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Depression circuit adaptation in post-stroke depression.

Yanzi Fan1, Luoyu Wang2, Haibo Jiang3

  • 1Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, China.

Journal of Affective Disorders
|May 18, 2023
PubMed
Summary
This summary is machine-generated.

Post-stroke depression (PSD) shows specific changes in the brain's depression circuit, particularly involving the left dorsolateral prefrontal cortex (DLPFC). These findings may aid in developing objective markers for diagnosing and treating PSD.

Keywords:
Depression circuitFunctional connectivityPost-stroke depressionRepetitive transcranial magnetic stimulationResting-state functional magnetic resonance imaging

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Post-stroke depression (PSD) is linked to lesions in a specific depression circuit centered on the left dorsolateral prefrontal cortex (DLPFC).
  • Compensatory adaptations within this circuit in PSD remain largely unexplored.

Purpose of the Study:

  • To investigate the existence and characteristics of the brain's depression circuit in patients with PSD.
  • To examine alterations in DLPFC-seeded functional connectivity in PSD.
  • To identify potential targets for repetitive transcranial magnetic stimulation (rTMS) therapy for PSD.

Main Methods:

  • Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 39 PSD patients, 82 non-depressed stroke patients, and 74 healthy controls.
  • Connectivity analyses focused on the left DLPFC and its relationship with lesioned areas and other brain regions.
  • The study also analyzed connectivity between potential rTMS targets and the DLPFC.

Main Results:

  • The left DLPFC exhibited stronger connectivity to lesions in PSD patients compared to non-depressed stroke patients.
  • PSD patients showed increased DLPFC connectivity with the bilateral lingual gyrus, contralesional superior frontal gyrus, precuneus, and middle frontal gyrus (MFG) compared to both control groups.
  • Connectivity between the DLPFC and the contralesional lingual gyrus positively correlated with depression severity.
  • The MFG emerged as a promising rTMS target due to significant between-group connectivity differences with the DLPFC and high predicted clinical efficacy.

Conclusions:

  • Post-stroke depression is associated with distinct alterations in the brain's depression circuit.
  • These findings suggest potential for objective imaging markers for early diagnosis and targeted interventions in PSD.
  • Further longitudinal studies are needed to track circuit alterations over time.