Статья посвящена проблеме постинсультной апатии, которая признается важным нейропсихиатрическим синдромом, что связано с ее воздействием на эффективность реабилитации, социальную адаптацию больного, возвращение к трудовой активности. В работе представлены литературные данные по распространенности, клиническим проявлениям, диагностическим критериям постинсультной апатии, ассоциация ее с возрастом, полом, депрессией, когнитивной дисфункцией. Рассмотрены вопросы патогенеза постинсультной апатии, взаимосвязи с локализацией очага поражения мозга, тяжестью инсульта, представлены направления лечения и прогноз.
Ключевые слова: инсульт, постинсультная апатия.
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The article is devoted to the problem of post-stroke apathy, which is recognized as an important neuropsychiatric syndrome, which is associated with its impact on the effectiveness of rehabilitation, social adaptation of the patient, and return to work activity. The paper presents literature data on the prevalence, clinical manifestations, and diagnostic criteria of post-stroke apathy, its Association with age, gender, depression, and cognitive dysfunction. The article deals with the pathogenesis of post-stroke apathy, the relationship with the localization of the brain lesion, the severity of stroke, the directions of treatment and prognosis.
1. Ferro JM, Caeiro L, Santos C Poststroke emotional and behavior impairment: a narrative review. Cerebrovasc. Dis 2009; 27 (Suppl. 1): 197–203.
2. Kim JS Post-stroke mood and emotional disturbances: pharmacological therapy based on mechanisms. J Stroke 2016; 18 (3): 244–55.
3. Савина М.А. Постинсультные психические нарушения: клинико-статистические, клинические, клинико-патогенетические, прогностические аспекты. Дис. ... д-ра мед. наук. М., 2016.
[Savina M.A. Postinsul'tnye psikhicheskie narusheniia: kliniko-statisticheskie, klinicheskie, kliniko-patogeneticheskie, prognosticheskie aspekty. Dis. ... d-ra med. nauk. Moscow, 2016 (in Russian).]
4. Brodaty H, Sachdev PS, Withall A et al. Frequency and clinical, neuropsychological and neuroimaging correlates of apathy following stroke – the Sydney stroke study. Psychol Med 2005; 35 (12): 1707–16.
5. Van Dalen JW, Moll van Charante EP, Nederkoorn PJ et al. Poststroke apathy. Stroke 2013; 44 (3): 851–60.
6. Williams LS. What bothers caregivers of stroke victims? J Neuroscience Nursing 2004; 26: 155–161.
7. Петрова Е.А. Аффективные расстройства у больных с церебральным инсультом. Дис. ... д-ра мед. наук. М., 2013.
[Petrova E.A. Affektivnye rasstroistva u bol'nykh s tserebral'nym insul'tom. Dis. ... d-ra med. nauk. Moscow, 2013 (in Russian).].
8. Reekum R. Apathy: why care? J Neuropsychiatry Clin Neurosci 2005; 17 (1): 7–19.
9. Кутлубаев М.А., Ахмадеева Л.Р. Симптомы патологической усталости, апатии и депрессии у пациентов после церебрального инсульта. Неврология, нейропсихиатрия, психосоматика. 2015; 7 (2): 16–21.
[Kutlubaev M.A., Akhmadeeva L.R. Simptomy patologicheskoi ustalosti, apatii i depressii u patsientov posle tserebral'nogo insul'ta. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2015; 7 (2): 16–21 (in Russian).]
10. Robinson RG, Jorge RE, Clarence-Smith K, Starkstein S. Double-blind treatment of apathy in patients with poststroke depression using nefiracetam. J Neuropsych Clin Neuroscien 2009; 21 (2): 144–51.
11. Bleuler E. Dementia praecox or the group of schizophrenias. New York: International Universities Press, 1983.
12. Stuss DT, van Reekum R, Murphy KJ. Differentiation of states and causes of apathy. In: Borod J (Ed.) The Neuropsychology of Emotion. New York, Oxford University Press. 2000: p. 340–63.
13. Starkstein SE, Leentjens AF. The nosological position of apathy in clinical practice. J Neurol Neurosurg Psychiatry 2008; 79 (10): 1088–92.
14. Heron CI, Apps MA, Husain M. The anatomy of apathy: a neurocognitive framework for amotivated behaviour. Neuropsychologia 2018; 118: 54–67.
