Predictors of cognitive level and depression severity are different in patients with left and right hemispheric stroke within the first year of illness

Spalletta, Gianfranco; Guida, Giovanni; Angelis, Domenico De; Caltagirone, Carlo

doi:10.1007/s00415-002-0885-z

Cited by 61 publications

(44 citation statements)

References 47 publications

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“…Furthermore, PET studies during migraine attacks demonstrated episodic dysfunction of certain brainstem areas [20]. Our data are consistent with these reports and with previous studies showing a relationship between anxiety and depression with vascular left cerebral lesions [4] and with metabolic alteration in left frontal regions [5]. Therefore, the correlation between left unilateral migraine, anxiety and depression we found in migraineurs offers new clues on the role of left cerebral hemisphere in these disorders.…”

Section: Discussionsupporting

confidence: 92%

Psychiatric disorders and pain location in unilateral migraineurs

et al. 2005

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To explore the relationship between the side of pain during attacks and psychopathological features in strictly unilateral migraine, we recruited 35 patients affected by migraine with and/or without aura diagnosed according to the revised ICHD-II criteria. Seventeen patients had right side-locked pain (R-SUM), 11 had left side-locked (L-SUM) and 7 had side-shifting pain (SSM). Patients were administered the Hamilton Anxiety Scale, the State and Trait Anxiety Inventory-State Anxiety, the Beck Depression Inventory and the 20-item Toronto Alexithymia Scale. Statistical analyses showed that the L-SUM group was significantly more anxious and depressed than the other two groups of patients. Our preliminary data suggest that strictly left unilateral migraine is associated with more severe anxiety and depression. This finding appears to be consistent with studies that reported a higher degree of these disorders in patients with left cerebral hemispheric damage

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Section: Discussionsupporting

confidence: 92%

Psychiatric disorders and pain location in unilateral migraineurs

et al. 2005

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“…Furthermore, two vascular risk factors emerged as independent predictors of DS, namely pre-existent TIA(s) and a history of diabetes mellitus (either type 1 or type 2). The finding that diabetes mellitus is a risk factor for the presence of depressive pathology after stroke has been reported before, but this association was found solely in patients with a stroke in the left hemisphere [8]. According to some authors, diabetes is a risk factor for DS through a biological mechanism linking the metabolic changes of diabetes to changes in the brain structure or function [41].…”

Section: Gms Nys Et Al / Journal Of the Neurological Sciences XX mentioning

confidence: 89%

Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke

Nys¹,

Zandvoort²,

Worp³

et al. 2006

Journal of the Neurological Sciences

255

198

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Objective: The aim of the present study was to examine the predictive value of cognitive impairment in the acute phase after stroke as a risk factor for long-term (six to ten months after stroke) depressive symptoms (DS) and a reduced quality of life (QOL), independent of demographic and neurological predictors. Methods: We evaluated 143 patients within the first 3 weeks post-stroke. Predictor variables included domain-specific cognitive function, demographic data, vascular risk factors, lesion characteristics, and clinical factors. Predictor variables associated with long-term DS (Montgomery Å sberg Depression Rating Scale ! 7) and QOL (Stroke-Specific Quality of Life Scale) were identified with multiple logistic and linear regression. Results: Long-term DS were independently predicted by cognitive impairment at baseline, DS at baseline, female sex, diabetes mellitus, and previous TIA(s). Cognitive impairment, increasing age, and functional dependence predicted a reduced QOL, whereas hypercholesterolaemia predicted a better QOL. Among all cognitive disorders, unilateral neglect was the greatest risk factor for DS after 6 months, whereas a disorder in visual perception and construction affected QOL the most. Conclusions: Cognitive impairment and vascular risk factors are important predictors of long-term DS and QOL after stroke. The prognostic value of cognition suggests a reactive component in the development or continuation of long-term DS. D

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“…In the Spalletta et al study, 25 among 153 patients with first-ever stroke lesions of the left (n = 87) or right (n = 66) hemisphere who were less than 1-year poststroke, patients with lefthemisphere lesions and major depression (n = 30) showed significantly more impairment on the MMSE than nondepressed patients with left-hemisphere lesions (n = 27).…”

Section: Diagnosismentioning

confidence: 97%

Post-Stroke Depression: A Review

Robinson

Jorge

2016

AJP

829

632

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Objective-To review the world's (English-language) publications related to depression following stroke.Method-The databases from MEDLINE and PubMed were reviewed for articles related to poststroke depression (PSD), depression and cerebral vascular accident, depression and cerebral vascular disease, and depression and cerebral infarction.Results-Most studies examined prevalence rates of depression and the clinical correlates of depression. Based on pooled data, the overall prevalence of major depression was 21.7% and minor depression was 19.5%. The strongest single correlate of depression was severity of impairment in activities of daily living. However, the existence of depression at baseline was found to be associated with greater impairment at follow-up, ranging from 6 weeks to 2 years in 83% of studies. Further, depression following acute stroke was also associated with greater cognitive impairment and increased mortality. PSD has been shown in 6 double-blind controlled studies to be effectively treated with antidepressants, and 1 study has recently shown that PSD can be effectively prevented.Conclusions-During the past 20 years, significant progress has been made in the identification and treatment of depression following stroke. In the future, antidepressant treatment will likely play an increasing role in the management of patients with acute stroke. Further research is needed to identify the mechanisms of depression and why antidepressants lead to improved physical and cognitive recovery and decreased mortality.Keywords poststroke depression; stroke-related impairments; prevalence; diagnosis; mortality; mechanism of depression The group of cerebrovascular diseases, which includes both sudden-onset ischemia of the brain, owing to thrombosis or emboli and hemorrhagic bleeds within the brain parenchyma or subdural or epidural regions, usually owing to aneurysms or trauma, constitute some of the most common life-threatening problems among the elderly population. Stroke, defined as a sudden loss of blood supply to the brain leading to permanent tissue damage caused by thrombotic, embolic, or hemorrhagic events, ranks as the third leading cause of death (behind only heart disease and cancer) in patients aged 50 years and older. The psychiatric complications of stroke lesions, although recognized for more than 100 years, 1 have never received the attention that has been devoted to poststroke motor deficits, language problems, or intellectual disturbances. Some of these psychiatric complications of stroke, such as depression, have been a focus of research, whereas other complications, such as anxiety or emotional lability, have received relatively little attention. Our paper reviews the world's literature on PSD. NIH Public Access Results DiagnosisThe method for diagnosis of depression among patients with stroke is to conduct a structured or semi-structured MMSE using instruments such as the SCID 2 or the CIDI. 3 The type of symptoms, their severity, and their duration are applied to DSM-IV 4 diagnostic ...

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Predictors of cognitive level and depression severity are different in patients with left and right hemispheric stroke within the first year of illness

Cited by 61 publications

References 47 publications

Psychiatric disorders and pain location in unilateral migraineurs

Psychiatric disorders and pain location in unilateral migraineurs

Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke

Post-Stroke Depression: A Review

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