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J Neurol Neurosurg Psychiatry 2009;80:1082-1086 doi:10.1136/jnnp.2009.175372
  • Research paper

Microbleeds and post-stroke emotional lability

  1. W K Tang1,
  2. Y K Chen1,2,
  3. J Y Lu1,
  4. V C T Mok2,
  5. Y T Xiang1,
  6. G S Ungvari1,
  7. A T Ahuja3,
  8. K S Wong2
  1. 1
    Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
  2. 2
    Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China
  3. 3
    Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Hong Kong SAR, China
  1. Correspondence to Dr W K Tang, Department of Psychiatry, Shatin Hospital, Shatin, NT, Hong Kong SAR, China; tangwk{at}cuhk.edu.hk
  • Received 17 February 2009
  • Revised 24 May 2009
  • Accepted 27 May 2009
  • Published Online First 18 June 2009

Abstract

Objective: The clinical significance of microbleeds (MBs) in the development of psychiatric conditions following a stroke is unknown. Lesions located in various cortical and subcortical areas are thought to be involved in the pathophysiology of post-stroke emotional lability (PSEL). This study examined the association between PSEL and MBs.

Methods: A total of 519 Chinese patients with acute ischaemic stroke consecutively admitted to the acute stroke unit of a university affiliated regional hospital in Hong Kong were screened for PSEL 3 months after their index stroke. The number and location of MBs were evaluated with MRI.

Results: According to Kim’s criteria, 74 (14.3%) patients had PSEL. In comparison with the non-PSEL group, patients in the PSEL group were more likely to have MBs in the thalamus as a whole (16.2% vs 6.5%; p = 0.004), its anterior (6.9% vs 2.0%, p = 0.02) and paramedian territories (8.1% vs 3.1%; p = 0.04), and a higher number of MBs in the entire brain (1.7+3.4 vs 1.3+5.0; p = 0.031). MBs in the thalamus remained an independent predictor of PSEL in the multivariate analysis, with an odds ratio of 4.7 (p = 0.002).

Conclusion: Our results suggest that MBs in the thalamus may play a role in the development of PSEL. The importance of MBs in PSEL and other psychiatric conditions in stroke survivors warrants further investigation.

Footnotes

  • Funding This work was supported by a direct grant for research 2005/2006 from the Chinese University of Hong Kong.

  • Competing interests None.

  • Ethics approval The study protocol was approved by the Clinical Research Ethics Committee of the Chinese University of Hong Kong.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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