15. Nobis L, Husain М. Apathy in Alzheimer's disease. Curr Opin Behav Sci 2018; 22: 7–13.
16. Захаров В.В., Вознесенская Т.Г. Нервно-психические нарушения: диагностические тесты. М.: Медпресс-информ, 2018.
[Zakharov V.V., Voznesenskaia T.G. Neuropsychiatric disorders: diagnostic tests. Moscow: Medpress-inform, 2018 (in Russian).]
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[Voznesenskaia T.G. Sindrom apatii. Nevrologicheskii zhurn. 2013; 3: 4–8 (in Russian).]
18. Marin RS. Apathy: a neuropsychiatric syndrome. J Neuropsychiatry Clin Neurosci 1991; 3: 243–54.
19. Marin RS, Biedrzycki RC, Firinciogullar S. Reliability and validity of the apathy evaluation scale. Psychiatry Res 1991; 38: 143–62.
20. Marin RS, Wilkosz PA. Disorders of diminished motivation. J Head Trauma Rehabil 2005; 20 (4): 377–88.
21. Marin RS. Differential diagnosis and classification of apathy. Am J Psychiatry 1990; 147: 22–30.
22. Starkstein SE. Apathy and withdrawal. Int Psychogeriatr 2000; 12: 135–8.
23. Levy R, Dubois B. Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cerebral Cortex 2006; 16: 916–28.
24. Cummings JL, Mega M, Gray K et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.
25. Starkstein SE, Petracca G, Chemerinski E et al. Syndromic validity of apathy in Alzheimer’s disease. Am J Psychiatry 2001; 158: 872–7.
26. Strauss ME, Sperry SD. An informant-based assessment of apathy in Alzheimer disease. Neuropsychiatry Neuropsychol Behav Neurol 2002; 15 (3): 176–83.
27. Robert PH, Clairet S, Benoit M et al. The apathy inventory: assessment of apathy and awareness in Alzheimer’s disease, Parkinson’s disease and mild cognitive impairment. Int J Geriatr Psychiatry 2002; 17 (12): 1099–105.
28. Robert P, Onyike CU, Leentjens AF et al. Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders. Eur Psychiatry 2009; 24: 98–104.
29. Mayo NE, Fellows LK, Scott SC et al. A longitudinal view of apathy and its impact after stroke. Stroke 2009; 40: 3299–307.
30. Cameron JI. The impact of stroke survivors' behavioural and psychological symptoms on informal caregivers' mental health. PhD dissertation. University of Toronto Press. 2004: p. 237.
31. Cameron JI, Cheung AM, Streiner DL et al. Stroke survivors' behavioral and psychologic symptoms are associated with informal caregivers' experiences of depression. Arch Physical Med Rehabil 2006; 87: 177–83.
32. Zhao QF, Tan L, Wang HF et al. The prevalence of neuropsychiatric symptoms in Alzheimer's disease: systematic review and meta-analysis. J Aff Dis 2016; 190: 264–71.
33. Нодель М.Р., Яхно Н.Н. Апатия при болезни Паркинсона. Невролог. журн. 2014; 1: 9–15.
[Nodel' M.R., Iakhno N.N. Apatiia pri bolezni Parkinsona. Nevrolog. zhurn. 2014; 1: 9–15 (in Russian).]
34. Den Brok MG, van Dalen JW, van Gool WA et al. Apathy in Parkinson's disease: a systematic review and meta-analysis. Mov Dis 2015; 30 (6): 759–69.
35. Clarke DE, van Reekum R, Simard M et al. Apathy in dementia: clinical and sociodemographic correlates. J Neuropsychiatry Clin Neurosci 2008; 20 (3): 337–47.
36. Вознесенская Т.Г. Депрессия в пожилом возрасте. Consilium Medical. 2000; 11: 74–9.
[Voznesenskaia T.G. Depression in old age. Consilium Medical. 2000; 11: 74–9 (in Russian).]
37. Goldfine АМ, Dehbandi В, Briana S et al. Quantifying post-stroke apathy with actimeters. J Neuropsychiatry Clin Neurosci 2016; 28 (3): 199–204.
38. Петрова Е.А., Поневежская Е.В., Савина М.А., Скворцова В.И. Клинические особенности постинсультной апатии. Журн. неврологии и психиатрии им. С.С. Корсакова. 2012; 12: 15–9.
