Influence of Premorbid Psychopathology and Lesion Location on Affective and Behavioral Disorders After Ischemic Stroke

Abstract

Early recognition of psychopathological symptoms (PSs) after stroke is important because they greatly influence the recovery of patients. The aim of this study was to investigate the predictive factors of PSs occurring in patients with ischemic stroke. Eighty-nine patients were prospectively evaluated upon admission and 4, 12, and 26 weeks later with the Neuropsychiatric Inventory, Hamilton's Rating Scales for Depression and Anxiety, and a battery of neuropsychological and functional scales. Depression and apathy were the most frequent PSs detected after stroke. Premorbid psychopathologies and right-hemisphere location were the main predictive indicators of early and long-term PSs.

Poststroke Apathy

“…Four articles provided longitudinal data with the length of followup ranging from 6 to 16 months. 6,21,31,36 The estimate for the mean prevalence of apathy across studies was 34.6% (95% CI, 29.5-40.2). Heterogeneity was moderate (I 2 =46.4%).…”

“…[33][34][35][36][37][38][39][40][41][42] Assessment of the risk of bias per study is provided in Appendix SIII in the online-only Data Supplement.…”

“…In 3 studies, the association between apathy and other concurrent neuropsychiatric symptoms was assessed, but none were found. 27,36,42 In one study, personality before stroke was assessed, and no association with apathy was found. 37 More research on the interplay between other factors, such as fatigue and apathy, is needed to further elucidate the nosological position of poststroke apathy.…”

“…Apathy rates are reported to be rather stable over time in longitudinal studies, 6,31 sometimes after a significantly lower prevalence in the first months after stroke. 21,36 There were insufficient data for pooling the results of longitudinal studies separately. Stratification of studies according to the average time since stroke shows that reported apathy rates were generally lower in studies with assessment later after stroke.…”

Prevalence of anxiety in people with aphasia after stroke

“…The association of anxiety with younger age may indicate a risk factor to be considered in this population, though results from studies that have considered this in the whole stroke population are inconsistent, with some studies supporting it (Broomfield, Scoular, Welsh, Walters, & Evans, 2013;Castellanos-Pinedo et al, 2011) and others not (Lincoln et al, 2013;Tang et al, 2012).…”