Bally Frédéric
email: frederic.bally@univ-smb.fr

Keywords: sociology, urban study, citizen initiatives, nature, collective gardening

published or not. The documents may come

Thinking about the future of cities: practices and impacts of collective gardens

Introduction

After a dominant metropolization, [START_REF] Hanna | Rethinking Urban Poverty: A Look at Community Gardens[END_REF], characterized by a period of liberal planning of urban space [START_REF] Peck | Neoliberalizing Space[END_REF][START_REF] Pudup | It takes a garden: Cultivating citizen-subjects in organized garden projects[END_REF], nature is coming back to cities in France and more largely in Occident. At the same time, residents of cities develop a desire for nature. In the psychological field, benefits from nature on human functioning [START_REF] Roszak | The Voice of the Earth: An Exploration of Ecopsychology[END_REF] are proved, and the field of natural sciences informs the way that nature can counter pollution, reduce the ecological print of cities and the effect of waves heat [START_REF] Clergeau | Services écologiques et Trame Verte Urbaine[END_REF]. Its beauty, calm and benefits are rediscovered and so the necessity to preserve it in cities [START_REF] Bailly | Des espaces publics aux espaces paysagers de la ville durable[END_REF] after a massive metropolization. Raising concerns about poor urban environmental quality, a lack of nature, food insecurity, have led to a growing interest in environmental initiatives and particularly in urban gardening. These collective forms of action aim to bring back nature in city and to contest urban planning as it was developed in the 20th century. They emerged in different countries and at different timelines.

This text aims to think about tomorrow cities through the perception of citizen initiatives on the urban context of Lyon. We define citizens' initiatives, environmental, as movement which aimed to put back nature in cities and their own neighborhood, through gardening practices. Our assumption is that these collective gardening initiatives contribute to the construction and urban development, to prepare the future of city, with a variety of collective gardening actions. We define here urban development as all action which allowed an improvement for residents' lives, through the landscape, education, and different services.

The purpose of this article is to examine and define these different forms of collective urban gardening by questioning how these gardens have the potential to participate in urban planning with authorities? The following includes a brief history of community gardens, a review of the literature, our methodology and our findings on how these forms of urban gardening impact their neighborhood and the city.

History of urban community gardening: example from United States

Urban community gardening finds its origins in the 19th century, in the United States. In 1890, country is hit by a social and economic crises. Few municipalities react by setting up cultivation projects in vacant-lot and school gardens, to provide food support to the poorest, immigrants and newcomers in city [START_REF] Lawson | The tenant movement in New York City, 1904 -1984[END_REF]. These first urban gardens are often known as Labour Gardens [START_REF] Moore | Forgotten Roots of the Green City: Subsistence Gardening in Columbus, Ohio, 1900-1940[END_REF], and will be replicated in other American cities such as New York, Philadelphia, Baltimore and Chicago [START_REF] Hynes | A Patch of Eden: America's Inner-City Gardeners (1st edition)[END_REF][START_REF] Warner | To Dwell Is To Garden: A History Of Boston's Community Gardens[END_REF]. Different crises during the 20th centuryafter the World War I, during the 1930s, after the World War II -will be moments for municipalities, residents and the Government, to develop these forms of gardening in order to give supplies the populations most touched by these events. Gardening also became an act of patriotism during the two World War [START_REF] Bentley | Eating for Victory: Food Rationing and the Politics of Domesticity[END_REF] with « Sow Seeds for Victory » and other considerations such as « Every garden a Munitions plan » [START_REF] Basset | Jardins partagés : Utopie, écologie, conseils pratiques[END_REF][START_REF] Hynes | A Patch of Eden: America's Inner-City Gardeners (1st edition)[END_REF][START_REF] Warner | To Dwell Is To Garden: A History Of Boston's Community Gardens[END_REF]. These projects tend to be stopped once crises are over.

Economic crises of the 1970s will modify urban landscape of many cities, such as New York, strongly hit by a rising of urban vacant after the closing of several factories and stores. Some residents decide to take care of these vacant transforming them into gardens, open to all, based on a motivation to develop nature and to fight abandoned space, where criminality grow up. The group Guerilla Gardening was the first to occupy a vacant, with their « seed bombs », illegally at first and will be supported by New York municipality and the Green Thumb program in 1976 [START_REF] Eizenberg | Actually Existing Commons: Three Moments of Space of Community Gardens in New York City[END_REF].

Here start the community gardens: green spaces in cities' center where there are individual and collective plots, and where people gather to grow food and flowers. These community gardens will be developed in other cities until 1990s. Giuliani's administration in New York, 1995, shut down several community gardens, seen as unproductive and nonprofit spaces, to develop other urban projects [START_REF] Schmelzkopf | Incommensurability, Land Use, and the Right to Space: Community Gardens in New York City1[END_REF]. After this contesting period [START_REF] Schmelzkopf | Urban Community Gardens as Contested Space[END_REF], community gardens will therefore spread to other countries.

American literature is extensive on this subject, principally between 1990 and 2003 [START_REF] Irvine | Community gardens and sustainable land use planning: A case-study of the Alex Wilson community garden[END_REF]. S. [START_REF] Moore | Forgotten Roots of the Green City: Subsistence Gardening in Columbus, Ohio, 1900-1940[END_REF] draws a picture of the community garden's history in the United States, by showing how they are tied to the economic and social crises of the 20th century. E.

Eizenberg study the « commons » produced by New York City's garden and the different conception of space [START_REF] Eizenberg | Actually Existing Commons: Three Moments of Space of Community Gardens in New York City[END_REF], according to H. Lefebvre theories. J. Welsh and R. MacRae analyze a potential « food citizenship » [START_REF] Welsh | Food Citizenship and Community Food Security: Lessons from Toronto, Canada[END_REF] and the emergence of citizens communities, based on production of food in these gardens, in Toronto. In extend to these considerations, R. Ghose and M. Pettygrove (2014) rely on a rich literature to think these community gardens as spaces of citizenship: where residents can structure, shape their urban environment (Amstrong, 2000 ;Baker, 2004), and where they have the possibility to contest, with their actions, urban planning and claim their « right to the city » [START_REF] Lefebvre | Le Droit à la ville[END_REF][START_REF] Schmelzkopf | Incommensurability, Land Use, and the Right to Space: Community Gardens in New York City1[END_REF] [START_REF] Staeheli | Conflicting rights to the city in New York's community gardens[END_REF].

A participation which does not trigger automatically the empowerment of these residents [START_REF] Staeheli | Citizenship and the problem of community[END_REF]. In result, these approaches on community gardens highlight five points: Development of an identity or citizenship with the act of gardening, production of food (individual), inclusion of residents in a movement that can be global, appropriation of urban spaces and positive impact on the neighborhood by producing commons. Therefore, it appears as a consensus that community gardens contribute to city's building and planning.

We will describe collective gardens in France, to analyze if these gardens, as community ones in the United States and other countries, contribute to city planning.

Collective gardens in France

In France, urban gardens came out in a similar way, but had a different development in time. We distinguish two forms of collective urban gardening: Shared gardens and Street gardens.

First, it is important to distinguish familial gardens and shared gardens: these two forms are often mistaken. Familial gardens have emerged in 1952 and were directly inspired by working gardens [START_REF] Guyon | Les jardins familiaux aujourd'hui : des espaces socialement modulés[END_REF]: they are defined by rural code and has to be managed by association [START_REF] Dubost | Côté jardins[END_REF].

These gardens offer individual lots, dedicated to families, to discover the benefits of agriculture.

Shared gardens emerged later in France, in 1997 inspired by the community gardens. Here, no plot is dedicated to an individual and all gardens are shared to a group. The food produced is shared between participants, often cooked for events on the garden like a shared meal on a Saturday. The creation of an informal network, Jardin dans Tous ses Etats, has been a trigger for the development of shared gardens in France. From 2010, the majority of urban gardens created are shared gardens [START_REF] D'andrea | Jardins collectifs et écoquartiers bordelais : De l'espace cultivé à un habiter durable ?[END_REF]. If the familial gardens were set up in the suburbs, shared gardens are developed in the center: with some benefits for the accessibility. Shared gardens present different spaces, for experimentation, leisure, plantations, learning, etc. As the family gardens, the shared gardens just started to be included in the urban development of Lyon. It concerns three gardens for now: one in the 8th district, one in the third and one in the 7th. In these cases, municipality request residents to manage a green space, one or several lots. An association is created, and sign a convention of occupation with municipalities. However, the majority of the shared gardens are created through a bottom-up process: residents who desire to occupy a green space to garden, builtup an association to formulate a demand with the municipality.

Street gardens (C. Scribes, 2009) are designed to decorate streets where concrete is too dominant for residents. These urban gardens can be built anywhere in the city because they don't need a green space. Street gardens can be wild herbs emerging from the concrete, flower plants on little green space, flowers on the space between a habitation and the pavement or flowers in a trail. The residents choose to cultivate their street and to take care of flowers during the year. They have to make a demand to the municipality, which can dig a hole in the pavement, or legitimate an existant trail.

These street gardens are interesting because they grow on public space, without a fence, where everyone can act, even badly, on the flowers.

The table 1 presents the different characteristics of collective gardens in Quebec, Community Gardens, shared gardens and street gardens, and is based both on our observations and the literature.

Methodology

Research context

Our ethnographic research takes place on the territory of Lyon, read here through the question of the resident's participation to urban construction. This city presents several interesting features for our study. Firstly, Lyon is crossed by two rivers, Rhone and Saone, which allowed the development of blue and green lines of nature. The cityand the conurbation1 -are strongly engaged in an energetic transition, particularly to fight its own image: Lyon is often associated with a negative urban vision, districts where industries and habitations were mixed [START_REF] Saunier | Représentations sociales de l'espace et histoire urbaine : les quartiers d'une grande ville française, Lyon au XIXe siècle[END_REF].

