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Neuroimaging of Post-stroke Depression

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Psychiatry and Neuroscience Update

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Abstract

The prevalence of depression after stroke is approximately 33%. Depression in this setting is linked to a high psychological distress. Many of these patients face poor detection and treatment, thus jeopardizing their quality of life and rehabilitation, as well as increasing their mortality.

The beneficial effects of early treatment and rehabilitation have been the focus of prior research. Reduction in mortality with antidepressant treatment has also been reported.

Most authors concur that there is a multifactorial origin of post-stroke depression. Moreover, white matter disease, cerebrovascular dysregulation, altered neuroplasticity, and changes in glutamate neurotransmission might also be relevant etiological factors.

Neuroimaging studies, particularly magnetic resonance imaging (MRI), seem promissory describing associations between specific areas injured by stroke and depression symptoms. MRI has improved morphological definition as compared with computed tomography (CT) or other imaging techniques. The classification and size of the stroke, especially in deep gray matter structures, are improved with this technique. Also, the implementation of new MR techniques such as functional MRI (fMRI), MR volumetry, MR diffusion tensor imaging (DTI), and MR spectroscopy (MRS) allows further detection of subtle functional, white matter, or metabolic abnormalities in the brain.

There is an urgent need to improve recognition and diagnosis of post-stroke depression. Neuroimaging can have an important role here, and it is an area where further research would certainly improve clinical practice.

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References

  1. Kathol RG, Petty F. Relationship of depression to medical illness. A critical review. J Affect Disord. 1981;3:111–21.

    Article  CAS  Google Scholar 

  2. Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry. 2003;54:376–87.

    Article  Google Scholar 

  3. Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005;36:1330–40.

    Article  Google Scholar 

  4. Jaracz K, Kozubski W. Quality of life in stroke patients. Acta Neurol Scand. 2003;107:324–9.

    Article  CAS  Google Scholar 

  5. Verdehlo A, Hénon H, Lebert F, Pasquier F, Leys D. Depressive symptoms after stroke and relationship with dementia: a three-year follow-up study. Neurology. 2004;62:905–11.

    Article  Google Scholar 

  6. Ramasubbu R, Patten SB. Effect of depression on stroke morbidity and mortality. Can J Psychiatr. 2003;48:250–7.

    Article  Google Scholar 

  7. Gonzalez-Torrecillas JL, Mendlewicz J, Lobo A. Effects of early treatment of poststroke depression on neuropsychological rehabilitation. Int Psychogeriatr. 1995;7:547–60.

    Article  CAS  Google Scholar 

  8. Gainotti G, Antonucci G, Marra C, Paolucci S. Relation between depression after stroke, antidepressant therapy, and functional recovery. J Neurol Neurosurg Psychiatry. 2001;71:258–61.

    Article  CAS  Google Scholar 

  9. Chan DY, Chan CC, Au DK. Motor relearning programme for stroke patients: a randomized controlled trial. Clin Rehabil. 2006;20:191–200.

    Article  Google Scholar 

  10. Jorge RE, Robinson RG, Tateno A, Narushima K, Acion L, Moser D, Arndt S, Chemerinski E. Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study. Biol Psychiatry. 2004;55:398–405.

    Article  Google Scholar 

  11. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016;173:221–31.

    Article  Google Scholar 

  12. Di Carlo A, Baldereschi M, Amaducci L, Maggi S, Grigoletto F, Scarlato G, Inzitari D. Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. J Am Geriatr Soc. 2000;48:775–82.

    Article  Google Scholar 

  13. Modrego PJ, Mainar R, Turull L. Recurrence and survival after first-ever stroke in the area of Bajo Aragon, Spain. A prospective cohort study. J Neurol Sci. 2004;224:49–55.

    Article  Google Scholar 

  14. Lobo-Escolar A, Saz P, Marcos G, Quintanilla MA, Campayo A, Lobo A, ZARADEMP Workgroup. Somatic and psychiatric comorbidity in the general elderly population: results from the ZARADEMP project. J Psychosom Res. 2008;65:347–55.

    Article  Google Scholar 

  15. Jorm AF, Anstey KJ, Christensen H, de Plater G, Kumar R, Wen W, Sachdev P. MRI hyperintensities and depressive symptoms in a community sample of individuals 60–64 years old. Am J Psychiatry. 2005;162:699–705.

    Article  Google Scholar 

  16. Sheline YI, Price JL, Vaishnavi SN, Mintun MA, Barch DM, Epstein AA, Wilkins CH, Snyder AZ, Couture L, Schechtman K, McKinstry RC. Regional white matter hyperintensity burden in automated segmentation distinguishes late-life depressed subjects from comparison subjects matched for vascular risk factors. Am J Psychiatry. 2008;165:524–32.

