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Pan X, Cheng L, Zeng J, Jiang X, Zhou P. Three-needle electroacupuncture ameliorates depressive-like behaviors in a mouse model of post-stroke depression by promoting excitatory synapse formation via the NGL-3/L1cam pathway. Brain Res 2024; 1841:149087. [PMID: 38871241 DOI: 10.1016/j.brainres.2024.149087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
Three-needle electroacupuncture (TNEA) has shown promise as a non-pharmacological treatment for post-stroke depression (PSD). However, the underlying mechanisms of its therapeutic effects remain unclear. In this study, we investigated the potential molecular and synaptic mechanisms by which TNEA ameliorates depressive-like behaviors in a mouse model of PSD. Male C57BL/6 mice were subjected to middle cerebral artery occlusion (MCAO) to induce PSD and subsequently treated with TNEA for three weeks at specific acupoints (GV24 and bilateral GB13). Through a combination of behavioral tests, neuronal activation assessment, synaptic function examination, transcriptomic analysis, and various molecular techniques, we found that TNEA treatment significantly improved anxiety and depressive-like behaviors in PSD mice. These improvements were accompanied by enhanced neuronal activation in the medial prefrontal cortex (mPFC) and primary somatosensory cortex (PSC), as well as the promotion of excitatory synapse formation and transmission function in the mPFC. Transcriptomic analysis revealed that TNEA upregulated the expression of Netrin-G Ligand-3 (NGL-3), a postsynaptic cell adhesion molecule, in the mPFC. Further investigation showed that the extracellular domain of NGL-3 binds to the presynaptic protein L1cam, promoting the formation of Vesicular Glutamate Transporter 1 (vGluT1) puncta on neuronal dendrites. Notably, cortical neuron-specific knockout of NGL-3 abolished the antidepressant-like effects of TNEA in PSD mice, confirming the crucial role of the NGL-3/L1cam pathway in mediating the therapeutic effects of TNEA. These findings provide novel insights into the molecular and synaptic mechanisms underlying the therapeutic effects of acupuncture in the treatment of PSD and highlight the potential of targeting the NGL-3/L1cam pathway for the development of alternative interventions for PSD and other depressive disorders.
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Affiliation(s)
- Xiaojin Pan
- Shenzhen Baoan District Hospital of Traditional Chinese Medicine, Shenzhen, Guang Dong 518000, China.
| | - Lihua Cheng
- Shenzhen Baoan District Hospital of Traditional Chinese Medicine, Shenzhen, Guang Dong 518000, China
| | - Jixiang Zeng
- Shenzhen Baoan Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guang Dong 518000, China
| | - Xin Jiang
- Shenzhen Baoan District Hospital of Traditional Chinese Medicine, Shenzhen, Guang Dong 518000, China
| | - Peng Zhou
- Shenzhen Baoan District Hospital of Traditional Chinese Medicine, Shenzhen, Guang Dong 518000, China.
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Liu C, Tang H, Liu C, Ma J, Liu G, Niu L, Li C, Li J. Transcutaneous auricular vagus nerve stimulation for post-stroke depression: A double-blind, randomized, placebo-controlled trial. J Affect Disord 2024; 354:82-88. [PMID: 38452937 DOI: 10.1016/j.jad.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND It is a well-established fact that post-stroke depression (PSD) is a prevalent condition that affects a significant proportion of individuals who have suffered a stroke. Hence, our research endeavors to explore the safety, efficacy and the potential molecular mechanism of transcutaneous auricular vagus nerve stimulation (ta-VNS) for the treatment of depression in PSD patients by conducting a double-blind, sham-controlled, randomized trial. METHODS Patients who had experienced strokes and exhibited depressive symptoms, with a Hamilton Depression Scale (HAMD-17) score of ≥8 and met the DSM-IV criteria, were diagnosed with PSD. A volunteer sample of participants (N = 80) were randomly divided into either the ta-VNS group (which received ta-VNS in addition to conventional treatment) or the control group (which received conventional treatment only), in a 1:1 ratio. The effectiveness of the interventions was evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD-17), Zung Self-Rating Depression Scale (SDS), and Barthel Index (BI) scores. Furthermore, Plasma BDNF, CREB1, and 5-HT levels were measured before and after treatment. RESULTS The concomitant application of ta-VNS demonstrated a remarkable reduction in HAMD-17 and SDS scores, leading to noteworthy enhancements in patients' daily functioning, as evidenced by improved activities of daily living, at all assessed time points, in contrast to the control group (p < 0.0001). Notably, the ta-VNS group exhibited superior effects in modulating the measured neurotrophic biomarkers when compared to the control group (p < 0.05). CONCLUSIONS The synergistic approach of combining ta-VNS with conventional treatment has demonstrated remarkable efficacy and tolerability in managing depression following a stroke.
