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Mood Changes After Right-Hemisphere Lesions

  • Sergio E. Starkstein (a1), Robert G. Robinson (a2), Marc A. Honig (a3), Rajesh M. Parikh (a3), John Joselyn (a4) and Thomas R. Price (a5)...

Abstract

Ninety-three patients with acute stroke lesions restricted to the right hemisphere were examined for the presence of mood changes. While 46 patients showed no mood changes, 19 were unduly cheerful, 17 had developed major depression, and 11 had developed minor depression. Although there were no significant between-groups differences in other demographic variables, neurological deficits, activities of daily living, cognitive impairment, or quality of social support, patients with major depression had a significantly higher frequency of familial history of psychiatric disorder and lesions of the parietal cortex than patients with either no mood change or major depression following left-hemisphere lesions. On the other hand, undue cheerfulness was significantly associated with lesions of the right frontal operculum. These findings suggest that major depression following right-hemisphere lesions may have a different aetiology and mechanism than major depression following left frontal or basal ganglia lesions.

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Meyer 4-119, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, Maryland 21205, USA

References

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American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). Washington DC: APA.
Andreasen, N., Endicott, J., Spitzer, R. L., et al (1977) The family history method using diagnostic criteria: reliability and validity. Archives of General Psychiatry, 34, 577582.
Cutting, J. (1978) Study of anosognosia. Journal of Neurology, Neurosurgery and Psychiatry, 41, 548555.
Finklestein, S., Benowitz, L. I., Baldessarini, R. J., et al (1982) Mood, vegetative disturbance, and dexamethasone suppression test after stroke. Annals of Neurology, 12, 463468.
Finset, A. (1988) Depressed mood and reduced emotionality after right hemisphere brain damage. In Cerebral Hemisphere Function in Depression (ed. Kinsbourne M.). Washington DC: American Psychiatric Press.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Folstein, M. F., Maiberger, R. & McHugh, P. R. (1977) Mood disorder as a specific complication of stroke. Journal of Neurology, Neurosurgery and Psychiatry, 40, 10181020.
Gainotti, G. (1972) Emotional behavior and hemispheric side of the lesion. Cortex, 8, 4155.
Gasparrini, W. G., Satz, P., Heilman, K. M., et al (1978) Hemispheric asymmetries of affective processing as determined by the Minnesota Multiphasic Personality Inventory. Journal of Neurology, Neurosurgery and Psychiatry, 41, 470473.
Hamilton, M. A. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.
Kleist, K. (1931) Die storungen der ichleistungen und ihre lokalisation inn orbital-, innen und zwischenhirn. Monatschrift für Psychiatrie und Neurologic 79, 338350.
Kunitz, S. C., Gross, C. R., Heyman, A., et al (1984) The pilot Stroke Data Bank: definition, design and data. Stroke, 15, 740746.
Levine, D. N. & Grek, A. (1984) The anatomic basis of delusions after right cerebral infarction. Neurology, 34, 577582.
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., et al (1983) Mood change following bilateral hemisphere brain injury. British Journal of Psychiatry, 143, 266273.
Nauta, W. J. H. (1971) The problem of the frontal lobe: a reinterpretation. Journal of Psychiatric Research, 8, 167187.
Oppenheim, H. (1890) Zur pathologic der grosshirngeschwultse. Archives für Psychiatrie, 21, 560587.
Robinson, R. G. & Benson, D. F. (1981) Depression in aphasic patients: frequency, severity and clinical pathological correlations. Brain and Language, 14, 282291.
Robinson, R. G. & Szetela, B. (1981) Mood change following left hemispheric brain injury. Annals of Neurology, 9, 447453.
Robinson, R. G., Starr, L. B., Kubos, K. L., et al (1983) Mood changes in stroke patients: relationship to lesion location. Comprehensive Psychiatry, 24, 555566.
Robinson, R. G., Kubos, K. L., Starr, L. B., et al (1984) Mood disorders in stroke patients: importance of location of lesion. Brain, 107, 8193.
Robinson, R. G., Bolla-Wilson, K., Kaplan, E., et al (1986) Depression influences intellectual impairment in stroke patients. British Journal of Psychiatry, 148, 541547.
Robinson, R. G., Starkstein, S. E. & Price, T. R. (1987) Post-stroke depression and lesion location. Stroke, 19, 125.
Ross, E. D. & Rush, A. J. (1981) Diagnosis and neuroanatomical correlates of depression in brain damaged patients. Archives of General Psychiatry, 38, 13441354.
Rylander, G. (1939) Personality Changes after Operations of the Frontal Lobes. London: Oxford University Press.
Sinyor, D., Jacques, P., Kaloupek, D. G., et al (1986) Post-stroke depression and lesion location: an attempted replication. Brain, 109, 537546.
Starkstein, S. E., Robinson, R. G. & Price, T. R. (1987a) Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain, 110, 10451059.
Starkstein, S. E., Boston, J. & Robinson, R. G. (1987b) Mechanisms of mania following brain injury: twelve case reports and review of the literature. Journal of Nervous and Mental Disease, 176, 87100.
Starkstein, S. E., Robinson, R. G., Berthier, M. L., et al (1988) Depressive disorders following posterior circulation compared with middle cerebral artery infarcts. Brain, 111, 375387.
Starr, L. B., Robinson, R. G. & Price, T. R. (1983) Reliability, validity, and clinical utility of the Social Functioning Exam in the assessment of stroke patients. Experimental Aging Research, 9, 101110.
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and classification of psychiatric symptoms. Instruction Manual for the PSE. London: Cambridge University Press.
Zung, W. W. K. (1965) A self-rating depression scale. Archives of General Psychiatry, 12, 6370.

Mood Changes After Right-Hemisphere Lesions

  • Sergio E. Starkstein (a1), Robert G. Robinson (a2), Marc A. Honig (a3), Rajesh M. Parikh (a3), John Joselyn (a4) and Thomas R. Price (a5)...

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Mood Changes After Right-Hemisphere Lesions

  • Sergio E. Starkstein (a1), Robert G. Robinson (a2), Marc A. Honig (a3), Rajesh M. Parikh (a3), John Joselyn (a4) and Thomas R. Price (a5)...
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