Herrmann M, Bartels C, Wallesch C W
Department of Rehabilitation Psychology, Freiburg University, Germany.
J Neurol Neurosurg Psychiatry. 1993 Jun;56(6):672-8. doi: 10.1136/jnnp.56.6.672.
Depressive alterations were investigated in 21 acute and 21 chronic aphasic patients with single left sided strokes. The assessment of depression was based on a psychometrically evaluated German version of the Cornell Scale for Depression (CDS) and the Research Diagnostic Criteria (RDC). No significant difference was found concerning depression sum-scores between the two aphasic groups. The acute group, however, exhibited significantly higher ratings in items related to physical signs of depression and disturbances of cyclic functions. Patients corresponding to the RDC-syndrome of major depression were only found in the acute group. Neither age, sex nor degree of hemiparesis discriminated the patients on the severity of depressive symptoms. In the acute patient group, nonfluency of aphasia was the only parameter that could be identified which had an effect on the mood symptom scores. A CT scan analysis in the acute patient group showed an association between the severity of depression and anterior lesions. A significant correlation was found between CDS sum-scores and the proximity of the anterior border of the lesion to the frontal pole of the hemisphere whereas the volume of lesions seemed to have no effect on depressive alterations in acute aphasic patients. Superimposition of the lesions of the aphasic patients with major depressive disorders showed a common subcortical lesion area involving putaminal and external pallidal structures.
对21例左侧单发卒中的急性失语患者和21例慢性失语患者的抑郁改变进行了研究。抑郁评估基于经过心理测量评估的德文版康奈尔抑郁量表（CDS）和研究诊断标准（RDC）。在两个失语组之间，抑郁总分没有发现显著差异。然而，急性组在与抑郁体征和循环功能障碍相关的项目上表现出显著更高的评分。仅在急性组中发现符合重度抑郁RDC综合征的患者。年龄、性别和偏瘫程度均不能区分患者抑郁症状的严重程度。在急性患者组中，失语的非流畅性是唯一可确定的对情绪症状评分有影响的参数。急性患者组的CT扫描分析显示抑郁严重程度与前部病变之间存在关联。CDS总分与病变前边界到半球额极的距离之间存在显著相关性，而病变体积似乎对急性失语患者的抑郁改变没有影响。患有重度抑郁症的失语患者的病变叠加显示出一个共同的皮质下病变区域，涉及壳核和外苍白球结构。
