Acute Post-stroke Depression Research Articles

Machine learning models of plasma proteomic data predict mood in chronic stroke and tie it to aberrant peripheral immune responses

Post-stroke depression is common, long-lasting and associated with severe morbidity and death, but mechanisms are not well-understood. We used a broad proteomics panel and developed a machine learning algorithm to determine whether plasma protein data can predict mood in people with chronic stroke, and to identify proteins and pathways associated with mood. We used Olink to measure 1,196 plasma proteins in 85 participants aged 25 and older who were between 5 months and 9 years after ischemic stroke. Mood was assessed with the Stroke Impact Scale mood questionnaire (SIS3). Machine learning multivariable regression models were constructed to estimate SIS3 using proteomics data, age, and time since stroke. We also dichotomized participants into better mood (SIS3 > 63) or worse mood (SIS3 ≤ 63) and analyzed candidate proteins. Machine learning models verified that there is indeed a relationship between plasma proteomic data and mood in chronic stroke, with the most accurate prediction of mood occurring when we add age and time since stroke. At the individual protein level, no single protein or set of proteins predicts mood. But by using univariate analyses of the proteins most highly associated with mood we produced a model of chronic post-stroke depression. We utilized the fact that this list contained many proteins that are also implicated in major depression. Also, over 80% of immune proteins that correlate with mood were higher with worse mood, implicating a broadly overactive immune system in chronic post-stroke depression. Finally, we used a comprehensive literature review of major depression and acute post-stroke depression. We propose that in chronic post-stroke depression there is over-activation of the immune response that then triggers changes in serotonin activity and neuronal plasticity leading to depressed mood.

Influence of Evidence-Based Nursing on Psychological Status, Neurological Function, and Life Quality of Patients with Acute Poststroke Depression.

Objective This research sets out to elucidate the influence of evidence-based nursing (EBN) on psychological status (PSY), neurological function, and quality of life (QoL) of patients with acute poststroke depression (PSD). Methods One hundred and fifty stroke patients who received treatment in the Characteristic Medical Center of PLA Rocket Force between December 2019 and December 2021 were enrolled, including 100 cases (Group A) treated with comprehensive EBN and 50 patients (Group B) with routine nursing. Anxiety and depression (Self-Rating Anxiety Scale [SAS] and Self-Rating Depression Scale [SDS] scores), neurological function (National Institutes of Health Stroke Scale [NIHSS] and Scandinavian Stroke Scale [SSS] scores), QoL (Generic Quality Of Life Inventory-74 [GQOLI-74] score), and complication rate of both groups were evaluated, as well as total effective rate and nursing satisfaction. Results Group A outperformed Group B with lower scores of NIHSS, SSS, SAS, and SDS and higher GOOLI-74 scores. Besides, lower complication rate and higher total effective rate and nursing satisfaction were determined in Group A. Conclusions EBN can better improve the PSY of patients with acute PSD, restore their neurological function, and effectively improve their QoL.

Correction: Acute post stroke depression at a Primary Stroke Center in the Middle East

[This corrects the article DOI: 10.1371/journal.pone.0208708.].

Acute Poststroke Depression Is Associated with Thalamic Lesions and Clinical Outcomes: A Case–Control Study

We investigated the role of acute-phase stroke lesions and patient characteristics in poststroke depression (PSD) and its effect on the clinical outcome. Five and 30 days after admission, 175 patients self-reported their depressive symptoms on the Patient Health Questionnaire-9. We compared the clinical characteristics and outcomes in patients with (n = 41) and without PSD (n = 134). Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS); the modified Rankin Scale (mRS) was used to determine the functional outcome. There was no significant difference between patients with and without PSD in the age, gender ratio, lesion side, and the history of hypertension, diabetes mellitus, alcohol and tobacco use, and previous stroke. Thalamic lesions were significantly associated with PSD (P = .03), although there was no significant difference in both the NIHSS score and the final mRS score of patients with thalamic lesions. Backward stepwise logistic regression analysis showed that a higher NIHSS score and thalamic lesions were independent predictors of PSD. Total hospitalization was significantly longer in patients with PSD. At the time of admission, the NIHSS score was significantly higher in patients who developed moderate to severe PSD than in those with mild PSD or without PSD. PSD in the acute phase was associated with thalamic lesions and severe stroke. Hospitalization was significantly longer in patients with PSD and their functional disability was more severe, suggesting that PSD played a role in the unsatisfactory results of poststroke rehabilitation.

