The relationship between poststroke depression and lesion location in long-term follow-up

Background: We have previously reported that during the acute poststroke period, poststroke major depression was significantly associated with left anterior lesions. Furthermore, we found that proximity of the lesion to the left frontal pole was correlated with severity of depression. Several investigators, however, have failed to replicate these findings when patients were studied beyond the acute stroke period. Methods: We longitudinally examined the relationship between lesion size, lesion location, impairment variables, and the presence and severity of depression in 60 single lesion patients examined in-hospital and at short-term (3-6 months) and long-term (1-2 years)follow-up. Results: Only in-hospital depression was significantly associated with left anterior hemisphere lesion location. At short-term follow-up, proximity of the lesion to the frontal pole, and lesion volume correlated with depression in both right and left hemisphere. At 1-2 years poststroke, depression was significantly associated with right-hemisphere lesion volume and proximity of the lesion to the occipital pole, Conclusions: The anatomical correlates of poststroke depression change over time and may explain interstudy differences in the association of lesion location with poststroke depression. (C) 1999 Society of Biological Psychiatry.