Anergia after Right Insular Stroke

FACUNDO MANES; SERGIO PARADISO; ROBERT ROBINSON

Los Ángeles

Encuentro; 10th Annual Meeting of the American Neuropsychiatric Association; 1999

American Neuropsychiatric Association

Background: The insula is a major component of the limbic brain (Yakovlev, J Neuropathol Exp Neurol 1959; 18:22—55). The behavioral implications of insular damage, however, remain to be elucidated. We compared the neuropsychiatric profiles of patients with right and left insular damage. Methods: Subjects were 6 patients with left insular stroke and 7 patients with right insular stroke as evidenced by MRI scans. Patient groups had comparable race, age, education, and sex. Patients were included who had lesions involving the insular cortex and no more than a small portion of adjacent white matter. Between 4 and 8 weeks following acute stroke, patients were administered a neuropsychiatric battery including the Ham-D, Ham-A, Zung Depression Scale, modified Present State Examination (PSE), MMSE, Johns Hopkins Functioning Inventory (JHFI), Social Functioning Exam (SFE), and Social Ties Checklist (STC). Results:Patients with right and left damage showed comparable depression, anxiety, cognitive function, functional disability, and social functioning scores. 5 (71%) right insular lesion patients reported symptoms of anergia and underactivity compared with 1 (16%) patient with left insular damage (Pearson χ2=3.90, df=1,P