Secondly, the territory of Lyon propose at least 12 000 hectares of green space and count 14 parks, with 200km of nature paths, where a Charter for nature was adopted in 2000. The nature development in city is ruled by the Tree Charter, which summarizes the vision, principle and recommendation for a common landscape dynamic between the actors of the territory. The municipalities are engaged in a sustainable management of the green space since 2000, with alternative methods to the phyto-sanitary product: introduction of predatory insects, vegetalization with different kinds of plants or salvage of rain water.

Since 2017, the conurbation has adopted the « 0 phyto » plan, consisting in an interdiction to usefor citizens and city's technicians -fertilizer product in public space. This plan is linked to a visual communication campaign showing the beauty of wild nature in city, like herbs growing in the pavement, for example. The headline is: « when vegetation came back, life is good ». This to raise awareness of citizens but also technicians of city (public roads), that "wild" nature isn't a danger in the street, and can be: accepted, beautiful and have different benefits.

Thirdly, the conurbation Grand Lyon support shared gardens by leasing them a land, and by fundings dedicated to their functioning 2 , if gardeners formulate a demand. The land is free and an agreement is signed between the municipality and the association in charge of the shared garden. This agreement has some obligation like: no noise and nuisance by night and taking care and clean the plots. From an economic point of view, leasing these lands is a cost for municipalities: they are in the center and most are very well situated. Some private actor, investor, want to buy these lands. So keeping it for shared gardens relied on a good will of certain political actor. In some gardens, an organizer is funded by the city to open all week and host the garden. It concerns 3 gardens in Lyon for now. The organizer allow the garden to be open for visitors, students and kids from school. The organizer animates some school classes for kids from schools in the district, around the nature, the soil, etc. The Conurbation also funds Passe-Jardins, an association created in 1998 to support shared gardens in the region. The association has few salaries and volunteers. It delivers a label coming with a chart, formations for gardeners and information. It's a support for new shared gardens that provide help on how to manage a group, how to garden without pesticide, how to adopt permaculture, how to organize an eco-responsible event. Few employees can ensure formation for all volunteers, for example. Passe-Jardins, a regional association partly funded by the conurbation, also organize events, twice a year, to gather all the volunteers and actors from Rhone-Alpes. De facto, Passe-Jardins acts either like a structure which can organize and help the shared gardens on the territory and like a network, where gardeners and new garden's organizer can meet other people, find advices and resources.

The street gardens are also supported by the municipalities: the Green Space Direction gather the demands of residents and organize the layout for the micro garden. The goal is to mobilize residents to develop this kind of initiative. For example, two streets of the 3rd district has been vegetalized and are now maintained by few residents. The person in charge gathers the demands, gives seeds twice a year to gardeners and organize events. Those events is the occasion to meet the gardeners, to give them advice on how to grow plants, which organic fertilizer to use, how to recognize the plants, how to maintain them in a good shape, etc. These kind of events finish with a shared meal with all the gardeners.

Research design

We decided to use a purely qualitative approach, to better understand the logic, the experience lived by the gardeners when they are in the garden. We use an ethnographic approach with semi-directive interviews, observations and field notes, and an immersion in each garden [START_REF] Gumperz | Engager la conversation: introduction à la sociolinguistique interactionnelle[END_REF][START_REF] Mehan | Structuring School Structure[END_REF][START_REF] Spradley | Participant observation[END_REF] and an approach of case-study on multiple gardens [START_REF] Merriam | Case study research in education: A qualitative approach[END_REF]Yin, 1984). Using a qualitative study allowed to seek new theoretical insights with the richness of the data and material collected [START_REF] Cuervo-Cazurra | From the Editors: Can I trust your findings? Ruling out alternative explanations in international business research[END_REF]. Besides, qualitative methods are much more suited to how and why questions [START_REF] Yin | Case study research: design and methods[END_REF] than quantitative methods. A qualitative approach allowed the depth and breadth necessary to truly understand the experience and the practice of each gardener with details on their past, decisions, behaviors and representations. It is important to specify that we have selected shared gardens that emerged from citizens, according to the data shared by the person in charge of the shared gardens at the municipality.

The interview guide for gardeners covers five main themes, derived from the literature: the garden / project historical, the functioning of the garden and the collective, the relation to city and public actors, the relation between gardeners, the impacts of the gardens and the perception of the city. Like Mead (1965) and Blumer [START_REF] Blumer | Symbolic Interactionism: Perspective and Method[END_REF], we suppose that we can understand the behavior of the participant only with the signification that they attribute to their actions. We interviewed 57 gardeners (shared and street gardens), plus 11 elected people and actors in charge of public green spaces on the territory. Those interviews were inseparable of multiple observation on shared gardens, to see the interaction on the gardens between gardeners, events with public and how gardeners occupy the space. The analysis of these qualitative content was made through the Atlas TI software. We extracted verbatim to restore the density of the data collected.

For this text, we base our observations on the 22 visited shared gardens: two are described below in detail. For the street gardens, we focused on two neighborhoods: Guillotiere, a popular district of Lyon where there is a strong associative movement and a low income rate, and Montchat, a more recent district, with a high income rate, with more individual houses. Both presents a high number of street gardens, and strong collective of residents taking care of it.

We describe here two gardens in detail to show how a shared garden functions, how they are configured and their history, in order to better understand their diversity. Those two are quite representative of how a shared garden is created and how it evolves through the year ; even if the closure of Les Pendarts is a particular case.

Garden Ilot d'Amaranthe

The shared garden Ilot d'Amaranthe is located in the 7th district of Lyon, in the -popularneighborhood of Guillotiere. Born in 2004 on the place Mazagran, on demand of the municipality, this garden has been part of a requalification of the place. A designer has been employed and it was decided to create two green spaces closed by a tall metal gate all around. The central place was built in concrete, with benches and space for the use of residents. In 2006, the designer called an association to manage the two green spaces and to transform them into a shared garden: Brin d'Guill, an association of 80 members, which also convert some small urban space to street gardens. In 2011, this place will be changed again, with consultation with residents and participants on the garden.

Since 2013, the garden is open again and is funded by the municipality, to employ an organizer for the association Brin d'Guill. She manages the garden during weeks, opens it during the day and organizes different learning sessions for kids from the neighborhood's schools. The garden has a space for relaxation, a space for experimentation, a collective space for gardening and some specific tray for disabled people. The surface of this shared garden is 633m2, and the association count 50 participants, with 10-12 regular participants. Each month, there is a meeting gathering all gardeners and those who came not only to gardenwhere decisions are made, map of the culture, etc. The garden also has a composter (installed by another association called Les Compostiers) and a water butt. During the week, some young students come to chill in the relaxation space, and to talk to the organizer ; after school, parentsincluding some residents that are not part of the association -come with their children to take advantage of this space. During the weekend, there are more residents and participants, essentially for gardening, share a meal and discuss.

Garden Pendarts

Created in the spring of 2014, the association La Ruche de Croix Rousse wanted to « give the possibility to residents to invest a central space of the neighborhood and to develop a new space of sociability, creation and social development » (Pauline, Pendarts, April 2018). The place spotted is a wilderness of 1700m2, situated on the top of Croix-Rousse, with a former villa. The association asked for an agreement to the municipality to occupy the place with a garden that it never obtained. This spot was supposed to be sold to a private investor for a parking lot: which was finally not possible because of the soil instability. At the beginning of 2015, bored to wait for so long, the association decided to invest the space by cleaning the vacant plot and the villa, to convert the green space into a garden and to install a composter. The association rapidly counted 118 members, essentially neighborhood residents. The shared garden open illegally in spring of 2015: in addition to gardening, the association propose activities like Yoga and Do it yourself learning classes. The garden Pendarts was a « space where we can meet other people, discuss, laugh, dance, sing, share and invent » (Pauline, Pendarts, April 2018). On April 17, 2015, the municipality forbid the resident to continue their activities on the plot, and installed a fence to block the garden access. On the first of May, the association cut a part of the fence to continue its occupation. This illegal garden continued until September 2015: policemen started to guard the fence and definitely blocked the garden access to participants. This garden has disappeared today but stay an example of conflicts between authorities and residents on a collective garden. It was a particular, informal form of collective gardening, where residents didn't wait the loan agreement, where every gardener could do whatever he wants, based on a model close to "hackers"everyone can contribute producing commons.

Those different forms of urban and collective gardening are bottom-up, started by residents and take place on the public space. How these gardens contribute to the urban planning and the development of their neighborhood?

Findings: Urban development and vegetalization by collective gardening

With or without the city?

Collective gardens take place on public spaces and therefore are directly dependent of institutions' decisions in terms of urban planning. These citizen initiatives cannot avoid consultation and links with the municipality through the occupation agreement, for example. In Lyon, three shared gardens have been created by public authorities and the sustainable development topic represents a real interest for public actors. For S. Devaux, those interests are characteristics of a competitive logic [START_REF] Devaux | L'habitat participatif: de l'initiative habitante à l'action publique[END_REF]: to grasp tourists and potential future residents. In a logic of lower financial redistribution by the central State, managing green spaces with citizens is an excellent way of doing savings.

Shared gardens have to demand and sign with the municipality an occupation agreement, in order to manage a green space. This agreement contains some rules like no tree plantation, no loud music, responsibility towards the garden, etc. They cannot occupy illegally a place, without being expelled by authorities. Some shared gardens are also funded by the municipality, mainly to buy tools, flowers or seeds.

We sign this agreement every three years. This is really a thing! It is a real engagement for us. We have relation with authorities, we often need support, funds for our little cabin. For our event to come, we will borrow few chairs from the municipality for people. (Martine, gardener, Shared garden La Muette, June 2018). This logic also applied to street gardens: residents must have the endorsement of city to install a trail, or to plant in the street. In this last example, work is done by companies on institutions' decision, to manage the pavement and let a hole for the plantation. For those gardens, asking authorities seems to be the only way to garden, or to keep alive a garden.

Those who are not known by the municipality see their project fail. Indeed, technicians and cleaning agent, who can't identify a converting green space, will cut the flowers or simply destroy the space by cleaning the street ». (Emeline, Project organizer, Green space Direction, May 2017).

