Neurobehavioural consequences of stroke – Post-stroke neuropsychiatric symptoms (NPS)

As outlined on the slide, after a stroke many people go on to experience neuropsychiatric symptoms including depression, anxiety, apathy, and fatigue.¹ Furthermore, many people who experience a stroke also experience psychological distress below the threshold for a psycho…

Making an accurate diagnosis of post-stroke neuropsychiatric symptoms, including depression can be challenging, partly because of the overlap in symptoms and partly because the symptoms of stroke can mask some neuropsychiatric symptoms.^1,4 A further complication comes fro…

Whilst there are no established screening tools for many of the neuropsychiatric symptoms that can occur after a stroke, there are screening tools which are clinically useful, some of which are introduced on the slide.⁶ Adapted screening tools for people with varying degr…

There are many scales that can be used to assess fatigue or that include a subscale about fatigue.¹ One such scale is the Greater Manchester Stroke Assessment Tool, which has been studied as a tool for assessing patients six months after a stroke, and has been found to be…

As outlined on the slide, depression is a common symptom after a stroke. Compared with roughly 3.4% of the general population,⁷ approximately 30% of people experience depression after a stroke.^1,2

References:
1.Chun HY, Ford A, Kutlubaev MA, Almeida OP, Mead GE. Depressio…

As shown on the slide, there are many potential points of interaction between the disease processes of stroke and depression.^1,2 Whilst a systematic review published in 2000 found no support for an association between the risk of depression and the site of brain lesion ca…

As outlined on the slide, anxiety is common after a stroke, experienced by roughly 20–25% of people post-stroke,^1,3 compared with approximately 3.8% of the general population.⁴ The anxiety disorders which can accompany stroke share the core clinical anxiety symptoms of un…

As shown on the slide, there are many potential points of interaction between the disease processes of stroke and anxiety.^1,2

References:
1.Kapoor A, Si K, Yu AYX, et al. Younger age and depressive symptoms predict high risk of generalized anxiety after stroke and transie…

Apathy – a reduction in goal-directed behaviour – is a common occurrence after stroke.^1,2 Because of overlapping clinical presentation, apathy can be misdiagnosed as depression.¹ However, despite its prevalence, apathy after stroke is poorly understood.¹

References:
1.Tay…

Apathy is thought to arise from the neurobiological changes of a stroke, as outlined on the slide.¹ However, it is not as simple as stroke directly causing damage to areas of the brain involved in goal-directed behaviours.¹ Rather, there is thought to be a spread of strok…

As a symptom, fatigue can be found throughout the general population, but it does appear to be common in patients with chronic diseases, including stroke as outlined on the slide.^1-3

References:
1.Cumming TB, Packer M, Kramer SF, English C. The prevalence of fatigue after…

Emotional lability is thought to result from damage to certain descending pathways in the brain, as detailed on the slide.¹ Such damage can occur in several diseases, including Parkinson’s disease, amyotrophic lateral sclerosis, and as a result of stroke.¹

References:
1.C…

Reference:
1.Bland M. An Introduction to Medical Statistics, 3rd edition. Oxford Medical Publications. 1986.