Post-stroke mood disorders, characterization and early detection
Defended on September 23rd, 2016
Stroke is the second leading cause of death and the leading cause of acquired disability in adults worldwide. Over the last twenty years, treatment in the acute phase of stroke has improved considerably. As a result, post-stroke mortality began to decline and the proportion of surviving patients with mild or moderate disabilities has increased. The long-term monitoring of this category of patients allowed to highlight, in a significant proportion of them, the occurrence of high psychological distress. These mood disorders significantly reduce post-stroke quality of life and, therefore, the assumption that put primary emphasis on the motor deficits, sensory or language now begins to move towards the psychological care of patients. These complications are however still insufficiently understood and their management remains unsatisfactory.In this context, the objective of this PhD was to better describe these post-stroke mood disorders and highlight, through objective measurement tools, the existence of risk factors for their occurrence. 91 patients were followed during one year after stroke and were evaluated on cognitive assessments, mood state evaluation, sleep recording and language recording. The results allowed us to better understand the involvement of some variables in the occurrence or progression of some mood disorders, for example sleep fragmentation and post-stroke apathy or affective prosody and post-stroke depression. Cerebellar lesions also appear to be related to the occurrence of post-stroke mood disorders. These results are part of the increasing research on post-stroke mood disorders.
Key words : Mood disorders, apathy, depression, anxiety, sleep, prosody, cerebellum
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Charlotte Cosin, Ecole Pratique des Hautes Etudes (EPHE) INCIA, CNRS UMR 5287 Equipe de Neuroimagerie et Cognition Humaine
- Mathilde HUSKY, PU, Université de Bordeaux (rapporteur et présidente du jury)
- David CLARYS, PU, Université de Poitiers (rapporteur)
- Serge TIMSIT, PUPH, UBO, CHRU Brest (membre du jury)
- Imad GHORAYEB, MCU et PH, CHU Bordeaux (membre du jury)
- Willy MAYO, CR INSERM (Directeur de thèse)
- Joël Swendsen, DR CNRS, Directeur d’Etudes Cumulant EPHE (co-directeur de thèse)
- Igor SIBON, PUPH, Université de Bordeaux, CHU Bordeaux (co-encadrant de thèse)
Directeurs de thèse
- Willy Mayo, Chargé de Recherche, INSERM.Directeur de thèse, Team: Neuroimaging and Human Cognition. INCIA
- Joël Swendsen, Directeur de Recherche CNRS, Directeur d’Etudes Cumulant EPHE (co-directeur de thèse)
- Igor SIBON, PUPH, Université de Bordeaux,(co-encadrant de thèse) Responsable de l’unité Neurovasculaire, CHU de Bordeaux