Depression and anxiety symptoms are associated to disruption of Default Mode Network in subacute ischemic stroke

Author(s)

Jéssica Elias Vicentini

• Document type: Master's Dissertation
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2016-00-00

Examining board members

Marcondes Cavalcante França Júnior; Rodrigo Bazan; Ana Carolina Coan

• Advisor: Li Li Min

Abstract

Depression and anxiety symptoms are common after stroke and associated to reduction in quality of life and poor physical and social outcomes. The Default Mode Network (DMN) is a brain network that plays an important role in the emotional processing. We investigated whether these psychiatric symptoms are associated to a disruption of DMN functional connectivity in the first month after stroke. Thirty-four subacute ischemic stroke patients were submitted to: 1) behavioral assessment through Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Structured Clinical Interview for DSM Disorders (SCID-CV); 2) cognitive assessment using Mini Mental State Examination (MMSM) and Montreal Cognitive Assessment (MoCA); 3) assessment of functional impairment using Barthel Index and modified Rankin Scale; 4) resting state functional magnetic resonance imaging acquisition using a 3T scanner (Philips Achieva®). Patients with depression and/or anxiety symptoms showed an increased DMN functional connectivity in left inferior parietal lobule, right middle frontal lobule and left basal nuclei, when compared to stroke controls. Specific correlation between BDI/BAI scores and DMN functional connectivity indicated that depression symptoms are correlated with increased functional connectivity in left inferior parietal lobule, while anxiety symptoms are correlated with increased functional connectivity in left and right cerebellum, left and right brainstem and right middle frontal lobule. Our study provides new insights into the underlying mechanisms of post stroke depression and anxiety symptoms, suggesting an alternate explanation other than regional structural damage following ischemic event, that these psychiatric symptoms are related to brain network dysfunction (AU)

• FAPESP's process: 13/23183-3 - Functional connectivity in default mode network in patients with depression and/or anxiety symptoms post-stroke
• Grantee: Jéssica Elias Vicentini
• Support Opportunities: Scholarships in Brazil - Master