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J Neuropsychiatry Clin Neurosci 1990; 2:1-14
Copyright © 1990 by American Neuropsychiatric Association
Current research in affective disorders following stroke
RG Robinson and SE Starkstein
Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The prevalence, diagnosis, clinical presentation, evolution, and treatment
of depression and mania following stroke are discussed. Among the many
studies presented in the review is one that indicates major depression
following right hemisphere lesions is associated with a positive family
history of psychiatric disorder and lesions involving the parietal cortex.
The co-occurrence of major depression and generalized anxiety disorder is
associated with cortical lesions, while depression alone is associated with
subcortical lesions. A recent study has also shown a strong association
between mania and direct or indirect dysfunction of the basotemporal cortex
in the right hemisphere. Possible mechanisms for both mania and depression
following stroke are presented, and ideas for future directions in research
are suggested.
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