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Poststroke Depression and Lesion Location Revisited

Received July 3, 2002; revised October 31, 2002; accepted November 6, 2002. From the Departments of Neurology, Memory Research Unit, Stroke Unit, Psychiatry, Psychiatric Consultation Unit; Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland. Address correspondence to Dr. Erkinjuntti, Memory Research Unit, Department of Neurology, Helsinki University Central Hospital, P.O. Box 300, FIN-00029 HUS, Finland, timo.erkinjuntti{at}hus.fi (E-mail).

Seventy patients with one brain infarct on magnetic resonance imaging (MRI) were studied 3 months after ischemic stroke by a standardized protocol to detail side, site, type, and extent of the brain infarct, as well as severity of white matter lesions and brain atrophy. Depression was diagnosed by DSM-III-R and DSM-IV criteria. The brain infarcts that affected structures of the frontal-subcortical circuits, (i.e., the pallidum and caudate, especially on the left side) predisposed stroke patients to depression. The size of the infarcts at these sites in the depressed patients was larger. Using a logistic regression analysis, the authors found that a brain infarct that affected pallidum was a strong independent MRI correlate for poststroke depression (odds ratio=7.2).

Key Words: Stroke • Depression • Lesion Location

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