    Article  Google Scholar 

  17. Robinson RG, Starr LB, Kubos KL, Price TR. A two-year longitudinal study of post-stroke mood disorders: findings during the initial evaluation. Stroke. 1983;14:736–41.

    Article  CAS  Google Scholar 

  18. Starkstein SE, Robinson RG. Affective disorders and cerebral vascular disease. Br J Psychiatry. 1989;154:170–82.

    Article  CAS  Google Scholar 

  19. Vataja R, Pohjasvaara T, Leppävuori A, Mäntylä R, Aronen HJ, Salonen O, Kaste M, Erkinjuntti T. Magnetic resonance imaging correlates of depression after ischemic stroke. Arch Gen Psychiatry. 2001;58:925–31.

    Article  CAS  Google Scholar 

  20. Narushima K, Kosier JT, Robinson RG. A reappraisal of poststroke depression, intra- and inter-hemispheric lesion location using meta-analysis. J Neuropsychiatry Clin Neurosci. 2003;15:422–30.

    Article  CAS  Google Scholar 

  21. Hackett ML, Anderson CS. Predictors of depression after stroke: a systematic review of observational studies. Stroke. 2005;36:2296–301.

    Article  Google Scholar 

  22. Godefroy O. Frontal syndrome and disorders of executive functions. J Neurol. 2003;250:1–6.

    Article  Google Scholar 

  23. Spalletta G, Bossù P, Ciaramella A, Bria P, Caltagirone C, Robinson RG. The etiology of poststroke depression: a review of the literature and a new hypothesis involving inflammatory cytokines. Mol Psychiatry. 2006;11:984–91.

    Article  CAS  Google Scholar 

  24. Martens EJ, Nyklícek I, Szabó BM, Kupper N. Depression and anxiety as predictors of heart rate variability after myocardial infarction. Psychol Med. 2008;38:375–83.

    CAS  PubMed  Google Scholar 

  25. Nahshoni E, Aravot D, Aizenberg D, Sigler M, Zalsman G, Strasberg B, Imbar S, Adler E, Weizman A. Heart rate variability in patients with major depression. Psychosomatics. 2004;45:129–34.

    Article  Google Scholar 

  26. Martens EJ, Smith OR, Winter J, Denollet J, Pedersen SS. Cardiac history, prior depression and personality predict course of depressive symptoms after myocardial infarction. Psychol Med. 2008;38:257–64.

    CAS  PubMed  Google Scholar 

  27. Chrapko WE, Jurasz P, Radomski MW, Lara N, Archer SL, Le Mellédo JM. Decreased platelet nitric oxide synthase activity and plasma nitric oxide metabolites in major depressive disorder. Biol Psychiatry. 2004;56:129–34.

    Article  CAS  Google Scholar 

  28. Smith PJ, Blumenthal JA, Babyak MA, Hoffman BM, Doraiswamy PM, Waugh R, Hinderliter A, Sherwood A. Cerebrovascular risk factors, vascular disease, and neuropsychological outcomes in adults with major depression. Psychosom Med. 2007;69:578–86.

    Article  Google Scholar 

  29. Hayley S, Poulter MO, Merali Z, Anisman H. The pathogenesis of clinical depression: stressor- and cytokine-induced alterations of neuroplasticity. Neuroscience. 2005;135:659–78.

    Article  CAS  Google Scholar 

  30. Pucak ML, Kaplin AI. Unkind cytokines: current evidence for the potential role of cytokines in immune-mediated depression. Int Rev Psychiatry. 2005;17:477–83.

    Article  Google Scholar 

  31. Basterzi AD, Aydemir C, Kisa C, Aksaray S, Tuzer V, Yazici K, Göka E. IL-6 levels decrease with SSRI treatment in patients with major depression. Hum Psychopharmacol. 2005;20:473–6.

    Article  CAS  Google Scholar 

  32. Jiao JT, Cheng C, Ma YJ, Huang J, Dai MC, Jiang C, Wang C, Shao JF. Association between inflammatory cytokines and the risk of post-stroke depression, and the effect ofdepression on outcomes of patients with ischemic stroke in a 2-year prospective study. Exp Ther Med. 2016;12:1591–8.

    Article  CAS  Google Scholar 

  33. Brodaty H, Cullen B, Thompson C, Mitchell P, Parker G, Wilhelm K, Austin MP, Malhi G. Age and gender in the phenomenology of depression. Am J Geriatr Psychiatry. 2005;13:589–96.

    Article  Google Scholar 

  34. Kennedy SH, Evans KR, Krüger S, Mayberg HS, Meyer JH, McCann S, Arifuzzman AI, Houle S, Vaccarino FJ. Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. Am J Psychiatry. 2001;158:899–905.

    Article  CAS  Google Scholar 

  35. Brody AL, Saxena S, Silverman DH, Alborzian S, Fairbanks LA, Phelps ME, Huang SC, Wu HM, Maidment K, Baxter LR Jr. Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine. Psychiatry Res. 1999;91:127–39.