However, few associations and groups of residents act without municipalities' support. These citizen initiatives are afraid to be assimilated to institutions and prefer to act without obligation. That is the case of the shared garden Pendarts. This association occupied the garden occasionally during more than one year, illegally. They defined their own action as hacking:

We are hackers now, because what we do is hacking the public space. We had no right to be on this place. All our activities were not declared to the authorities. This was a fight." (Pauline, gardener, Shared Garden Pendarts, April 2018).

They use the space differently as it was planned: they made a space of gardening, social, of relaxing, instead of a space of transition or a parking. This example show all the will of residents to occupy public places in their neighborhood, to grow flowers, to gather or simply to have a space to relax. This concept of hacking space is also present in associations like Brin d'Guill or Incredible Edible with their « wild tray »: tray of soil with planted flowers or aromatics, which everyone can water, and with their micro-plantations that are installed without the municipality's agreement. Those illegal gardens are temporary. Either a bad weather erase those gardens, either the municipality's agent removing them. This is one of the characteristics of the urban collective gardens: a state of uncertainty in time. Those citizens actor don't know if the place occupied will be, in a near future, dedicated to other activities. It can be bought by a third party, a society, etc.

It has been noted to residents that this shared garden is temporary, it is not a long-term project for us. Because the neighborhood will be renewed so we don't know what this space will become. But local authorities really want to keep up these dynamics of collective gardens, so it may persist after the renewing. (Leila, Municipality of Oullins, December 2017).

It appears to be difficult for gardeners to act without local authorities, especially because they invest a public space. Therefore, the wait can be too long for gardeners and few will either quit the association before the start, or will invest a place without agreement.

The wait is sometimes quite long for a shared garden. Between the project that we have and the first realization, there was three years of meeting, files filling, things like that. For people that are interested in gardening, they rarely like this. Some leave, some stay, we decided to invest the street with another project, the street gardens, during the wait. (Luc, gardener, Shared Garden Le Secret, June 2018) Acting without the city is a way to bypass the rules and to contest local politics and city planning.

But the downside is that in conflict, gardens can't stay over time. Still, we observe on Lyon that collective garden just began to be taken into account by public authorities, and are slowly integrated in urban planning.

Integration of Gardens in urban planning

Are those collective gardens participating to urban planning? They crystallise a lot of expectations from the political actors. With their 20 years of experience in France, shared gardens are now a part of urban politics in few cities like in Lyon. Traditionally, these shared gardens are initiatives from residents, who want to develop a garden, to develop nature, to socialize and to bring to life their neighborhood (Bally, 2018). They are now few gardens created on demand of municipalities, during the renewing of a neighborhood, for example. Coccinelles de Sans Souci is a shared garden in the 3 th district of Lyon, which has emerged from the municipality. They reserved a specific place, they organized public meetings with residents, facilitate the process of creation and the co-ordination with Passe-Jardin. Few other shared gardens were also created by municipalities those last years. This because there are strong expectations behind these projects: for institutions, collective gardens are places that create socialization between residents of the same neighborhood, that allow newcomers to participate to the neighborhood life, planning and easily meet people. The participation of citizens to city planning seems to be particularly important for some actors. Local authorities also see those collective gardens as places of nature in the city, that can bring peace and visual agreement.

The point of these gardens is to have eco-citizen's projects. For us, the mission is to promote social bonds, diversity but also to promote biodiversity, that is more developed in those gardens than in a public garden. It allows citizen participation in the urban planning, and favors the neighborhood dynamic. (Elisabeth, Green spaces project organizer, City of Lyon, December 2018).

For few political actors, these collective gardens have to be nourishing, and are part of a future urban agriculture project. The association Passe Jardin ask gardeners to weight their harvest every yearin kilograms. Therefore, as community gardens in United States, Lyon's collective gardens have an impact on their territory, direct and indirect. What kind of impacts these gardens produce?

Impact of gardens on Neighborhood

Interviews done also show that collective gardening has impacts on the neighborhood and on citizen's life. We will not underline efficiency or efficacy of these activities, but instead, based on the data collected, highlight the different activities and their potential impacts for the territory.

With their activities on collective gardens, citizens also participate actively in the neighborhood life and have few impacts. Indeed, practices on collective gardens go from basic gardeningwater, trim, plantto diverse activities like bee keeping, animation, concerts, shared meals, learning classes for the younger. Collective gardens and more particularly shared gardens are not limited to gardening activities.

First, collective garden is based on an association or a group of residents, who share certain values and activities. Collective gardening appears as a paradox, because gardening is a solitary activity [START_REF] Dubost | Côté jardins[END_REF], like water and trim, that can't be shared by definition. But these gardens try to overcome this paradox by assuming individual activities paired with collective activities. Indeed, gardeners also share practices like construction, planning, meetings and decisions, for example. If individual practices are more common during the week, where every gardener comes as they have time, as they want, the weekend is more subject of collective actions. This is when gardeners plan construction, reorganisation and shared meals.

On the Saturday there are more people yes. We planned this Saturday a work, we start the morning, we shared a meal, everyone bring something to eat and we continue on the afternoon. (Anna, gardener, shared garden Ilot d'Amaranthe, May 2018).

One of the goals of these collective activities is, beyond the will to work the soil, to take care of it and to develop nature, as gardeners describe their motivations (Bally, 2018), to socialize, i.e to meet people of their neighborhood. Few gardeners interviewed were newcomers and participated in a collective garden precisely to meet other people. Being on a garden with others, shared a practice or an interest and integrate a group indeed help to connect with other people. Collective gardens gather people on common values and interest: gardening, ecology, nature, etc. It also makes gardeners visible by other residents, as actors of their neighborhood.

Being active in our street, it allows to create social bond with neighbours: we don't have other occasions to meet them, and these collective projects gather us. We are in the street, on the public space when we garden, and people can come, discuss, ask something, this is positive. Put some life in this concrete world, that is collective gardening. (Noémie, gardener, Street garden Monchat, December 2017).

The convention signed with the municipality stipulate that when a gardener is in the garden, the door has to stay open, to allow visitors. These can interact with gardeners, ask questions, visit and enjoy the garden. Gardeners also organize different kinds of events, like concerts, gathering for the Lyon famous Fête des Lumières, visiting sessions, etc. The idea is both to meet other gardeners and to open the garden to visitors, to make it more visible and active. Participation to those activities allows the residents to develop capacities in human relationship (Bergeron et al., 2002). From these activities result interactions, which are part of a social frame « enhance the activity herself » [START_REF] Duchemin | Agriculture urbaine : un outil multidimensionnel pour le développement des quartiers[END_REF]. Collective gardens can impact the city by bringing spots, places of socialization, even if they can be the subject of strong criticism in terms of diversity for example [START_REF] Mestdagh | Des jardinier.e.s partagé.e.s entre discours et pratiques : du lien social à l'entre-soi[END_REF].

Secondly, these urban collective gardens are also places of education. Gardeners bring their children for sessions of gardening on the week end, but volunteer gardeners are also in contact with school of their district and organize some special classes on the work of soil, plantations, agriculture, etc.

We are in contact with the social center Bonnefoy, the Arche de Noé, a structure for children with behavior trouble: they come to do some activities with soil on the garden.

We also got contact with day nurseries, some schools. We mainly learn them to plant.

Sometimes we do something on ecology, discovery of insects… Educational trays are for them: they came every week. (Jane, organizer, shared garden Ilot d'Amaranthe, April 2015).

Shared garden appeared to be the ideal place for learning, because it presents in the same time « the context of educational situation, its object, a strategy and an approach » [START_REF] Duchemin | Agriculture urbaine : un outil multidimensionnel pour le développement des quartiers[END_REF].

Those times of learning lean on values of those gardens that are, according to gardeners: ecology, environmental education, accessibility for everyone and social integration.

Those educational activities on the gardens allow the citizens' initiatives to complete the learning process of schools, with a soil practice, with nature and its functioning, and in the same time reinforce their place in the district. From this point of view, the collective gardens are real actors in their neighborhood.

Thirdly, collective gardens bring nature in cities and impacts, more or less, the landscape of a neighborhood by its presence and development. One of the gardeners' motivation is to develop nature in the city at their level. In their representation, nature transform urban landscape and makes it beautiful, worth being seen. The shared garden La Réserve is a space in transition: it has been abandoned by a previous association and is now restored, renewed by another one. This garden, in construction, will let more "wild" nature.

Even if it is still a wilderness, many flowers have been planted, so it is covered by flowers in spring and very delightful to see. In the summer, it can dry quickly therefore.

But if we want to transform the landscape, we have to plant trees, to build up a wood cabin, and to grow both flowers and a vegetable garden. At start the garden was in order, we want to create something more organic, participate to the landscape. A beautiful garden will attract more people. (Cyril, gardener, Shared Garden La Réserve, April 2018).

Here, these gardens offer a rural environment [START_REF] Dubost | Côté jardins[END_REF] in the city. It creates a new harmony and contribute to the development of a green thread [START_REF] Calenge | Idéologie verte et rhétorique paysagère[END_REF]. According to C. Calenge, « not a single urban project can forget the landscape level » ( 2003): every urban planning project, including citizens ones, take into account this landscape problematic. Indeed, every urban planning project has a consequence on urban landscape and contribute changing it. Here, residents want to give meaning to the city by bringing back nature in their district. For gardeners, an artistic nature can be a way to enlighten landscape. That is why few residents keep their street gardens up.

When they are covered with flowers, trays are just beautiful, in spring and summer, very beautiful. It touches few spaces, but it contributes to landscape. Even in other seasons, everything is green, it is superb. Visually, these flowers, bushes are as many little things that contribute to the change. (Michelle, garderner, street Gardens Oullins, December 2017).

