N°252 – Poststroke apathy: Major role of cognitive, depressive and neurological disorders over imaging determinants

Mickael Aubignat (1, 2) , Martine Roussel (1, 2, 3) , Ardalan Aarabi (2, 1, 3) , Chantal Lamy (3, 2, 4) , Daniela Andriuta (1, 2, 3) , Sophie Tasseel-Ponche (2, 1, 3) , Malek Makki (1, 2, 3) , Olivier Godefroy (4, 2, 1, 3)

1 CHU Amiens-Picardie
2 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
3 GRECogVASC study group
4 Service de neurologie [Amiens]

Objectives Despite its frequency, determinants of poststroke global hypoactivity with apathy (GHA) remain partly defined. This study was aimed at examining the prevalence of GHA, to identify confusing sources of hypoactivity and to define its neuroimaging determinants using multivariate Voxel Lesion Symptom-Mapping (mVLSM) analyses. Content Methods: In a subgroup of 325 patients of GRECogVASC cohort, GHA was assessed as well as confusing factors (depression, anxiety, severity of neurological deficit and gait disorders). Results: GHA was present in 120 patients (36.9%, 95%CI: 31.7–42.2) and was associated with depressive symptoms (R2 = 0.3, p = 0.0001), cognitive impairment (R2 = 0.015, p = 0.02) and neurological deficit (R2 = 0.110, p = 0.0001). Accordingly 9 (7.5%) patients only had GHA without confusing factor, i.e., primary GHA. In conventional VLSM analysis, GHA was associated with a large number of subcortical lesions that vanished after controlling for confusing factors. mVLSM analysis selected 4 strategic sites associated with GHA: right corticospinal tract (R2 = 0.11; p = 0.0001), left frontostriatal tract (R2 = 0.11; p = 0.0001), left thalamus (R2 = 0.04; p = 0.0001) and left amygdala (R2 = 0.01; p = 0.013). After controlling for confusion factors, these regions remained significant but explained a lower amount of variance. Conclusion: Our findings support that poststroke GHA is mainly due to associated disorders such as depression, neurological deficit, and cognitive impairment and to a lower extent to specific lesion locations, 4 of them (right corticospinal tract, left frontostriatal tract, mediodorsal thalamus and amygdala) found to be independent.

Mots clés: Stroke; Apathy; Depression; Dementia; Mild cognitive impairment; Voxel-based lesion-symptom mapping

Domaines: Neurosciences [q-bio.NC]

Mickael Aubignat, Martine Roussel, Ardalan Aarabi, Chantal Lamy, Daniela Andriuta, et al.. N°252 – Poststroke apathy: Major role of cognitive, depressive and neurological disorders over imaging determinants. Clinical Neurophysiology, Clinical Neurophysiology, 150, pp.e152-e153, 2023, ⟨10.1016/j.clinph.2023.03.241⟩. ⟨hal-04104500⟩