Predictors of Early-Onset Depression after First-Ever Stroke

Rabi-Zikic, Tamara; Živanović, Željko; Đajić, Vlado; Simić, Svetlana; Ruzicka-Kaloci, Svetlana; Slankamenac, Sonja; Žikić, M.

doi:10.20471/acc.2020.59.01.10

Cited by 5 publications

(5 citation statements)

References 43 publications

(58 reference statements)

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“…On one hand, depression could lead to cognitive impairment as we discussed above. Alternatively, with some exceptions [65,66], studies have proposed that cognitive impairment could be the cause, with depression as the consequence [65,67]. One possible explanation is that cognitive improvement associated with lower emotional distress [68] could reduce depression morbidity.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Sobreiro

Terroni

Mattos

et al. 2023

Life

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Background: Depressive symptoms have been associated with cognitive impairment after stroke, and women may be specifically affected. Objective: The aim of this study was to investigate gender-specific characteristics in the relationship between changes in depression severity and changes in cognitive performance after stroke. Methods: We prospectively evaluated 73 patients without a previous history of depression in the first and fourth months after a first ischemic stroke. The severity of depressive symptoms was assessed using the 31-item version of the Hamilton Rating Scale for Depression, and executive function, attention, working memory, and verbal fluency were assessed using a neuropsychological battery. Results: We included 46 (63.0%) men and 27 (36.9%) women, with mean ages of 55.2 (SD ± 15.1) and 46.8 (SD ± 14.7) years, respectively. We found significant improvement in the digit span forward and Stroop dots from month 1 to month 4 post stroke for both men and women. Women, but not men, presented a correlation between changes in phonemic verbal fluency and changes in the 31-item version of the Hamilton Rating Scale for Depression scores. Improvement in depression was correlated with improvement in verbal fluency, and worsening in depression was correlated with worsening in verbal fluency. Conclusions: Our results suggest that women might be more vulnerable to the relationship between depressive symptoms and cognitive performance, and improvement of depression may be necessary for women’s improvement in phonemic verbal fluency from the first to the fourth month after a stroke. We did not adjust the results for multiple comparisons. Thus, our findings might be considered preliminary, and confirmatory studies, also focusing on specific characteristics of women that could explain these differences, are warranted.

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Section: Discussionmentioning

confidence: 99%

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Sobreiro

Terroni

Mattos

et al. 2023

Life

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“…Research showed that XNJY could treat depression by improving rat body weight, sucrose preference, voluntary activity, and resting time during forced swimming. The quality of life of patients with PSD is significantly lower than that of patients with simple stroke, especially in the fields of cognition, emotion, limb function, and social function [ 27 , 28 ]. PSD and poor neural prognosis may be directly related to neuronal damage or apoptosis after stroke.…”

Section: Discussionmentioning

confidence: 99%

Xingnao Jieyu Decoction Reduces Neuroinflammation through the NF-κB Pathway to Improve Poststroke Depression

Wang

Han

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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The neuroinflammatory pathway regulated by nuclear factor kappa-B (NF-κB) plays an important role in the occurrence, development, and prognosis of poststroke depression (PSD). The regulatory effect of the traditional Chinese medicine compound Xingnao Jieyu decoction (XNJY) on the NF-κB pathway of PSD is still unclear. This study aimed to observe the effect of XNJY on PSD and explore the molecular mechanism of its intervention in the NF-κB pathway. Middle cerebral artery occlusion (MCAO) and chronic unpredictable mild stress were used to establish a PSD rat model. Body mass measurement, behavioral testing, Nissl staining, ELISA, and Western blot were also performed. XNJY and fluoxetine hydrochloride (Flu) treatment of PSD model rats showed significant antidepressant effects. XNJY and Flu treatment could reduce cortical and hippocampal neuronal damage. XNJY reduced inflammation and restored the levels of IL-4, IL-10, and BDNF. In addition, XNJY showed a significant regulatory effect on the NF-κB pathway and the expression of synapse-related proteins PSD-95 and SYN. These results showed that XNJY could significantly reduce the depressive symptoms of PSD rats, and this reduction may be related to the regulation of the NF-κB signaling pathway to improve neuroinflammation and synaptic function.

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“…); and disease-related factors (stroke site, NIHSS score, hypertension, diabetes, history of hyperlipidemia, etc. ) ( Rabi-Žikić et al, 2020 ; Schöttke et al, 2020 ). Considering so many related risk factors, accurate prediction of PSD tools and early intervention by clinicians is an effective means to improve the prognosis of PSD patients ( Vogel, 1995 ).…”

Section: Introductionmentioning

confidence: 99%

Establishment and verification of a nomogram model for predicting the risk of post-stroke depression

Luo

Zhang

Mao

et al. 2023

PeerJ

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Objective The purpose of this study was to establish a nomogram predictive model of clinical risk factors for post-stroke depression (PSD). Patients and Methods We used the data of 202 stroke patients collected from Xuanwu Hospital from October 2018 to September 2020 as training data to develop a predictive model. Nineteen clinical factors were selected to evaluate their risk. Minimum absolute contraction and selection operator (LASSO, least absolute shrinkage and selection operator) regression were used to select the best patient attributes, and seven predictive factors with predictive ability were selected, and then multi-factor logistic regression analysis was carried out to determine six predictive factors and establish a nomogram prediction model. The C-index, calibration chart, and decision curve analyses were used to evaluate the predictive ability, accuracy, and clinical practicability of the prediction model. We then used the data of 156 stroke patients collected by Xiangya Hospital from June 2019 to September 2020 for external verification. Results The selected predictors including work style, number of children, time from onset to hospitalization, history of hyperlipidemia, stroke area, and the National Institutes of Health Stroke Scale (NIHSS) score. The model showed good prediction ability and a C index of 0.773 (95% confidence interval: [0.696–0.850]). It reached a high C-index value of 0.71 in bootstrap verification, and its C index was observed to be as high as 0.702 (95% confidence interval: [0.616–0.788]) in external verification. Decision curve analyses further showed that the nomogram of post-stroke depression has high clinical usefulness when the threshold probability was 6%. Conclusion This novel nomogram, which combines patients’ work style, number of children, time from onset to hospitalization, history of hyperlipidemia, stroke area, and NIHSS score, can help clinicians to assess the risk of depression in patients with acute stroke much earlier in the timeline of the disease, and to implement early intervention treatment so as to reduce the incidence of PSD.

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Predictors of Early-Onset Depression after First-Ever Stroke

Cited by 5 publications

References 43 publications

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Xingnao Jieyu Decoction Reduces Neuroinflammation through the NF-κB Pathway to Improve Poststroke Depression

Establishment and verification of a nomogram model for predicting the risk of post-stroke depression

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