scholarly journals Diagnostic Values of miR-221-3p in Serum and Cerebrospinal Fluid for Post-Stroke Depression and Analysis of Risk Factors

Author(s):  
Yan Cui ◽  
Guodi Ma ◽  
Fanying Kong ◽  
Lingli Song

Background: We aimed to explore the diagnostic values of miR-221-3p in serum and cerebrospinal fluid (CSF) for post-stroke depression (PSD) and to analyze the risk factors of the disease. Methods: Admitted to the Second Affiliated Hospital of Harbin Medical University, Harbin, China from May 2013 to May 2020, 136 stroke patients were enrolled, among which 76 PSD patients were taken as a PSD group and 60 non-depressed patients were taken as a Non-PSD group. miR-221-3p expression in serum and CSF and concentrations of inflammatory cytokines (IL-6, TNF-α) in serum were detected, to analyze the diagnostic and prognostic values of the indicators for PSD. Correlations of miR-221-3p in serum with that in CSF, with the National Institute of Health Stroke Scale (NIHSS) score and the Hamilton Depression Rating Scale (HAMD) score, and with inflammatory cytokines were analyzed, so as to analyze the risk factors affecting the occurrence of PSD. Results: Compared with the Non-PSD group, miR-221-3p remarkably upregulated in serum and CSF in the PSD group, and its areas under the curves (AUCs) for PSD identification were 0.900 and 0.925, respectively. According to the correlation analysis, miR-221-3p in serum was remarkably positively correlated with that in CSF, NIHSS score, HAMD score, IL-6 and TNF-α. In addition, a history of mental illness, NIHSS score, HAMD score, IL-6, TNF-α and miR-221-3p were risk factors of PSD. Conclusion: miR-221-3p in serum and CSF can be used as the diagnostic and risk warning indicators of PSD.

Author(s):  
Gurumayum Sonachand Sharma ◽  
Anupam Gupta ◽  
Meeka Khanna ◽  
Naveen Bangarpet Prakash

Abstract Objective The aim of the study is to observe the effect of post-stroke depression on functional outcomes during inpatient rehabilitation. Patients and Methods The design involved is prospective observational study. The location involved is Neurological Rehabilitation unit in a tertiary care university hospital. The study period ranges from October 2019 to April 2020. The participants involved are the patients with first ever stroke, male and female with age ≥18 years and duration less than 1 year. All participants were assessed at admission and after 14 sessions of inpatient rehabilitation by depression subscale of Hospital Anxiety and Depression Scale (HADS-D) and Hamilton Depression Rating Scale (HDRS). The stroke outcomes measures used were: Barthel Index (BI), Scandinavian Stroke Scale (SSS), and Modified Rankin Scale (MRS). Results There are a total of 30 participants (18 males) with median stroke duration of 90 days. The median age of the patients was 58 years. Sixteen patients had ischemic and 14 had hemorrhagic stroke. Out of these, 57% (n = 17) had symptoms of depression (HADS-D >7). Participants in both groups (with and without depression) showed improvement in all the functional outcome measures (BI, SSS, MRS) at the time of discharge as compared with admission scores. The changes in the outcome measures were statistically significant within groups (p < 0.05) but not significant between the groups (p > 0.05). Conclusion The post-stroke depression is common among stroke survivors of less than 1 year duration. There was no significant difference in the functional outcomes between stroke patients with depression and those without depression with inpatient rehabilitation program.


2019 ◽  
Vol 14 (1) ◽  
pp. 31
Author(s):  
Fitria Handayani ◽  
Setyowati Setyowati ◽  
Dwi Pudjonarko ◽  
Dian Ratna Sawitri ◽  
Hastaning Sakti ◽  
...  

