Abstract
In 21 patients (15 males and 6 females, mean age 62 years old) who developed the depressive state without dementia after stroke in the cerebral hemisphere, we studied the time course of the depression and its relation to the recovery of regional cerebral function evaluated by the change of regional cerebral blood flow (rCBF). Zung's self-rating depression scale (SDS) was administered for the quantitative evaluation of the depression. Regional CBF was measured with 133-Xe inhalation method.
Ten patients showed improvement in depressive state, but 7 patients had no change in SDS scores and 4 patients became more depressive during the mean follow-up periods of 7 months. The degree of improvement in depressive state was not significantly related to sex, age, duration from the attack, and mean blood pressure in the initial interview. The recovery of activities of daily living had also no relation to its improvement. On the other hand, the patients with higher cortical dysfunction or Parkinsonism showed poor improvement of the depression. The changes of mean rCBF was inversely correlated with that of SDS scores significantly (r=-0.77, p<0.001). Moreover, the improvement in depressive state were strongly related to the increase of rCBF in the anterior portion of the bilateral temporal lobe, in the posterior lower portion of the left frontal lobe, and in the right parietal lobe.
The depressive disorder after cerebrovascular accident may be closely related to the pathophysiology of the temporal lobe function.
