Multicohort Study Maps Brain Networks Linked to Post-Stroke Depressive Symptoms

Researchers reanalyzed four previously published observational cohorts comprising 1,864 patients with stroke from France, Korea, Germany and the United States. They used voxel-wise Bayes factor mapping to assess associations between depressive symptoms and lesion locations, and tested structural disconnection and functional lesion-network maps using normative connectome data.

Lesion associations were identified in right-hemisphere cortical and subcortical clusters, including frontal, insular and parietal regions, the striatum, amygdala and hippocampus, as well as adjacent white matter. Structural disconnection associated with symptoms involved bilateral frontal white matter, particularly the corpus callosum and anterior thalamic radiation. Lesion-network mapping found an association with connectivity in the left posterior cingulate cortex and precuneus; evidence involving the bilateral anterior insula was less consistent. The strongest associations involved right frontal lesions and right-dominant disruption of frontal cortico-subcortical circuits.

The analysis also found evidence against lesion contributions in large parts of the left hemisphere. These results refine the anatomical picture of post-stroke depressive symptoms but do not establish a diagnostic or treatment approach; the study reanalyzed observational data and reports associations, not causal effects.