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Neuroimaging of Post-stroke Depression

  • Nicolás Fayed
  • Humberto Morales
  • Carlos Torres
  • Laura Viguera
Chapter

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.

Keywords

Depression Stroke Magnetic resonance imaging Magnetic resonance spectroscopy Structural brain imaging Perfusion Diffusion weighted imaging Diffusion tensor imaging Functional magnetic resonance imaging 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nicolás Fayed
    • 1
  • Humberto Morales
    • 2
  • Carlos Torres
    • 3
    • 4
  • Laura Viguera
    • 5
  1. 1.Department of RadiologyQuirónsalud HospitalZaragozaSpain
  2. 2.Section of Neuroradiology, Department of RadiologyUniversity of Cincinnati Medical CenterCincinnatiUSA
  3. 3.Department of RadiologyUniversity of OttawaOttawaCanada
  4. 4.Department of Medical ImagingThe Ottawa HospitalOttawaCanada
  5. 5.Department of AnesthesiologyMiguel Servet HospitalZaragozaSpain

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