    Article  CAS  Google Scholar 

  36. DeRubeis RJ, Siegle GJ, Hollon SD. Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nat Rev. 2008;9:788–96.

    Article  CAS  Google Scholar 

  37. Duhameau B, Ferré JC, Jannin P, Gauvrit JY, Vérin M, Millet B, Drapier D. Chronic and treatment-resistant depression: a study using arterial spin labeling perfusion MRI at 3Tesla. Psychiatry Res. 2010;182:111–6.

    Article  Google Scholar 

  38. Whalen PJ, Johnstone T, Somerville LH. A functional magnetic resonance imaging predictor of treatment response to venlafaxine in generalized anxiety disorder. Biol Psychiatry. 2008;63:858–63.

    Article  CAS  Google Scholar 

  39. Sheline YI, Barch DM, Donnelly JM, et al. Increased amygdala response to masked emotional faces in depressed subjects resolves with antidepressant treatment: an fMRI study. Biol Psychiatry. 2001;50:651–8.

    Article  CAS  Google Scholar 

  40. Anand A, Li Y, Wang Y, et al. Activity and connectivity of brain mood regulating circuit in depression: a functional magnetic resonance study. Biol Psychiatry. 2005;57:1079–88.

    Article  Google Scholar 

  41. Irwin W, Anderle MJ, Abercrombie HC, Schaefer SM, Kalin NH, Davidson RJ. Amygdalar interhemispheric functional connectivity differs between the non-depressed and depressed human brain. Neuroimage. 2004;21:674–86.

    Article  Google Scholar 

  42. Lui S, Wu Q, Qiu L, et al. Resting-state functional connectivity in treatment-resistant depression. Am J Psychiatry. 2011;168:642–8.

    Article  Google Scholar 

  43. Mervaala E, Föhr J, Könönen M, Valkonen-Korhonen M, Vainio P, Partanen K, Partanen J, Tiihonen J, Viinamäki H, Karjalainen AK, Lehtonen J. Quantitative MRI of the hippocampus and amygdala in severe depression. Psychol Med. 2000;30:117–25.

    Article  CAS  Google Scholar 

  44. Lacerda AL, Brambilla P, Sassi RB, Nicoletti MA, Mallinger AG, Frank E, Kupfer DJ, Keshavan MS, Soares JC. Anatomical MRI study of corpus callosum in unipolar depression. J Psychiatr Res. 2005;39:347–54.

    Article  Google Scholar 

  45. Robinson RG, Szetela B. Mood change following left hemispheric brain injury. Ann Neurol. 1981;9:447–53.

    Article  CAS  Google Scholar 

  46. Carson AJ, MacHale S, Allen K, et al. Depression after stroke and lesion location: a systematic review. Lancet. 2000;356:122–6.

    Article  CAS  Google Scholar 

  47. Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M. ‘Vascular depression’ hypothesis. Arch Gen Psychiatry. 1997;54:915–22.

    Article  CAS  Google Scholar 

  48. Bielau H, Trubner K, Krell D, Agelink MW, Bernstein HG, Stauch R, et al. Volume deficits of subcortical nuclei in mood disorders. A postmortem study. Eur Arch Psychiatry Clin Neurosci. 2005;255:401–12.

    Article  Google Scholar 

  49. Frodl T, Meisenzahl EM, Zetzsche T, Hohne T, Banac S, Schorr C, et al. Hippocampal and amygdala changes in patients with major depressive disorder and healthy controls during a 1-year follow-up. J Clin Psychiatry. 2004;65:492–9.

    Article  Google Scholar 

  50. Hama S, Yamashita H, Shigenobu M, Watanabe A, Kurisu K, Yamawaki S, Kitaoka T. Post-stroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia. Eur Arch Psychiatry Clin Neurosci. 2007;257:149–52.

    Article  Google Scholar 

  51. Bozikas VP, Gold G, Kovari E, Herrmann F, Karavatos A, Giannakopoulos P, Bouras C. Pathological correlates of poststroke depression in elderly patients. Am J Geriatr Psychiatry. 2005;13:166–9.

    Article  Google Scholar 

  52. Brodaty H, Withall A, Altendorf A, Sachdev PS. Rates of depression at 3 and 15 months poststroke and their relationship with cognitive decline: the Sydney Stroke Study. Am J Geriatr Psychiatry. 2007;15:477–86.

    Article  Google Scholar 

  53. Beaulieu C. The basis of anisotropic water diffusion in the nervous system – a technical review. NMR Biomed. 2002;15:435–55.

    Article  Google Scholar 

  54. Hickie I, Scott E, Mitchell P, Wilhelm K, Austin MP, Bennett B. Subcortical hyperintensities on magnetic resonance imaging: clinical correlates and prognostic significance in patients with severe depression. Biol Psychiatry. 1995;37:151–60.

