Lesions in the right Rolandic operculum are associated with self-rating affective and apathetic depressive symptoms for post-stroke patients

Abstract

Stroke survivors majorly suffered from post-stroke depression (PSD). The PSD diagnosis is commonly performed based on the clinical cut-off for psychometric inventories. However, we hypothesized that PSD involves spectrum symptoms (e.g., apathy, depression, anxiety, and stress domains) and severity levels. Therefore, instead of using the clinical cut-off, we suggested a data-driven analysis to interpret patient spectrum conditions. The patients’ psychological conditions were categorized in an unsupervised manner using the k-means clustering method, and the relationships between psychological conditions and quantitative lesion degrees were evaluated. This study involved one hundred sixty-five patient data; all patients were able to understand and perform self-rating psychological conditions (i.e., no aphasia). Four severity levels—low, low-to-moderate, moderate-to-high, and high—were observed for each combination of two psychological domains. Patients with worse conditions showed the significantly greater lesion degree at the right Rolandic operculum (part of Brodmann area 43). The dissimilarities between stress and other domains were also suggested. Patients with high stress were specifically associated with lesions in the left thalamus. Impaired emotion processing and stress-affected functions have been frequently related to those lesion regions. Those lesions were also robust and localized, suggesting the possibility of an objective for predicting psychological conditions from brain lesions.

Distinct neurostructural signatures of anxiety-, fear-related and depressive disorders: a comparative voxel-based meta-analysis

“…The insula/Rolandic operculum are implicated in interoceptive, salience and emotion processing (42). Restingstate fMRI and lesion studies suggested that deficits in Rolandic operculum are associated with GAD and high anxiety and perceived stress which characterizes GAD (43,44). The left IFG has been consistently reported in previous meta-analyses examining brain structural markers of both, GAD (22) and mixed AD (27,28).…”

Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study

“…The ROL plays a recognized role in various neurologic and psychiatric conditions ( Mălîia et al, 2018 ; Sutoko et al, 2020 ). Its complex functions include sensory, motor, autonomic, cognitive, and emotion processing.…”

“…These functions are implemented by highly specialized neuronal populations and their widespread connections (Mȃlîia et al, 2018). Sutoko et al (2020) found that the high severity level in other psychological domains (e.g., apathy, depression, and anxiety) is associated with the high lesion degree at the right ROL. Janse et al (2019) reported that compared with neutral images, the ROL has reduced neural response to emotional images in alcohol-dependent patients versus HCs.…”

Altered Spontaneous Brain Activity Patterns and Functional Connectivity in Adults With Intermittent Exotropia: A Resting-State fMRI Study

“…The increased ALFF/fALFF values in the PreCG, IFG, and increased FC between these regions and brain areas related to the ocular movement indicates a compensation and devotion to remaining in the normal eye position. Some scholars believe that ROL is associated with self-rating affective and apathetic depressive symptoms, which may indicate symptoms of depression of IXT patients (Sutoko et al, 2020).…”