title: Depression-executive dysfunction syndrome in stroke patients.
abstract: OBJECTIVE
  It has been suggested that executive dysfunction could be the core defect in patients with geriatric or vascular depression, and that this depression-dysexecutive syndrome (DES) might be related to frontal-subcortical circuit dysfunction. The authors tested this hypothesis in 158 poststroke patients, of whom 21 had both depression and executive dysfunction.
  
  
  METHODS
  In this cross-sectional cohort study, a neurological, psychiatric, and neuropsychological examination was carried out 3 months after ischemic stroke, and brain infarcts, white-matter changes, and brain atrophy were recorded by MRI.
  
  
  RESULTS
  The 21 patients with DES had significantly more brain infarcts affecting their frontal-subcortical circuit structures than the 137 patients without DES, or the 41 patients with depression but without executive dysfunction. Patients with DES also had more severe depressive symptoms and worse psychosocial functioning, and they coped less well in complex activities of daily living.
  
  
  CONCLUSIONS
  DES is a valid concept and may define a subgroup of poststroke patients with frontal-subcortical pathology and with distinct prognosis and treatment options.
authors.affiliation: Memory Research Unit, Department of Neurology, Helsinki University Central Hospital, P.O. BOX 300, FIN-00029 HUS, Finland.
authors.forename: Risto
authors.initials: R
authors.lastname: Vataja
authors.forename: Tarja
authors.initials: T
authors.lastname: Pohjasvaara
authors.forename: Riitta
authors.initials: R
authors.lastname: Mäntylä
authors.forename: Raija
authors.initials: R
authors.lastname: Ylikoski
authors.forename: Maarit
authors.initials: M
authors.lastname: Leskelä
authors.forename: Hely
authors.initials: H
authors.lastname: Kalska
authors.forename: Marja
authors.initials: M
authors.lastname: Hietanen
authors.forename: Hannu
authors.initials: H
authors.lastname: Juhani Aronen
authors.forename: Oili
authors.initials: O
authors.lastname: Salonen
authors.forename: Markku
authors.initials: M
authors.lastname: Kaste
authors.forename: Antero
authors.initials: A
authors.lastname: Leppävuori
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000503:physiopathology*