In addition to contributing to urban landscape, these gardens are spaces where residents « escape the city » [START_REF] Chiesura | The role of urban parks for the sustainable city[END_REF], as well as the public park: the green, the tree, plants, sometimes the calm bring a particular atmosphere on the garden, which is radically different than the city. Interviewed gardeners have the feeling that they are outside the city, in the countryside. That is what some gardeners are looking for in a garden: a touch of countryside in city.

The garden is a pocket of nature, of greenery inside the neighborhood, mostly urbanized. When we work, when we are in the garden, we sometimes forgot that we are in Lyon. (Matthieu, gardener, Shared Garden Le Secret, November 2017).

For the gardeners, the concrete represents the gloominess of cities and can be countered by nature, park and gardens. It is also a way to reconnect to nature and its benefits [START_REF] Nisbet | Underestimating nearby nature: affective forecasting errors obscure the happy path to sustainability[END_REF]. So a beautiful urban landscape has to integrate, according to them, nature.

Those few examples show the way that citizens, in groups, desire to claim urban space, to occupy the city by being an actor instead of simple consumer. With the creation of an association to manage shared garden, those participants impulse a movement of appropriation of space: by giving the possibility to residents to « intervene in the socio-spatial construction of their daily environment » [START_REF] Baudry | L'espace public à l'épreuve des jardins 51[END_REF], those residents going further than a simple role of consumers to become actor of urban planning. These places can also offer a learning process of democracy [START_REF] Alaimo | Community gardening, neighborhood meetings, and social capital[END_REF]. The summary of these results can be found in table 2.

Conclusion

There is a rise of collective gardens that emerged today in many cities, in France and elsewhere, which represents as many patches of nature. It comes from both residents and citizens demand, to have access to more nature and green, to breathe in the city and counterbalance the concrete, and from the institutions, which try to take into account these demands and transform cities into attractive places. These collective gardens are particular, as they transform an individual activity into a collective one, gardening, and set up diverse activities to try building a group.

From an independent movement emerging through citizens, collective gardens became close to institutions as well as their development is now dependent on a good political will, but is also well support by these public authorities. Taking place on public spaces, these collective gardens are de facto participating to urban planning, and have different impacts, even if those are minor. They favor socialization, by gathering gardeners and passers-by around the practice of gardening, around different events like meals, construction, concert for example. It creates a place of socialization on the neighborhood with these activities, a free space where consumerism isn't the goal [START_REF] Parham | Food and Urbanism[END_REF]. Collective gardens are also places where education can take an importance, according to gardeners will and associations, with partnership between gardens and associations, schools to promote gardening and ecological practices. Finally, collective gardens also have an impact on the landscape, by creating plots of nature through the city and adding green touches in the urban landscape.

Therefore, these collective gardens have to be read through their limits. Some conflicts on participation in shared gardens can appear for example (Dumont, 2010): on a too engaged management (Bourdeau-Lepage and Vidal, 2012), about some gardeners too presents, about sharing production. A second limit is the feeling that shared gardens are just a privatization of urban space, a territory specific to gardeners and a place without diversity [START_REF] Demailly | Les jardins partagés franciliens, scènes de participation citoyenne ?[END_REF][START_REF] Mestdagh | Des jardinier.e.s partagé.e.s entre discours et pratiques : du lien social à l'entre-soi[END_REF].

Despite their desire to open the gardens to everyone, these places are often closed: to prevent from squat at night and vandalism. The accessibility for the public is dependent of the opening hours, and the presence of one gardener at least.

However, those collective gardens should be more integrated in local urban policies in two ways: a more systematic proposition to residents of a vacant lot in neighborhoods in order to create gardens, a better communication around collective gardens to minimize problems around street gardens for example.

Finally, this text shows how collective gardens are created and how they evolve through the years and should inspire residents, citizens to create shared or street gardens by learning their process and potential mistakes to avoid.

Further studies should point how the participation to a collective garden affects residents' habits, their everyday lives: does it have a real impact in terms of socialization? In terms of skills? In terms of ecological practices? This by focusing on participants in shared and street garden.

Table 1 : Different forms of urban and citizens gardening Collective gardens (Quebec) Community gardens (United States) Shared gardens (France) Street gardens (France)

 1

	Unique plot	Multiple plots	Unique plot	Multiple plots
	for the group	and a shared	for a group	for a groupe
		plot
	Explicit social	Implicit social	Explicit social	Implicit social
	and	and	and	and
	environmental	environmental	environmental	environmental
	mission	mission	mission	mission

Table 2 . Main findings

 2

	Forms of collective gardens	-Street gardens (on the pavement)
		-Shared gardens (vacants lots)
	Support of collective gardens	-Occupation agreement (and free loan for the lot) but temporary,
	by the city	-Preparation of the lots for the gardens,
		-Pontential subsidies to gardens for functioning (buying plants,
		tools...),
		-Fundings of Passe-Jardin, association helping shared gardens
	Expectations from	-Places of socialization,
	institutions	-Participation of residents to urban planning, Visual agreement for
		the city / neighborhood,
		-Production of food (local)
	Main impacts identified	-Education,
		-Places of nature (favorize wild bees for example and ways to
		escape the city for residents),
		-Landscape,
		-Socialization by collective practices

Urban conurbation of Lyon has been created 31 December 1966, by a state decree. Situated on the confluence of the Rhone and Saone, it count 59 municipalities, 1,3 million residents, 80% of the population on the Rhone department.

Often less than 1000 euros / year.


Présentée Pour L'

Obtention Du

Titre De

Docteur En

Médecine Diplôme D'état

Marie-Adeline Siegerth

Thèse Soutenue

Publiquement A La

Faculté De

Médecine De Grenoble

Président Du

Dominic Pr

Perennou

Olivier Pr

Dr Monica Detante

Pr Alexandre Baciu

Pr Mircea Krainik

Polosan

IS POST-STROKE DEPRESSION ASSOCIATED TO BRAIN IMAGING PARAMETERS? LA DEPRESSION POST AVC EST-ELLE ASSOCIEE A DES PARAMETRES D'IMAGERIE CEREBRALE? THÈSE

AVERTISSEMENT

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Dans le cas contraire, vous pouvez consulter en ligne les annuaires de l'ordre des médecins, des pharmaciens et des sages-femmes.

Au Pr Perennou pour m'avoir proposé ce travail de thèse, votre accompagnement tout au long de mon internat, votre disponibilité et votre pédagogie.

Aux Pr Detante, Dr Baciu, Pr Polosan et Pr Krainik d'avoir accepté de participer à la lecture et à la soutenance de ce travail en tant que membres du jury.

A Louis, pour ta collaboration durant la réalisation de ce travail.

A Céline, pour ton investissement, ta rigueur, ta pédagogie et ta patience.

A Julien, pour ta pédagogie, ta patience et ta gentillesse.

A Margo, Héléna et Camille pour votre aide précieuse qui a contribué à l'aboutissement de cette thèse.

A Françoise, pour votre bienveillance, générosité, humanité, esprit d'équipe et pédagogie.

A l'ensemble des médecins qui ont contribué à ma formation au cours de l'internat.

Aux professionnels paramédicaux et rééducateurs avec qui j'ai pu travailler dans la joie et la bonne humeur auprès des patients.

A mes parents, pour votre amour et votre soutien sans relâche durant ce long parcours d'étude. Vous m'avez permis de réaliser un métier passionnant et qui me tenait à coeur d'exercer. Vous m'avez transmis de belles valeurs humaines qui fondent le médecin que je suis devenue.

A mon frère, François, ton soutien, ton écoute et tes précieux conseils dès la première année et à chaque année passée m'ont aidé à garder confiance et motivation.

A ma grand-mère et Josette pour votre amour et pour avoir toujours été fières de moi.

A Val, Charlène, Marine, Céline, Émeraude et Lara pour tous les bons moments partagés ensemble, votre soutien, votre amitié fidèle et bienveillante depuis nos rencontres respectives à différents moments de mon parcours.

A Anaïs pour tout l'amour que tu me portes et le bonheur de partager la vie avec toi. Pour la force, la bienveillance et le précieux soutien que tu m'apportes au quotidien. L'imagerie cérébrale a été réalisée grâce à l'Imagerie par Résonance Magnétique (IRM) à environ deux mois de l'AVC [START_REF] Nagaraja | Reversible diffusion-weighted imaging lesions in acute ischemic stroke : A systematic review[END_REF]. Nous avons recherché le lien entre la dépression post-AVC et trois paramètres d'imagerie: les structures altérées par l'AVC (Voxelbased Lesion Symptom Mapping (VLSM)), le volume de l'AVC (nombre de voxels) et les hypersignaux de substance blanche (selon la classification de Fazekas).

Résultats: au total 126 patients ont été analysés. Leur age médian était de 65.9 [58. 1-72.4] ans.

Dans notre population il existait une prédominance masculine (n=85 (67%)). Les patients ont étaient principalement évalués pour la dépression à J30 (n=70, 55%). Parmi eux 53 (42%) étaient dépressifs. L'ADRS médiane était de 10 [6][7][8][9][10][11][12][13][14][15]. La dépression et sa sévérité étaient associées à l'existence d'hypersignaux de substance blanche (p=0.011), mais pas au volume de l'AVC (p=0.619) ni à une structure cérébrale spécifique.

Conclusion

Abstract

Background and purpose: the depression is a common complication after stroke, which has a negative impact on the rehabilitation and the recovery. Some behavioral findings suggest that post-stroke depression (PSD) could be a reactional phenomena, an interpretation that would predict no relationship with a specific brain area. This point, which remains debated, has never been investigated by modern technics of brain imaging analyses on a cohort including an adequate number of individuals to exclude false negative results. This was the objective of the present study.

Methods:

it is an ancillary study from the DOBRAS (Determinants of Balance Recovery After Stroke) cohort, in which participants were regularly and systematically assessed on 30 (± 3) (D30) and 60 (± 3) (D60) days after stroke. The depression was assessed by the Aphasic Depression Rating Scale (ADRS) a specific tool quantifying PSD, regardless aphasia (scores from 0 to 32, cut off egal or over 11). Brain imaging were analyzed on Magnetic Resonance Imaging (MRI) around 2 months after stroke [START_REF] Nagaraja | Reversible diffusion-weighted imaging lesions in acute ischemic stroke : A systematic review[END_REF]. We sought the relationship between PSD and three brain imaging parameters: structures affected by the stroke (Voxel-based Lesion Symptom Mapping (VLSM)), stroke volume (number of voxels) and white matter hyperintensities (WMH) (assessed by the Fazekas scale).

