POSTSTROKE DEPRESSION - IS THERE A PATHOANATOMIC CORRELATE FOR DEPRESSION IN THE POSTACUTE STAGE OF STROKE

Background and Purpose This study is aimed at the pathoanatomic correl ates of depression in the postacute stage of patients with stroke. Met hods Of a consecutive series of 104 stroke patients, a subgroup of 47 patients with single demarcated unilateral lesions was selected. Clini cal examination, neuroradiological CT scan examination, and psychiatri c assessment were performed within a 2-month period after the acute st roke. Depression was assessed with the Cornell Depression Scale, the M ontgomery-Asberg Depression Rating Scale, and according to modified DS M-III-R criteria. The neuroradiological examination of all patients wa s performed on the same scanner, and lesion location, lesion volume, a nd ventricle-to-brain ratio were analyzed. Results We found no signifi cant differences in depression scores between patients with left and r ight hemisphere lesions and no correlation between the severity of dep ression and the anteriority and the volume of lesion or brain atrophy. Major depressive disorders were only found in nine patients with left hemisphere lesions, all involving the basal ganglia, whereas none of the patients with right hemisphere stroke exhibited major depression. Conclusions Lesions in the vicinity of the left hemisphere basal gangl ia tend to play a crucial role in the development of major depression after the acute stage of stroke. The pathophysiological implications o f this finding are discussed.