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Cerebrovascular Diseases: Post-stroke Depression and Anhedonia

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Anhedonia: A Comprehensive Handbook Volume II

Abstract

Increasing interest in depression within acute and chronic cerebrovascular pathology is justified for its clinical relevance, since its identification and management is of use in reducing disability, the caregiver’s burden and the social-economic impact of cerebrovascular disease. Anhedonia, or markedly diminished interest or pleasure, is a hallmark symptom of major depression, schizophrenia and other neuropsychiatric disorders, including cerebrovascular disorders. Since stroke survivors frequently suffer from depression, research has focused on the incidence, phenomenology, course and risk factors of post-stroke depression (PSD), paying special attention to the biological explanatory models, such as the lesion location and vascular depression hypotheses. Small vessel pathology and microvascular lesions are no longer considered as minor players in the fields of cognitive impairment and mood regulation. Unlike cognition, the relationship between these lesions and mood dysregulation is still a matter of intense debate. However, the chronic accumulation of lacunes in thalamus, basal ganglia and deep white matter has been recently considered as a strong correlate of PSD.

In addition to such biological approaches, the role of psychosocial factors should not be neglected. This chapter is aimed at investigating the complex relationship between depressive mood and cerebrovascular disorders, either acute or chronic, with particular regards to the etiology and prevalence of the disabling symptom anhedonia in PSD.

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Abbreviations

NIHSS:

National Institute of Health Stroke Scale

Qol:

Quality of life

CVD:

Cerebrovascular Disease

LA:

Leukoaraiosis

WMH:

White matter hyperhintesities

LADIS:

Leukoaraiosis and Disability in the Elderly Study

MRI:

Magnetic resonance imaging

VAD:

Vascular Depression

PST:

Problem-solving therapy

PSD:

Post stroke depression

DSMIVTR:

Diagnostic and statistical manual of mental disorders: Fourth Edition Text Revision

ICD-10:

International statistical classification of diseases and related health problems 10TH edition

PSDS:

Post Stroke Depression Scale

VMPFC:

Ventromedial prefrontal cortex

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Authors and Affiliations

  1. IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Contrada Casazza, 98124, Messina, Italy

    Rocco Salvatore Calabrò, Letteria Spadaro & Placido Bramanti

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  1. Rocco Salvatore Calabrò
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  2. Letteria Spadaro
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  3. Placido Bramanti
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Correspondence to Rocco Salvatore Calabrò .

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  1. Haifa & Sha'ar Menashe Mental Health Center, Israel Institute of Technology, Hadera, Israel

    Michael S. Ritsner

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Calabrò, R.S., Spadaro, L., Bramanti, P. (2014). Cerebrovascular Diseases: Post-stroke Depression and Anhedonia. In: Ritsner, M. (eds) Anhedonia: A Comprehensive Handbook Volume II. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8610-2_15

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