Post-stroke apathy and hypoperfusion in basal ganglia: SPECT study

Area of Science:

• Neurology
• Neuropsychiatry
• Medical Imaging

Background:

• Apathy is a common neuropsychiatric symptom post-stroke.
• Limited research exists on regional cerebral blood flow (rCBF) in stroke patients experiencing apathy.
• This study investigates rCBF differences between apathetic and non-apathetic stroke survivors.

Purpose of the Study:

• To compare regional cerebral blood flow (rCBF) in stroke patients with and without apathy.
• To explore the relationship between basal ganglia lesions, cerebral blood flow, and apathy.
• To determine the prevalence of apathy in the post-stroke population.

Main Methods:

• Recruited 102 patients within one month of cerebral infarction.
• Conducted neuropsychiatric assessments, including the apathy scale.
• Quantitatively measured rCBF using N-isopropyl-p-(123)I-iodoamphetamine single-photon emission computed tomography (SPECT).

Main Results:

• Apathy was present in 36% (37/102) of stroke patients.
• Apathetic patients exhibited lower cognitive function and higher depressive symptoms.
• Reduced rCBF in the basal ganglia was observed in the apathetic group compared to the non-apathetic group.
• Left basal ganglia lesions correlated with hypoperfusion in bilateral basal ganglia and apathy.

Conclusions:

• Apathy is a frequent complication following stroke.
• Hypoperfusion in the basal ganglia, potentially due to lesions, is implicated in the development of post-stroke apathy.
• Findings highlight the role of basal ganglia integrity in emotional and cognitive regulation after stroke.