Conclusions
In this large study of structure-function-inference for depressive symptoms after stroke based on VLBM in 270 patients, we identified a significant association between lesions in the left VLPFC and the severity of depressive symptoms 6 months poststroke. Lesions in this location may be considered as a clinically relevant biological factor for PSD. This region is plausible because the VLPFC participates in mood regulation as part of the SN, which has been shown before to be dysfunctional in patients with depression. Our results converge with recent studies on lesion location and depression toward a causal role of damage to the left lateral prefrontal cortex in PSD.
Nonstandard Abbreviations and Acronyms
DLPFC = dorsolateral prefrontal cortex
FWE = family wise error
HADS = Hospital Anxiety and Depression Scale
HADS-A = Hospital Anxiety and Depression Scale, anxiety subscale
HADS-D = Hospital Anxiety and Depression Scale, depression subscale
NIHSS = National Institutes of Health Stroke Scale
PSD = poststroke depression
SN = salience network
VLBM = voxel-based lesion behavior mapping
VLPFC = ventrolateral prefrontal cortex
Acknowledgments
Drs Klingbeil and Saur conceptualized the study; M.-L. Brandt had major role in acquisition of cohort 1; Dr Baum had major role in acquisition of cohort 2; K.-T. Hoffmann had major role in acquisition of neuroimaging data for both cohorts; Dr Wawrzyniak and H.R. Schneider had major role in preprocessing of neuroimaging data; Dr Klingbeil and M.-L. Brandt analyzed the data and performed all statistical analyses; Dr Klingbeil drafted the article; all authors reviewed the article.
Sources of Funding
This Study was funded by the German Research Foundation (DFG Grant SA 1723/5-1 to Drs Saur and Klingbeil) and the Medical Faculty of the University of Leipzig (Grant 990101–113 to M.-L. Brandt and Dr Wawrzyniak was supported by the Clinician Scientist Program). Study cohort 2 was recruited with financial support by Merz Pharma GmbH & Co. KGaA (Frankfurt, Germany; Grant BGAAF-0136 to Dr Baum) and IPSEN Pharma GmbH (Munich, Germany; Grant BGAAF-0135 to Dr Baum).
Stroke. 2021;52(3):830-837. © 2021 American Heart Association, Inc.
