Correlated Resting-State Functional MRI Activity of Frontostriatal, Thalamic, Temporal, and Cerebellar Brain Regions Differentiates Stroke Survivors with High Compared to Low Depressive Symptom Scores

Abstract

Background. One in three survivors of stroke experience poststroke depression (PSD). PSD has been linked with poorer recovery of function and cognition, yet our understanding of potential mechanisms is currently limited. Alterations in resting-state functional MRI have been investigated to a limited extent. Fluctuations in low frequency signal are reported, but it is unknown if interactions are present between the level of depressive symptom score and intrinsic brain activity in varying brain regions. Objective. To investigate potential interaction effects between whole-brain resting-state activity and depressive symptoms in stroke survivors with low and high levels of depressive symptoms. Methods. A cross-sectional analysis of 63 stroke survivors who were assessed at 3 months poststroke for depression, using the Montgomery–Åsberg Depression Rating Scale (MÅDRS-SIGMA), and for brain activity using fMRI. A MÅDRS-SIGMA score of >8 was classified as high depressive symptoms. Fractional amplitude of frequency fluctuations (fALFF) data across three frequency bands (broadband, i.e., ~0.01–0.08; subbands, i.e., slow-5: ~0.01–0.027 Hz, slow-4: 0.027–0.07) was examined. Results. Of the 63 stroke survivors, 38 were classified as “low-depressive symptoms” and 25 as “high depressive symptoms.” Six had a past history of depression. We found interaction effects across frequency bands in several brain regions that differentiated the two groups. The broadband analysis revealed interaction effects in the left insula and the left superior temporal lobe. The subband analysis showed contrasting fALFF response between the two groups in the left thalamus, right caudate, and left cerebellum. Across the three frequency bands, we found contrasting fALFF response in areas within the fronto-limbic-thalamic network and cerebellum. Conclusions. We provide evidence that fALFF is sensitive to changes in poststroke depressive symptom severity and implicates frontostriatal and cerebellar regions, consistent with previous studies. The use of multiband analysis could be an effective method to examine neural correlates of depression after stroke. The START-PrePARE trial is registered with the Australian New Zealand Clinical Trial Registry, number ACTRN12610000987066.

Frequency Specific Alterations of the Degree Centrality in Patients with Acute Basal Ganglia Ischemic Stroke: A Resting-State fMRI Study

“…For example, Zhu and colleague (Zhu et al 2015) found that the change of regional properties of cortical networks are mainly concentrated on slow-5 band by using amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) methods. However, DC abnormalities in the subcortical structures and limbic system was not found in the slow-4 band in this study (Goodin et al 2019;Zuo et al 2010). Our study mainly investigated changes in the frequency-dependent effects on DC among acute BGIS patients, we speculate that the possible reason is that the interaction of the functional impairment and remodeling may not have fully developed in the early stage.…”

Amplitude of Low-Frequency Oscillations in First-Episode Drug-Naive Patients with Major Depressive Disorder: A Resting State Functional Magnetic Resonance Imaging Study

“… 5 In recent studies, it was reported that fALFF was sensitive to changes in post-stroke depressive symptom severity and implicated frontostriatal and cerebellar regions. 6 …”

Neural Substrates of Poststroke Depression: Current Opinions and Methodology Trends

“…The aberrant regional brain activity could be a more sensitive feature than lesion location and volume to characterize PSD in small samples ( Egorova et al, 2017 ). Another rs-fMRI study identified a significant correlation between PSD severity and fALFF in frontostriatal, temporal, thalamic, and cerebellar regions ( Goodin et al, 2019 ). These fMRI results also provided evidence for the role of the frontal-limbic system in PSD.…”