The Relationship between Frontal Lobe Lesions, Course of Post-Stroke Depression, and 1-year Prognosis in Patients with First-Ever Ischemic Stroke

Shi, Yuzhi; Xiang, Yu‐Tao; Wu, Shuolin; Zhang, Ning; Zhou, Juan; Bai, Ying; Wang, Shuo; Wang, Yilong; Wang, Wenjuan; Ungvári, Gábor S.; Chiu, Helen F.K.; Wang, Yongjun; Wang, Chunxue

doi:10.1371/journal.pone.0100456

Cited by 27 publications

(20 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Proximity of the stroke lesion to the frontal pole was examined as an early approach to relate PSD to stroke lesion location, and more frontal location of stroke lesions was associated with higher rates of PSD ( 53 , 58 ), a finding just recently reproduced in a large sample of stroke patients ( 59 ).…”

Section: Lesion Location—visual Analysismentioning

confidence: 99%

Post-Stroke Depression: Impact of Lesion Location and Methodological Limitations—A Topical Review

Nickel

Thomalla

2017

Front. Neurol.

View full text Add to dashboard Cite

Post-stroke depression (PSD) affects approximately one-third of all stroke patients. It hinders rehabilitation and is associated with worse functional outcome and increased mortality. Since the identification of PSD is a significant clinical problem, clinicians and researchers have tried to identify predictors that indicate patients at risk of developing PSD. This also includes the research question whether there is an association between PSD and stroke lesion characteristics, e.g., lesion size and lesion location. Early studies addressing this question are largely limited by technical constraints and, thus, focused on simple lesion characteristics such as lesion side or proximity of the lesion to the frontal pole of the brain. More recent studies have addressed the impact of involvement of specific neuronal circuits in the stroke lesion. State-of-the-art methods of lesion symptom mapping to study PSD have only been applied to small patient samples. Overall, results are controversial and no clear pattern of stroke lesions associated with PSD has emerged, though there are findings suggesting that more frontal stroke lesions are associated with higher incidence of PSD. Available studies are hampered by methodological limitations, including drawbacks of lesion analysis methods, small sample size, and the issue of patient selection. These limitations together with differences in approaches to assess PSD and in methods of image analysis limit the comparability of results from different studies. To summarize, as of today no definite association between lesion location and PSD can be ascertained and the understanding of PSD rests incomplete. Further insights are expected from the use of modern lesion inference analysis methods in larger patient samples taking into account standardized assessment of possible confounding parameters, such as stroke treatment and reperfusion status.

show abstract

Section: Lesion Location—visual Analysismentioning

confidence: 99%

Post-Stroke Depression: Impact of Lesion Location and Methodological Limitations—A Topical Review

Nickel

Thomalla

2017

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…In clinical practice, frontal lobe stroke is the most common type of stroke that causes PSD 13 . This may be due to the frontal lobe being closely related to the emotion, cognitive, memory and other advanced functions of the brain 14 .…”

Section: Introductionmentioning

confidence: 99%

A Study of the Brain Abnormalities of Post-Stroke Depression in Frontal Lobe Lesion

Shi¹,

Wu²,

Liu³

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Post stroke depression (PSD) is a serious complication of stroke. Brain imaging is an important method of studying the mechanism of PSD. However, few studies have focused on the single lesion location. The aim of this study was to investigate the brain mechanism of frontal lobe PSD using combined voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI). In total, 30 first-time ischemic frontal lobe stroke patients underwent T1 weighted MRI and resting-state fMRI scans. Clinical assessments included the 24-item Hamilton Rating Scale for Depression, the National Institutes of Health Stroke Scale, and the Mini-Mental State Examination. In our result, decreased gray matter (GM) volume in patients was observed in the prefrontal cortex, limbic system and motor cortex. The anterior cingulate cortex, selected as a seed to perform connectivity analyses, showed a greatly decreased functional connectivity with the prefrontal cortex, cingulate cortex, and motor cortex, but had an increased functional connectivity with the hippocampus gyrus, parahippocampa gyrus, insular, and amygdala. Stroke lesion location reduces excitability of brain areas in the ipsilateral brain. PSD affects mood through the brain network of the prefrontal-limbic circuit. Some brain networks, including motor cortex and the default mode network, show other characteristics of PSD brain network.