[Petrova E.A., Ponevezhskaia E.V., Savina M.A., Skvortsova V.I. Klinicheskie osobennosti postinsul'tnoi apatii. Zhurn. nevrologii i psikhiatrii im. S.S. Korsakova. 2012; 12: 15–9 (in Russian).]
39. Finset A, Andersson S. Coping strategies in patients with acquired brain injury: relationships between coping, apathy, depression and lesion location. Brain Inj 2009; 14 (10): 887–905.
40. Sagen U, Vik TG, Moum T et al. Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. J Psychosomat Res 2009; 67 (4): 325–32.
41. Harvey PO, Fossati P, Pochon JB et al. Cognitive control and brain resources in major depression. Neuroimage 2005; 26: 860–69.
42. Andersson S, Krogstad JM, Finset A. Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity. Psychol Med 1999; 29: 447–56.
43. Starkstein SE, Fedoroff JP, Price TR et al. Apathy following cerebrovascular lesions. Stroke 1993; 24: 1625–30.
44. Kennedy JM, Dora BS, Granato А, Goldfine AM Natural history of post-stroke apathy during acute rehabilitation. J Neuropsychiatry Clin Neurosci 2015; 27 (4): 333–8.
45. Боголепова А.Н. Депрессивные расстройства у больных с цереброваскулярной патологией. Справочник поликлинического врача. 2006; 8.
[Bogolepova A.N. Depressive disorders in patients with cerebrovascular pathology. Handbook for Practitioners Doctors. 2006; 8 (in Russian).]
46. Aharon-Peretz J, Kliot D, Tomer R. Behavioral differences between white matter lacunar dementia and Alzheimer’s disease: a comparison on the neuropsychiatric inventory. Dement Geriatr Cogn Dis 2000; 11: 294–8.
47. McGilchrist I, Goldstein LH, Jadresic D et al. Thalamo-frontal psychosis. Br J Psychiatry 1993; 163: 113–5.
48. Bhatia KP, Marsden CD. The behavioural and motor consequences of focal lesions of the basal ganglia in man. Brain 1994; 117: 859–76.
49. Okada K, Kobayashi S, Yamagata S et al. Poststroke apathy and regional cerebral blood flow. Stroke 1997; 28: 2437–41.
50. Parks RW, Crockett DJ, Manji HK et al. Assessment of bromocriptine intervention for the treatment of frontal lobe syndrome: a case study. J Neuropsychiatry Clin Neurosci 1992; 4: 109–11.
51. Watanabe MD, Martin EM, DeLeon OA et al. Successful methylphenidate treatment of apathy after subcortical infarcts. J Neuropsychiatry Clin Neurosci 1995; 7: 502–4.
52. Doody RS, Massman P, Mahurin R et al. Positive and negative neuropsychiatric features in Alzheimer’s disease. J Neuropsychiatry Clin Neurosci 1995; 7: 54–60.
53. Galynker I, Ieronimo C, Miner C et al. Methylphenidate treatment of negative symptoms in patients with dementia. J Neuropsychiatry Clin Neurosci 1997; 9: 231–39.
54. Reichman WE, Coyne AC, Amirneni S et al. Negative symptoms in Alzheimer’s disease. Am J Psychiatry 1996; 153: 424–6.
55. Aarsland DА, Cummings JL, Larsen JP. Neuropsychiatric differences between Parkinson’s disease with dementia and Alzheimer’s disease. Int J Geriatr Psychiatry 2001; 16: 184–91.
56. Paulsen JS, Ready RE, Hamilton JM et al. Neuropsychiatric aspects of Huntington’s disease. J Neuro Neurosurg Psychiatry 2001; 71: 310–4.
57. Narushima K, Robinson RG. The effect of early versus late antidepressant treatment on physical impairment associated with poststroke depression: is there a time-related therapeutic window? J Nerv Ment Dis 2003; 191 (10): 645–52.
58. Rasmussen A, Lunde M, Poulsen DL et al. A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Psychosomatics 2003; 44 (3): 216–21.
59. Zhang LS, Hu XY, Yao LY et al. Prophylactic effects of duloxetine on post-stroke depression symptoms: an open single-blind trial. Eur Neurol 2013; 69 (6): 336–43.