<p><span>Background </span></p><p><span>The Post Stroke Depression (PSD) prevalence of stroke survivor after three months onset was ranged from 17% to 37%. Depression led to fatigue, low quality of life, severe morbidity, and mortality.<span>  </span>Functional Outcome influence depression on stroke survivor. <span> </span>However, correlation between functional state level and depression among stroke survivor after three months onset has not been established. </span></p><p><span>Objective</span></p><p><span>This study was aimed to investigate the correlation of executive functional outcome and PSD among stroke survivor after three months onset. </span></p><p><span>Method</span></p><p><span>This study was a correlation study. The participants were 44 stroke ischemic patients after three months onset. Participants were recruited in an outpatient unit. PSD was measured using <span>The GRID-Hamilton Rating Scale for Depression 17 (GRID-HAMD 17) and </span>Functional Outcome was measured using <span>Barthel Index (BI). The reliability of GRID-HAMD 17 was .776. <span> </span>Both instruments were conducted on backward translation in to bahasa. Data was examined using </span>simple linier regression analyses. <span> </span>The ethical approval was obtained from the Ethical Research Committee of the Medical Faculty Diponegoro University and Tugurejo Semarang Hospital. </span></p><p><span>Results</span></p><p><span>The presence of PSD were 56.82. The median of HAMD-GRID-17 was 10.38 ± 7.58, and Barthel Index was 69.56 ± 21.69.<span>  </span>The Barthel Index showed positive correlation with HAMD-GRID-17 (?= -.41 ?=.006). The Functional Outcome determined PSD as much as 16.8 %. </span></p><p><span>Conclusion</span></p><p><span>Moderate association demonstrated the correlation between Functional Outcome and PSD. Nursing intervention should consider these two variables for an optimum quality of life among stroke survivors. </span></p><p> </p>


2021 ◽  
Author(s):  
Lam Wai Ching ◽  
Hui Juan Li ◽  
Jianwen Guo ◽  
Liang Yao ◽  
Janita Chau ◽  
...  

Abstract Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.


2018 ◽  
Vol 6 (5) ◽  
pp. 782-785 ◽  
Author(s):  
Danijela Vojtikiv-Samoilovska ◽  
Anita Arsovska

BACKGROUND: Although post-stroke depression (PSD) is the most common neuro-psychiatric consequence after a stroke there is still some obscurity regarding its aetiology and risk factors, which complicates its management. A better knowledge of the predictors will enable better prevention and treatment.AIM: The aim of this work was the identification of the risk factors for PSD, typical for the Macedonian population, which will help in early prediction, timely diagnosis and treatment of the disease.MATERIALS AND METHODS:  We carried out a prospective study at the Clinical Hospital in Tetovo, the Republic of Macedonia to determine the prevalence of PSD and to analyse the socio-demographic characteristics as possible risk factors in 100 patients on discharge and after 5 months. The depression symptoms were quantified using the Hamilton Depression Ranking Scale (HAM-d) and the Geriatric Depression Scale (GDS).RESULTS: The average age of the patients with PSD on the first examination is 65.0 ± 8.3, whereas on the second examination is 64.5 ± 9.2. According to the Mann-Whitney U test, the difference between the average ages on both examinations is statistically insignificant for p > 0.05. On both examinations, the statistically significant dependence of p > 0.05 between PSD and the occupational status and PSD and education is not recorded. On both examinations, the PSD in male patients was 78.0% and 62.7%, while in female patients it was 85.4% and 68.3% not recording the statistically significant dependence of p < 0.05 between PSD and the gender.CONCLUSION: The socio-demographic characteristics of the patients with PSD cannot be considered as predictors of the disease.


Author(s):  
Fidel López-Espuela ◽  
Raúl Roncero-Martín ◽  
Maria de la Luz Canal-Macías ◽  
Jose M. Moran ◽  
Vicente Vera ◽  
...  

We aimed to know the prevalence of post-stroke depression (PSD) in our context, identify the variables that could predict post-stroke depression, by using the Hamilton Depression Rating Scale, occurring within six months after stroke, and identify patients at high risk for PSD. Methods: descriptive, cross-sectional and observational study. We included 173 patients with stroke (transient ischemic attack (TIA) included) and collected sociodemographic and clinical variables. We used the Hamilton Depression Scale (HDS) for depression assessment and Barthel Index and modified Rankin Scale (mRS) for functional assessment. The neurological severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS). Results: 35.5% were women, aged 71.16 (±12.3). Depression was present in 42.2% patients (n = 73) at six months after stroke. The following variables were significantly associated with PSD: diagnosis of previous depression (p = 0.005), the modified Rankin Scale at discharge (p = 0.032) and length of hospital stay (p = 0.012). Conclusion: PSD is highly prevalent after stroke and is associated with the severity, left location of the stroke, and the degree of disability at discharge. Its impact justifies the evaluation and early treatment that still continues to be a challenge today.


