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Post-stroke depression and lesion location: a systematic review.

Na Wei1, Wu Yong, Xinyan Li

  • 1Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, 430030, China.

Journal of Neurology
|October 14, 2014
PubMed
Summary

Post-stroke depression (PSD) risk is not strongly linked to stroke location overall. However, right hemisphere strokes show a significant association with depression in the subacute phase (1-6 months).

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Post-stroke depression (PSD) is a common complication following stroke, impacting rehabilitation outcomes.
  • Existing research on the association between lesion location and PSD risk presents conflicting findings.
  • A comprehensive evaluation is needed to clarify the relationship between stroke lesion location and depression.

Purpose of the Study:

  • To conduct a systematic meta-analysis to evaluate the relationship between lesion location and the risk of post-stroke depression (PSD).
  • To investigate potential subgroup differences based on the time since stroke onset and patient cohort characteristics.

Main Methods:

  • Systematic literature search of PubMed, ISI Web of Science, and EMBASE databases.
  • Meta-analysis of 43 studies including 5,507 stroke patients, using odds ratios (ORs) and 95% confidence intervals (CIs).
  • Assessment of heterogeneity using Cochran's Q test and I²; publication bias examined using Begg's funnel plot and Egger's test.

Main Results:

  • The overall meta-analysis did not reveal a significant association between stroke location and depression risk (OR = 0.99, 95% CI 0.88-1.11).
  • Subgroup analyses indicated a statistically significant association between right hemisphere stroke and increased depression risk specifically within the subacute phase (1-6 months post-stroke) (OR = 0.79, 95% CI 0.66-0.93).
  • No significant association was found between left hemisphere lesions and an increased risk of depression.

Conclusions:

  • This meta-analysis suggests that stroke location, in general, is not a strong predictor of post-stroke depression.
  • A significant association between right hemisphere lesions and depression risk is identified, but only during the subacute recovery phase.
  • Further research may be warranted to explore the specific mechanisms linking right hemisphere damage to depression in the subacute period.