Results: a total of 126 individuals were analyzed. Their median age was 65.9 [58. 1-72.4] years and 85 (67%) males. They had been mostly assessed on D30 (n=70, 55%). Among them 53 (42%) were depressive. The median ADRS score was 10 [6][7][8][9][10][11][12][13][14][15]. Depression and its severity were associated to the existence of WMH (p=0.011), but not with stroke volume (p=0.619), not any specific areas.

Conclusion:

PSD must be particularly detected in case of WMH. This absence of specific

INTRODUCTION

Depression is a common complication after stroke. It has been shown that its prevalence varies between 20 % and 65 % (Hackett et al., 2005). The functional and cognitive impairment, the dependance and disability level are associated to the post-stroke depression (PSD) [START_REF] Ayerbe | Natural history, predictors and outcomes of depression after stroke : Systematic review and meta-analysis[END_REF]. In addition, the depression also results in a negative impact on the rehabilitation and the functional recovery. This behavioral findings suggest that PSD could be a reactional phenomena. However, a previous study demonstrated that stroke patients were significantly more depressed than equally impaired orthopaedic patients, suggesting that a vascular phenomenon may be involved in depression [START_REF] Folstein | Mood disorder as a specific complication of stroke[END_REF].

Several studies have gone further in the study of the link between depression and brain injury. Indeed, many of them have been interested in the relationship between the brain injury location and depression. First of all, an old study demonstrated that a group of patients with left hemispheric stroke were significantly more depressed than a group with traumatic injury to the left hemisphere, with the ischemic lesions tending to be more anteriorly situated than the traumatic lesions [START_REF] Robinson | Mood change following left hemispheric brain injury[END_REF]. Recently, several studies [START_REF] Vataja | Magnetic Resonance Imaging Correlates of Depression After Ischemic Stroke[END_REF][START_REF] Murakami | Neuroanatomic Pathways Associated with Poststroke Affective and Apathetic Depression[END_REF][START_REF] Yang | A significant risk factor for poststroke depression : The depression-related subnetwork[END_REF][START_REF] Levada | Poststroke Depression Biomarkers : A Narrative Review[END_REF] have found that patients with left hemispheric and limbic strokes were more depressive. However, Robinson et al. demonstrated that patients with anterior right damages also presented PSD, although milder than for left stroke [START_REF] Robinson | Mood changes in stroke patients : Relationship to lesion location[END_REF]. In addition, other authors analysed the relationship between depression and lesions more specifically affecting the white matter, in particular the white matter hyperintensities (WMH) and the microbleeds. Liang et al. demonstrated that microvascular lesions were post stroke depression predictors after three months [START_REF] Liang | Enlarged perivascular spaces are associated with health-related quality of life in patients with acute ischemic stroke[END_REF]. Bae et al. demonstrated that the periventricular WMH were associated with an earlier depression whereas the depression was more severe and later when the hyperintensities were deep [START_REF] Bae | Associations of white matter hyperintensities with poststroke depression : A 1-year longitudinal study[END_REF]. The periventricular white matter hyperintensities (PWMH) were associated to a chronic depression evolution and a less therapeutic efficiency (Diegez et al. 2004). Moreover, Tang et al. wrote several papers and demonstrated that the lobar microbleeds were predictors of a less depression symptoms remission and the suicide was more frequent when the patients had frontal and thalamic microbleeds (Tang et al., 2010(Tang et al., -2014)).

The literature which studies the link between vascular lesions and depression is broad, the methodologies are variable because depression is assessed with various scales, the brain imaging and the statistics also vary and lead to divergent conclusions. Then PSD physiopathology is still unclear and the PSD neural bases stay a mystery. From now on the resort to the magnetic resonance imaging (MRI) in stroke and the statistical analysis is more successful to study neural bases of PSD. One of them is the voxel-based lesion symptom mapping (VLSM), which use the MRI, generating data as good as from functional MRI [START_REF] Bates | Voxel-based lesionsymptom mapping[END_REF] and only few studies use VLSM to study PSD [START_REF] References Abe | Voxel-based analyses of gray/white matter volume and diffusion tensor data in major depression[END_REF]. In addition, aphasic patients are often excluded, resulting in a possible bias.

In this study, we hypothesize that PSD has an organic and not only reactional origin. Using VLSM analysis in a cohort of subjects including aphasics, we investigate the relationship between brain imaging parameters and the PSD emergence 2 months after stroke.

THEORICAL PART 1. Post-stroke depression (PSD)

PSD is a frequent complication after stroke. That is an important topic at the subacute phase due to its negative impact on the recovery and on the rehabilitation. About risk factors, the methodology varies according to studies, that is probably responsible for major differences in risk factors for PSD reported in the literature. The most frequently cited risk factors for PSD are sex (female), history of depression, stroke severity, functional impairment or level of handicap, level of independence, family and social support [START_REF] De Ryck | Risk factors for poststroke depression : Identification of inconsistencies based on a systematic review[END_REF]. We suppose that PSD is a reactional mood disorder particularly due to the functional and cognitive impairment [START_REF] Ayerbe | Natural history, predictors and outcomes of depression after stroke : Systematic review and meta-analysis[END_REF] and the dependance (living in a nursing home [START_REF] Burvill | Risk factors for post-stroke depression[END_REF]) though the physiopathology still not clear.

Indeed, several studies have gone further in the study of the link between PSD and brain injury. Many of them have been interested in the relationship between the brain injury location and depression [START_REF] Robinson | Mood change following left hemispheric brain injury[END_REF][START_REF] Robinson | Mood changes in stroke patients : Relationship to lesion location[END_REF][START_REF] Vataja | Magnetic Resonance Imaging Correlates of Depression After Ischemic Stroke[END_REF][START_REF] Murakami | Neuroanatomic Pathways Associated with Poststroke Affective and Apathetic Depression[END_REF][START_REF] Yang | A significant risk factor for poststroke depression : The depression-related subnetwork[END_REF][START_REF] Levada | Poststroke Depression Biomarkers : A Narrative Review[END_REF]. Other studies have found a relationship between WMH, microbleeds and PSD [START_REF] Liang | Enlarged perivascular spaces are associated with health-related quality of life in patients with acute ischemic stroke[END_REF][START_REF] Bae | Associations of white matter hyperintensities with poststroke depression : A 1-year longitudinal study[END_REF]. The methodologies are variable because PSD is assessed with various scales, aphasics individuals are often exluded, the brain imaging and the statistics to analyze the relationship between stroke location and PSD are variable.

In our study, we have included aphasic individuals and we have evaluated them with the Aphasic Depression Rating Scale (ADRS). We have analyzed the relationship between three brain imaging parameters (stroke volume, stroke location, WMH) and PSD.

Aphasic Depression Rating Scale (ADRS)

ADRS was developed to detect and measure depression in aphasic patients during the subacute stage of stroke [START_REF] Bénaïm | [END_REF]. The items of ADRS are filled-in during the rehabilitation staff and with the pluridisciplinary team. This scale is particularly appropriate for the rehabilitation stage. ADRS evaluate the somatic symptoms (including insomnia, loss of appetite, constipation, fatigability) of the depression, Bénaïm et al. demonstrated that the presence of these symptoms is often associated with depression and that ADRS displays a good sensitivity and a good specificity [START_REF] Bénaïm | [END_REF]. We have chosen this scale to assess the PSD in our study because we have included aphasic individuals whereas previous studies often excluded them and also because we have studied the PSD at 2 months after stroke, so on subacute stage.

ADRS is presented on Appendix.

White matter hyperintensities (WMH)

Physiopathology

WMH are types of subcortical brain damages due to small vessel disease [START_REF] Pantoni | Cerebral small vessel disease : From pathogenesis and clinical characteristics to therapeutic challenges[END_REF]. The WMH physiopathology is incompletely known. Abnormalities of vessels structures are described (a loss of smooth muscular wall, a lumen reduction and a vessel wall thickening) and cause a blood flow reduction and a loss of vascular brain auto regulation.

These dysfunctions lead to a chronic and a subclinical ischemia which cause a loss of white matter (demyelination, hyperintensities on T2-weighted MRI).

Fazekas scale

Fazekas scale [START_REF] Fazekas | MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging[END_REF] is the most used in clinical practice and research to quantify white matter lesions on MRI, on T2 FLAIR (Fluid Attenuated Inversion Recovery).

According to their locations (deep white matter (DWM), periventricular white matter (PVWM)) and their extension, the WMH are graded as follow: grade 0 (absent), grade 1 (caps or pencil-thin lining in PVWM, punctate foci in DWM), grade 2 (smooth halo in PVWM, beginnig confluence in DWM), grade 3 (irregular PVWM extending into the deep white matter, large confluent areas in DWM). We used it in our study but simplifying the score regardless the location of WMH .

Clinical consequences

On LADIS (leukoaraiosis and disability) study, older adults who seek medical attention for non-disabling complaints, severe age related changes in white matter independently and strongly predict rapid global functional decline [START_REF] Inzitari | Changes in white matter as determinant of global functional decline in older independent outpatients : Three year follow-up of LADIS (leukoaraiosis and disability) study cohort[END_REF]. Beyond the presence of WMHs which has an impact on functional capabilities, Moon et al. demonstrated that a speed progression of WMH is associated with gait and walk declin among older adults [START_REF] Moon | Prospective associations between white matter hyperintensities and lower extremity function[END_REF]. We could think that the recovery after stroke is influence by the WMH and we suppose that the functional capacities after rehabilitation are less great when the individuals have a severe leukoaraiosis. About this hypothesis, a meta-analysis [START_REF] Georgakis | WMH and long-term outcomes in ischemic stroke : A systematic review and meta-analysis[END_REF] concluded that the presence and severity of WMH are associated with [...] functional impairment, stroke recurrence, and mortality after ischemic stroke. Sagnier et al. demonstrated that the mesure of the white matter integrity early after an ischemic stroke is an important factor to predict the functional outcome (Rankin Scale Modified) and may be additional markers to include in studies evaluating post-stroke recovery [START_REF] Sagnier | Normal-appearing white matter integrity is a predictor of outcome after ischemic stroke[END_REF].