60. Kraglund KL, Mortensen JK, Grove EL et al. TALOS: a multicenter, randomized, double-blind, placebo-controlled trial to test the effects of citalopram in patients with acute stroke. Int J Stroke 2015; 10 (6): 985–7.
61. Flaster M, Sharma A, Rao M. Poststroke depression: a review emphasizing the role of prophylactic treatment and synergy with treatment for motor recovery. Top Stroke Rehabil 2013; 20 (2): 139–50.
62. Kraglund KL, Mortensen JK, Grove EL et al. TALOS: a multicenter, randomized, double-blind, placebo-controlled trial to test the effects of citalopram in patients with acute stroke. Int J Stroke 2015; 10 (6): 985–7.
63. Hama S, Yamashita H, Shigenobu M et al. Post-stroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia. Eur Arch Psychiatry Clin Neurosci 2011; 257 (3): 149–52.
64. Santa N, Sugimori H, Kusuda K et al. Apathy and functional recovery following first-ever stroke. Int J Rehabil Res 2008; 31 (4): 321–6.
________________________________________________
1. Ferro JM, Caeiro L, Santos C Poststroke emotional and behavior impairment: a narrative review. Cerebrovasc. Dis 2009; 27 (Suppl. 1): 197–203.
2. Kim JS Post-stroke mood and emotional disturbances: pharmacological therapy based on mechanisms. J Stroke 2016; 18 (3): 244–55.
3. Savina M.A. Postinsul'tnye psikhicheskie narusheniia: kliniko-statisticheskie, klinicheskie, kliniko-patogeneticheskie, prognosticheskie aspekty. Dis. ... d-ra med. nauk. Moscow, 2016 (in Russian).
4. Brodaty H, Sachdev PS, Withall A et al. Frequency and clinical, neuropsychological and neuroimaging correlates of apathy following stroke – the Sydney stroke study. Psychol Med 2005; 35 (12): 1707–16.
5. Van Dalen JW, Moll van Charante EP, Nederkoorn PJ et al. Poststroke apathy. Stroke 2013; 44 (3): 851–60.
6. Williams LS. What bothers caregivers of stroke victims? J Neuroscience Nursing 2004; 26: 155–161.
7. Petrova E.A. Affektivnye rasstroistva u bol'nykh s tserebral'nym insul'tom. Dis. ... d-ra med. nauk. Moscow, 2013 (in Russian).
8. Reekum R. Apathy: why care? J Neuropsychiatry Clin Neurosci 2005; 17 (1): 7–19.
9. Kutlubaev M.A., Akhmadeeva L.R. Simptomy patologicheskoi ustalosti, apatii i depressii u patsientov posle tserebral'nogo insul'ta. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2015; 7 (2): 16–21 (in Russian).
10. Robinson RG, Jorge RE, Clarence-Smith K, Starkstein S. Double-blind treatment of apathy in patients with poststroke depression using nefiracetam. J Neuropsych Clin Neuroscien 2009; 21 (2): 144–51.
11. Bleuler E. Dementia praecox or the group of schizophrenias. New York: International Universities Press, 1983.
12. Stuss DT, van Reekum R, Murphy KJ. Differentiation of states and causes of apathy. In: Borod J (Ed.) The Neuropsychology of Emotion. New York, Oxford University Press. 2000: p. 340–63.
13. Starkstein SE, Leentjens AF. The nosological position of apathy in clinical practice. J Neurol Neurosurg Psychiatry 2008; 79 (10): 1088–92.
14. Heron CI, Apps MA, Husain M. The anatomy of apathy: a neurocognitive framework for amotivated behaviour. Neuropsychologia 2018; 118: 54–67.
15. Nobis L, Husain М. Apathy in Alzheimer's disease. Curr Opin Behav Sci 2018; 22: 7–13.
16. Zakharov V.V., Voznesenskaia T.G. Neuropsychiatric disorders: diagnostic tests. Moscow: Medpress-inform, 2018 (in Russian).
17. Voznesenskaia T.G. Sindrom apatii. Nevrologicheskii zhurn. 2013; 3: 4–8 (in Russian).
18. Marin RS. Apathy: a neuropsychiatric syndrome. J Neuropsychiatry Clin Neurosci 1991; 3: 243–54.
19. Marin RS, Biedrzycki RC, Firinciogullar S. Reliability and validity of the apathy evaluation scale. Psychiatry Res 1991; 38: 143–62.
