Starkstein S E, Fedoroff J P, Price T R, Leiguarda R, Robinson R G
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Stroke. 1993 Nov;24(11):1625-30. doi: 10.1161/01.str.24.11.1625.
Although apathy has been reported to constitute a frequent sequela of stroke lesions, there have been no prospective studies on the frequency and correlates of apathy after stroke lesions. In the present study, we examined the frequency and correlates of apathy in a consecutive series of 80 patients with cerebrovascular lesions.
We included patients within the first 10 days after a stroke lesion. Patients were examined with a comprehensive neuropsychiatric battery that included the Apathy Scale.
Eighteen patients (22.5%) showed apathy, nine of whom were also depressed. On the other hand, 18 patients (22.5%) showed depression in the absence of apathy. Although depression and apathy may exist independent of one another, major depression (but not minor depression) was associated with an increased frequency of apathy. Apathy was also significantly associated with older age, cognitive impairments, and deficits in activities of daily living. Finally, apathy was significantly associated with lesions in the posterior limb of the internal capsule.
These findings demonstrate that apathy is a frequent finding among patients with acute stroke lesions and may coexist with important emotional and cognitive poststroke disturbances.
尽管据报道淡漠是中风损伤常见的后遗症，但尚无关于中风损伤后淡漠的发生率及其相关因素的前瞻性研究。在本研究中，我们对连续的80例脑血管病变患者的淡漠发生率及其相关因素进行了研究。
我们纳入了中风损伤后10天内的患者。采用包括淡漠量表在内的综合神经精神检查对患者进行评估。
18例患者（22.5%）表现为淡漠，其中9例同时伴有抑郁。另一方面，18例患者（22.5%）表现为抑郁但无淡漠。尽管抑郁和淡漠可能相互独立存在，但重度抑郁（而非轻度抑郁）与淡漠发生率增加相关。淡漠还与高龄、认知障碍及日常生活活动缺陷显著相关。最后，淡漠与内囊后肢病变显著相关。
这些发现表明，淡漠在急性中风损伤患者中很常见，且可能与中风后重要的情绪和认知障碍共存。
