Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke
IntroductionPost-stroke depressive symptoms (PSDS) are common and relevant for patient outcome, but their complex pathophysiology is ill understood. It likely involves social, psychological and biological factors. Lesion location is a readily available information in stroke patients, but it is uncle...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1144228/full |
| _version_ | 1797825257173680128 |
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| author | Julian Klingbeil Max-Lennart Brandt Anika Stockert Petra Baum Karl-Titus Hoffmann Dorothee Saur Max Wawrzyniak |
| author_facet | Julian Klingbeil Max-Lennart Brandt Anika Stockert Petra Baum Karl-Titus Hoffmann Dorothee Saur Max Wawrzyniak |
| author_sort | Julian Klingbeil |
| collection | DOAJ |
| description | IntroductionPost-stroke depressive symptoms (PSDS) are common and relevant for patient outcome, but their complex pathophysiology is ill understood. It likely involves social, psychological and biological factors. Lesion location is a readily available information in stroke patients, but it is unclear if the neurobiological substrates of PSDS are spatially localized. Building on previous analyses, we sought to determine if PSDS are associated with specific lesion locations, structural disconnection and/or localized functional diaschisis.MethodsIn a prospective observational study, we examined 270 patients with first-ever stroke with the Hospital Anxiety and Depression Scale (HADS) around 6 months post-stroke. Based on individual lesion locations and the depression subscale of the HADS we performed support vector regression lesion-symptom mapping, structural-disconnection-symptom mapping and functional lesion network-symptom-mapping, in a reanalysis of this previously published cohort to infer structure–function relationships.ResultsWe found that depressive symptoms were associated with (i) lesions in the right insula, right putamen, inferior frontal gyrus and right amygdala and (ii) structural disconnection in the right temporal lobe. In contrast, we found no association with localized functional diaschisis. In addition, we were unable to confirm a previously described association between depressive symptom load and a network damage score derived from functional disconnection maps.DiscussionBased on our results, and other recent lesion studies, we see growing evidence for a prominent role of right frontostriatal brain circuits in PSDS. |
| first_indexed | 2024-03-13T10:50:17Z |
| format | Article |
| id | doaj.art-7c6c65b5ad6d44c48f43e96b4c296445 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T10:50:17Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-7c6c65b5ad6d44c48f43e96b4c2964452023-05-17T16:19:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-05-011410.3389/fneur.2023.11442281144228Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post strokeJulian Klingbeil0Max-Lennart Brandt1Anika Stockert2Petra Baum3Karl-Titus Hoffmann4Dorothee Saur5Max Wawrzyniak6Neuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, GermanyNeuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, GermanyNeuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, GermanyDepartment of Neurology, University of Leipzig Medical Center, Leipzig, GermanyDepartment of Neuroradiology, University of Leipzig Medical Center, Leipzig, GermanyNeuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, GermanyNeuroimaging Laboratory, Department of Neurology, University of Leipzig Medical Center, Leipzig, GermanyIntroductionPost-stroke depressive symptoms (PSDS) are common and relevant for patient outcome, but their complex pathophysiology is ill understood. It likely involves social, psychological and biological factors. Lesion location is a readily available information in stroke patients, but it is unclear if the neurobiological substrates of PSDS are spatially localized. Building on previous analyses, we sought to determine if PSDS are associated with specific lesion locations, structural disconnection and/or localized functional diaschisis.MethodsIn a prospective observational study, we examined 270 patients with first-ever stroke with the Hospital Anxiety and Depression Scale (HADS) around 6 months post-stroke. Based on individual lesion locations and the depression subscale of the HADS we performed support vector regression lesion-symptom mapping, structural-disconnection-symptom mapping and functional lesion network-symptom-mapping, in a reanalysis of this previously published cohort to infer structure–function relationships.ResultsWe found that depressive symptoms were associated with (i) lesions in the right insula, right putamen, inferior frontal gyrus and right amygdala and (ii) structural disconnection in the right temporal lobe. In contrast, we found no association with localized functional diaschisis. In addition, we were unable to confirm a previously described association between depressive symptom load and a network damage score derived from functional disconnection maps.DiscussionBased on our results, and other recent lesion studies, we see growing evidence for a prominent role of right frontostriatal brain circuits in PSDS.https://www.frontiersin.org/articles/10.3389/fneur.2023.1144228/fullstrokedepressiondiaschisisdisconnectionlesion network mapping |
| spellingShingle | Julian Klingbeil Max-Lennart Brandt Anika Stockert Petra Baum Karl-Titus Hoffmann Dorothee Saur Max Wawrzyniak Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke Frontiers in Neurology stroke depression diaschisis disconnection lesion network mapping |
| title | Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke |
| title_full | Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke |
| title_fullStr | Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke |
| title_full_unstemmed | Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke |
| title_short | Associations of lesion location, structural disconnection, and functional diaschisis with depressive symptoms post stroke |
| title_sort | associations of lesion location structural disconnection and functional diaschisis with depressive symptoms post stroke |
| topic | stroke depression diaschisis disconnection lesion network mapping |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1144228/full |
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