뇌졸중 환자에서 뇌 병변 부위와 정서적 문제와의 관계

Abstract

Objective: This study is aimed at the pathoanatomic correlates of emotional problem in the patients with stroke. Method: Thirty patients with single, unilateral hemispheric lesion and no predisposing factors for psychiatric disorder were selected. Several neuropsychological assessments such as Minimental status examination-Korean (MMSE-K), Minnesota multiphasic personality inventory (MMPI), Symptom checklist-90-Revision (SCL-90-R) and Functional independence measure (FIM) were performed on all patients by a clinical psychologist and an occupational therapist. Results: There were statistically significant differences between right and left hemisphere lesion group in emotional problems. Right hemispheric lesion group showed significantly higher scores of psychasthenia (MMPI), Obsessive-compulsive (SCL-90-R) and self care (FIM) than left hemispheric lesion group did. But there were no statistically significant differences between cortical and subcortical lesion group. Groups of left cortical lesion, right cortical lesion, left subcortical lesion and right subcortical lesion were not significantly different in their neuropsychological assessments and FIM except self care. Conclusion: Obsessive-compulsive and anxious emotional problems are more closely related with right hemispheric lesion. Therefore patients with right hemispheric lesion need more careful psychological and psychiatric evaluation. However, because of the small numbers of subjects involved in the study, the role of lesion location remains unclear so that consecutive follow-up studies are needed.