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

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

Luisa Terroni,1 Edson Amaro Jr,2 Dan V Iosifescu,3 Patricia Mattos,4 Fabio I Yamamoto,5 Gisela Tinone,5 Adriana B Conforto,5 Matildes FM Sobreiro,1 Valeri D Guajardo,1 Mara Cristina S De Lucia,7 Ayrton C Moreira,6 Milberto Scaff,5 Claudia C Leite,2 Renerio Fraguas1 1Consultation-Liaison Psychiatry...

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Autores principales: Terroni L, Amaro Jr E, Iosifescu DV, Mattos P, Yamamoto FI, Tinone G, Conforto AB, Sobreiro MFM, Guajardo VD, De Lucia MC, Moreira AC, Scaff M, Leite CC, Fraguas R
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2015
Materias:
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/831488ccadd54e6db096a0bac9a800aa
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spelling oai:doaj.org-article:831488ccadd54e6db096a0bac9a800aa2021-12-02T09:06:38ZThe association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region1178-2021https://doaj.org/article/831488ccadd54e6db096a0bac9a800aa2015-02-01T00:00:00Zhttp://www.dovepress.com/the-association-of-post-stroke-anhedonia-withnbspsalivary-cortisol-lev-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Luisa Terroni,1 Edson Amaro Jr,2 Dan V Iosifescu,3 Patricia Mattos,4 Fabio I Yamamoto,5 Gisela Tinone,5 Adriana B Conforto,5 Matildes FM Sobreiro,1 Valeri D Guajardo,1 Mara Cristina S De Lucia,7 Ayrton C Moreira,6 Milberto Scaff,5 Claudia C Leite,2 Renerio Fraguas1 1Consultation-Liaison Psychiatry Group, Department and Institute of Psychiatry, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 2Department of Radiology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 3Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; 5Department of Neurology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 6Department of Medicine, University of São Paulo, School of Medicine, Ribeirão Preto, Brazil; 7Division of Psychology, Central Institute, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil 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. Keywords: anhedonia, stroke, glucocorticoids, depression, hippocampus, parahippocampalTerroni LAmaro Jr EIosifescu DVMattos PYamamoto FITinone GConforto ABSobreiro MFMGuajardo VDDe Lucia MCMoreira ACScaff MLeite CCFraguas RDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 233-242 (2015)
institution DOAJ
collection DOAJ
language EN
topic Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Terroni L
Amaro Jr E
Iosifescu DV
Mattos P
Yamamoto FI
Tinone G
Conforto AB
Sobreiro MFM
Guajardo VD
De Lucia MC
Moreira AC
Scaff M
Leite CC
Fraguas R
The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
description Luisa Terroni,1 Edson Amaro Jr,2 Dan V Iosifescu,3 Patricia Mattos,4 Fabio I Yamamoto,5 Gisela Tinone,5 Adriana B Conforto,5 Matildes FM Sobreiro,1 Valeri D Guajardo,1 Mara Cristina S De Lucia,7 Ayrton C Moreira,6 Milberto Scaff,5 Claudia C Leite,2 Renerio Fraguas1 1Consultation-Liaison Psychiatry Group, Department and Institute of Psychiatry, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 2Department of Radiology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 3Mood and Anxiety Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; 5Department of Neurology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil; 6Department of Medicine, University of São Paulo, School of Medicine, Ribeirão Preto, Brazil; 7Division of Psychology, Central Institute, Clinical Hospital, University of São Paulo School of Medicine, São Paulo, Brazil 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. Keywords: anhedonia, stroke, glucocorticoids, depression, hippocampus, parahippocampal
format article
author Terroni L
Amaro Jr E
Iosifescu DV
Mattos P
Yamamoto FI
Tinone G
Conforto AB
Sobreiro MFM
Guajardo VD
De Lucia MC
Moreira AC
Scaff M
Leite CC
Fraguas R
author_facet Terroni L
Amaro Jr E
Iosifescu DV
Mattos P
Yamamoto FI
Tinone G
Conforto AB
Sobreiro MFM
Guajardo VD
De Lucia MC
Moreira AC
Scaff M
Leite CC
Fraguas R
author_sort Terroni L
title The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
title_short The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
title_full The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
title_fullStr The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
title_full_unstemmed The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
title_sort association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/831488ccadd54e6db096a0bac9a800aa
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