Behavioral disinhibition in stroke
BackgroundPost-stroke behavioral disinhibition (PSBD) is common in stroke survivors and often presents as impulsive, tactless or vulgar behavior. However, it often remains undiagnosed and thus untreated, even though it can lead to a longer length of stay in a rehabilitation facility. The proposed st...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1345756/full |
| _version_ | 1797279256521211904 |
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| author | Wai Kwong Tang Edward Hui Edward Hui Thomas Wai Hong Leung |
| author_facet | Wai Kwong Tang Edward Hui Edward Hui Thomas Wai Hong Leung |
| author_sort | Wai Kwong Tang |
| collection | DOAJ |
| description | BackgroundPost-stroke behavioral disinhibition (PSBD) is common in stroke survivors and often presents as impulsive, tactless or vulgar behavior. However, it often remains undiagnosed and thus untreated, even though it can lead to a longer length of stay in a rehabilitation facility. The proposed study will aim to evaluate the clinical, neuropsychological and magnetic resonance imaging (MRI) correlates of PSBD in a cohort of stroke survivors and describe its 12-month course.MethodsThis prospective cohort study will recruit 237 patients and will be conducted at the Neurology Unit of the Prince of Wales Hospital. The project duration will be 24 months. The patients will be examined by multiple MRI methods, including diffusion-weighted imaging, within 1 week after stroke onset. The patients and their caregivers will receive a detailed assessment at a research clinic at 3, 9 and 15 months after stroke onset (T1, T2 and T3, respectively). The disinhibition subscale of the Frontal Systems Behavior Scale (FrSBe) will be completed by each subject and caregiver, and scores ≥65 will be considered to indicate PSBD.A stepwise logistic regression will be performed to assess the importance of lesions in the regions of interest (ROIs), together with other significant variables identified in the univariate analyses. For patients with PSBD at T1, the FrSBe disinhibition scores will be compared between the groups of patients with and without ROI infarcts, using covariance analysis. The demographic, clinical and MRI variables of remitters and non-remitters will be examined again at T2 and T3 by logistic regression.DiscussionThis project will be the first MRI study on PSBD in stroke survivors. The results will shed light on the associations of lesions in the orbitofrontal cortex, anterior temporal lobe and subcortical brain structures with the risk of PSBD. The obtained data will advance our understanding of the pathogenesis and clinical course of PSBD in stroke, as well as other neurological conditions. The findings are thus likely to be applicable to the large population of patients with neurological disorders at risk of PSBD and are expected to stimulate further research in this field. |
| first_indexed | 2024-03-07T16:22:36Z |
| format | Article |
| id | doaj.art-602db5cd7bac4b179d29c7c36645cd4e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-07T16:22:36Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-602db5cd7bac4b179d29c7c36645cd4e2024-03-04T04:25:00ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-03-011510.3389/fneur.2024.13457561345756Behavioral disinhibition in strokeWai Kwong Tang0Edward Hui1Edward Hui2Thomas Wai Hong Leung3Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Psychiatry, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaBackgroundPost-stroke behavioral disinhibition (PSBD) is common in stroke survivors and often presents as impulsive, tactless or vulgar behavior. However, it often remains undiagnosed and thus untreated, even though it can lead to a longer length of stay in a rehabilitation facility. The proposed study will aim to evaluate the clinical, neuropsychological and magnetic resonance imaging (MRI) correlates of PSBD in a cohort of stroke survivors and describe its 12-month course.MethodsThis prospective cohort study will recruit 237 patients and will be conducted at the Neurology Unit of the Prince of Wales Hospital. The project duration will be 24 months. The patients will be examined by multiple MRI methods, including diffusion-weighted imaging, within 1 week after stroke onset. The patients and their caregivers will receive a detailed assessment at a research clinic at 3, 9 and 15 months after stroke onset (T1, T2 and T3, respectively). The disinhibition subscale of the Frontal Systems Behavior Scale (FrSBe) will be completed by each subject and caregiver, and scores ≥65 will be considered to indicate PSBD.A stepwise logistic regression will be performed to assess the importance of lesions in the regions of interest (ROIs), together with other significant variables identified in the univariate analyses. For patients with PSBD at T1, the FrSBe disinhibition scores will be compared between the groups of patients with and without ROI infarcts, using covariance analysis. The demographic, clinical and MRI variables of remitters and non-remitters will be examined again at T2 and T3 by logistic regression.DiscussionThis project will be the first MRI study on PSBD in stroke survivors. The results will shed light on the associations of lesions in the orbitofrontal cortex, anterior temporal lobe and subcortical brain structures with the risk of PSBD. The obtained data will advance our understanding of the pathogenesis and clinical course of PSBD in stroke, as well as other neurological conditions. The findings are thus likely to be applicable to the large population of patients with neurological disorders at risk of PSBD and are expected to stimulate further research in this field.https://www.frontiersin.org/articles/10.3389/fneur.2024.1345756/fullstrokebehavior disinhibitionMRIprefrontal cortexanterior temporal lobecaudate |
| spellingShingle | Wai Kwong Tang Edward Hui Edward Hui Thomas Wai Hong Leung Behavioral disinhibition in stroke Frontiers in Neurology stroke behavior disinhibition MRI prefrontal cortex anterior temporal lobe caudate |
| title | Behavioral disinhibition in stroke |
| title_full | Behavioral disinhibition in stroke |
| title_fullStr | Behavioral disinhibition in stroke |
| title_full_unstemmed | Behavioral disinhibition in stroke |
| title_short | Behavioral disinhibition in stroke |
| title_sort | behavioral disinhibition in stroke |
| topic | stroke behavior disinhibition MRI prefrontal cortex anterior temporal lobe caudate |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1345756/full |
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