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STUDY PROTOCOL article

Front. Neurol.
Sec. Neurorehabilitation
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1452491

Irritability in Stroke: A Protocol for a Prospective Study

Provisionally accepted
Wai Kwong Tang Wai Kwong Tang 1*Edward Hui Edward Hui 2Thomas Wai Hong Leung Thomas Wai Hong Leung 3
  • 1 Department of Psychiatry, The Chinese University of Hong Kong, Shatin, China
  • 2 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, China
  • 3 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, China

The final, formatted version of the article will be published soon.

    Poststroke irritability (PSI) is common among stroke survivors and can lead to a poor quality of life, difficulties in social interactions, criticism from caregivers, and caregiver stress. The planned study will evaluate the clinical, neuropsychological, and magnetic resonance imaging (MRI) correlates of PSI in a cohort of stroke survivors. In addition, the study will examine the 15-month progression of PSI.This will be a prospective cohort study that will recruit 285 participants. Participants and their caregivers will undergo detailed assessments at a research clinic at 3, 9, and 15 months after stroke onset (T1/T2/T3). The irritability/lability subscale of the Chinese version of the Neuropsychiatric Inventory (CNPI) will be completed by caregivers. Potential covariates will also be measured. Patients will undergo MRI, including diffusion-weighted imaging, within 1 week of stroke onset. A stepwise logistic regression will be performed to evaluate the importance of lesions in the regions of interest (ROIs) along with other significant variables identified in univariate analyses. These analyses will be repeated for patients with and without PSI at T2 and T3. Repeated measures analysis of covariance (ANCOVA) will be used to assess changes in CNPI scores for the entire sample. In ANCOVA analyses, the frequency of infarcts in the ROIs will be treated as the predictor. Discussion:This will be the first MRI study on PSI in stroke survivors. The findings will provide insights into the association of the orbitofrontal cortex, anterior cingulate cortex, anterior temporal lobe, insula, amygdala, thalamus, and basal ganglia lesions with the risk of PSI.

    Keywords: Stroke, irritability, MRI, Prefrontal Cortex, anterior cingulate cortex, Anterior Temporal Lobe, insula, Amygdala

    Received: 24 Jun 2024; Accepted: 26 Nov 2024.

    Copyright: © 2024 Tang, Hui and Leung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wai Kwong Tang, Department of Psychiatry, The Chinese University of Hong Kong, Shatin, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.