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Am J Psychiatry 1988; 145:172-178
Copyright © 1988 by American Psychiatric Association
Comparison of mania and depression after brain injury: causal factors
RG Robinson, JD Boston, SE Starkstein and TR Price
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Patients who developed secondary mania after brain injury (N = 17) had a
significantly greater frequency of injury to right hemisphere areas
connected with the limbic system than poststroke patients with major
depression (N = 31), who had injury primarily in the left frontal cortex
and basal ganglia. For patients without mood disturbance after brain injury
(N = 28), the location of the lesion was not significant. Secondary mania
patients also had a significantly greater frequency of family history of
affective disorder than did the other two groups. These results suggest
that an interaction between injury to certain areas of the right hemisphere
and genetic factors or other neuropathological conditions produces
secondary mania.
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