Microbleeds and post-stroke emotional lability.
OBJECTIVE
The clinical significance of microbleeds (MBs) in the development of psychiatric conditions following a stroke is unknown. Lesions located in various cortical and subcortical areas are thought to be involved in the pathophysiology of post-stroke emotional lability (PSEL). This study examined the association between PSEL and MBs.


METHODS
A total of 519 Chinese patients with acute ischaemic stroke consecutively admitted to the acute stroke unit of a university affiliated regional hospital in Hong Kong were screened for PSEL 3 months after their index stroke. The number and location of MBs were evaluated with MRI.


RESULTS
According to Kim's criteria, 74 (14.3%) patients had PSEL. In comparison with the non-PSEL group, patients in the PSEL group were more likely to have MBs in the thalamus as a whole (16.2% vs 6.5%; p = 0.004), its anterior (6.9% vs 2.0%, p = 0.02) and paramedian territories (8.1% vs 3.1%; p = 0.04), and a higher number of MBs in the entire brain (1.7+3.4 vs 1.3+5.0; p = 0.031). MBs in the thalamus remained an independent predictor of PSEL in the multivariate analysis, with an odds ratio of 4.7 (p = 0.002).


CONCLUSIONS
Our results suggest that MBs in the thalamus may play a role in the development of PSEL. The importance of MBs in PSEL and other psychiatric conditions in stroke survivors warrants further investigation.
Tang
W K
WK
Department of Psychiatry, Shatin Hospital, Shatin, NT, Hong Kong SAR, China. tangwk@cuhk.edu.hk
Chen
Y K
YK
Lu
J Y
JY
Mok
V C T
VC
Xiang
Y T
YT
Ungvari
G S
GS
Ahuja
A T
AT
Wong
K S
KS
D000342:Affective Symptoms / Q000209:etiology* / Q000473:pathology; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology* / Q000523:psychology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000473:pathology* / Q000523:psychology