Poststroke apathy and regional cerebral blood flow

Area of Science:

• Neurology
• Neuroscience
• Psychiatry

Background:

• Apathy is a known neuropsychiatric symptom post-stroke.
• Previous research lacked studies on regional cerebral blood flow (rCBF) in stroke-associated apathy.
• This study addresses this gap by examining rCBF in stroke patients with apathy.

Purpose of the Study:

• To estimate apathy severity in stroke patients using the Apathy Scale.
• To investigate the relationship between apathy severity and regional cerebral blood flow (rCBF).
• To identify specific brain regions affected by reduced rCBF in apathetic stroke patients.

Main Methods:

• 40 stroke patients were assessed using neuropsychiatric batteries, including the Apathy Scale, verbal intelligence, frontal function tests, depression scale, and activities of daily living.
• Regional cerebral blood flow (rCBF) was measured using the 133Xe inhalation method.
• MRI was used to assess lesion distribution, though not directly correlated with apathy scores.

Main Results:

• 50% of stroke patients exhibited apathy.
• Apathetic patients showed lower verbal intelligence and frontal function scores, and higher depression scores.
• Significantly reduced bilateral hemisphere rCBF was observed in apathetic patients, particularly in the right dorsolateral frontal and left fronto-temporal regions.
• Apathy scores negatively correlated with rCBF in these specific brain areas.

Conclusions:

• Apathy is a common symptom in elderly stroke patients, often co-occurring with cognitive deficits, depression, and frontal dysfunction.
• Hypoactivity in the frontal lobe and anterior temporal regions is implicated in the development of apathy following stroke.
• These findings highlight the importance of assessing rCBF in understanding and potentially treating apathy after stroke.