Post-stroke emotional incontinence after small lenticulocapsular stroke: correlation with lesion location

Although post-stroke emotional incontinence (EI) often occurs after lenticulocapsular strokes, what factors determine the development of EI in these patients has not been identified. I prospectively studied the development of EI in 25 patients (13 men and 12 women, mean age 58.5 years) with single, unilateral, first-ever stroke (24 infarcts and one hemorrhage) of < or = 2 cm in diameter at 2-6 months after the stroke. The patients with major depression were excluded. The lesion location was analysed by CT and/or MRI. The results showed that 13 patients (52 %) had post-stroke EI. The presence of EI was not related to age, gender, the presence of motor or sensory dysfunction, Barthel index score or the size and the laterality of the lesion. Among the lesions involving mainly the globus pallidus, dorsally located lesions were more often associated with EI than ventrally located ones. I conclude that EI is frequent in the patients with small lenticulocapsular stroke, more often associated with the lesions affecting the dorsal than the ventral part of the globus pallidus. The findings appear to be consistent with alleged chemical neuroanatomy that serotonergic fibers are particularly abundant in the internal globus pallidus.