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@ARTICLE{Krick:1018437,
      author       = {Krick, Sebastian and Koob, Janusz L and Latarnik, Sylvia
                      and Volz, Lukas J and Fink, Gereon R and Grefkes, Christian
                      and Rehme, Anne K},
      title        = {{N}euroanatomy of post-stroke depression: the association
                      between symptom clusters and lesion location},
      journal      = {Brain communications},
      volume       = {5},
      number       = {5},
      issn         = {2632-1297},
      address      = {[Großbritannien]},
      publisher    = {Guarantors of Brain},
      reportid     = {FZJ-2023-04812},
      pages        = {fcad275},
      year         = {2023},
      abstract     = {Post-stroke depression affects about $30\%$ of stroke
                      patients and often hampers functional recovery. The
                      diagnosis of depression encompasses heterogeneous symptoms
                      at emotional, motivational, cognitive, behavioural or
                      somatic levels. Evidence indicates that depression is caused
                      by disruption of bio-aminergic fibre tracts between
                      prefrontal and limbic or striatal brain regions comprising
                      different functional networks. Voxel-based lesion-symptom
                      mapping studies reported discrepant findings regarding the
                      association between infarct locations and depression.
                      Inconsistencies may be due to the usage of sum scores,
                      thereby mixing different symptoms of depression. In this
                      cross-sectional study, we used multivariate support vector
                      regression for lesion-symptom mapping to identify regions
                      significantly involved in distinct depressive symptom
                      domains and global depression. MRI lesion data were included
                      from 200 patients with acute first-ever ischaemic stroke
                      (mean 0.9 ± 1.5 days of post-stroke). The
                      Montgomery-Åsberg Depression Rating interview assessed
                      depression severity in five symptom domains encompassing
                      motivational, emotional and cognitive symptoms deficits,
                      anxiety and somatic symptoms and was examined 8.4 days of
                      post-stroke (±4.3). We found that global depression
                      severity, irrespective of individual symptom domains, was
                      primarily linked to right hemispheric lesions in the
                      dorsolateral prefrontal cortex and inferior frontal gyrus.
                      In contrast, when considering distinct symptom domains
                      individually, the analyses yielded much more sensitive
                      results in regions where the correlations with the global
                      depression score yielded no effects. Accordingly,
                      motivational deficits were associated with lesions in
                      orbitofrontal cortex, dorsolateral prefrontal cortex, pre-
                      and post-central gyri and basal ganglia, including putamen
                      and pallidum. Lesions affecting the dorsal thalamus,
                      anterior insula and somatosensory cortex were significantly
                      associated with emotional symptoms such as sadness. Damage
                      to the dorsolateral prefrontal cortex was associated with
                      concentration deficits, cognitive symptoms of guilt and
                      self-reproach. Furthermore, somatic symptoms, including loss
                      of appetite and sleep disturbances, were linked to the
                      insula, parietal operculum and amygdala lesions. Likewise,
                      anxiety was associated with lesions impacting the central
                      operculum, insula and inferior frontal gyrus. Interestingly,
                      symptoms of anxiety were exclusively left hemispheric,
                      whereas the lesion-symptom associations of the other domains
                      were lateralized to the right hemisphere. In conclusion,
                      this large-scale study shows that in acute stroke patients,
                      differential post-stroke depression symptom domains are
                      associated with specific structural correlates. Our findings
                      extend existing concepts on the neural underpinnings of
                      depressive symptoms, indicating that differential lesion
                      patterns lead to distinct depressive symptoms in the first
                      weeks of post-stroke. These findings may facilitate the
                      development of personalized treatments to improve
                      post-stroke rehabilitation.Keywords: MADRS; SVR-LSM;
                      large-scale; multivariate; neural substrates.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525) / DFG
                      project 431549029 - SFB 1451: Schlüsselmechanismen normaler
                      und krankheitsbedingt gestörter motorischer Kontrolle
                      (431549029)},
      pid          = {G:(DE-HGF)POF4-5252 / G:(GEPRIS)431549029},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {37908237},
      UT           = {WOS:001186789900009},
      doi          = {10.1093/braincomms/fcad275},
      url          = {https://juser.fz-juelich.de/record/1018437},
}