Functional and neuroanatomic correlations in poststroke depression - The Sunnybrook stroke study

被引:151
作者
Singh, A
Black, SE
Herrmann, N
Leibovitch, FS
Ebert, PL
Lawrence, J
Szalai, JP
机构
[1] Sunnybrook & Womens Coll, Dept Med Neurol, Div Neurol, Res Program Aging,Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada
[2] Sunnybrook & Womens Coll, Dept Psychiat, Hlth Sci Ctr, Res Program Aging, Toronto, ON M4N 3M5, Canada
[3] Sunnybrook & Womens Coll, Dept Res Design & Biostat, Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada
[4] Univ Toronto, Toronto, ON, Canada
关键词
depression; stroke assessment; stroke outcome; tomography; x-ray computed;
D O I
10.1161/01.STR.31.3.637
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-The purpose of our study was to determine the functional and neuroanatomic correlates of poststroke depressive symptoms. Methods-Patients with consecutive admissions to a regional stroke center for new-onset unilateral hemispheric stroke who:met World Health Organization and National Institute of Neurological and Communicative Disorders and Stroke criteria were eligible for inclusion in a longitudinal study. Acutely, patients underwent CT scanning, and at 3 months and 1 year after stroke, depressive symptoms were assessed by using both the Montgomery-Asberg Depression Rating Scale and the Zung Self-Rating Depression Scale. The Functional Independence Measure (FIM) served as an indication of functional outcome and was obtained at 1 month, 3 months,and I year after stroke, along with other demographic information. The Talairach and Tournoux stereotactic atlas was used for the primary determination of CT lesion localization. Lesion proximity to the anterior frontal pole was also measured. Results-Eighty-one patients participated in the longitudinal study. Stepwise:linear regression analyses generated a highly significant model (F-3.76=9.8, R-2=28%, P<0.0005), with lower 1-month total FIM scores, living at home, and damage to the-inferior frontal region predicting higher depression scores at 3 months. Similarly, lower 3-month total FIM scores correlated with higher 3-month depression scores, and lower 1-year total FIM scores correlated with higher I-year depression scores. Conclusions-Functional measures correlated with poststroke depression across time and, together with neuroanatomic measures, predicted depressive symptoms longitudinally. Although inferior frontal lesion location, irrespective of side, appeared to play a role as a risk factor in this study, the degree of: functional dependence after stroke imparted the greatest risk.
引用
收藏
页码:637 / 644
页数:8
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