163. Inflammation and post-stroke depression: Preliminary progress

Norton, Stata; Sher-Glass, R.; Mann, Sarah; Moccio, M.; Zimmerman, Aphrodite; Menza, Matthew; Contrada, Richard J.; Fiedler, Nancy; Leventhal, Howard; McCarthy, Danielle E.; McKinney, James S.; Kusnecov, Alex

doi:10.1016/j.bbi.2014.06.183

Cited by 3 publications

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“…Moreover, a subset of AIS patients develops PSD, which can slow recovery and increase risk of recurrent stroke and mortality. Because proinflammatory cytokines can induce depression-like symptoms, high-sensitivity C-reactive protein (Hs-CRP) may influence the development of PSD [19]. In addition, Pascoe et al [20] reported that HCY was significantly associated with depressive symptomatology in elderly Swedish stroke survivors.…”

Section: Introductionmentioning

confidence: 99%

Serum Levels of High-sensitivity C-Reactive Protein at Admission Are More Strongly Associated with Poststroke Depression in Acute Ischemic Stroke than Homocysteine Levels

et al. 2015

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Inflammatory processes have fundamental roles in depression. The primary purpose of this study was to assess the serum levels of high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) at admission to the presence of poststroke depression (PSD). From December 2012 to December 2013, first-ever acute ischemic stroke patients who were admitted to the hospital within the first 24 h after stroke onset were consecutively recruited and followed up for 6 months. Serum levels of Hs-CRP and HCY were tested at admission. Based on the symptoms, diagnoses of depression were made in accordance with DSM-IV criteria for depression at 6 months after stroke. Ninety-five patients (42.0%) showed depression (major + minor) at 6 months after admission, and in 69 patients (30.5%), this depression was classified as major. In the 69 patients with major depression, our results showed significantly higher Hs-CRP and HCY levels at admission than patients without major depression. After adjusting all other possible covariates, Hs-CRP and HCY still were independent predicators of PSD with adjusted OR of 1.332 (95% CI, 1.230-1.452; P < 0.001) and 1.138 (95% CI, 1.072-1.274; P < 0.001), respectively. The area under the receiver operating characteristic curve values of Hs-CRP and HCY were 0.765 (95% CI, 0.701-0.9825) and 0.684 (95% CI, 0.610-0.757) for PSD, respectively. The prognostic accuracy of combined model (HCY and Hs-CRP) was higher compared to those biomarkers alone and other markers. Elevated serum levels of Hs-CRP and HCY at admission were found to be associated with depression 6 months after stroke, suggesting that these alterations might participate in the pathophysiology of depression symptoms in stroke patients.

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Section: Introductionmentioning

confidence: 99%

Serum Levels of High-sensitivity C-Reactive Protein at Admission Are More Strongly Associated with Poststroke Depression in Acute Ischemic Stroke than Homocysteine Levels

et al. 2015

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“…Moreover, a subset of AIS patients develops PSD, which can slow recovery and increase risk of recurrent stroke and mortality. Because pro-inflammatory cytokines can induce depression-like symptoms, AIS-related inflammation may influence the development of PSD [19].…”

Section: Introductionmentioning

confidence: 99%

Elevated Serum Levels of Neopterin at Admission Predicts Depression After Acute Ischemic Stroke: a 6-Month Follow-Up Study

et al. 2015

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Inflammation and cell-mediated immune activation are attributed to the pathogenesis and pathophysiology in depression. Our aim was to test the possible association between serum levels of neopterin and the development of post-stroke depression (PSD) in Chinese patients. The subjects were first-ever acute ischemic stroke patients who were hospitalized at the First Affiliated Hospital of Xinxiang Medical University during the period from December 2012 to December 2013. Clinical information and stroke severity were collected at admission. Neurological and neuropsychological evaluations were conducted at the 6-month follow-up. Serum neopterin levels were measured using fluorometry and a high performance liquid chromatography (HPLC) method. Multivariate analyses were performed using logistic regression models. During the study period, 226 patients were included and finished the 6-month follow-up. Sixty-nine patients (30.5 %) were diagnosed as having major depression at 6 months. Patients with major depression showed higher levels of serum neopterin (21.6[IQR, 18.9-25.7]nmol/L vs. 14.6[IQR, 12.2-18.4]nmol/L, P < 0.0001) at admission. In multivariate analyses, serum neopterin was an independent predictor of PSD at 6 months [odds ratio (OR): 1.952 (95 % CI, 1.358-2.805), P < 0.0001]. With an AUC of 0.850 (95 % CI, 0.797-0.902), neopterin showed a significantly greater discriminatory ability as compared with high-sensitivity C-reactive protein, age, body mass index, and National Institutes of Health and Stroke Scale score. Neopterin is a novel, independent predictor of the development of depression 6 months after stroke. This indicated that the elevated neopterin levels may play a significant role in the pathology of depression and that the pathways leading to inflammation and cell-mediated immune activation warrant further exploration.

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“…A metaanalysis found that depression and CRP were positively associated in clinical and community samples (Howren et al, 2009), while Ford and Erlinger (2004) reported that major depression was strongly associated with increased levels of CRP among men. Because proinflammatory cytokines can induce depression-like symptoms, AIS-related inflammation (Hs-CRP) may influence the development of PSD (Norton et al, 2014). Moreover, a subset of AIS patients develops PSD, which can slow recovery and increase risk of recurrent stroke and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a subset of AIS patients develops PSD, which can slow recovery and increase risk of recurrent stroke and mortality. Because proinflammatory cytokines can induce depression-like symptoms, AIS-related inflammation (Hs-CRP) may influence the development of PSD (Norton et al, 2014). However, the relationship between the Hs-CRP and the depression after stroke has not yet been studied.…”

Section: Introductionmentioning

confidence: 99%

The relationship between high‐sensitivity C‐reactive protein at admission and post stroke depression: a 6‐month follow‐up study

Yang

Lu²,

et al. 2015

Int J Geriat Psychiatry

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163. Inflammation and post-stroke depression: Preliminary progress

Cited by 3 publications

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Serum Levels of High-sensitivity C-Reactive Protein at Admission Are More Strongly Associated with Poststroke Depression in Acute Ischemic Stroke than Homocysteine Levels

Serum Levels of High-sensitivity C-Reactive Protein at Admission Are More Strongly Associated with Poststroke Depression in Acute Ischemic Stroke than Homocysteine Levels

Elevated Serum Levels of Neopterin at Admission Predicts Depression After Acute Ischemic Stroke: a 6-Month Follow-Up Study

The relationship between high‐sensitivity C‐reactive protein at admission and post stroke depression: a 6‐month follow‐up study

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