Post-stroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia

Abstract

This study was designed to examine the correlation between damage to the basal ganglia or frontal lobe and depression status (both affective and apathetic dimensions) in 243 stroke patients. We assessed the affective dimension in post-stroke depression (PSD) using the Zung Self-rating Depression Scale (SDS) and the apathetic dimension in PSD using the apathy scale (AS). We classified basal ganglia or frontal lobe damage into four groups: no damage, damage to the left side only, damage to the right side only, and damage to both sides. Affective and/or apathetic PSD was found in 126 patients (51.9%). The severity of affective depression (SDS score) was associated with left frontal lobe (but not basal ganglia) damage, and that of apathetic depression (AS score) was related to damage to the bilateral basal ganglia (but not to the frontal lobe). The anatomical correlates of PSD differ depending on the PSD dimension (affective or apathetic) and may explain interstudy differences regarding the association between lesion location and type of PSD.

The association between mean platelet volume levels and poststroke depression

“…This finding was in accord with previous studies (Armstrong et al, 2017; Lim et al, 2017). However, there was no significant association between PSD and other clinical characteristics, such as lesion location (Guiraud, et al, 2016; Hama et al, 2007; Metoki et al, 2016), although among some of previous studies the results about lesion location remained controversial.…”

Post-Stroke Depression: Main Phenomenological Clusters and their Relationships with Clinical Measures

“…Major PSD has been frequently associated to left frontal lesions [37,45,46]; furthermore, a modification of such anatomical substrate during the poststroke period has been proposed [40]. Data from Hama et al [20] have suggested differential anatomical substrates of two different subtypes of PSD: "apathetic" PSD, associated to bilateral basal ganglia damage, and "affective" PSD, associated to left frontal lobe lesions.…”

“…Results from previous studies investigating the anatomical substrate of post-stroke apathy are quite inconsistent. It has been related to right side of lesion [8]; furthermore, it has been related to bilateral subcortical damage [20] and to reduced concentration of N-acetyl-aspartate in left frontal lobe [18], independently from the site of lesion. Finally, a functional study has reported a relationship between apathy and hypoperfusion of both frontal lobes after stroke [29].…”

‘Insistence on recovery’ as a positive prognostic factor in Japanese stroke patients

“…[11][12][13][18][19][20] Patients completed the AS within 1 month after admission. The AS consists of 14 questions concerning spontaneity, initiation, emotionality, activity level, and interest in hobbies.…”

“…[11][12][13]17 Patients completed the SDS within 1 month after admission. We classified the patients into two groups according to their score: a non-depressed group (SDS score <45 points) and a depressed group (SDS score Ն45 points).…”