Several brain imaging markers have been studied in the development of post-stroke depression (PSD) and post-stroke apathy (PSA), but inconsistent associations have been reported. This systematic review and meta-analysis aims to provide a comprehensive and up-to-date evaluation of imaging markers associated with PSD and PSA. Databases (Medline, Embase, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews) were searched from inception to July 21, 2016. Observational studies describing imaging markers of PSD and PSA were included. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated to examine the association between PSD or PSA and stroke lesion laterality, type, and location, also stratified by study phase (acute, post-acute, chronic). Other imaging markers were reviewed qualitatively. The search retrieved 4502 studies, of which 149 studies were included in the review and 86 studies in the meta-analyses. PSD in the post-acute stroke phase was significantly associated with frontal (OR 1.72, 95% CI 1.34–2.19) and basal ganglia lesions (OR 2.25, 95% CI 1.33–3.84). Hemorrhagic stroke related to higher odds for PSA in the acute phase (OR 2.58, 95% CI 1.18–5.65), whereas ischemic stroke related to higher odds for PSA in the post-acute phase (OR 0.20, 95% CI 0.06–0.69). Frequency of PSD and PSA is modestly associated with stroke type and location and is dependent on stroke phase. These findings have to be taken into consideration for stroke rehabilitation programs, as this could prevent stroke patients from developing PSD and PSA, resulting in better clinical outcome.

中文翻译：

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脑卒中后抑郁和冷漠的影像学标志：系统评价和荟萃分析

在脑卒中后抑郁症（PSD）和脑卒中后冷漠症（PSA）的发展过程中已经研究了几种脑成像标志物，但已报道了不一致的关联。这项系统的综述和荟萃分析旨在提供与PSD和PSA相关的成像标记的全面和最新评估。从开始到2016年7月21日，检索了数据库（Medline，Embase，PsycINFO，CINAHL和Cochrane系统评价数据库）。包括描述PSD和PSA成像标志物的观察性研究。计算合并的优势比（OR）和95％置信区间（CI），以检查PSD或PSA与中风病灶的偏侧性，类型和位置之间的关联，还按研究阶段（急性，急性后，慢性）进行分层。其他影像学标志物进行了定性检查。搜索检索到4502个研究，评价中包括149个研究，荟萃分析中包括86个研究。急性中风后阶段的PSD与额叶（OR 1.72，95％CI 1.34–2.19）和基底神经节病变（OR 2.25，95％CI 1.33–3.84）显着相关。出血性卒中与急性期PSA的机率较高有关（OR 2.58，95％CI 1.18-5.65），而缺血性卒中与急性期后PSA的机率较高有关（OR 0.20，95％CI 0.06-0.69） 。PSD和PSA的频率适度地与笔划类型和位置相关，并取决于笔划相位。这些发现对于中风康复计划必须予以考虑，因为这可以防止中风患者发展为PSD和PSA，从而获得更好的临床效果。急性中风后阶段的PSD与额叶（OR 1.72，95％CI 1.34–2.19）和基底神经节病变（OR 2.25，95％CI 1.33–3.84）显着相关。出血性卒中与急性期PSA的机率较高有关（OR 2.58，95％CI 1.18-5.65），而缺血性卒中与急性期后PSA的机率较高有关（OR 0.20，95％CI 0.06-0.69） 。PSD和PSA的频率适度地与笔划类型和位置相关，并取决于笔划相位。这些发现对于中风康复计划必须予以考虑，因为这可以防止中风患者发展为PSD和PSA，从而获得更好的临床效果。急性中风后阶段的PSD与额叶（OR 1.72，95％CI 1.34–2.19）和基底神经节病变（OR 2.25，95％CI 1.33–3.84）显着相关。出血性卒中与急性期PSA的机率较高有关（OR 2.58，95％CI 1.18-5.65），而缺血性卒中与急性期后PSA的机率较高有关（OR 0.20，95％CI 0.06-0.69） 。PSD和PSA的频率适度地与笔划类型和位置相关，并取决于笔划相位。这些发现对于中风康复计划必须予以考虑，因为这可以防止中风患者发展为PSD和PSA，从而获得更好的临床效果。出血性卒中与急性期PSA的机率较高有关（OR 2.58，95％CI 1.18-5.65），而缺血性卒中与急性期后PSA的机率较高有关（OR 0.20，95％CI 0.06-0.69） 。PSD和PSA的频率适度地与笔划类型和位置相关，并取决于笔划相位。这些发现对于中风康复计划必须予以考虑，因为这可以防止中风患者发展为PSD和PSA，从而获得更好的临床效果。出血性卒中与急性期PSA的机率较高有关（OR 2.58，95％CI 1.18-5.65），而缺血性卒中与急性期后PSA的机率较高有关（OR 0.20，95％CI 0.06-0.69） 。PSD和PSA的频率适度地与笔划类型和位置相关，并取决于笔划相位。这些发现对于中风康复计划必须予以考虑，因为这可以防止中风患者发展为PSD和PSA，从而获得更好的临床效果。