20. Marin RS, Wilkosz PA. Disorders of diminished motivation. J Head Trauma Rehabil 2005; 20 (4): 377–88.
21. Marin RS. Differential diagnosis and classification of apathy. Am J Psychiatry 1990; 147: 22–30.
22. Starkstein SE. Apathy and withdrawal. Int Psychogeriatr 2000; 12: 135–8.
23. Levy R, Dubois B. Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cerebral Cortex 2006; 16: 916–28.
24. Cummings JL, Mega M, Gray K et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.
25. Starkstein SE, Petracca G, Chemerinski E et al. Syndromic validity of apathy in Alzheimer’s disease. Am J Psychiatry 2001; 158: 872–7.
26. Strauss ME, Sperry SD. An informant-based assessment of apathy in Alzheimer disease. Neuropsychiatry Neuropsychol Behav Neurol 2002; 15 (3): 176–83.
27. Robert PH, Clairet S, Benoit M et al. The apathy inventory: assessment of apathy and awareness in Alzheimer’s disease, Parkinson’s disease and mild cognitive impairment. Int J Geriatr Psychiatry 2002; 17 (12): 1099–105.
28. Robert P, Onyike CU, Leentjens AF et al. Proposed diagnostic criteria for apathy in Alzheimer’s disease and other neuropsychiatric disorders. Eur Psychiatry 2009; 24: 98–104.
29. Mayo NE, Fellows LK, Scott SC et al. A longitudinal view of apathy and its impact after stroke. Stroke 2009; 40: 3299–307.
30. Cameron JI. The impact of stroke survivors' behavioural and psychological symptoms on informal caregivers' mental health. PhD dissertation. University of Toronto Press. 2004: p. 237.
31. Cameron JI, Cheung AM, Streiner DL et al. Stroke survivors' behavioral and psychologic symptoms are associated with informal caregivers' experiences of depression. Arch Physical Med Rehabil 2006; 87: 177–83.
32. Zhao QF, Tan L, Wang HF et al. The prevalence of neuropsychiatric symptoms in Alzheimer's disease: systematic review and meta-analysis. J Aff Dis 2016; 190: 264–71.
33. Nodel' M.R., Iakhno N.N. Apatiia pri bolezni Parkinsona. Nevrolog. zhurn. 2014; 1: 9–15 (in Russian).
34. Den Brok MG, van Dalen JW, van Gool WA et al. Apathy in Parkinson's disease: a systematic review and meta-analysis. Mov Dis 2015; 30 (6): 759–69.
35. Clarke DE, van Reekum R, Simard M et al. Apathy in dementia: clinical and sociodemographic correlates. J Neuropsychiatry Clin Neurosci 2008; 20 (3): 337–47.
36. Voznesenskaia T.G. Depression in old age. Consilium Medical. 2000; 11: 74–9 (in Russian).
37. Goldfine АМ, Dehbandi В, Briana S et al. Quantifying post-stroke apathy with actimeters. J Neuropsychiatry Clin Neurosci 2016; 28 (3): 199–204.
38. Petrova E.A., Ponevezhskaia E.V., Savina M.A., Skvortsova V.I. Klinicheskie osobennosti postinsul'tnoi apatii. Zhurn. nevrologii i psikhiatrii im. S.S. Korsakova. 2012; 12: 15–9 (in Russian).
39. Finset A, Andersson S. Coping strategies in patients with acquired brain injury: relationships between coping, apathy, depression and lesion location. Brain Inj 2009; 14 (10): 887–905.
40. Sagen U, Vik TG, Moum T et al. Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. J Psychosomat Res 2009; 67 (4): 325–32.
41. Harvey PO, Fossati P, Pochon JB et al. Cognitive control and brain resources in major depression. Neuroimage 2005; 26: 860–69.
42. Andersson S, Krogstad JM, Finset A. Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity. Psychol Med 1999; 29: 447–56.
43. Starkstein SE, Fedoroff JP, Price TR et al. Apathy following cerebrovascular lesions. Stroke 1993; 24: 1625–30.
44. Kennedy JM, Dora BS, Granato А, Goldfine AM Natural history of post-stroke apathy during acute rehabilitation. J Neuropsychiatry Clin Neurosci 2015; 27 (4): 333–8.
