Abstract
In this study, we aimed to explore the relationship among miR-22, deep cerebral microbleeds (CMBs), and post-stroke depression (PSD) 1 month after ischemic stroke. We consecutively recruited 257 patients with first-ever and recurrent acute cerebral infarction and performed PSD diagnosis in accordance with the Diagnostic and Statistical Manual IV criteria for depression. Clinical information, assessments of stroke severity, and imaging data were recorded on admission. We further detected plasma miR-22 using quantitative PCR and analyzed the relationship among miR-22, clinical data, and PSD using SPSS 23.0 software. Logistic regression showed that deep (OR=1.845, 95%CI: 1.006-3.386, P=0.047) and brain stem CMBs (OR=2.652, 95%CI: 1.110–6.921, P=0.040), as well as plasma miR-22 levels (OR=2.094, 95%CI: 1.066–4.115, P=0.032) were independent risk factors for PSD. In addition, there were significant differences in baseline National Institutes of Health Stroke Scale scores (OR=1.881, 95%CI: 1.180–3.011, P=0.007) and Widowhood scores (OR=1.903, 95%CI: 1.182–3.063, P=0.012). Analysis of the receiver operating curve (AUC=0.723, 95%CI: 0.562–0.883, P=0.016) revealed that miR-22 could predict PSD one month after ischemic stroke. Furthermore, plasma miR-22 levels in brainstem and deep CMBs patients showed an upward trend (P=0.028) relative to the others. Patients with acute ischemic stroke, having brainstem and deep cerebral microbleeds, or a higher plasma miR-22 were more likely to develop PSD. These findings indicate that miR-22 might be involved in cerebral microvascular impairment and post-stroke depression.
Highlights
Post-stroke depression (PSD) is an emotional disorder and one of the most common complications of ischemic stroke
Patients in the PSD and non-PSD groups showed no difference with regards to age, gender, history of stroke, common vascular risk factors of ischemic stroke as well as TOAST classification of stroke etiology
A further analysis of the relationship between miR22 and brainstem and deep cerebral microbleeds (CMBs) showed an upward trend of plasma miR-22 in patients with brainstem and deep CMBs compared to those without (P=0.028) (Figure 5)
Summary
Post-stroke depression (PSD) is an emotional disorder and one of the most common complications of ischemic stroke. Given that its pathogenesis is still unclear, there is a need to study risk factors related to PSD and further explore new stable biomarkers for its diagnosis and treatment. They play an important role in release of neurotransmitters and synaptic plasticity [4]. These RNAs have been shown to play a critical role in major depression and suicidal behavior, generating a negative outcome [5]. Previous studies have shown that differential expression of miRNAs influenced homeostasis of neural and synaptic pathways, by negatively regulating expression of genes such as brainderived neurotrophic factor (BDNF)-tyrosine kinase receptor B (TrkB) pathways and other important signaling pathways [6,7]. Our previous research showed that tyrosine kinase receptor B was associated with PSD in Chinese people [8]
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