A related study of the type A Behavior, the level of BDNF and hypersensitive C-reactive protein in patients with post stroke depression in acute ischemic stroke

Abstract

Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD), and explore the correlation between them. Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116). TABP, Social Support Scale, MMSE, NIHSS, mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80); fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls(NC group). Results (1)The incidence of acute PSD was 31.03%.(2)The constituent ratio of type A behavior(83.33% vs 57.50%), CH scores, TH+ CH scores were significantly higher in PSD group than NPSD group(P <0.01). Social Support Scale scores, MMSE scores were significantly lower in PSD group than NPSD group(P <0.01, P<0.05). NIHSS scores, mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P <0.01). (3) The levels of serum BDNF, hs-CRP in the PSD group, the NPSD group and the normal control group were respectively (BDNF(617.24(274.98, 976.22))pg/ml, (938.19(615.88, 1 714.76))pg/ml, (4 149.46(1 658.83, 7 583.34))pg/ml); (hs-CRP(6.47(2.66, 11.21))mg/L, 1.77(0.74, 6.51)mg/L, (0.86(0.47, 1.59))mg/L). The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group(P <0.01). (4) The severity of depression was positively correlated with CH, TH+ CH scores(r=0.38, P<0.05; r=0.43, P<0.01). CH scores were negatively correlated with social support(r=-0.38, P<0.05), and were positively correlated with hs-CRP levels(r=0.34, P<0.05). Conclusion In patients with post stroke depression, the BDNF levels decrease and hs-CRP levels increase, but severity of depression and cognitive function are not correlated with BDNF levels. Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support. Hostility and excessive competition are psychosocial risk factors occurring PSD. Key words: Post stroke depression; Type A behavior; Hostility; Brain-derived neurotrophic factor; Hypersensitive C-reactive protein