Clinical Research in Stroke

Martins-Filho R.K.a· Rodrigues G.a· da Costa R.F.a· Castro R.S.a· Zanon Zotin M.C.b,c· Camilo M.R.a· Pontes-Neto O.M.a

Author affiliations

aDepartment of Neurosciences and Behavioural Sciences, Hospital das Clínicas – Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
bDepartment of Neurology, J. Philip Kistler Stroke Research Center, MGH, Boston, MA, USA
cDepartment of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, Ribeirão Preto, Brazil

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Article / Publication Details

First-Page Preview

Received: January 09, 2022
Accepted: August 15, 2022
Published online: October 24, 2022

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Introduction: Poststroke apathy (PSA) is a common neuropsychiatric disorder that may affect up to 30% of stroke patients. Despite the difficulties of investigating this condition (overlapping with depression, heterogeneity of diagnostic criteria, a small number of studies), some recent diffusion tensor imaging studies have suggested that widespread microstructural white matter (WM) disruption plays a key role in the development of PSA. Therefore, we intended to investigate this hypothesis by evaluating the relationship between WM hyperintensities (WMH) and apathy in patients with cerebrovascular disease. Methods: We studied patients with apathy (n = 7), depression (n = 13), comorbid apathy and depression (n = 13), and controls (n = 20), and we investigated the variables associated with the volume of WMH measured by an automated brain MRI segmentation software. Results: The overall prevalence of PSA was 37.7% (pure and comorbid). Patients with apathy presented a higher volume of WMH in comparison to controls. Mini-Mental State Examination (MMSE), NPI-A, and the number of cerebral microbleeds were the only variables associated with WMH. Conversely, NPI-D did not correlate to WMH. Discussion/Conclusion: This is an exploratory study that supports the view of PSA as a distinct syndrome from PSD mediated mainly by diffuse white matter hyperintensities, which suggests that WM disruption is an important pathway to the development of apathy in stroke patients.

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First-Page Preview

Received: January 09, 2022
Accepted: August 15, 2022
Published online: October 24, 2022

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

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