White matter lesions might reduce brain plasticity and cognitive reserve [START_REF] Galluzzi | White matter lesions in the elderly : Pathophysiological hypothesis on the effect on brain plasticity and reserve[END_REF]. Concerning the PSD and WMH, Tang et al. demonstrated that, in comparison with the non-PSD group, patients in the PSD group had severe deep WMH (Tang et al., 2010). Severe deep WMH remained an independent predictor of PSD.WMH increase with the age just as stroke. Also, we could considere WMH is a predictor and a confunding factor of PSD. In our study, we considered WMH of 2 ways. At first, we have analyzed the relationship between the ADRS score and WMH. In a second time, we have performed lesional analyses which had as objective to research if there are specific brain areas associated with PSD. Because, WMH still a confunding factor of PSD and we have decided that the individuals with severe WMH (Fazekas 3) were excluded of lesional analyses. Indeed, we avoided the confusion bias in analyses of the relationship between stroke location and PSD.

METHODS

Study design

This work was a monocentric observational ancillary study using the data of the DOBRAS cohort (ClinicalTrial.gov NCT03203109). In DOBRAS cohort, the participants were comprehensively assessed in routine care, initially in the first weeks after the admission in the rehabilitation ward of Grenoble-Alpes University hospital. The participants were regularly and systematically assessed at 30 (± 3) (D30) and 60 (± 3) (D60) days after stroke. The DOBRAS-depression study was focused on the occurrence of PSD, assessed with the ADRS [START_REF] Bénaïm | [END_REF]) before D60 and with an evaluation of the behavioral factors and anatomical features. In our study, there were two types of approach concerning anatomical features: on the one hand, on the totality of individuals included in the study, we analyzed the link between PSD and WMH, between PSD and the basic stroke caracteristics (side, vascular location, stroke volume) through the brain damages evaluated on the MRI controlled at the subacute stage. On the other hand, we excluded the severe WMH, because this is a confunding factor of PSD. We analyzed the lesional data with a substraction mapping and a VLSM analysis to study the link between PSD and a specific brain area.

Ethical consideration

The DOBRAS study was performed with Helsinki declaration and was registered at the

Participants

From January 2012 to September 2018, 208 consecutives individuals were included in the DOBRAS data base. Inclusion criteria for DOBRAS were : adults between 18 and 80 years ; with a first unilateral hemispheric stroke (no cerebellar or brainstem's stroke) which was confirmed by MRI or CT-scan. Exclusion criteria for DOBRAS were : previous stroke ; others neurological diseases (peripherical neurologic diseases, movement disorder diseases, neuromuscular diseases, vestibular diseases); cognitive or psychological disorders prior to stroke ; unstable medical conditions.

For the present study, supplementary specific eligibility criteria were applied. We included individuals with an ADRS score assessed before D60 and a MRI performed at subacute stage (around 2 months). Two months after the stroke is the interval being recommended to avoid overestimating stroke volume and to better analyze brain structures encroached by the stroke [START_REF] Nagaraja | Reversible diffusion-weighted imaging lesions in acute ischemic stroke : A systematic review[END_REF]. We excluded the individuals with early (first week) MRI controls because the perilesional oedema distorts the stroke boundaries. Individuals with late (> 4 months) MRI controls were also excluded because the brain imaging had no mapping with the ADRS score made before D60. Also excluded, individuals with bilateral or multiple strokes or severe subarachnoid hemorrhage detected after a careful reading of MRI and brain hernia in acute phase of stroke.

Previous studies demonstrated the link between the PSD and the white matter hyperintensities (WMH) [START_REF] Bae | Associations of white matter hyperintensities with poststroke depression : A 1-year longitudinal study[END_REF][START_REF] Dieguez | Is poststroke depression a vascular depression[END_REF]. We could considere WMH is a predictor and a confunding factor of PSD, so to avoid a confusion bias in the lesional analysis, we have excluded the individuals with a severe WMH (Fazekas grade 3).

The flowchart of study is represented in figure 1.

The anatomo-clinical correlation and particularly VLSM method did not provide a theoretical number of participants. However, it seemed reasonable to include more than 30 patients by referring to relevant scientific literature [START_REF] Karnath | Reprint of : Mapping human brain lesions and their functional consequences[END_REF].

Clinical data

Depression assessment

The depression was assessed by ADRS which is a specific scale for PSD assessment, in individuals with or without aphasia, at the subacute stage after stroke (Bénaim et al., 2004 ;[START_REF] Pantoni | Cerebral small vessel disease : From pathogenesis and clinical characteristics to therapeutic challenges[END_REF]. As recommended, the ADRS questionnaire was filled-in by a trained psychologist during a multidisciplinary staff of our neurorehabilitation ward, with the help of the whole team. The ADRS scores range from 0 to 32 [START_REF] Bénaïm | [END_REF]. The depression was diagnosed for ADRS scores over 11 to get a 62 % sensitivity and 81 % specificity. In clinical routine, the depression was assessed on D30 and/or on D60. For this study, we kept the worst ADRS score as primary outcome. We have constituated two groups: depressive and nondepressive individuals.

Other clinical assessment

The disability was assessed by the Functional Independance Measure (FIM) [START_REF] Granger | Advances in functional assessment for medical rehabilitation[END_REF].

Brain imaging

Acquisition

MRI was performed with 1,5 Tesla machine, either Magnetom Vision plus (Siemens, Erhlangen, Germany) or Achieva (Philips, Amsterdam, The Netherlands). A T1-weighted high-resolution, a T2-weighted and a fluid attenuated inversion recovery (FLAIR) were acquired.

White matter hyperintensities (WMH)

WMH of the hemisphere spared by the stroke was graded with the Fazekas scale [START_REF] Fazekas | MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging[END_REF] on T2-FLAIR sequences, by a radiologist. Fazekas 0 (no WMH), Fazekas 1 (light WMH), Fazekas 2 (moderate WMH), Fazekas 3 (severe WMH).

In our study, we considered WMH of 2 ways. At first, we analyzed the relationship between the ADRS score and WMH, for that we definied 2 groups: no/light WMH and moderate/severe WMH . In a second time, we performed lesional analyses which had as objective to research if there were specific brain areas associated with PSD. Because, severe WMH could include a confusion bias, we decided that the individuals with severe WMH (Fazekas 3) were excluded of lesional analyses.

Brain imaging reconstruction

The lesions were reconstructed by using MRIcron [START_REF] Rorden | Stereotaxic display of brain lesions[END_REF] from MRI axial slices (axial AC-PC, T2 FLAIR, 4-mm thickness). The lesions were drawn manually by a first operator on axial slices of a T1-weighted MRI template from the Montreal Neurological Institute (www.bic.mni.mcgill.ca/cgi/icbm_view) normalized to Talairach's space and controlled by a second operator. Both operators were blinded to clinical measurements and study hypothesis. The disagreements were resolved by consensus. Individual brain lesions were superimposed by using MRIcron (http://www.mccauslandcenter.sc.edu/mricro/mricron).

We did not use an automatic segmentation and a normalisation algorithms because the manual reconstruction is more reliable than these techniques [START_REF] Kimberg | Power in Voxel-based Lesion-Symptom Mapping[END_REF] for analysis on patients with advanced age. Indeed, with aging the cerebral architecture is frequently modified (mostly ventricular dilatation or cerebral atrophy) [START_REF] Rorden | Improving Lesion-Symptom Mapping[END_REF]. In our behavioral data in function of the proportion of right and left lesions in depressive and nondepressive individuals (table 1) the right lesions were flipped so that the left hemisphere is the damaged one and the right non damaged. This method allows to increase the statistical power.

This step allowed us to obtain the stroke volumes and their locations in order to analyze the relationship between the stroke volume, the stroke location and PSD.

Stroke volume

Nys et al. demonstrated that the severity of depressive symptoms was related to the stroke volume [START_REF] Nys | Early depressive symptoms after stroke : Neuropsychological correlates and lesion characteristics[END_REF]. So, we analyzed the relationship between the stroke volume which was defined in voxels during the brain imaging reconstruction and PSD. The stroke volume was determined as the amount of hemisphere encroached on by the lesion (number of voxels for the lesion /number of voxels for the hemisphere) [START_REF] Karnath | The anatomy of spatial neglect based on voxelwise statistical analysis : A study of 140 patients[END_REF].

Stroke location

Behavioral analysis

The stroke location has often been studied in its link with the PSD. In our study, we performed several analyses about stroke location. First, a behavioral analysis of the stroke location. The location could be classified of many ways [START_REF] Levada | Poststroke Depression Biomarkers : A Narrative Review[END_REF], we have chosen a classification according to the vascular territories [START_REF] Vataja | Magnetic Resonance Imaging Correlates of Depression After Ischemic Stroke[END_REF]. For each individual, we defined 3 stroke location groups: superficial, deep and global. According to the vascular territories, when the lesion damaged the cortical area and the white matter out of the internal capsule the stroke was considered as superficial. When the lesion damaged the internal capsule or the basal ganglia the stroke was considered as deep. Finally when it was superficial and deep, we called it a global stroke. That is a vascular classification including several neural structures without a precious analysis of the location. That's why we will use two complementary methods using brain imaging reconstruction. First, a descriptive method with the substraction mapping (frequency mapping). Second, a statistical method using VLSM analysis to study the link between the cerebral damage and PSD.

