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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},
}