Brain, Vol. 107, No. 1, 81-93, 1984
© 1984 Oxford University Press
research-article |
MOOD DISORDERS IN STROKE PATIENTS: IMPORTANCE OF LOCATION OF LESION
1From the Departments of Psychiatry and Neuroscience, Johns Hopkins University School of Medicine Baltimore, MD 21205 2From the Department of Psychiatry, University of Maryland School of Medicine Baltimore, MD 21201, USA 5From the Department of Neurology, University of Maryland School of Medicine Baltimore, MD 21201, USA 4From the Department of Radiology, University of Maryland School of Medicine Baltimore, MD 21201, USA 3From the Department of Social Work, University of Maryland School of Medicine Baltimore, MD 21201, USA
Correspondence to:
Reprint requests and correspondence to Dr Robert G. Robinson, Department of Psychiatry, Adolf Meyer Building 4-119, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
In a selected group of right-handed patients with single stroke lesions of either the right (n=14) or left (n=22) hemisphere and no predisposing factors for psychiatric disorder, we found that the severity of depression was significantly increased in patients with left anterior lesions as opposed to any other lesion location. In addition, the severity of depression correlated significantly with proximity of the lesion on CT scan to the frontal pole in the left anterior group. The right hemisphere lesion group showed the reverse trend: patients with right posterior lesions were more depressed than patients with right anterior lesions, who were unduly cheerful and apathetic. These findings suggest that intrahemispheric lesion location is in some way related to mood disorder in stroke patients and that there is a graded effect of lesion location on severity of mood change. The neuroanatomy of the biogenic amine-containing pathways in the cerebral cortex might explain this graded effect and provide a neurochemical basis for the mood change.
Revised March 29, 1983.
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