Emotional correlates of structural brain injury with particular emphasis on post-stroke mood disorders

This article reviews the emotional disorders which have historically been associated with brain injury and hypotheses about the nature of the relationship between emotional symptoms and neuropathology. Although a causal connection between emotional disorders and neurophysiological changes in the brain has been proposed, most clinicians have attributed the emotional disorders to a psychological response to the lesion-induced impairments. Relatively recent studies utilizing measurement of emotions, however, have suggested that emotional symptoms are not explained by severity of impairment. Studies of lateralization of emotional response to brain injury are discussed which exemplify the development of neurobiological theories for post-brain injury mood disorders. The importance of lesion size and location, time since injury, as well as physical and intellectual impairments and social factors on post-brain injury emotional disorders, are all reviewed in relation to recent findings. Results of a recent double-blind drug study suggest that post-stroke depressive disorders may be treatable with antidepressants.