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Affective disorders and cerebral vascular disease
1Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
The British Journal of Psychiatry : the Journal of Mental Science
|February 1, 1989
Summary
Depression affects 30-50% of stroke survivors and is linked to left-brain lesions. Mania is rare but associated with right-brain lesions and other factors, offering insights into affective disorders.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Major and minor depressive disorders affect 30-50% of stroke patients.
- These mood disorders can persist for over a year without treatment.
- Depression is not strongly linked to impairment severity or demographics but often to specific brain lesions.
Purpose of the Study:
- To investigate the occurrence and characteristics of mood disorders following stroke.
- To explore the association between lesion location and mood disorders post-stroke.
- To understand the potential mechanisms underlying post-stroke mood disturbances.
Main Methods:
- Review of empirical studies on stroke-related mood disorders.
- Correlation analysis between lesion location (left frontal, left basal ganglia, right limbic-connected areas) and mood disorder presentation.
- Examination of potential etiological factors including neurotransmitter dysfunction and genetic predisposition.
Main Results:
- Major depression in stroke patients is associated with left frontal or left basal ganglia lesions and pre-existing subcortical atrophy.
- Post-stroke mania is rare and linked to right hemisphere limbic-connected lesions plus predisposing factors.
- Serotonergic or noradrenergic dysfunction may contribute to depressive disorders.
Conclusions:
- Specific brain lesion locations are associated with distinct mood disorders after stroke.
- The lesion method is valuable for studying the neurobiological mechanisms of affective disorders.
- Further research into neurotransmitter roles and genetic factors is warranted.