Focal or generalized vascular brain damage and vulnerability to depression after stroke: a 1-year prospective follow-up study

2006 ◽  
Vol 18 (1) ◽  
pp. 19-35 ◽  
Author(s):  
I. Aben ◽  
J. Lodder ◽  
A. Honig ◽  
R. Lousberg ◽  
A. Boreas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Damage ◽  
Rating Scales ◽  
Screening Tools ◽  
Vascular Depression ◽  
Lesion Location ◽  
Post Stroke ◽  
Negative Results ◽  
Post Stroke Depression ◽  
One Year

Background: Both the lesion location hypothesis and the vascular depression hypothesis have been proposed to explain the high incidence of depression in stroke patients. However, research studying both hypotheses in a single cohort is, at present, scarce.Objective: To test the independent effects of lesion location (left hemisphere, anterior region) and of co-occurring generalized vascular damage on the development of depression in the first year after ischemic stroke, while other risk factors for depression are controlled for.Methods: One hundred and ninety consecutive patients with a first-ever, supratentorial infarct were followed up for one year. CT was performed in the acute phase of stroke, while in 75 patients an additional MRI scan was also available. Depression was assessed at 1, 3, 6, 9, and 12 months after stroke using self-rating scales as screening tools and the SCID-I to diagnose depression according to DSM-IV criteria.Results: Separate analyses of the lesion location hypothesis and the vascular depression hypothesis failed to reveal significant support for either of these biological models of post-stroke depression. Similar negative results appeared from one overall, multivariate analysis including variables of both focal and generalized vascular brain damage, as well as other non-cerebral risk factors. In addition, level of handicap and neuroticism were independent predictors of depression in this cohort, as has been reported previously.Conclusion: This study supports neither the lesion location nor the vascular depression hypothesis of post-stroke depression. A biopsychosocial model including both premorbid (prior to stroke) vulnerability factors, such as neuroticism and (family) history of depression, as well as post-stroke stressors, such as level of handicap, may be more appropriate and deserves further study.

Post-stroke depression, obstructive sleep apnea, and cognitive impairment: Rationale for, and barriers to, routine screening

2016 ◽  
Vol 11 (5) ◽  
pp. 509-518 ◽  
Author(s):  
Richard H Swartz ◽  
Mark Bayley ◽  
Krista L Lanctôt ◽  
Brian J Murray ◽  
Megan L Cayley ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Routine Screening ◽  
Screening Tools ◽  
Stroke Recurrence ◽  
Post Stroke ◽  
Obstructive Sleep ◽  
Post Stroke Depression ◽  
The Impact

Stroke can cause neurological impairment ranging from mild to severe, but the impact of stroke extends beyond the initial brain injury to include a complex interplay of devastating comorbidities including: post-stroke depression, obstructive sleep apnea, and cognitive impairment (“DOC”). We reviewed the frequency, impact, and treatment options for each DOC condition. We then used the Ottawa Model of Research Use to examine gaps in care, understand the barriers to knowledge translation, identification, and addressing these important post-stroke comorbidities. Each of the DOC conditions is common and result in poorer recovery, greater functional impairment, increased stroke recurrence and mortality, even after accounting for traditional vascular risk factors. Despite the strong relationships between DOC comorbidities and these negative outcomes as well as recommendations for screening based on best practice recommendations from several countries, they are frequently not assessed. Barriers related to the nature of the screening tools (e.g., time consuming in high-volume clinics), practice environment (e.g., lack of human resources or space), as well as potential adopters (e.g., equipoise surrounding the benefits of treatment for these conditions) pose challenges to routine screening implementation. Simple, feasible approaches to routine screening coupled with appropriate, evidence-based treatment protocols are required to better identify and manage depression, obstructive sleep apnea, and cognitive impairment symptoms in stroke prevention clinic patients to reduce the impact of these important post-stroke comorbidities. These tools may in turn facilitate large-scale randomized controlled treatment trials of interventions for DOC conditions that may help to improve cardiovascular outcomes after stroke or TIA.

A prospective cohort study of lesion location and its relation to post-stroke depression among Chinese patients

2012 ◽  
Vol 136 (1-2) ◽  
pp. e83-e87 ◽  
Author(s):  
Tong Zhang ◽  
Xue Jing ◽  
Xingquan Zhao ◽  
Chunxue Wang ◽  
Zhaorui Liu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Chinese Patients ◽  
Lesion Location ◽  
Post Stroke ◽  
Post Stroke Depression

scholarly journals Associations between stroke severity, aphasia severity, lesion location, and lesion size in acute stroke, and aphasia severity one year post stroke

Aphasiology ◽  
2021 ◽  
pp. 1-23
Author(s):  
Hedda Døli ◽  
Wenche Andersen Helland ◽  
Turid Helland ◽  
Halvor Næss ◽  
Håkon Hofstad ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Lesion Size ◽  
Stroke Severity ◽  
Lesion Location ◽  
Post Stroke ◽  
One Year

scholarly journals Post Stroke Depression and Lesion Location: A Hospital based cross sectional study

