Association of lesion location with post-stroke depression in China: a systematic review and meta-analysis.

ABSTRACT

Background: Post-stroke depression (PSD) is a mental health condition that can develop after a stroke, with a higher risk of death and negative outcomes. However, limited research has explored how PSD incidence relates to brain locations in Chinese patients. This study aims to fill this gap by examining the link between PSD occurrence and brain lesion location, as well as the type of stroke experienced by the patient. Methods: We conducted a systematic search in databases to gather post-stroke depression literature published between January 1, 2015 and May 31, 2021. Following this, we performed a meta-analysis using RevMan to analyze the incidence of PSD associated with different brain regions and types of stroke separately. Results: We analyzed seven studies, with a total of 1604 participants. Our findings indicated that the incidence of PSD was higher when the stroke occurred in the left hemisphere compared to the right hemisphere (RevMan Z = 8.93, P <0.001, OR = 2.69, 95% CI 2.16-3.34, fixed model); PSD was more common when the stroke affected the cerebral cortex rather than the subcerebral cortex (RevMan Z = 3.96, P <0.001, OR = 2.00, 95% CI 1.42-2.81) and when it affected the anterior cortex compared to the posterior cortex (RevMan Z = 3.85, P <0.001, OR = 1.89, 95% CI 1.37-2.62). However, we did not find a significant difference in the occurrence of PSD between ischemic and hemorrhagic strokes (RevMan Z = 0.62, P = 0.53, OR = 0.02, 95% CI -0.05-0.09). Conclusions: Our findings revealed a higher likelihood of PSD in the left hemisphere, specifically in the cerebral cortex and anterior region.