Imaging predictors of poststroke depression: methodological factors in voxel-based analysis

Sophia A. Gozzi, Amanda G. Wood, Jian Chen, Krishnarao Vaddadi, Thanh G. Phan

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The purpose of this study was to explore the relationship between lesion location and poststroke depression using statistical parametric mapping.

METHODS: First episode patients with stroke were assessed within 12 days and at 1-month poststroke. Patients with an a priori defined cut-off score of 11 on the Hospital Anxiety and Depression Scale (HADS) at follow-up were further assessed using the Mini-International Neuropsychiatric Interview (MINI) to confirm a clinical diagnosis of major or minor depression in accordance with Diagnostic and Statistical Manual-IV (DSM-IV) inclusion criteria. Participants were included if they were aged 18-85 years, proficient in English and eligible for MRI. Patients were excluded if they had a confounding diagnosis such as major depressive disorder at the time of admission, a neurodegenerative disease, epilepsy or an imminently life-threatening comorbid illness, subarachnoid or subdural stroke, a second episode of stroke before follow-up and/or a serious impairment of consciousness or language. Infarcts observed on MRI scans were manually segmented into binary images, linearly registered into a common stereotaxic coordinate space. Using statistical parametric mapping, we compared infarct patterns in patients with stroke with and without depression.

RESULTS: 27% (15/55 patients) met criteria for depression at follow-up. Mean infarct volume was 19±53 mL and National Institute of Health Stroke Scale (NIHSS) at Time 1 (within 12 days of stroke) was 4±4, indicating a sample of mild strokes. No voxels or clusters were significant after a multiple comparison correction was applied (p>0.05). Examination of infarct maps showed that there was minimal overlap of infarct location between patients, thus invalidating the voxel comparison analysis.

CONCLUSIONS: This study provided inconclusive evidence for the association between infarcts in a specific region and poststroke depression.

Original languageEnglish
Article numbere004948
Number of pages7
JournalBMJ Open
Volume4
Issue number7
DOIs
Publication statusPublished - 7 Jul 2014

Bibliographical note

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use.

Keywords

  • depression
  • magnetic resonance imaging
  • stroke

Fingerprint Dive into the research topics of 'Imaging predictors of poststroke depression: methodological factors in voxel-based analysis'. Together they form a unique fingerprint.

Cite this