Jan Mihalov, Peter Mikula, Jaroslav Budis, Peter Valkovic. Frontal Cortical Atrophy as a Predictor of Poststroke Apathy. Journal of Geriatric Psychiatry and Neurology, 29(4):171-176. 2016.

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The aim of the study was to identify associations between the symptoms of
poststroke apathy and sociodemographic, stroke-related (severity of stroke,
degree of disability, and performance in activities of daily living), and
radiological correlates. We determined the degree of cortical and subcortical
brain atrophy, the severity of white matter and basal ganglia lesions on baseline
computed tomography (CT) scans, and the localization of acute ischemia on control
CT or magnetic resonance imaging scans in subacute stages of stroke. During
follow-up examinations, in addition to the assessment of apathy symptoms using
the Apathy Scale, we also evaluated symptoms of depression and anxiety using the 
Hospital Anxiety and Depression Scale. The study included 47 consecutive patients
with acute ischemic stroke. Correlates significantly associated with apathy,
determined at baseline and during follow-up, were entered into the \"predictive\"
and \"associative\" multiple regression models, respectively. Frontal cortical
atrophy and symptoms of depression were most strongly associated with poststroke 
apathy symptoms. In order to model an interrelation between both cortical atrophy
and white matter lesions and aging, we supplemented 2 additional \"predictive\"
models using interaction variables, whereby we confirmed the role of frontal
cortical atrophy as a predictor of poststroke apathy also as a function of the
increasing age of patients.