    Article  CAS  Google Scholar 

  55. Taylor WD, Payne ME, Krishnan KR, Wagner HR, Provenzale JM, Steffens DC, MacFall JR. Evidence of white matter tract disruption in MRI hyperintensities. Biol Psychiatry. 2001;50:179–83.

    Article  CAS  Google Scholar 

  56. Taylor WD, MacFall JR, Payne ME, McQuoid DR, Provenzale JM, Steffens DC, Krishnan KR. Late-life depression and microstructural abnormalities in dorsolateral prefrontal cortex white matter. Am J Psychiatry. 2004;161:1293–6.

    Article  Google Scholar 

  57. Alexopoulos GS, Gunning-Dixon FM, Latoussakis V, Kanellopoulos D, Murphy CF. Anterior cingulate dysfunction in geriatric depression. Int J Geriatr Psychiatry. 2008;23:347–55.

    Article  Google Scholar 

  58. Fayed N, Modrego PJ, Medrano J. Comparative test-retest reliability of metabolite values assessed with magnetic resonance spectroscopy of the brain. The LCModel versus the manufacturer software. Neurol Res. 2009;31:472–7.

    Article  Google Scholar 

  59. Fayed N, Gonzalez-Toledo E. Magnetic resonance spectroscopy (MRS) of the brain. In: Brahme A, editor. Comprehensive biomedical physics, vol. 3. Amsterdam: Elsevier; 2014. p. 273–85.

    Chapter  Google Scholar 

  60. Yildiz-Yesiloglu A, Ankerst DP. Review of 1H magnetic resonance spectroscopy findings in major depressive disorder: a meta-analysis. Psychiatry Res. 2006;147:1–25.

    Article  CAS  Google Scholar 

  61. Ajilore O, Haroon E, Kumaran S, Darwin C, Binesh N, Mintz J, Miller J, Thomas MA, Kumar A. Measurement of brain metabolites in patients with type 2 diabetes and major depression using proton magnetic resonance spectroscopy. Neuropsychopharmacology. 2007;32:1224–31.

    Article  CAS  Google Scholar 

  62. Kumar A, Thomas A, Lavretsky H, Yue K, Huda A, Curran J, Venkatraman T, Estanol L, Mintz J, Mega M, Toga A. Frontal white matter biochemical abnormalities in late-life major depression detected with proton magnetic resonance spectroscopy. Am J Psychiatry. 2002;159:630–6.

    Article  Google Scholar 

  63. Glodzik-Sobanska L, Slowik A, McHugh P, Sobiecka B, Kozub J, Rich KE, Urbanik A, Szczudlik A. Single voxel proton magnetic resonance spectroscopy in post-stroke depression. Psychiatry Res. 2006;148:111–20.

    Article  Google Scholar 

  64. Glodzik-Sobanska L, Slowik A, Kieltyka A, Kozub J, Sobiecka B, Urbanik A, Szczudlik A. Reduced prefrontal N-acetylaspartate in stroke patients with apathy. J Neurol Sci. 2005;238:19–24.

    Article  CAS  Google Scholar 

  65. Rajkowska G, Miguel-Hidalgo JJ. Gliogenesis and glial pathology in depression. CNS Neurol Disord Drug Targets. 2007;6:219–33.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Quirónsalud Hospital, Zaragoza, Spain

    Nicolás Fayed

  2. Section of Neuroradiology, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA

    Humberto Morales

  3. Department of Radiology, University of Ottawa, Ottawa, Canada

    Carlos Torres

  4. Department of Medical Imaging, The Ottawa Hospital, Ottawa, Canada

    Carlos Torres

  5. Department of Anesthesiology, Miguel Servet Hospital, Zaragoza, Spain

    Laura Viguera

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  1. Nicolás Fayed
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  2. Humberto Morales
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  3. Carlos Torres
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  4. Laura Viguera
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Editors and Affiliations

  1. Cathedra of Psychopathology, Catholic University of Argentina, Mendoza, Argentina

    Pascual Ángel Gargiulo

  2. Laboratory of Neurosciences and Experimental Psychology, Area of Pharmacology, Department of Pathology, National University of Cuyo, Council of Scientific and Technological Research (CONICET), Mendoza, Argentina

    Humberto Luis Mesones Arroyo

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Fayed, N., Morales, H., Torres, C., Viguera, L. (2019). Neuroimaging of Post-stroke Depression. In: Gargiulo, P., Mesones Arroyo, H. (eds) Psychiatry and Neuroscience Update . Springer, Cham. https://doi.org/10.1007/978-3-319-95360-1_31

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  • DOI: https://doi.org/10.1007/978-3-319-95360-1_31

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