A related study of the type A Behavior, the level of BDNF and hypersensitive C-reactive protein in patients with post stroke depression in acute ischemic stroke

Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD), and explore the correlation between them. Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116). TABP, Social Support Scale, MMSE, NIHSS, mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80); fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls(NC group). Results (1)The incidence of acute PSD was 31.03%.(2)The constituent ratio of type A behavior(83.33% vs 57.50%), CH scores, TH+ CH scores were significantly higher in PSD group than NPSD group(P <0.01). Social Support Scale scores, MMSE scores were significantly lower in PSD group than NPSD group(P <0.01, P<0.05). NIHSS scores, mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P <0.01). (3) The levels of serum BDNF, hs-CRP in the PSD group, the NPSD group and the normal control group were respectively (BDNF(617.24(274.98, 976.22))pg/ml, (938.19(615.88, 1 714.76))pg/ml, (4 149.46(1 658.83, 7 583.34))pg/ml); (hs-CRP(6.47(2.66, 11.21))mg/L, 1.77(0.74, 6.51)mg/L, (0.86(0.47, 1.59))mg/L). The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group(P <0.01). (4) The severity of depression was positively correlated with CH, TH+ CH scores(r=0.38, P<0.05; r=0.43, P<0.01). CH scores were negatively correlated with social support(r=-0.38, P<0.05), and were positively correlated with hs-CRP levels(r=0.34, P<0.05). Conclusion In patients with post stroke depression, the BDNF levels decrease and hs-CRP levels increase, but severity of depression and cognitive function are not correlated with BDNF levels. Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support. Hostility and excessive competition are psychosocial risk factors occurring PSD. Key words: Post stroke depression; Type A behavior; Hostility; Brain-derived neurotrophic factor; Hypersensitive C-reactive protein

Neuropathologic features of suicide victims who presented with acute poststroke depression: significance of association with neurodegenerative disorders.

To investigate the neuropathologic characteristics of poststroke depression (PSD) leading to suicide, we retrospectively selected deceased subjects who had been diagnosed as having early PSD. Cases were divided into subjects who had committed suicide and those who had not. Neuropathologic examinations, including immunohistochemistry, were conducted. Twenty-four subjects fulfilled criteria for early PSD; 11 of these had committed suicide, and the other 13 had not. Lesion type, size of stroke, and location of stroke were variable but did not differ significantly between the groups. Alzheimer disease-related pathology stages also did not differ between the groups. Argyrophilic grain disease was found in both the suicide group (6 of 11) and the nonsuicide group (2 of 13); there were 2 highly possible cases of early progressive supranuclear palsy in the suicide group. Together, argyrophilic grain disease and progressive supranuclear palsy were found significantly more frequently in suicide cases than in nonsuicide cases (p = 0.01). These data suggest that overlapping 4-repeat tauopathies, which include argyrophilic grain disease and progressive supranuclear palsy, might be an important aggravating factor of PSD that could lead to suicide. The presence of other neurodegenerative diseases does not preclude PSD because the prevalence of these diseases in older persons suggests that they might often occur concomitantly.

The effect of psychological intervention on the patients with acute post -stroke depression

Objective To investigate the effect of psychological intervention on rehabilitation of acute post-stroke depression patients. Methods 100 post-stroke depression were randomly divided into control and treatment groups, each group 50 cases. All the patients were treated with routine medicine and physical rehabilita-tion, and treatment group was received psychological intervention besides routine therapy. Hamilton depression scale, Fugl -Meyer and Barthel index of two groups were analyzed. Results Hamilton depression scale, Fugl -Meyer and Barthel index of two groups were different after treatment. Conclusions Psychological intervenetion were benefit to rehabilitation of post -stroke depression. Key words: Post -stroke depression; Psychological intervention; Behabilitation

Poststroke Depression in Acute Phase after Stroke

We studied factors associated with acute poststroke depression in 100 patients, aged 27–70, 2 weeks after their first clinically significant stroke. Depressive symptoms were relatively common (27% Beck Depression Inventory ≧10), but the prevalence of major depression was only 5.6%. Older patients were most vulnerable to poststroke depression. Patients with left hemisphere lesion had no more depression than other patients, but when the lesion was in the left hemisphere or in the brainstem, stroke severity was associated with depression.

Functional impairment associated with acute poststroke depression: the Stroke Data Bank Study.

To examine the independent association of depression following acute stroke with impairment in activities of daily living (ADL), the authors conducted a cross-sectional analysis of stroke patients enrolled in the Stroke Data Bank (U.S.A.) who had completed the Center for Epidemiological Studies Depression Scale (CES-D). Scores on the Barthel Index, a measure of ADL, were compared between depressed (CES-D > or = 16) and nondepressed patients (CES-D < or = 15) at 7-10 days after stroke. Of the 626 who completed CES-D, 160 were depressed. Depressed stroke patients evidenced greater impairment in ADL than nondepressed patients, independently of all other factors that influenced poststroke physical disabilities. CES-D scores were negatively correlated with Barthel scores in the entire stroke population. Neurological factors, greater age, poor prestroke physical activity, and prestroke disturbances in sexual functioning were also independently associated with limitations in functional status of stroke patients.

Depression after stroke

During the past year, significant contributions have been made to the literature on post-stroke depression. These studies have confirmed the importance of left-anterior cerebral hemisphere lesion in the production of major depression and identified this as a phenomenon which is most evident during the acute post-stroke period. In addition, premorbid and post-stroke risk factors such as cerebral atrophy, history of psychiatric disorders, negative life events, neuroticism, aphasia, living alone, and few social contacts, have been identified as increasing the risk of post-stroke depression. Finally, a new study has indicated that the risk of mortality, during a 10-year follow up, is increased 3.5 times by the existence of acute post-stroke depression.