Structural and functional changes of Post-Stroke Depression: A multimodal magnetic resonance imaging study

This study investigated changes in gray matter volume (GMV), white matter microstructure, and spontaneous brain activity in post-stroke depression (PSD) using multiple MRI techniques, including neurite orientation dispersion and density imaging (NODDI). Changes in GMV, neurite density index (NDI), orientation dispersion index (ODI), fraction of isotropic water (ISO), diffusion tensor imaging (DTI) parameters, and the amplitude of frequency fluctuations (ALFF) were assessed between PSD (n = 20), post-stroke without depression (n = 20), and normal control (n = 20) groups. Receiver operating characteristic (ROC) curve analysis was performed to test the classification performance of the variant parameters of each MRI modality, each single MRI modality and multiple MRI modality. Compared to patients with post-stroke without depression (non-PSD), those with PSD showed increased ODI and ISO in the widespread white matter, as well as increased ALFF in the left pallidum. No significant differences in the GMV or DTI parameters were observed between the two groups. Furthermore, the ODI of the right superior longitudinal fasciculus and NODDI showed the best classification performance for PSD at their respective comparison level (the areas under the ROC curves (AUC) = 0.917(0.000), 0.933(0.000)). The model of NODDI-derived parameters combined with non-diffusion MRI modality parameters (i.e., GMV and ALFF) showed better diagnostic performance than that of DTI-derived parameters. These findings suggest that PSD is associated with structural and functional abnormalities that may contribute to depressive symptoms. Additionally, NODDI showed its advantages in the description of structural alterations in emotion-related white matter pathways and classification performance in PSD.