The Association of Free Fatty Acids and Eicosanoids with the Severity of Depressive Symptoms in Stroke Patients

Dariusz Kotlega,Malgorzata Szczuko,Agnieszka Zembron-Lacny,Monika Golab-Janowska,Przemyslaw Nowacki

doi:10.3390/ijms21155220

Dariusz Kotlega, Malgorzata Szczuko + Show 3 more

Open Access

https://doi.org/10.3390/ijms21155220

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Abstract

The study was designed to demonstrate the relationship of free fatty acids (FFAs) and eicosanoids levels with the severity of depressive symptoms in stroke. The ischemic stroke patients (n = 74) were included in the prospective study. The risk of depression was evaluated by the Beck Depression Inventory-II (BDI-II) 7 days and 6 months after the stroke onset. FFAs and inflammatory metabolites were determined by gas chromatography and liquid chromatography. In the acute phase of stroke, BDI-II and FFAs inversely correlated with C13:0 tridecanoic acid, C15:1 cis-10-pentadecanoid acid, C17:1 cis-10- heptadecanoid acid, C18:0 stearic acid, C20:3n6 eicosatrienoic acid, C22:1cis13 docosenoic acid and C22:6n3 docosahexaenoic acid (DHA). DHA level was significantly lower in patients with low vs. high BDI-II score. In the follow-up examination, BDI-II score directly correlated with C16:0 palmitic acid. The changes in BDI-II score during 6-month observation inversely correlated with lipoxin A4 and protectin D1, and directly correlated with 5-oxo-ETE. Importantly, the severity of depressive symptoms was associated with n3 PUFA level. Diet-derived FFAs were observed to potentially affect the inflammatory pathways in pathogenesis of depression in stroke and reduced DHA levels can attenuate depressive symptoms in stroke patients.

Highlights

IntroductionDepression is a common disorder with lifetime prevalence ranging from 1.5% to 19%, with a probability of lifelong persistence reaching up to 30%
The increase in the number of points in the Beck Depression Inventory-II (BDI-II) scale correlated with the decrease in the levels of certain free fatty acids (FFAs) such as: C13:0 tridecanoic acid, C15:1 cis-10-pentadecanoid acid, C17:1 cis−10-heptadecanoid acid −0.251, C18:0 Stearic acid, C20:3n6 eicosatrienoic acid, C22:6n3 docosahexaenoic acid (Table 2)
We evaluated the association between the types of stroke according to the TOAST classification system, eicosanoids and FFAs

Summary

Introduction

Depression is a common disorder with lifetime prevalence ranging from 1.5% to 19%, with a probability of lifelong persistence reaching up to 30%. The most common scale for depressive symptoms assessment which is used by psychiatrists and psychologists is the Beck Depression Inventory (BDI) [1]. Ischemic stroke is the main cause of disability in adults. It provokes neuropsychological deterioration and depression among patients. Stroke patients in the acute phase develop depressive symptoms or depression in 5 to 54% of cases depending on the tools used for the depressive symptoms measurement. Depressive symptoms in the acute phase of stroke were found to be associated with the persistence of depression and increased mortality after one year [8]

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