Depression and Hemispheric Site of Cerebral Vascular Accident

In order to investigate the possible role of left and right hemisphere neural structures in the manifestation of depression, 50 left brain damaged and 50 right brain damaged stroke inpatients were administered the Zung Depression Scale (20 S) during the course of the rehabilitation phase of their treatment. These subjects were randomly chosen from all stroke patients receiving rehabilitation services who could be administered the ZDS. Approximately 30 % of these sub-jects, regardless of the site of lesion, were clinically depressed. The severity of depression was independent of demographic factors and time since injury. Right brain damaged patients reported sigm@antly more sleep disturbance, psycho-motor agitation and pervasive sense of sadness. These results were discussed in light of previous findings that damage to the left hemisphere results in greater depression. A model of reactive depression that results from neurological disabil-ity was proposed to partially account for these findings. Many investigators have examined the relationship between mood disorder associated with cerebral vascular accident and the hemispheric site of the brain lesion. Clinical observations of stroke patients with left-hemisphere lesions suggested that they experienced a greater frequency of depressive catastrophic reactions (Goldstein, 1939). Others have observed that right-hemisphere strokes are associated with apathy and indifference (Denny-Brown, Meyer, & Horenstein, 1952). Experimental studies of these phenomena have generally supported these observations. Studies of patients submitted to unilateral Amytal injection indicated that sedation of the left-hemisphere resulted in depressive cata-strophic reactions whereas sedation of the right-hemisphere resulted in eu