Author(s):  
PETER BURVILL ◽  
GLORIA JOHNSON ◽  
KONRAD JAMROZIK ◽  
CRAIG ANDERSON ◽  
EDWARD STEWART-WYNNE

2006 ◽  
Vol 18 (1) ◽  
pp. 19-35 ◽  
Author(s):  
I. Aben ◽  
J. Lodder ◽  
A. Honig ◽  
R. Lousberg ◽  
A. Boreas ◽  
...  

Background: Both the lesion location hypothesis and the vascular depression hypothesis have been proposed to explain the high incidence of depression in stroke patients. However, research studying both hypotheses in a single cohort is, at present, scarce.Objective: To test the independent effects of lesion location (left hemisphere, anterior region) and of co-occurring generalized vascular damage on the development of depression in the first year after ischemic stroke, while other risk factors for depression are controlled for.Methods: One hundred and ninety consecutive patients with a first-ever, supratentorial infarct were followed up for one year. CT was performed in the acute phase of stroke, while in 75 patients an additional MRI scan was also available. Depression was assessed at 1, 3, 6, 9, and 12 months after stroke using self-rating scales as screening tools and the SCID-I to diagnose depression according to DSM-IV criteria.Results: Separate analyses of the lesion location hypothesis and the vascular depression hypothesis failed to reveal significant support for either of these biological models of post-stroke depression. Similar negative results appeared from one overall, multivariate analysis including variables of both focal and generalized vascular brain damage, as well as other non-cerebral risk factors. In addition, level of handicap and neuroticism were independent predictors of depression in this cohort, as has been reported previously.Conclusion: This study supports neither the lesion location nor the vascular depression hypothesis of post-stroke depression. A biopsychosocial model including both premorbid (prior to stroke) vulnerability factors, such as neuroticism and (family) history of depression, as well as post-stroke stressors, such as level of handicap, may be more appropriate and deserves further study.


2020 ◽  
pp. 096452842096767
Author(s):  
Kun Zhang ◽  
Guangwei Cui ◽  
Yuan Gao ◽  
Weidong Shen

Objective: To evaluate the effectiveness of acupuncture combined with antidepressants in the treatment of post-stroke depression (PSD). Methods: The following electronic databases were systematically searched: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Wanfang Data, China National Knowledge Infrastructure and Chongqing VIP database. The primary outcome was the Hamilton depression scale (HAMD) score. Two independent investigators screened for eligible clinical trials. The Cochrane risk of bias tool was used to assess the methodological quality, and RevMan 5.3 was applied for meta-analysis. Results: Thirteen randomized controlled trials (RCTs) involving 904 participants were included in the study. The results of this meta-analysis showed that, compared with antidepressants alone, acupuncture combined with antidepressants led to a significant decrease in the HAMD score (mean difference (MD): −3.60, 95% confidence interval (CI): −4.25 to −2.95, P < 0.001), had a better effective rate (risk ratio (RR): 1.33, 95% CI 1.19 to 1.49, P < 0.001) and lower National Institutes of Health Stroke Scale (NIHSS) scores (MD: −2.39, 95% CI: −3.37 to −1.41, P < 0.001), and led to a significant increase in the Barthel index scores (MD: 8.10, 95% CI: 5.25 to 10.94; P < 0.001). Conclusions: Acupuncture combined with antidepressants showed a more favourable effect on the treatment of PSD than antidepressants alone. However, given the limited methodological quality, more high-quality RCTs conducted based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines are necessary.


Sign in / Sign up

Export Citation Format

Share Document