Page 265 - merged

S058-1

Poststroke Aggression among Hong Kong Stroke Survivors

Wai Kwong Tang

The Chinese University of Hong Kong, Hong Kong

Background/Objective: Aggression is common in stroke survivors. Unlike poststroke depression,
poststroke aggression (PSA) has not been extensively investigated and the significance of infarct
location in its development is unknown. The present proposal aims to evaluate the frequency, clinical
and brain imaging correlates of PSA in a cohort of Hong Kong stroke survivors. The 12 month
clinical course of poststroke anger will be examined as well.

Method: It is a prospective longitudinal study. A cohort of 396 patients was recruited.
Measurements were conducted at 3, 9 and 15 months after the index stroke. PSA was assessed with
the agitation/aggression subscale of the Neuropsychiatric Inventory. The presence and location of
infarcts were evaluated with magnetic resonance imaging.

Result: At 9-month follow up, compared with the non–PSA group, PSA patients were more likely to
have acute pontine, cerebellar and internal capsule infarcts. Pontine, cerebellar and cerebellar infarcts
were independent predictors of PSA in the multivariate analysis, with odds ratios of 4.98 (p=0.009),
3.97 (p=0.014) and 2.08 (p=0.002), respectively. Of the 80 patients who had PSA at 3-month follow
up, 51 attended the 9-month follow-up, and 32 (62.7%) were diagnosed as still having PSA.
Similarly, 23 attended the 15-month follow-up, and 15 (65.2%) were diagnosed as still having PSA

Conclusion: In conclusion, the results indicate that pontine cerebellar and internal capsule infarcts
are associated with a higher risk of PSA and may contribute to its pathogenesis. Further
investigations are warranted to clarify whether pontine, cerebellar and internal capsule infarcts have
any effect on the clinical presentation, treatment response, and outcome of PSA. PSA may be a
persistent problem in stroke survivors.