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Scientific article
English

The neuroanatomical model of post-stroke depression: towards a change of focus?

Published inJournal of the neurological sciences, vol. 283, no. 1-2, p. 158-162
Publication date2009
Abstract

One third of all stroke survivors develop post-stroke depression (PSD). Depressive symptoms adversely affect rehabilitation and significantly increase risk of death in the post-stroke period. One of the theoretical views on the determinants of PSD focuses on psychosocial factors like disability and social support. Others emphasize biologic mechanisms such as disruption of biogenic amine neurotransmission and release of proinflammatory cytokines. The "lesion location" perspective attempts to establish a relationship between localization of stroke and occurrence of depression, but empirical results remain contradictory. These divergences are partly related to the fact that neuroimaging methods, unlike neuropathology, are not able to assess precisely the full extent of stroke-affected areas and do not specify the different types of vascular lesions. We provide here an overview of the known phenomenological profile and current pathogenic hypotheses of PSD and present neuropathological data challenging the classic "single-stroke"-based neuroanatomical model of PSD. We suggest that vascular burden due to the chronic accumulation of small macrovascular and microvascular lesions may be a crucial determinant of the development and evolution of PSD.

Keywords
  • Antidepressive Agents/therapeutic use
  • Brain/pathology/physiopathology
  • Depression/*epidemiology/*physiopathology/therapy
  • Humans
  • *Models, Neurological
  • Models, Psychological
  • Stroke/*epidemiology/*physiopathology/therapy
Citation (ISO format)
SANTOS, Micaela et al. The neuroanatomical model of post-stroke depression: towards a change of focus? In: Journal of the neurological sciences, 2009, vol. 283, n° 1-2, p. 158–162. doi: 10.1016/j.jns.2009.02.334
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ISSN of the journal0022-510X
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