Descriptive method: overlap mapping and substraction mapping

First, we presented a description of our population with mappings of all stroke reconstructed in MRIcron, which called an overlapping. This overlapping represented for each voxel, the number of patients who had an injury in that voxel. We performed an overlapping of all individuals, depressive and non depressive individuals. The substraction of the overlapping of depressive and non depressive call the frequency mapping (substraction mapping). The frequency mapping allowed to see if the cerebral areas were differents between the depressive and non depressive individuals. Then, we performed a Chi2 test to analyze statistically this comparaison and know if there were specific brain area associated with the PSD. Nevertheless, it seemed interesting and more precise to do an analysis without a previous depression or location classification, so we performed a least statistical method using VLSM analysis [START_REF] Karnath | The anatomy of spatial neglect based on voxelwise statistical analysis : A study of 140 patients[END_REF].

Voxel-based lesion symptom mapping (VLSM)

We performed, a statistical method using VLSM. VLSM analyzed the relationship between cerebral damage and behavior represented by a continous variable (ADRS score) on voxel by voxel basis, as in functional neuroimaging [START_REF] Bates | Voxel-based lesionsymptom mapping[END_REF]. It was a lesional analysis based on a voxelwise approach with an independent test (non-parametric mapping (NPM) in a toolbox) computed for every voxel of the whole brain [START_REF] Bates | Voxel-based lesionsymptom mapping[END_REF]. To avoid an increase of the error risk (p value) due to the analyses repeating, we performed a Bonferroni correction.

VLSM allowed a great spatial resolution and was adapted when there was not a strong a priori prediction regarding the spatial location of the cerebral injury [START_REF] Rorden | Improving Lesion-Symptom Mapping[END_REF].

Classical statistical analyses

The continuous data are presented as median with the interquartile range [Q1-Q3], the dichotomized and categorical data as number (%). The continuous data were compared between two groups by Mann-Whitney U-test, the proportions were compared by chi-square or Fisher exact test. The effect sizes were calculated by using the Z values of the Mann-Whitney test, r=Z/√n and the X 2 of the chi-square or Fisher exact test, v=√(X²/n*df). The effect size (r or v) of 0.1, 0.3, and 0.5 represent a small, medium, and large effect, respectively. The correlations were calculated by using the Kruskall-Wallis. A p value < 0.05 was considered as statistically significant. The statistical analysis involved using SPSS 21.0. First, we studied demographical and clinical features of the participants. Then, we studied the influence of the WMH, the lesion size and the location on the PSD.

RESULTS

Demographical and clinical features of participants

A total of 126 individuals had an ADRS before D60 after the stroke and a MRI at the 67 th day (+/-19 days) post-stroke. Their demographical and clinical features are presented in table 1.

Their median age was 65.9 [58. 1-72.4] years, with a male predominance (n=85, 67%).

Concerning the characteristics of the stroke, there were more frequently an infarct (n=102, 81 %) in the left side (n=73, 58%).

Median ADRS score was 10 [6][7][8][9][10][11][12][13][14][15]. There were 53 (42%) depressive individuals and 73 (58%) non-depressive individuals (table 1). They had been mostly assessed on D30 (n=70, 55%).

The depressive individuals differed from others by a worse functional independance (table 1).

Our clinical data showed that the proportion of right and left lesions were comparable in depressive and non-depressive individuals (table 1). Moreover, we had compared the size of the lesion in right and left stroke and there was no significant difference (p=0.239). To increase statistical power, the right lesions were flipped on the left hemisphere.

Influence of the WMH on PSD

Among the 126 individuals, 25 (20 %) had no WMH (Fazekas grade 0), 56 (44 %) a light WMH (Fazekas grade 1), 38 (30 %) a moderate WMH (Fazekas grade 2), and 7 (6 %) a severe WMH (Fazekas grade 3) (figure 2). Due to the small number of individuals with a Fazekas grade 3, two groups were constituted as follows : no/light WMH (n=81 ; 64%) and moderate/ severe WMH (n=45, 36%). The group moderate/severe WMH had higher ADRS scores than the group none/light WMH (12 [8][9][10][11][12][13][14][15][16][17] vs 9 [6][7][8][9][10][11][12][13][14] ; p=0.011, r=0.23)(figure 3).

The WMH were associated with the PSD and its severity.

Influence of the stroke volume on PSD

The stroke volume was comparable between the depressive and the non-depressive individuals (19994 [4279-48997] voxels vs 17934 [3412-39464] voxels ; p=0.619). This meant that the stroke volume was not associated with PSD.

Influence of the stroke location on PSD

Behavior analysis

ADRS scores were similar for superficial (n=48, 9 [6][7][8][9][10][11][12][13][14][15]), deep (n=45, 10 [6-16], and global (n=33, 10 [8-15]) strokes (z=1.692 ; p= 0.429). The lesion location was not associated with the PSD in this primary analysis. were located on all arterial territories. The lesions were more frequently found in middle cerebral artery territory and deep structures which are often perfused by posterior cerebral artery. The prefrontal regions were more preserved in depressive group (figure 5A). Lesions were observed mainly in the internal and external capsule, the insula and in the basal ganglia in the depressive and non depressive individuals (figure 5 A,B). In both groups, occipital regions were relatively preserved (figure 5 A,B).

Overlap mapping, substraction mapping and VLSM analysis

The mapping substraction (figure 5 C) between the depressive and the non-depressive individuals allowed us to obtain regions of interest (ROI) which were different between the depressive and the non depressive individuals. In the red area, the post arm of the internal capsule, the thalamus, the putamen and the corona radiata were more frequently injured in the depressive individuals whereas in the blue area, the caudate nucleus was more frequently injured in the non-depressive individuals (figure 5 C). The Chi2 test was not significant. Then, the statistical analysis of the brain imaging using the VLSM analysis was not significant.

There was not cerebral area associated with the ADRS score. According to the results of different steps to study the relationship between the stroke location and PSD, we could conclude there was not specific brain area associated with the PSD.

DISCUSSION

PSD and WMH

Our study showed a significant link between the presence of WMH and PSD. This conclusion is consistent with the more in-depth work of Bae et al. who had demonstrated in a population studied at 15 days and one year post-stroke that WMH periventricular were associated with early PSD while deep WMH was associated with PSD late and severe [START_REF] Bae | Associations of white matter hyperintensities with poststroke depression : A 1-year longitudinal study[END_REF].

From a pathophysiological point of view, Dieguez et al. evoked moreover the hypothesis of the vascular mechanism in the onset of PSD: the presence of both periventricular and deep WMH are associated with PSD with less remission more progression to chronicity and a poorer response to treatment [START_REF] Dieguez | Is poststroke depression a vascular depression[END_REF]. WMH are part of a subcategory of microvascular injury caused by cardiovascular risk factors. Among the other types of lesions microvascular that we can observe, we also describe the microbleeds. About that, Tang et al. has demonstrated in several publications the link between microbleeds and post-stroke depression: the presence of lobar microbleeds was associated with less of remission of depression over a period evaluating individuals at 3 and 15 months after stroke. Suicide was also more common in individuals with frontal lobar microbleeds whether early (7%) or late (14%) after stroke (Tang et al., 2010(Tang et al., -2014)). It would therefore appear that lesions of microvascular origin (WHM and microbleeds) play an important role in the severity of depression, its course and therapeutic response. Prevention of microangiopathy is based on simple principles of controlling cardiovascular risk factors, in particular especially high blood pressure.

PSD and stroke location/volume

Furthermore, although we might have expected a link between the location and/or stroke volume with PSD, our study did not show a significant association concerning these two hypotheses. Indeed, one would have expected that the lesions large or in areas with high functional potential such as the internal capsule provide PSD due to the functional impairment engendered, such as walking which affects autonomy. Conversely, a right lesion more prone to anosognosia could suggest a protective factor of the PSD. A few articles in the literature also conclude that there is no link between location and PSD, Nys et al. have not shown a significant link between location of the recent stroke or a lacunar stroke and the occurrence of PSD [START_REF] Nys | Early depressive symptoms after stroke : Neuropsychological correlates and lesion characteristics[END_REF]. In the systematic review carried out by Carson et al., the location of the lesion was also not retained as a risk factor involved in PSD [START_REF] Carson | Depression after stroke and lesion location : A systematic review[END_REF]. We can however emphasize that our study has included a large series of patients compared to previous studies which were limited to a smaller sample individuals [START_REF] Levada | Poststroke Depression Biomarkers : A Narrative Review[END_REF].

To date, our study is one of the only studies of the literature on neural bases hemispherical PSD performed in VLSM analysis and on a significant series of aphasic patients.

Our results suggest that the neural basis of depression may not be so simple to demonstrate because they probably pass through cortical and subcortical networks which would join. Liao et al. who showed that depression chronic and severe disease in non-stroke patients was associated with abnormal white matter in right frontal lobe, right fusiform gyrus, left frontal gyrus and the right occipital lobe. In this article, the role of the corpus callosum, the gyrus right fusiform and inferior longitudinal fasciculus suggesting that any disconnection within the white matter of these systems could be at the origin of a depression [START_REF] Liao | Is depression a disconnection syndrome? Meta-analysis of diffusion tensor imaging studies in patients with MDD[END_REF].

The VLSM analysis may not have been able to identify these networks, but methods such as diffusion tensor imaging would allow us to study more precisely the hypothesis of fronto subcortical dysconnection.

Limitations

Concerning the depression assessment, we have used the ADRS which is a scale with a good reliability. However, we might have been able to perfect assessment of mood with a complementary scale-type self-assessment scale face so that it remains usable in our aphasic individuals. Before ADRS, the Visual Analog Mood Scales (VAMS) [START_REF] Arruda | Measurement of mood states in stroke patients : Validation of the visual analog mood scales[END_REF] was the depression scale for aphasic individuals. The association of ADRS and VAMS could then be very useful for assessing mood disorders in aphasic patients [START_REF] Bénaïm | [END_REF].

Concerning behavioral data, we have not assessed the anosognosia while it could be a factor impacting PSD because patients with anosognosia have not conscience of their difficulties and their dependance and we could think they are protected of PSD.

