Correlation between white matter hyperintensities and post-stroke depression

Abstract

Objective To investigate the correlation between white matter hyperintensities (WMHs) and post-stroke depression (PSD) in patients with acute ischemic stroke. Methods From December 2015 to December 2016, patients with acute ischemic stroke admitted to the Department of Neurology, Yijishan Hospital, Wannan Medical College were enrolled retrospectively. The demographic and baseline clinical data were documented. The patients underwent a 3.0 T-MRI examination within 3 d of admission, and the severity of periventricular and deep WMHs was graded using the Fazekas 4-point scale. Depression was diagnosed at 3 months after onset according to Chinese classification of mental disorders (3rd edition). The patients were divided into PSD group and non-PSD group. Multivariate logistic regression analysis was used to determine the independent correlation between WMHs and PSD. Results A total of 203 patients were enrolled and followed up, including 117 males (57.64%) and 86 females (42.36%), aged 66.6±10.2 years. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 4.7±2.8; 67 patients in the PSD group (33.00%) and 136 patients in the non-PSD group (67.00%). Univariate analysis showed that there were significant differences in years of education, baseline NIHSS score, Mini-Mental State Examination (MMSE) score at 3 months, severe deep WMHs (Fazekas 3), and prefrontal infarction between the PSD group and the non-PSD group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for years of education, baseline NIHSS score, 3-month MMSE score, and prefrontal infarction, severe deep WMHs (odds ratio [OR] 2.192, 95% confidence interval [CI] 1.212-4.946; P=0.019) was independently correlated with PSD. In addition, baseline NHISS score (OR 1.071, 95% CI 1.009-1.137; P=0.034) and acute prefrontal infarction (OR 4.326, 95% CI 1.074-14.371; P=0.045) were also independently correlated with PSD. Conclusion Severe deep WMHs is the independent risk factor for PSD at 3 months after the onset of ischemic stroke. Key words: Stroke; Brain ischemia; White matter; Depressive disorder; Risk factors