show abstract

“…MRI studies reveal that major depressive disorder may involve pathological changes of the temporal and frontal lobes, including the superior temporal gyrus, the hippocampus, the amygdala, the anterior cingulate gyrus, and the orbitofrontal area [22] . Involvement of the frontal lobe and infarcts on frontal subcortical circuits are also an independent predictor of the development of post-stroke depression [23][24][25] . Medial pre-frontal networks that are connected to the medial pre-frontal cortex and the medial as well as the caudo-lateral orbital cortex are involved in the neural networks related to depressive episodes [26] .…”

Section: Discussionmentioning

confidence: 99%

An association between the location of white matter changes and the behavioral and psychological symptoms of dementia in Alzheimer's disease patients

Lin

Kao

et al. 2016

Transl. Neurosci. Clin.

View full text Add to dashboard Cite

KEYWORDSAlzheimer's diseas; white matter changes; leukoaraiosis; behavioral and psychological symptoms of dementia Objective:The frontal lobe may be involved in circuits associated with depression, apathy, aggression, and other psychiatric symptoms. Although white matter changes (WMC) are related to the severity of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD), it is unclear which part of the WMC may play the most important role in BPSD. This study was designed to investigate the relationship between the location of WMC and the severity of BPSD in AD patients. Methods: Among patients diagnosed with Alzheimer's disease between 2009 and 2014, 387 patients were retrospectively reviewed after those with pre-existing organic brain syndrome, psychiatric diseases, or toxic-metabolic encephalopathy were excluded. Patients' demographic and laboratory data, WMC measured with brain computed tomography and scored using the age-related white matter changes (ARWMC) scale, and neuropsychological tests, including the cognitive abilities screening instrument (CASI), the Mini-Mental State Examination (MMSE), the clinical dementia rating scale with sum-box (CDR-SB), and the neuropsychiatric inventory (NPI) were analyzed. Results: There was no significant difference in the NPI between patients with and without a history of stroke, hypertension, and diabetes. No significant difference in the NPI was identified between different sexes or different Apolipoprotein E (APOE) alleles. The NPI score was significantly correlated with the duration of education (r = -0.4515, P = 0.0172), CASI (r = -0.2915, P < 0.0001), MMSE (r = -0.8476, P < 0.0001), and CDR-SB (r = 2.2839, P < 0.0001). WMC in the right frontal lobe showed a significant difference in NPI in comparison to those without WMC (P = 0.0255). After adjusting for age, duration of education, and CASI, WMC in the right frontal lobe remained significantly associated with the NPI score (β = 3.8934, P = 0.042). Conclusions: WMC involving the right frontal lobe may play an important role in the BPSD in AD patients during their dementia diagnosis. Further studies are necessary to confirm whether controlling the risk factors of WMC can slow the progression of BPSD.Citation Lin TC, Lin YH, Kao LL, Kao YH, Yang YH, Chou PS, Wu MN. An association between the location of white matter changes and the behavioral and psychological symptoms of dementia in Alzheimer's disease patients.

show abstract

The Relationship between Frontal Lobe Lesions, Course of Post-Stroke Depression, and 1-year Prognosis in Patients with First-Ever Ischemic Stroke

Cited by 27 publications

References 40 publications

Post-Stroke Depression: Impact of Lesion Location and Methodological Limitations—A Topical Review

Post-Stroke Depression: Impact of Lesion Location and Methodological Limitations—A Topical Review

A Study of the Brain Abnormalities of Post-Stroke Depression in Frontal Lobe Lesion

An association between the location of white matter changes and the behavioral and psychological symptoms of dementia in Alzheimer's disease patients

Contact Info

Product

Resources

About