Concerning Fazekas scale, we have simplified the score and we have not considered independantly PWMH et DWMH whereas others studies had do that to study more precisely the relationship between WMH and PSD [START_REF] Dieguez | Is poststroke depression a vascular depression[END_REF][START_REF] Bae | Associations of white matter hyperintensities with poststroke depression : A 1-year longitudinal study[END_REF]. Moreover, there were not enough individuals in our severe WMH (Fazekas 3) group to demonstrate a correlation between WMH severity and PSD.

Reactional or organic PSD

We can also think that the reactional part in connection with the loss autonomy (loss of walking, balance disorder, cognitive decline), disability, impaired quality of life play a role in the onset of PSD. It is advisable to remain attentive to the clinical and iconographic risk factors (WMH and microbleeds), in order to identify subjects at risk of PSD to take them into load early and efficiently and thus limit symptoms and consequences that this complication causes.

Our study demonstrated a significant link between WMH and PSD. On the other hand, we did not demonstrate the link between stroke volume, stroke location and PSD. The introduction and re-evaluation of anti-depressant treatments are essential, the association of supportive psychotherapy with anti-depressants is clearly indicated for patients who accept it. By limiting the negative symptoms of depression, we can expect better patient participation during their rehabilitation phase and thus lead to a more complete recovery with a more satisfactory quality of life less inclined to promote depressive symptoms.

CONCLUSION

This is the largest series in which were sought the relationships between depression and brain imaging parameters such as structures altered by the stroke (voxel-based lesion symptom mapping,VLSM), stroke volume (number of voxels), and white matter hyperintensities (WMH) assessed with the Fazekas scale. A total of 126 individuals were analyzed. Their median age was 65.9 [58. 1-72.4] years, with a male predominance (n=85, 67%). They had been mostly assessed on D30 (n=70, 55 %). The depression was assessed by the Aphasic Depression Rating Scale (ADRS), a specific tool quantifying post-stroke depression (PSD), regardless aphasia (score ranging from 0 to 30, depression ≥ 11). Among them 53 (42%) were depressive and the median ADRS score was 10 [6][7][8][9][10][11][12][13][14][15]. Brain imaging were analyzed on MRI performed around 2 months after the stroke, using modern brain imaging analyses technics. PSD and its severity was only associated to the existence of a WMH, not with stroke volume or any specific brain areas. We conclude that PSD must be particularly detected in case of WHM. The absence of specific brain structure related advocates for the reactional hypothesis of PSD. Talairach z-coordinates [START_REF] Talairach | Co-planar stereotaxic atlas of the human brain : 3-dimensional proportional system: an approach to cerebral imaging[END_REF] of each transverse section are given. 1: There may be some reduction of mobility, not easily confirmed.

2: Reduction of mobility is definite but mild; the gaze, while oftenfixed, is still capable of shifting; mimic, although monotonous, isstill expressive. 2: Patient is distressed by fatigability in his everyday life (eating,washing, dressing, climbing stairs, or any other physical activity thepatient is usually able to do despite motor deficiency).

3: Fatigability is such that the patient must curb some activities.

4: Near-total reduction of activities owing to an overwhelmingsense of fatigue.

RésuméIntroduction:

  la dépression est une complication fréquente après un accident vasculaire cérébral (AVC). Cette complication a un impact négatif sur la rééducation et la récupération fonctionnelle. Plusieurs études comportementales suggèrent que la dépression post-AVC pourrait être un phénomène réactionnel. Cette interprétation laisse penser qu'il n'existe pas de lien entre la dépression post-AVC et une ou plusieurs aires cérébrales spécifiques. Ce point reste débattu et il n'a encore jamais été investigué par des techniques modernes d'analyse statistique basées sur l'imagerie cérébrale et réalisé sur une cohorte conséquente incluant un grand nombre de participants afin d'exclure un résultat faussement négatif. C'est l'objectif de notre étude. Méthode: il s'agit d'une étude annexe issue de la cohorte DOBRAS (Determinants of Balance Recovery After Stroke), dans laquelle les participants sont régulièrement et systématiquement évalués à 30 (± 3) (J30) et 60 (± 3) (J60) jours après l'AVC. La dépression était évaluée par l' Aphasic Depression Rating Scale (ADRS), un outil spécifique pour la dépression post-AVC, en présence ou non d'une aphasie (scores entre 0 et 32, seuil diagnostic à partir de 11 inclus).

  : la dépression post-AVC doit être particulièrement détectée en cas d'hypersignaux de substance blanche à l'IRM. L'absence d'aire cérébrale spécifique en lien avec la dépression post-AVC plaide en faveur de l'hypothèse réactionnelle.Mots clés: AVC, dépression, ADRS, imagerie cérébrale, hypersignaux de substance blanche, VLSM, volume de l'AVC.

National

  Committee for Informatics and Freedom (Commission nationale informatique et liberté; CNIL No. 2014874 v1) which is the French equivalent of the information Commisionner's Office in the United Kingdom. According to French law, observational studies do not require approval by an ethics committee, provided participants have been informed of the specific research and are not opposed. All possible participants were informed about the study verbally and by writing. Participants who refused to share their clinical data for research purposes fulfilled an opposition paper.

Figure 4

 4 Figure 4 represents the overlap strokes mapping of the 119 individuals. The stroke damages

Figure 1 .

 1 Figure 1. Study flowchart

Figure 2 .Figure 3 .

 23 Figure 2. Proportion of individuals on a total of 126 individuals according to their Fazekas

Figure 4 :

 4 Figure 4 : Overlay lesion plots of the 119 stroke individuals. The number of overlapping

Figure 5 .

 5 Figure 5. (A) overlay lesion plots of 47 stroke individuals with depression and (B) 72 stroke individuals without depression. The number of overlapping lesions is illustrated by different colors coding increasing frequency from violet (n=1) to red (n=47, depressive individuals; n=72 non depressive individuals). Talairach z-coordinates (Talairach and Tournoux, 1988) of each transverse section are given. (C) Overlay plot of the substracted superimposed lesions of the patients with depression minus the individuals without depression. The percentage of overlapping lesions of the depressive individuals after substraction of non depressive individuals is illustrated by five different colors coding increasing frequencies from dark red (difference: 1-16.7%) to yellow (difference 83.5-100%) and indicating regions damaged more frequently in patient with depression than in patient without disorder. Each color represents 16.7% increments. The colors from dark blue ( difference 1-16.7%) to light blue (difference 83.4 -100%) indicate regions damaged more frequently in patients without depression than in patients with depression. Talairach z-coordinates[START_REF] Talairach | Co-planar stereotaxic atlas of the human brain : 3-dimensional proportional system: an approach to cerebral imaging[END_REF] of each transverse section are given.

1 :

 1 Loss of appetite but continues to eat; heavy feelings in abdomen 2: Difficulty eating (not due to arm paresis); requests or requireslaxatives or medication for bowels or for gastrointestinal symptoms complaints, requests for help, etc. 4: Hypochondriacal delusions Item 6. Loss of WeightRating is by measurement and does not take into account loss ofweight that occurred during the acute poststroke phase. 0: 0.5 kg weight loss per week 1: 0.5 kg to 1 kg weight loss per week 2: > 1kg weight loss per week Item 7. Apparent SadnessItem represents despondency, gloom, and despair (more than justordinary transient low spirits) reflected in speech (not available incase of severe aphasia), facial expression, and posture. Rating is bydepth and inability to brighten mood. miserable all the time; extremely despondent Item 8. Mimic-Slowness of Facial Mobility (concernsonly the nonaffected side) 0: The head moves freely, resting flexibly on the body with thegaze either exploring the room or fixed on the examiner or on otherobjects of interest in an appropriate manner.

3 :

 3 Patient does not move the head or explore the room and usuallystares at the floor, seldom looking at the examiner; patient is slow tosmile; expression is unchanging. 4: Face is completely immobile and painfully inexpressive.

Item 9 .

 9 Fatigability (takes into account motor deficiency, if any)0: Fatigability is not indicated spontaneously (by verbal ornonverbal communication) or after direct questioning. 1: Fatigability is not indicated spontaneously, but evidence of itemerges in the course of the interview.

Remerciements

SERMENT D'HIPPOCRATE

En présence des Maîtres de cette Faculté, de mes chers condisciples et devant l'effigie d'HIPPOCRATE, Je promets et je jure d'être fidèle aux lois de l'honneur et de la probité dans l'exercice de la Médecine. Je donnerai mes soins gratuitement à l'indigent et n'exigerai jamais un salaire au dessus de mon travail. Je ne participerai à aucun partage clandestin d'honoraires. Admis dans l'intimité des maisons, mes yeux n'y verront pas ce qui s'y passe ; ma langue taira les secrets qui me seront confiés et mon état ne servira pas à corrompre les moeurs, ni à favoriser le crime.

Je ne permettrai pas que des considérations de religion, de nation, de race, de parti ou de classe sociale viennent s'interposer entre mon devoir et mon patient.

Je garderai le respect absolu de la vie humaine.

Même sous la menace, je n'admettrai pas de faire usage de mes connaissances médicales contre les lois de l'humanité.

Respectueux et reconnaissant envers mes Maîtres, je rendrai à leurs enfants l'instruction que j'ai reçue de leurs pères.

Que les hommes m'accordent leur estime si je suis fidèle à mes promesses.

Que je sois couvert d'opprobre et méprisé de mes confrères si j'y manque.

brain structure related advocates for the reactional hypothesis of PSD.

Key words: stroke, depression, Aphasic Depression Rating Scale (ADRS), brain imaging,

White Matter Hyperintensities (WMH), Voxel-based Lesion Symptom Mapping (VLSM), stroke volume Sex, lesion side and lesional mechanism are represented by the number and the proportion (%).

EXPERIMENTAL PART

Statistical significant is p value < 0.05

Appendix

ADRS Items [START_REF] Bénaïm | [END_REF])