45. Bogolepova A.N. Depressive disorders in patients with cerebrovascular pathology. Handbook for Practitioners Doctors. 2006; 8 (in Russian).
46. Aharon-Peretz J, Kliot D, Tomer R. Behavioral differences between white matter lacunar dementia and Alzheimer’s disease: a comparison on the neuropsychiatric inventory. Dement Geriatr Cogn Dis 2000; 11: 294–8.
47. McGilchrist I, Goldstein LH, Jadresic D et al. Thalamo-frontal psychosis. Br J Psychiatry 1993; 163: 113–5.
48. Bhatia KP, Marsden CD. The behavioural and motor consequences of focal lesions of the basal ganglia in man. Brain 1994; 117: 859–76.
49. Okada K, Kobayashi S, Yamagata S et al. Poststroke apathy and regional cerebral blood flow. Stroke 1997; 28: 2437–41.
50. Parks RW, Crockett DJ, Manji HK et al. Assessment of bromocriptine intervention for the treatment of frontal lobe syndrome: a case study. J Neuropsychiatry Clin Neurosci 1992; 4: 109–11.
51. Watanabe MD, Martin EM, DeLeon OA et al. Successful methylphenidate treatment of apathy after subcortical infarcts. J Neuropsychiatry Clin Neurosci 1995; 7: 502–4.
52. Doody RS, Massman P, Mahurin R et al. Positive and negative neuropsychiatric features in Alzheimer’s disease. J Neuropsychiatry Clin Neurosci 1995; 7: 54–60.
53. Galynker I, Ieronimo C, Miner C et al. Methylphenidate treatment of negative symptoms in patients with dementia. J Neuropsychiatry Clin Neurosci 1997; 9: 231–39.
54. Reichman WE, Coyne AC, Amirneni S et al. Negative symptoms in Alzheimer’s disease. Am J Psychiatry 1996; 153: 424–6.
55. Aarsland DА, Cummings JL, Larsen JP. Neuropsychiatric differences between Parkinson’s disease with dementia and Alzheimer’s disease. Int J Geriatr Psychiatry 2001; 16: 184–91.
56. Paulsen JS, Ready RE, Hamilton JM et al. Neuropsychiatric aspects of Huntington’s disease. J Neuro Neurosurg Psychiatry 2001; 71: 310–4.
57. Narushima K, Robinson RG. The effect of early versus late antidepressant treatment on physical impairment associated with poststroke depression: is there a time-related therapeutic window? J Nerv Ment Dis 2003; 191 (10): 645–52.
58. Rasmussen A, Lunde M, Poulsen DL et al. A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Psychosomatics 2003; 44 (3): 216–21.
59. Zhang LS, Hu XY, Yao LY et al. Prophylactic effects of duloxetine on post-stroke depression symptoms: an open single-blind trial. Eur Neurol 2013; 69 (6): 336–43.
60. Kraglund KL, Mortensen JK, Grove EL et al. TALOS: a multicenter, randomized, double-blind, placebo-controlled trial to test the effects of citalopram in patients with acute stroke. Int J Stroke 2015; 10 (6): 985–7.
61. Flaster M, Sharma A, Rao M. Poststroke depression: a review emphasizing the role of prophylactic treatment and synergy with treatment for motor recovery. Top Stroke Rehabil 2013; 20 (2): 139–50.
62. Kraglund KL, Mortensen JK, Grove EL et al. TALOS: a multicenter, randomized, double-blind, placebo-controlled trial to test the effects of citalopram in patients with acute stroke. Int J Stroke 2015; 10 (6): 985–7.
63. Hama S, Yamashita H, Shigenobu M et al. Post-stroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia. Eur Arch Psychiatry Clin Neurosci 2011; 257 (3): 149–52.
64. Santa N, Sugimori H, Kusuda K et al. Apathy and functional recovery following first-ever stroke. Int J Rehabil Res 2008; 31 (4): 321–6.
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2 ФГБНУ «Научный центр психического здоровья», Москва, Россия
*633201@mail.ru
________________________________________________
Elizaveta A. Petrova*1, Ekaterina V. Ponevejsky1, Maria A. Savina2, Evgenia A. Koltsova1
1 Pirogov Russian National Research Medical University, Moscow, Russia;
2 Research Center for Mental Health, Moscow, Russia
*633201@mail.ru