Abstract TP222: Cortical Differences in Patients With Stroke and Depressive Symptoms
Background and Purpose: The association of post-stroke depression and lesion location is still controversial. In the present study, we sought to investigate the association between depressive symptoms (DS) during the chronic phase of stroke and cortical differences detected by voxel-based morphometry analysis (VBM).
Methods: Patients with stroke admitted to a single academic medical center were followed prospectively. Only those with first, unilateral, anterior circulation ischemic stroke were selected. DS were assessed by the Beck Depression Inventory (BDI) and categorized in two levels (< 10 = absent/minimal and ≥ 10 = present). MRI (3T Philips Achieva, Best-Netherlands) was performed in the same day of the assessment. T1 images (TE=3.20 ms, TR= 7000 ms, FOV 240 x 240 x 180 mm) with 1mm3 isotropic voxel size were used for the VBM. Modulated, normalized, smoothed gray matter (GM) with affine transformation plus non-linear warping was used. Data were processed and analyzed using the VBM8 toolbox for SPM8 software (UCL, London-UK). Voxel-wise GM differences between patients with absent/minimal symptoms were compared to patients with symptoms. The independent samples t-test was used. An uncorrected two-sided p-value < 0.001 was considered as statistically significant.
Results: Forty-nine patients, 60±14 years (47% with left sided stroke) were analyzed. The median time from stroke onset to evaluation was 180 days (IQR 117-410). Seventeen patients were categorized as absent/minimal DS and 32 as present. Patients with DS showed a reduction of GM predominantly in the right precuneus (T=4.7). Other areas included the left cerebellar tonsil (T=3.95), right supplementary motor area (T=3.6) and left precuneus (T=3.5) - figure.
Conclusion: Patients in the chronic phase of ischemic stroke presenting with DS showed an association mainly with right sided cortical volumetric reduction, including the precuneus and supplementary motor area.
- © 2012 by American Heart Association, Inc.