Cor Vasa 2022, 64(1):25-33 | DOI: 10.33678/cor.2021.121

Poststroke depression in obstructive cerebrovascular diseases of internal carotid and vertebrobasilar circulation system

Yalcin Guzelhan

Psychiatry Clinic, Istanbul Education and Research Hospital, Istanbul, Turkey

Objective: The aim of this study was to investigate the neuroanatomic feature of cerebrovascular circulation and the rating of poststroke depression in obstructive cerebrovascular disease involving anterior (internal carotid) and posterior (vertebrobasilar) systems.

Materials and methods: One hundred and five patients with poststroke depression (PSD), 58 (55.2%) women and 47 (44.8%) men, mean age 61.3±10.2 years were enrolled in the study for correlation between potential risk factors and the incidence of poststroke depression (PSD). Demographic data, comorbidities and neurological symptoms were recorded. The correlations of the PSD with the factors: the side and site of brain infarcts, and the origin of cerebral circulation site were investigated. Disability Rating Scale was used to rate the effects of cerebral injury. Mini Mental State Examinations were applied to evaluate the cognitive state. Depression was diagnosed using DSM-III-R criteria. To measure the severity of depression, 17-item Hamilton Depression Scale and 21-item Beck Depression Scale were used within the first month of stroke.

Results: Most of the patients (81.9%) had clinical risk factors as hypertension, diabetes mellitus, ischemic heart disease. Hypertension was identified in 64.8% of the patients as the major risk factor. Smoking history was reported by 60.9% of the patients. The mean disability rating scale was 2.9±1.2 in 55 patients without PSD and 3.7±1.1 in 50 patients with PSD (p <0.05). The mean Mini Mental State Examination (MMSE) was found 27.4±1.5 in 55 patients without poststroke depression, and 24.7±2.3 in 50 patients with poststroke depression (p <0.05). Seventy patients had anterior (internal carotid) circulation system and 35 patients had posterior (vertebrobasilar) circulation system dominantly. Comparing with the patient’s gender according to anterior or posterior system dominancy, 40 female (38.1%) and 30 (28.6%) male patients suffered from internal carotid system occlusive lesions and 18 female (17.1%) and 17 male (16.2%) patients suffered from vertebrobasilar system occlusive lesions. There was no statistically signifi cant differences between the subgroups.

Conclusion: Our study did not confi rm any association between depression after stroke and brain lesion location. Future efforts should aim to enhance clinical and neuroanatomical studies for investigating the relationship between PSD and lesion location.

Keywords: Cerebral infarct, Cerebrovascular disorders, Neuropsychiatric consequences, Poststroke depression, Stroke

Received: September 8, 2021; Revised: October 10, 2021; Accepted: October 17, 2021; Published: February 22, 2022  Show citation