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Posted by on Oct 24, 2016 in Stroke | 1 comment

In a nutshell

This article examined the frequency of neuropsychiatric symptoms in stroke patients and whether a specific type of stroke results in a certain type of symptom. The authors concluded that patients with more severe stroke were more likely to have neuropsychiatric symptoms.

Some background

Neuropsychiatric symptoms include behavioral and psychological changes that can affect a persons’ mood, happiness or sleep, to name a few. Research has shown that neuropsychiatric symptoms are associated with stroke. It has not been shown whether a certain type of stroke results in more symptoms, or whether stroke patients with varying levels of brain function are more prone to certain symptoms.  

Methods & findings

The aim of this study was to determine the frequency of neuropsychiatric symptoms in stroke patients and whether specific symptoms could be grouped based on patient cognitive level (brain function). Additionally, the authors aimed to identify stroke-related risk factors that result in neuropsychiatric symptoms.

518 patients who had experienced a stroke or a transient ischemic stroke (TIA – minor stroke) were included. Patients were followed for an average of 5 months after stroke. Patients were assessed for neuropsychiatric symptoms including behavioral problems (aggression/irritability), psychosis (delusions, hallucinations), mood disturbance (depression, anxiety, insomnia) and euphoria (extreme happiness).

The patients were separated into groups depending on their cognitive function. Group 1 included 251 patients with normal cognitive behavior. Group 2 included 204 patients with mild cognitive impairments and group 3 included 63 patients with dementia.

Overall, 262 patients had at least one neuropsychiatric symptom. The frequency of symptoms increased as cognitive impairment levels increased. Only 28.7% of patients from group 1 had at least one neuropsychiatric symptom compared to 85.7% of patients from group 3.

Mood disturbance was the most common symptom. Patients who had experienced a cardioembolic stroke or intracranial hemorrhagic stroke had higher levels of symptoms than those who had a TIA.

The bottom line

The authors concluded that stroke patients commonly experience neuropsychiatric symptoms, particularly if they have higher levels of cognitive impairments. They also state that patients who have experienced a TIA report fewer neuropsychiatric symptom than those who have more serious strokes.  

The fine print

Future studies need a more robust diversity of patients with various other brain defects. 

Published By :

PLOS ONE

Date :

Sep 15, 2016

Original Title :

Neuropsychiatric Symptom Clusters in Stroke and Transient Ischemic Attack by Cognitive Status and Stroke Subtype: Frequency and Relationships with Vascular Lesions, Brain Atrophy and Amyloid.

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