Abstract
Post-stroke depression (PSD) is the most common stroke-related emotional disorder, and it severely affects the recovery process. However, more than half cases are not correctly diagnosed. This study was designed to develop a new method to assess PSD using EEG signal to analyze the specificity of PSD patients' brain network. We have 107 subjects attended in this study (72 stabilized stroke survivors and 35 non-depressed healthy subjects). A Hamilton Depression Rating Scale (HDRS) score was determined for all subjects before EEG data collection. According to HDRS score, the 72 patients were divided into 3 groups: post-stroke non-depression (PSND), post-stroke mild depression (PSMD) and post-stroke depression (PSD). Mutual information (MI)-based graph theory was used to analyze brain network connectivity. Statistical analysis of brain network characteristics was made with a threshold of 10–30% of the strongest MIs. The results showed significant weakened interhemispheric connections and lower clustering coefficient in post-stroke depressed patients compared to those in healthy controls. Stroke patients showed a decreasing trend in the connection between the parietal-occipital and the frontal area as the severity of the depression increased. PSD subjects showed abnormal brain network connectivity and network features based on EEG, suggesting that MI-based brain network may have the potential to assess the severity of depression post stroke.
Highlights
Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of cerebral ischemia (Cojocaru et al, 2013)
We noticed no significant difference between the healthy controls (HC) group and the post-stroke non-depression (PSND) group, but there are differences between PSND and PSD at several thresholds
We examined the brain network performance in post-stroke depressed patients using the EEG-Mutual information (MI)
Summary
Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of cerebral ischemia (Cojocaru et al, 2013). PSD is an abnormal negative emotional response caused by loss, disappointment or failure. PSD has a significant negative impact on the rehabilitation of stroke (Ghose et al, 2005), seriously affecting the patient’s future quality of life (Bays, 2001; Ayerbe et al, 2013; Chen et al, 2014) and delaying or even hindering the process for rehabilitation. One-third of stroke patients have aphasia (Berthier, 2005; Engelter et al, 2006), and approximately 70% will have cognitive impairment (Nys et al, 2007). Aphasia and cognitive impairment make it difficult to obtain the changes in patients’ emotions and interests, which pose a great challenge for the diagnosis of PSD. There are few guidelines for the assessment, treatment and prevention of PSD (Babkair, 2017), and more than half cases are not correctly diagnosed
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