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Sivin P Sam ◽  
Joice Geo ◽  
G I Lekshmi ◽  
Roy Abraham Kallivayalil
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lesion Location ◽  
Post Stroke ◽  
Post Stroke Depression

scholarly journals Socio-Demographic Characteristics of the Patients with a Post Stroke Depression from the Municipality of Tetovo, Republic of Macedonia

2018 ◽  
Vol 6 (5) ◽  
pp. 782-785 ◽  
Author(s):  
Danijela Vojtikiv-Samoilovska ◽  
Anita Arsovska
Keyword(s):  
Risk Factors ◽  
Occupational Status ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Demographic Characteristics ◽  
Depression Symptoms ◽  
Post Stroke ◽  
Republic Of Macedonia ◽  
Significant Dependence ◽  
Post Stroke Depression

BACKGROUND: Although post-stroke depression (PSD) is the most common neuro-psychiatric consequence after a stroke there is still some obscurity regarding its aetiology and risk factors, which complicates its management. A better knowledge of the predictors will enable better prevention and treatment.AIM: The aim of this work was the identification of the risk factors for PSD, typical for the Macedonian population, which will help in early prediction, timely diagnosis and treatment of the disease.MATERIALS AND METHODS:  We carried out a prospective study at the Clinical Hospital in Tetovo, the Republic of Macedonia to determine the prevalence of PSD and to analyse the socio-demographic characteristics as possible risk factors in 100 patients on discharge and after 5 months. The depression symptoms were quantified using the Hamilton Depression Ranking Scale (HAM-d) and the Geriatric Depression Scale (GDS).RESULTS: The average age of the patients with PSD on the first examination is 65.0 ± 8.3, whereas on the second examination is 64.5 ± 9.2. According to the Mann-Whitney U test, the difference between the average ages on both examinations is statistically insignificant for p > 0.05. On both examinations, the statistically significant dependence of p > 0.05 between PSD and the occupational status and PSD and education is not recorded. On both examinations, the PSD in male patients was 78.0% and 62.7%, while in female patients it was 85.4% and 68.3% not recording the statistically significant dependence of p < 0.05 between PSD and the gender.CONCLUSION: The socio-demographic characteristics of the patients with PSD cannot be considered as predictors of the disease.

scholarly journals Relationship Between Post-stroke Depression and Lesion Location: A Meta-Analysis

2004 ◽  
Vol 20 (8) ◽  
pp. 372-380 ◽  
Author(s):  
Lifa Yu ◽  
Ching-Kuan Liu ◽  
Jew-Wu Chen ◽  
Shing-Yaw Wang ◽  
Yu-Hsin Wu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Lesion Location ◽  
Post Stroke ◽  
Post Stroke Depression

Abstract W P384: De-Depress: Detection of Post Stroke Depression in the Outpatient Setting; the Interim Analysis

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Daniel Ackerman ◽  
Diana L Tzeng ◽  
Maria C Pineda
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Screening Program ◽  
Historical Control ◽  
Screening Tools ◽  
Depression Screening ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
Comprehensive Stroke Center ◽  
Stroke Center

Stroke is a major contributor to death and disability. For those who survive the initial incident, post stroke depression (PSD) represents a significant modifiable contributor to morbidity and mortality. The incidence of PSD is estimated between 9-50%, and may be higher as some prior studies have excluded those with communicative or cognitive impairments. We hypothesize that a depression screening program will significantly increase the rate of PSD detection and treatment, and can be implemented at a minimum of cost. Our primary objective is to evaluate the effectiveness and feasibility of initiating a depression screening program in the outpatient clinic of a comprehensive stroke center. Methods: This study is designed as a cross-sectional interventional prospective study with a historical control; divided into two phases. Phase I served as the control, wherein data was derived from a retrospective chart review of all patients newly presenting during 2013 with a diagnosis of ischemic stroke. Those already taking antidepressants or with a known mood disorder were excluded. Phase II began in 3/2014 with the initiation of a depression screen (via two validated screening tools, the Patient Health Questionaire-9 (PHQ-9), and the Aphasia Depression Rating Scale (ADRS)), and is ongoing at this time. Odds ratio, relative risk and absolute risk of a diagnosis of PSD will be calculated using a 2x2 table and the CHI-Squared method and compared with the historical control established in Phase I as well as expected norms. Interim Results: During Phase I, 591 new patient charts were reviewed with 268 qualifying for analysis. A diagnosis of PSD occurred in 13 patients (4.9%). The mean time from stroke to follow up was 5.75 months (1.85 in those diagnosed with PSD and 5.95 in those not diagnosed). Conclusion: Phase I of the De-Depress trial confirms a prevalence of PSD of 4.9% in the outpatient population of the cerebrovascular clinic at a comprehensive stroke center. We hypothesize that this is a result of under-recognition of this common condition, and will evaluate in phase II the effect of a simple depression screening program, implemented at a minimum of cost in time and resources.

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