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Lesion characteristics and depressed mood in the stroke data bank study
P L Morris1, R G Robinson, M L de Carvalho
1Department of Psychiatry, University of Melbourne, Victoria, Australia.
Insights
Depression after stroke is linked to lesion location, not size. Left hemisphere strokes show higher depression rates in patients with smaller lesions, suggesting lateralized effects on mood.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Depressed mood is a common complication following stroke.
- The relationship between stroke characteristics and mood disorders requires further investigation.
Purpose of the Study:
- To investigate the association between the size and location of cerebral infarction lesions and the occurrence of depressed mood in stroke patients.
Main Methods:
- Utilized data from the National Stroke Data Bank, including CT scans for lesion characterization.
- Analyzed 193 patients with first-ever cerebral infarction, assessing lesion size, location, and depressed mood.
- Compared depression rates between left and right hemisphere strokes, particularly for small-sized lesions.
Main Results:
- No overall association was found between lesion size or location and depression in the complete sample.
- However, among patients with small lesions, depression was significantly more frequent in left hemisphere strokes (31%) compared to right hemisphere strokes (16%).
- Brain edema in larger lesions may have confounded lateralized findings.
Conclusions:
- Lesion lateralization, specifically left hemisphere involvement, may be associated with increased depression risk in smaller strokes.
- Asymmetrical biogenic amine neurotransmitter responses to hemispheric injury could explain mood asymmetry.
- Further research is needed to understand the neurobiological underpinnings of post-stroke mood disorders.
Abstract:
This study examined the relationship between post-stroke lesion size and location and depressed mood by using data from the multicenter National Stroke Data Bank. For in patients with first-ever cerebral infarction, lesions were characterized by location and size from CT scans. Forty-seven (24%) of the 193 patients studied were depressed. In the complete sample, neither lesion size nor location was associated with depression. However, among patients with comparable small-sized lesions (n = 124), depression was more frequent among those with left hemisphere stroke than those with right hemisphere stroke (31% vs. 16%; P = 0.04). Among patients with larger lesions, brain edema was common and may have obscured lateralized findings. Different biogenic amine neurotransmitter responses to right and left hemisphere brain injury may underlie this mood asymmetry.