The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region

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art_TERRONI_The_association_of_poststroke_anhedonia_with_salivary_cortisol_2015.PDF (514.14 KB)
Citações na Scopus
17
Tipo de produção
article
Data de publicação
2015
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
DOVE MEDICAL PRESS LTD
Autores
IOSIFESCU, Dan V.
MATTOS, Patricia
LUCIA, Mara Cristina S. De
Citação
Neuropsychiatric Disease and Treatment, v.11, p.233-242, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Anhedonia constitutes a coherent construct, with neural correlates and negative clinical impact, independent of depression. However, little is known about the neural correlates of anhedonia in stroke patients. In this study, we investigated the association of post-stroke anhedonia with salivary cortisol levels and stroke location and volume. Patients and methods: A psychiatrist administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to identify anhedonia in 36 inpatients, without previous depression, consecutively admitted in a neurology clinic in the first month after a first-ever ischemic stroke. Salivary cortisol levels were assessed in the morning, evening, and after a dexamethasone suppression test. We used magnetic resonance imaging and a semi-automated brain morphometry method to assess stroke location, and the MRIcro program according to the Brodmann Map to calculate the lesion volume. Results: Patients with anhedonia had significantly larger diurnal variation (P-value =0.017) and higher morning levels of salivary cortisol (1,671.9 +/- 604.0 ng/dL versus 1,103.9 +/- 821.9 ng/dL; P-value =0.022), and greater stroke lesions in the parahippocampal gyrus (Brodmann area 36) compared to those without anhedonia (10.14 voxels; standard deviation +/- 17.72 versus 0.86 voxels; standard deviation +/- 4.64; P-value =0.027). The volume of lesion in the parahippocampal gyrus (Brodmann area 36) was associated with diurnal variation of salivary cortisol levels (rho=0.845; P-value =0.034) only in anhedonic patients. Conclusion: Our findings suggest that anhedonia in stroke patients is associated with the volume of stroke lesion in the parahippocampal gyrus and with dysfunction of the hypothalamic-pituitary-adrenal axis.
Palavras-chave
anhedonia, stroke, glucocorticoids, depression, hippocampus, parahippocampal
URI
https://observatorio.fm.usp.br/handle/OPI/9335
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Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - FM/MPS
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/15
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