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Microbleeds and Post-stroke Emotional Incontinence
  1. W K Tang (tangwk{at}cuhk.edu.hk)
  1. Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
    1. YK Chen (davischan78{at}cuhk.edu.hk)
    1. Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
      1. JY Lu (s0801284{at}mailserv.cuhk.edu.hk)
      1. Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
        1. VCT Mok (b105934{at}mailserv.cuhk.edu.hk)
        1. Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong
          1. YT Xiang (xyutly{at}cuhk.edu.hk)
          1. Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
            1. Gabor S Ungvari (gsungvari{at}cuhk.edu.hk)
            1. Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
              1. Anil T Ahuja (aniltahuja{at}cuhk.edu.hk)
              1. Department of Diagnostic Radiology and Organ Imaging, the Chinese University of Hong Kong, Hong Kong
                1. Ka Sing Wong (ks-wong{at}cuhk.edu.hk)
                1. Chinese University of Hong Kong, Hong Kong

                  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 poststroke emotional lability (PSEL). This study examined the association between PSEL and MBs.

                  Methods: A total of 519 Chinese patients with acute ischemic 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 to the non PSEL group, patients in the PSEL group was 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.

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