Cerebellar Stroke and Mood Disorders
Condition: Stroke
MeSH terms: Stroke; Mood Disorders
Study type: Interventional

Summary: 
      Post-stroke mood disorders (PSMD), including depression, anxiety and apathy, are observed in
      about 30 % of stroke patients at follow-up 3 or 4 months after stroke occurrence. They impair
      the functional outcome of the patients and their quality of life. Among the different brain
      structures involved in PSMD the role of the cerebellum has been under-evaluated while it is
      now well-known to be involved in mood regulation. The aim of this study will be to describe
      the characteristics of early and late mood disorders following a first acute ischemic
      cerebellar stroke using face to face interviews and mobile technologies and investigate their
      pathophysiological mechanisms through advanced brain Magnetic resonance imaging (MRI)
      evaluation of cortico-cerebello-cortical morphological and functional connectivity.
    

Detailed description: 
      Stroke is the leading cause of acquired disability in adults. Beyond these physical
      consequences, stroke is a major cause of mood disorders (depression, anxiety, apathy),
      affecting more than 30% of patients at 3 months after the initial accident. These mood
      disorders impair patient's quality of life and their post-stroke functional recovery. Their
      detection is usually based on an interview conducted during a follow-up visit and intensity
      is measured through dedicated scales. However the sensitivity of these assessments could be
      improved by multiple daily ecological assessments carried out in the patient environment
      through mobile technologies such as smartphones (Experience Sampling Method) and actimeters.
      Moreover, a better understanding of the pathophysiological mechanisms underlying the presence
      of post-stroke mood disorders could improve their management. Clinical factors such as the
      severity of the disability or the female gender are associated with the occurrence of mood
      disorders but the independent role of the anatomical location of brain injury remains
      uncertain. During the last decade many studies have suggested the role of the cerebellum in
      the regulation of cognition and, to a lesser extent, mood. An anatomical or functional
      impairment of the cortico-cerebellar-cortical loops might contribute to the occurrence of the
      mood disorders observed in some patients with cerebellar lesion.

      The aim of this project is to explore in the context of a cerebellar infarct the transverse
      association between the presence of post-stroke mood disorders, detected both by standard
      evaluations and assessments conducted in the ecological environment, and the functional and
      structural alteration of cortico-cerebellar-cortical loops evaluated by MRI.
    

Intervention name(s): Post stroke mood disorders evaluation
Intervention type(s): Other
Intervention description(s): Each patient will be assessed by a clinical evaluation, will have a standardized psychological evaluation, will perform a brain MRI and will be given a smartphone and an actimeter for a one-week period for the purpose of ecological evaluations
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Stroke; Cerebellum; Depression; Anxiety; Mood; Magnetic resonance imaging (MRI)