Towards a multi protein and mRNA expression of biological predictive and distinguish model for post stroke depression

Abstract

Previous studies suggest that neurotrophic factors participate in the development of stroke and depression. So we investigated the utility of these biomarkers as predictive and distinguish model for post stroke depression (PSD). 159 individuals including PSD, stroke without depression (Non-PSD), major depressive disorder (MDD) and normal control groups were recruited and examined the protein and mRNA expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptors (VEGFR2), placental growth factor (PIGF), insulin-like growth factor (IGF-1) and insulin-like growth factor receptors (IGF-1R). The chi-square test was used to evaluate categorical variable, while nonparametric test and one-way analysis of variance were applied to continuous variables of general characteristics, clinical and biological changes. In order to explore the predictive and distinguish role of these factors in PSD, discriminant analysis and receiver operating characteristic curve were calculated. The four groups had statistical differences in these neurotrophic factors (all P < 0.05) except VEGF concentration and IGF-1R mRNA (P = 0.776, P = 0.102 respectively). We identified these mRNA expression and protein analytes with general predictive performance for PSD and Non-PSD groups [area under the curve (AUC): 0.805, 95% CI, 0.704-0.907, P < 0.001]. Importantly, there is an excellent predictive performance (AUC: 0.984, 95% CI, 0.964-1.000, P < 0.001) to differentiate PSD patients from MDD patients. This was the first study to explore the changes of neurotrophic factors family in PSD patients, the results intriguingly demonstrated that the combination of protein and mRNA expression of biological factors could use as a predictive and discriminant model for PSD.

The protein and mRNA expression levels of glial cell line-derived neurotrophic factor in post stroke depression and major depressive disorder

“…The diagnostic criteria for PSD were as follows 27 : (1) Had stroke history before, or stroke occurs earlier than depressive symptoms; (2) Met at least two depressive symptoms in nine symptoms of MDD in DSM-IV except core criterion symptoms of depressed mood and loss of interest or pleasure; (3) Impairment to fit personal and work functioning; (4) More than one week of depressive symptoms; (5) Free of other major psychiatric disorders, including schizophrenia, bipolar disorder, substance abuse (caffeine, nicotine and alcohol).…”

“…All subjects were reviewed by two trained senior psychiatrists. The severity of depression and cognitive function were assessed by both the score of HAMD-17 and the mini mental state examination (MMSE) 27 .…”

“…Real-time PCR data were calculated by the data analysis module automatically. Relative expression levels were measured by the 2 −ΔΔCT method using glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as endogenous control 27 .…”

Poststroke Depression Biomarkers: A Narrative Review

“…Most of the studies showed that increased peripheral IGF-1 levels might predict the occurrence of MDD, whereas decreased IGF-1 levels might reflect the treatment effectiveness ( 96 ). Nevertheless, Yue et al found no differences in serum IGF-1 concentrations in PSD patients as opposed to non-depressed poststroke patients and persons with MDD ( 97 ). On the other hand, the authors revealed significantly greater serum IGF-1 mRNA concentrations in PSD group compared to depressed subjects without stroke ( 97 ).…”

“…Nevertheless, Yue et al found no differences in serum IGF-1 concentrations in PSD patients as opposed to non-depressed poststroke patients and persons with MDD ( 97 ). On the other hand, the authors revealed significantly greater serum IGF-1 mRNA concentrations in PSD group compared to depressed subjects without stroke ( 97 ).…”