Higher Concentration of Adrenocorticotropic Hormone Predicts Post-Stroke Depression

Wang, Yanyan; Wang, He; Sun, Wenzhe; Miao, Jinfeng; Liang, Wenwen; Qiu, Xiuli; Lan, Yan; Pan, Chensheng; Li, Guo; Zhao, Xin; Zhu, Zhou; Zhu, Suiqiang

doi:10.2147/cia.s356361

Cited by 11 publications

(5 citation statements)

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“…Previous studies have shown that physical activity can effectively prevent or reduce the incidence of depression ( 5 , 39 ). In our study, physical activity was divided into two categories based on whether patients exercise moderately or vigorously every week, such as jogging.…”

Section: Discussionmentioning

confidence: 99%

“…Post-stroke depression (PSD), as one of the most frequent psychiatric complications of cerebrovascular lesions, is closely linked to decreased functional status and higher mortality rates, which not only reduces the quality of life of patients but also places a heavy burden on caregivers ( 1 – 3 ). A new review reported that PSD prevalence was extremely high within 3 months after the acute event in the total stroke population ( 4 ), and our previously published literature showed that the overall prevalence of PSD at 3 months after stroke was up to 39.7% ( 5 ). Furthermore, a host of studies presented that there was a strong association between stroke severity and PSD ( 1 , 2 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

Wang

Sun²,

Miao³

et al. 2023

Front. Neurol.

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BackgroundPost-stroke depression (PSD) has been proven to be associated with stroke severity. Thus, we hypothesized that the prevalence of PSD would be lower in patients with mild stroke. We aim to explore predictors of depression at 3 months after mild acute ischemic stroke (MAIS) onset and to develop a practical and convenient prediction model for the early identification of patients at high risk.MethodsA total of 519 patients with MAIS were consecutively recruited from three hospitals in Wuhan city, Hubei province. MAIS was defined as a National Institute of Health Stroke Scale (NIHSS) score of ≤5 at admission. Meeting the DSM-V diagnostic criteria and a 17-item Hamilton Rating Scale for Depression (HAMD-17) score of >7 at their 3-month follow-up were considered the primary outcomes. A multivariable logistic regression model was used to determine the factors adjusted for potential confounders, and all independent predictors were brought into the construction of a nomogram to predict PSD.ResultsThe prevalence of PSD is up to 32% at 3 months after MAIS onset. After adjusting for potential confounders, indirect bilirubin (p = 0.029), physical activity (p = 0.001), smoking (p = 0.025), hospitalization days (p = 0.014), neuroticism (p < 0.001), and MMSE (p < 0.001) remained independently and significantly related with PSD. The concordance index (C-index) of the nomogram jointly constructed by the aforementioned six factors was 0.723 (95% CI: 0.678–0.768).ConclusionThe prevalence of PSD seems equally high even if the ischemic stroke is mild, which calls for great concern from clinicians. In addition, our study found that a higher level of indirect bilirubin can lower the risk of PSD. This finding may provide a potential new approach to PSD treatment. Furthermore, the nomogram including bilirubin is convenient and practical to predict PSD after MAIS onset.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

Wang

Sun²,

Miao³

et al. 2023

Front. Neurol.

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“…Previous studies have found that some associated sociodemographic factors differ in male and female PSD patients, such as age, cognitive impairment and physical exercise habits [ 14 , 15 ]. In addition, previous literatures have reported that some hormones were associated with PSD, such as free T3, free T4, thyroid stimulating hormone (TSH) [ 16 , 17 ], homocysteine [ 18 ], cortisol [ 19 ], brain derived neurotrophic factor (BDNF) [ 20 ], cortisol [ 21 ] and ACTH [ 22 ]. Only one study reported sex difference of blood biomarkers in PSD [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Explore the influencing factors and construct random forest models of post-stroke depression at 3 months in males and females

et al. 2022

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Background Post-stroke depression (PSD) is one of the most common neuropsychiatric complications after stroke. The occurrence, development and prognosis of PSD have long been different between males and females. The main purpose of this study was to explore the influencing factors of PSD at 3 months in males and females, and construct random forest (RF) models to rank the influencing factors. Methods This is a prospective multicenter cohort study (Registration number: ChiCTR-ROC-17013993). Stroke patients hospitalized in the department of Neurology of three hospitals in Wuhan were enrolled from May 2018 to August 2019. Scale assessments were performed 24 hours after admission and 3 months after stroke onset. Binary logistic regression analysis was used for univariate and multivariate (stepwise backward method) analysis, when p was less than 0.05, the difference between groups was considered statistically significant. Lastly, the RF models were constructed according to the results of multivariate regression analysis. Results This study found that several baseline variables were associated with PSD at 3 months in males and females. RF model ranked them as stroke severity (OR [odds ratio] =1.17, p < 0.001, 95%CI [confidence interval]:1.11–1.24), neuroticism dimension (OR = 1.06, p = 0.002, 95%CI:1.02–1.10), physical exercise (OR = 0.62, p = 0.007, 95%CI:0.44–0.88), sleeping time < 5 h (OR = 1.91, p = 0.006, 95% CI:1.20–3.04) and atrial fibrillation (OR = 4.18, p = 0.012, 95%CI:1.38–12.68) in males. In females, RF model ranked them as psychological resilience (OR = 0.98, p = 0.015, 95%CI:0.96–1.00), ability of daily living (OR = 0.98, p = 0.001, 95%CI:0.97–0.99), neuroticism dimension (OR = 1.11, p = 0.002, 95%CI:1.04–1.18) and subjective support (OR = 1.11, p < 0.001, 95%CI:1.05–1.78). Conclusion The study found influencing factors of PSD at 3 months were different in males and females, and construct RF models to rank them according to their importance. This suggests that clinicians should focus their interventions on sex-specific influencing factors in order to improve the prognosis of PSD patients. Trial registration ChiCTR-ROC-17013993.

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“…61,[99][100][101][102][103][104][105][106][107][108][109][110][111] Overall, evidence suggests that HPA axis dysfunction underpins a bidirectional relationship between many of these comorbidities and depression. 110,[112][113][114]…”

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confidence: 99%

Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders

Kanes¹,

Dennie²,

Perera³

2023

NDT

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A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body’s response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body’s stress response equilibrium to a “new normal” underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V 1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V 1b receptor.

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Higher Concentration of Adrenocorticotropic Hormone Predicts Post-Stroke Depression

Cited by 11 publications

References 51 publications

Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

Explore the influencing factors and construct random forest models of post-stroke depression at 3 months in males and females

Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders

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