Clinical predictor and circulating microRNA profile expression in patients with early onset post-stroke depression

ABSTRACTObjectivePost-stroke depression (PSD) is one of the most frequent psychiatric symptoms after a stroke event. The role of white matter hyperintensities (WMHs) associated with PSD in older patients remains unclear. This study aimed to examine the volume and location of white matter microstructure abnormalities among older patients with early-onset PSD.MethodsOlder (≥55 years) patients with acute cerebral infarction and hospitalized in King Chulalongkorn Memorial Hospital’s stroke unit from October 2019 to September 2020 were recruited. Participants were assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) within three months after the onset of stroke. All patients had MRI scans. The brain images were segmented into four regions via left/right, frontal/dorsal plains. Two WMHs volume detections (visual rating vs. semi-automated WMHs volumetric detection) were employed on the fluid-attenuated inversion recovery images (FLAIR) for each segment. The study then investigated the association between WMHs volume and MADRS score with regression analysis.ResultsThe study included twenty-nine patients with acute stroke. Total WMHs volume and segmented regions were not statistically associated with the MADRS score. However, there was a trend in different WHMs volume of the left anterior segment between depressed and non-depressed groups (t-test 2.058, p = 0.055). Further, demographic and clinical data showed no association with depressive symptoms.ConclusionThe volume of WHMs might not contribute to the development of early-onset PSD in older patients. This study showed a potential of a quantitative MRI analysis in clinical practice. Further investigation with a larger group of patients is needed.

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Early-Onset Depression in Stroke Patients: Effects on Unfavorable Outcome 5 Years Post-stroke

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.556981 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ya-Ying Zeng ◽

Meng-Xuan Wu ◽

Dan-Dan Geng ◽

Lin Cheng ◽

Sheng-Nan Zhou ◽

...

Keyword(s):

Early Onset ◽

Depression Scale ◽

Unfavorable Outcome ◽

Chinese Patients ◽

Hamilton Depression Scale ◽

Post Stroke ◽

Potential Risk Factors ◽

Post Stroke Depression ◽

State Examination

Background: Post-stroke depression (PSD) constitutes an essential complication of stroke and is associated with high-risk unfavorable outcome after stroke. The main objective of this prospective study was to determine the relationship between early-onset PSD (1 month after stroke) and functional outcomes 5 years after baseline enrollment.Methods: Four hundred thirty-six patients who met the criteria were included in this study from October 2013 to February 2015. The follow-up time for each patient was ~5 years, with follow-up every 3 months. Patients received questionnaires including the 17-item Hamilton Depression Scale (HAMD), the Mini-Mental State Examination (MMSE), the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the Barthel Index (BI).Results: Of the 436 patients, 154 (35.3%) patients with the prevalence of PSD status at baseline, 26 (7.2%) patients with the prevalence of PSD status, and 73 (20.1%) had an unfavorable outcome 5 years after stroke. The odds ratio (OR) for unfavorable outcome at 5 years in the PSD group was ~2.2 relative to the non-PSD group after adjusting for potential risk factors [OR = 2.217, 95% confidence interval (CI) = 1.179–4.421, P = 0.015]. In the early-onset PSD group, HAMD scores were independently associated with 5-year unfavorable outcome rates (OR = 1.168, 95% CI = 1.015–1.345, P = 0.031).Conclusions: Our findings indicate that early-onset PSD status in Chinese patients is an independent risk factor for unfavorable outcome 5 years after stroke, and that the severity of PSD is also related to unfavorable outcome.

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The combination of plasma glutamate and physical impairment after acute stroke as a potential indicator for the early-onset post-stroke depression

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2017.01.006 ◽

2017 ◽

Vol 96 ◽

pp. 35-41 ◽

Cited By ~ 7

Author(s):

Lei-Yu Geng ◽

Fang-Yuan Qian ◽

Jun-Feng Qian ◽

Zhi-Jun Zhang

Keyword(s):

Acute Stroke ◽

Early Onset ◽

Physical Impairment ◽

Post Stroke ◽

Potential Indicator ◽

Post Stroke Depression

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Early Symptom Measurement of Post‐Stroke Depression

PsycTESTS Dataset ◽

10.1037/t72564-000 ◽

2016 ◽

Author(s):

Jufang Li ◽

Linda Denise Oakley ◽

Roger L. Brown ◽

Yun Li ◽

Maiyun Ye ◽

...

Keyword(s):

Early Symptom ◽

Post Stroke ◽

Post Stroke Depression ◽

Symptom Measurement

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Early Symptom Measurement of Post‐Stroke Depression--Short Version

PsycTESTS Dataset ◽

10.1037/t72531-000 ◽

2019 ◽

Author(s):

Jufang Li ◽

Yun Li ◽

Ping Li ◽

Maiyun Ye

Keyword(s):

Short Version ◽

Early Symptom ◽

Post Stroke ◽

Post Stroke Depression ◽

Symptom Measurement

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Therapy of post-stroke depression – a systematic review

Die Psychiatrie ◽

10.1055/s-0038-1670863 ◽

2013 ◽

Vol 10 (02) ◽

pp. 108-129 ◽

Cited By ~ 1

Author(s):

W. Gaebel ◽

W. Wannagat ◽

J. Zielasek

Keyword(s):

Systematic Review ◽

Large Scale ◽

Repetitive Transcranial Magnetic Stimulation ◽

Placebo Control ◽

Post Stroke ◽

Pharmacological Studies ◽

Post Stroke Depression ◽

Control Procedures ◽

Antidepressant Pharmacotherapy

SummaryWe performed a systematic review of randomized placebo-controlled pharmacological and non-pharmacological trials for the therapy and prevention of post-stroke depression that have been published between 1980 and 2011. We initially identified 2 260 records of which 28 studies were finally included into this review. A meta-analytic approach was hampered by considerable differences regarding the kinds of therapeutic regimens and the study durations. Modest effects favoring treatment of post-stroke depression could be found for pharmacological treatment as well as repetitive transcranial magnetic stimulation. For the prevention of post-stroke depression, antidepressant pharmacotherapy showed promising results. However, large-scale studies with better standardized study populations, optimized placebo control procedures in non-pharmacological studies, and replication in larger follow-up studies are still necessary to find the optimal therapeutic regimens to prevent and treat post-stroke depression.

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