Depressive symptoms due to stroke are strongly predicted by the volume and location of the cerebral infarction, white matter hyperintensities, hypertension, and age: A precision nomothetic psychiatry analysis

Jaroonpipatkul, Chaichana; Onwanna, Jaruwan; Tunvirachaisakul, Chavit; Jittapiromsak, Nutchawan; Rakvongthai, Yothin; Chutinet, Aurauma; Supasitthumrong, Thitiporn; Maes, Michaël

doi:10.1016/j.jad.2022.04.041

Cited by 7 publications

(6 citation statements)

References 49 publications

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“…Moreover, a recent study by Jaroonpipatkul and colleagues [ 43 ] examined whether post-stroke depressive symptoms measured 3 months post-stroke using the Montgomery–Åsberg Depression Rating Scale (MADRS) were influenced by WMHs measured by fluid-attenuated inversion recovery (FLAIR) and infarction volume measured by diffusion-weighted imaging (DWI). Despite only mild elevations in MADRS scores 3 months after the acute infarction, stroke patients had significantly higher scores than controls.…”

Section: Discussionmentioning

confidence: 99%

“…Bilateral DWI stroke volumes and their accompanying disabilities led to these latter effects. Moreover, age, ischemic heart disease, and hypertension explained 37.5% of the variance in total WMHs, and these premorbid features also explained 30% of the variance in total DWI stroke volume [ 43 ]. Thus, age and hypertension are strongly linked to critical depressive symptoms (i.e., concentration–tension symptoms and lassitude), which are also related to higher WMH volume, greater stroke infarct volume, and the consequent disabilities.…”

Section: Discussionmentioning

confidence: 99%

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Leukoaraiosis as a Predictor of Depression and Cognitive Impairment among Stroke Survivors: A Systematic Review

Tziaka

Christidi

Tsiptsios

et al. 2023

Neurology International

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Stroke survivors are at increased risk of developing depression and cognitive decline. Thus, it is crucial for both clinicians and stroke survivors to be provided with timely and accurate prognostication of post-stroke depression (PSD) and post-stroke dementia (PSDem). Several biomarkers regarding stroke patients’ propensity to develop PSD and PSDem have been implemented so far, leukoaraiosis (LA) being among them. The purpose of the present study was to review all available work published within the last decade dealing with pre-existing LA as a predictor of depression (PSD) and cognitive dysfunction (cognitive impairment or PSDem) in stroke patients. A literature search of two databases (MEDLINE and Scopus) was conducted to identify all relevant studies published between 1 January 2012 and 25 June 2022 that dealt with the clinical utility of preexisting LA as a prognostic indicator of PSD and PSDem/cognitive impairment. Only full-text articles published in the English language were included. Thirty-four articles were traced and are included in the present review. LA burden, serving as a surrogate marker of “brain frailty” among stroke patients, appears to be able to offer significant information about the possibility of developing PSD or cognitive dysfunction. Determining the extent of pre-existing white matter abnormalities can properly guide decision making in acute stroke settings, as a greater degree of such lesioning is usually coupled with neuropsychiatric aftermaths, such as PSD and PSDem.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Leukoaraiosis as a Predictor of Depression and Cognitive Impairment among Stroke Survivors: A Systematic Review

Tziaka

Christidi

Tsiptsios

et al. 2023

Neurology International

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“…In this study, a younger age at stroke also predicted PSD. Jaroonpipatkul et al [ 32 ] found that interactions between chronological age, white matter hyperintensity load, and hypertension predicted depression after stroke. It may be that older patients with a reduced cognitive reserve secondary to prestroke white matter disease and hypertension are at greater risk for comorbidities such as psychiatric illness after stroke.…”

