title: Imaging predictors of poststroke depression: methodological factors in voxel-based analysis.
abstract: OBJECTIVE
  The purpose of this study was to explore the relationship between lesion location and poststroke depression using statistical parametric mapping.
  
  
  METHODS
  First episode patients with stroke were assessed within 12 days and at 1-month poststroke. Patients with an a priori defined cut-off score of 11 on the Hospital Anxiety and Depression Scale (HADS) at follow-up were further assessed using the Mini-International Neuropsychiatric Interview (MINI) to confirm a clinical diagnosis of major or minor depression in accordance with Diagnostic and Statistical Manual-IV (DSM-IV) inclusion criteria. Participants were included if they were aged 18-85 years, proficient in English and eligible for MRI. Patients were excluded if they had a confounding diagnosis such as major depressive disorder at the time of admission, a neurodegenerative disease, epilepsy or an imminently life-threatening comorbid illness, subarachnoid or subdural stroke, a second episode of stroke before follow-up and/or a serious impairment of consciousness or language. Infarcts observed on MRI scans were manually segmented into binary images, linearly registered into a common stereotaxic coordinate space. Using statistical parametric mapping, we compared infarct patterns in patients with stroke with and without depression.
  
  
  RESULTS
  27% (15/55 patients) met criteria for depression at follow-up. Mean infarct volume was 19±53 mL and National Institute of Health Stroke Scale (NIHSS) at Time 1 (within 12 days of stroke) was 4±4, indicating a sample of mild strokes. No voxels or clusters were significant after a multiple comparison correction was applied (p>0.05). Examination of infarct maps showed that there was minimal overlap of infarct location between patients, thus invalidating the voxel comparison analysis.
  
  
  CONCLUSIONS
  This study provided inconclusive evidence for the association between infarcts in a specific region and poststroke depression.
authors.affiliation: Department of Medicine, School of Psychology and Psychiatry, Monash University, Melbourne, Australia Department of Medicine, Stroke and Ageing Research Group, Southern Clinical School, Monash University, Melbourne, Australia.
authors.forename: Sophia A
authors.initials: SA
authors.lastname: Gozzi
authors.affiliation: Department of Medicine, Stroke and Ageing Research Group, Southern Clinical School, Monash University, Melbourne, Australia School of Psychology, University of Birmingham, Edgbaston, UK.
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Wood
authors.affiliation: Department of Medicine, Stroke and Ageing Research Group, Southern Clinical School, Monash University, Melbourne, Australia Department of Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Medicine, School of Psychology and Psychiatry, Monash University, Melbourne, Australia Southern Health, Melbourne, Australia.
authors.forename: Krishnarao
authors.initials: K
authors.lastname: Vaddadi
authors.affiliation: Department of Medicine, Stroke and Ageing Research Group, Southern Clinical School, Monash University, Melbourne, Australia.
authors.forename: Thanh G
authors.initials: TG
authors.lastname: Phan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000150:complications* / Q000473:pathology*; D055815:Young Adult
keywords: REHABILITATION MEDICINE; STROKE MEDICINE