Neuroanatomic pathway associated with attentional deficits after stroke.

We used magnetic resonance imaging (MRI) and the statistical parametric mapping (SPM) image analysis technique to localize lesions in post-stroke patients with attention deficits. SPM can be used to combine image data from multiple participants and correlate these images with other data sets. Magnetic resonance imaging acquisitions were obtained from 115 post-stroke patients, who were systemically assessed for attention deficits using a standardized test (the Clinical Assessment for Attention; CAT) that probes various domains of attention. We created an SPM that displayed an association between lesion location and attention deficit severity. The overlay plots were localized to the right hemisphere during a visual cancellation test, and were localized to the left hemisphere during other attention tests. Cortical lesion varied across specific test domain, whereas lesions from the thalamus to the basal ganglia on the dominant side were associated with performance across all attention tests/domains. Our findings are suggestive of a large-scale multimodal attentional network associated with the thalamus/basal ganglia.

Neuroanatomic pathways associated with poststroke affective and apathetic depression.

OBJECTIVES: Our goal was to localize lesions in poststroke depression patients using magnetic resonance imaging, based on the statistical parametric maps image analysis technique that can be used to combine image data from multiple participants and correlate these images with other data sets. METHODS: Magnetic resonance imaging acquisitions were obtained from 149 poststroke patients, who were assessed for affective and apathetic symptoms using the Hospital Anxiety and Depression Scale and the Apathy Scale, respectively. We created a statistical parametric map that displayed an association between lesion location and affective and apathetic symptoms. RESULTS: Among the patients with higher depressive scores, the lesion overlap centered on the brainstem, left basal ganglia, and left frontal cortex. Among the patients with higher apathy scores, the lesion overlap centered on the brainstem and bilateral striatum. The overlap lesion for both affective and apathetic depression centered mainly on the brainstem; however, the two types of depression often did not overlap. CONCLUSIONS: Two core symptoms that can occur after stroke, affective and apathetic symptoms, appear to be associated with different monoaminergic neuroanatomic pathways (serotonergic and dopaminergic).