de risco associados à ocorrência da depressão pós-AVC têm sido detectados, tais como: prejuízo funcional, prejuízo cognitivo, história de depressão no passado, idade, sexo, AVC prévio, hipercortisolemia, precária rede de suporte social e características neuroanatômicas do AVC. Estes têm fornecido suporte para formulação de um mecanismo fisiopatológico da depressão pós-AVC, relacionado às vias prefrontosubcortical e à neurotransmissão das aminas biogênicas.As repercussões da depressão são significativas, incorrendo em um maior grau de prejuízo funcional, retardo do processo de reabilitação, complicações na evolução e maior risco de mortalidade. A isto se soma o seu subdiagnóstico e subtratamento.Com o advento da ressonância magnética, pesquisadores devem investigar a associação de regiões cerebrais específicas com a manifestação depressiva e resposta terapêutica. Aspectos metodológicos devem ser levados em consideração para uma análise mais confiável.

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Poststroke Depression and Lesion Location

Cited by 218 publications

References 0 publications

Lesion location and poststroke depression

Lesion location and poststroke depression

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

Depressão pós-AVC: fatores de risco e terapêutica antidepressiva

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