title: Delayed atrophy in posterior cingulate cortex and apathy after stroke.
abstract: OBJECTIVE
  A few studies have been performed on chronic structural changes after stroke. The primary purpose of the present study was to investigate regional cortical volume changes after the onset of stroke and to examine how the cortical volume changes affected neuropsychiatric symptoms.
  
  
  METHODS
  Participants were 20 stroke patients and 14 control subjects. T1-MRI was performed twice, once at the subacute stage and again 6 months later, and whole brain voxel-based morphometric (VBM) analysis was used to detect significant cortical gray matter volume changes in patients. We also assessed the correlation between changes in cortical volumes and changes in neuropsychiatric symptoms during the 6 months following a stroke.
  
  
  RESULTS
  In the present study, we found significant volume reductions in the anterior part of the posterior cingulate cortex (PCC) over the 6 months following a stroke by exploratory VBM analysis. We also found that the amount of volume change was significantly correlated with the change in apathy-scale scores during the 6 months poststroke.
  
  
  CONCLUSIONS
  The present study suggests that delayed atrophic change is evident in the PCC 6 months after a stroke. There was greater apathetic change in the stroke patients with the larger volume reductions. The delayed atrophy of the PCC may reflect degeneration secondary to neuronal loss due to stroke. Such degeneration might have impaired control of goal-directed behavior, leading to the observed increase in apathy.
authors.affiliation: Department of Psychiatry, Nara Medical University, Kashihara, Japan.
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Yasuno
authors.forename: Akihiko
authors.initials: A
authors.lastname: Taguchi
authors.forename: Akihide
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Katsufumi
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kazui
authors.forename: Takashi
authors.initials: T
authors.lastname: Kudo
authors.forename: Atsuo
authors.initials: A
authors.lastname: Sekiyama
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kitamura
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Kiuchi
authors.forename: Jun
authors.initials: J
authors.lastname: Kosaka
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kishimoto
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Iida
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagatsuka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy; D001284:Atrophy / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology
keywords: apathy; magnetic resonance imaging; posterior cingulate cortex; stroke; voxel-based morphometric analysis