Relationship between plasma glutamate levels and post-stroke depression in patients with acute ischemic stroke

Abstract

Objective To test the association between the plasma glutamate levels during acute ischemic stroke and post-stroke depression (PSD) initially. Methods Seventy-four ischemic stroke patients admitted to the hospital within the first day of stroke onset were evaluated at a follow-up of 2 weeks.The Beck Depression Inventory (BDI,21-item) and DSM-Ⅳcriteria was used to diagnose post-stroke depression (PSD) at 2 weeks after stroke.The Hamilton Depression Rating Scale (HDRS,17-item) was used to assess the severity of major depressive symptoms.Plasma level of glutamate between PSD and non-PSD patients was measured by high performance liquid chromatography (HPLC) on day 2 and 2 weeks after stroke. Results (1) The glutamate levels on day 2 after stroke were significantly lower in PSD patients (Twenty-six patients) than non-PSD patients[ (4.995±2.514) g/L vs. (6.558±2.835) g/L;t=2.140,P=0.036]. (2) In post-stroke patients,a strong negative correlation was observed between glutamate levels on day 2 after stroke and severity of depression (r=-0.311,P=0.013). (3) In patients with PSD,the levels of glutamate at 2 weeks after stroke (6.312±2.604) g/L significantly increased compared to the levels of glutamate on day 2 after stroke (t=-2.361,P=0.026). (4) Using a multivariate logistic regression,plasma glutamate on day 2 was associated with incident PSD at 2 weeks after stroke (OR=0.651,95% CI: 0.459-0.922,P=0.016). Conclusion Plasma glutamate during the acute phase of stroke may be associated with PSD. Key words: Cerebrovascular accident; Depression; Glutamic acid