Section: Discussionmentioning

confidence: 99%

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Dulay

Criswell

Hodics

2023

IJERPH

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Background: Depression is the most common psychiatric condition that occurs after cerebrovascular accident, especially within the first year after stroke. Poststroke depression (PSD) may occur due to environmental factors such as functional limitations in daily activities, lower quality of life, or biological factors such as damage to areas in the brain involved in emotion regulation. Although many factors are hypothesized to increase the risk of PSD, the relative contribution of these factors is not well understood. Purpose: We evaluated which cross-sectional variables were associated with increased odds of PSD in our adult outpatient stroke neuropsychology clinic population. Methods: The sample included 325 patients (49.2% female; mean age of 59-years old) evaluated at an average of 8.1 months after an ischemic or hemorrhagic stroke. Variables included in logistic regression were stroke characteristics, demographics, psychosocial factors, comorbid medical problems, comorbid psychiatric conditions, and cognitive status. The Mini International Neuropsychiatric Inventory was used to determine DSM-defined PSD and anxiety disorders. A standard neuropsychological test battery was administered. Results: PSD occurred in 30.8% of the sample. Logistic regression indicated that increased odds of PSD were associated with a comorbid anxiety disorder (5.9 times more likely to suffer from PSD, p < 0.001). Further, increased odds of PSD were associated with a history of depression treatment before stroke (3.0 times more likely to suffer from PSD), fatigue (2.8 times more likely), memory impairment (2.4 times more likely), and younger age at stroke (all p values < 0.006). Discussion: Results suggest that PSD is likely multifactorial and extends the literature by demonstrating that a comorbid anxiety disorder correlated strongest with PSD. Poststroke screening and treatment plans should address not only depression but comorbid anxiety.

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“…Compared to the normal control group, patients with MDD exhibited greater severity of deep WMH signals (Brown, Lewine, Hudgins, & Risch, 1992). WMH severity is a crucial predictor of future depression risk in patients with CSVD (Park et al, 2015; Jaroonpipatkul et al, 2022; Ottavi, Pepper, Bateman, Fiorentino, & Brodtmann, 2023; F. Zhang, Ping, Jin, Hou, & Song, 2023). Specifically, those with extensive WMH at baseline are more likely to develop major depressive symptoms (Qiu et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Association Between Major Depressive Disorder and the Development of Cerebral Small Vessel Disease: A Mendelian Randomization Study

Lu,

Luo,

Yang

et al. 2023

Preprint

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BackgroundAlthough observational studies indicate a complex, bidirectional association between major depressive disorder (MDD) and cerebral small vessel disease (CSVD), the results are frequently inconsistent. This study investigated the potential correlation of MDD with both CSVD clinical outcomes and imaging markers, utilizing a bidirectional Mendelian randomization (MR) study design.MethodsInstrumental variables for both MDD and CSVD were extracted from the latest or most extensive genome-wide association study (GWAS) data available for each phenotype. Clinical outcomes and imaging markers of CSVD were defined using several parameters. The inverse variance weighting (IVW) method with additional sensitivity and heterogeneity analyses was used. Furthermore, a separate GWAS for depression was used to validate our significant findings.ResultsIn the forward MR analyses, the genetically predicted risk of MDD was positively associated with two CSVD phenotypes showing microscopic white matter (WM) damage: mean diffusivity (IVW OR = 2.191, 95 % CI 1.226 to 3.917, p = 0.008) and WM-enlarged perivascular space (OR = 1.053 95 % CI 1.006 to 1.101, p = 0.026). The use of an independent database for depression yielded no significant risk of depression associated with these two CSVD traits. Furthermore, reverse MR analyses showed no evidence of reverse causality between MDD and an altered CSVD risk.ConclusionsThis study utilizing MR imaging findings supports a substantial causal association between MDD and CSVD-related indicators of impaired WM microstructure. It is necessary to exercise caution when extending these results to individuals with depression.

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Depressive symptoms due to stroke are strongly predicted by the volume and location of the cerebral infarction, white matter hyperintensities, hypertension, and age: A precision nomothetic psychiatry analysis

Cited by 7 publications

References 49 publications

Leukoaraiosis as a Predictor of Depression and Cognitive Impairment among Stroke Survivors: A Systematic Review

Leukoaraiosis as a Predictor of Depression and Cognitive Impairment among Stroke Survivors: A Systematic Review

Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression

Association Between Major Depressive Disorder and the Development of Cerebral Small Vessel Disease: A Mendelian Randomization Study

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