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Affiliation(s)
- Chang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Tang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jingxi Ma
- Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China; Chongqing Key Laboratory of Neurodegenerative Disease, Chongqing, China
| | - Gang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingchuan Niu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Changqing Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiani Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Karisik A, Dejakum B, Moelgg K, Komarek S, Toell T, Mayer-Suess L, Pechlaner R, Kostner S, Sollereder S, Kiechl S, Rossi S, Schoenherr G, Lang W, Kiechl S, Knoflach M, Boehme C. Association between dysphagia and symptoms of depression and anxiety after ischemic stroke. Eur J Neurol 2024; 31:e16224. [PMID: 38308469 DOI: 10.1111/ene.16224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND AND PURPOSE Dysphagia is associated with poor outcome, higher mortality, reduced quality of life, and social isolation. We investigate the relationship between swallowing impairment and symptoms of anxiety and depression after ischemic stroke. METHODS Consecutive patients with ischemic stroke participating in the prospective STROKE-CARD Registry study from 2020 to 2022 were assessed for dysphagia on hospital admission (clinical swallowing assessment) and for persistence until discharge and 3-month follow-up (SINGER Independency Index). Anxiety and depression symptoms were recorded using Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) at 3-month follow-up. RESULTS Of 648 patients, 19.3% had dysphagia on admission, persisting in 14.8% at discharge and 6.8% at 3-month follow-up. With the presence or duration of dysphagia (no dysphagia, dysphagia at baseline, at discharge, at 3 months), score (mean ± SD) increased on the BDI (7.9 ± 6.7, 12.5 ± 8.7, 13.5 ± 9.0, 16.5 ± 10.2), HADS-D (4.4 ± 3.7, 7.1 ± 4.2, 7.7 ± 4.4, 9.8 ± 4.3), and HADS-A (4.4 ± 3.5, 5.4 ± 3.6, 6.0 ± 3.6, 7.0 ± 3.6). In linear regression analysis adjusting for age, sex, diabetes, dementia, and either functional disability or stroke severity, BDI and HADS-D scores were significantly higher in patients with dysphagia across all points in time (admission, discharge, 3-month follow-up). An independent association with HADS-A scores was only evident in patients with persisting dysphagia after 3 months. Patients with dysphagia were more likely to receive antidepressants, antipsychotics, or benzodiazepines at discharge and 3-month follow-up. CONCLUSIONS Dysphagia after stroke is common and severely affects psychosocial functioning of individuals. Our results highlight swallowing impairment as an independent predictor for poststroke depressive and, to a lesser extent, anxiety symptoms.
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Affiliation(s)
- Anel Karisik
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Benjamin Dejakum
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kurt Moelgg
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Komarek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Toell
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Mayer-Suess
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefanie Kostner
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Sophia Kiechl
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Hochzirl Hospital, Hochzirl, Austria
| | - Sonja Rossi
- ICONE-Innsbruck Cognitive Neuroscience, Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - Gudrun Schoenherr
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wilfried Lang
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Medical Faculty, Sigmund Freud Private University, Vienna, Austria
| | - Stefan Kiechl
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Knoflach
- VASCage-Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Boehme
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Mao Y, Weng J, Xie Q, Wu L, Xuan Y, Zhang J, Han J. Association between dietary inflammatory index and Stroke in the US population: evidence from NHANES 1999-2018. BMC Public Health 2024; 24:50. [PMID: 38166986 PMCID: PMC10763382 DOI: 10.1186/s12889-023-17556-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There is an increasing awareness that diet-related inflammation may have an impact on the stroke. Herein, our goal was to decipher the association of dietary inflammatory index (DII) with stroke in the US general population. METHODS We collected the cross-sectional data of 44,019 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The association of DII with stroke was estimated using weighted multivariate logistic regression, with its nonlinearity being examined by restricted cubic spline (RCS) regression. The least absolute shrinkage and selection operator (LASSO) regression was applied for identifying key stroke-related dietary factors, which was then included in the establishment of a risk prediction nomogram model, with the receiver operating characteristic (ROC) curve being built to evaluate its discriminatory power for stroke. RESULTS After confounder adjustment, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for stroke across higher DII quartiles were 1.19 (0.94-1.54), 1.46 (1.16-1.84), and 1.87 (1.53-2.29) compared to the lowest quartile, respectively. The RCS curve showed a nonlinear and positive association between DII and stroke. The nomogram model based on key dietary factors identified by LASSO regression displayed a considerable predicative value for stroke, with an area under the curve (AUC) of 79.8% (78.2-80.1%). CONCLUSIONS Our study determined a nonlinear and positive association between DII and stroke in the US general population. Given the intrinsic limitations of cross-sectional study design, it is necessary to conduct more research to ensure the causality of such association.
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Affiliation(s)
- Yukang Mao
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 215008, Suzhou, China
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China
| | - Jiayi Weng
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 215008, Suzhou, China
| | - Qiyang Xie
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China
| | - Lida Wu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 210006, Nanjing, China
| | - Yanling Xuan
- Nanjing University of Chinese Medicine, 210006, Nanjing, China
| | - Jun Zhang
- Department of Cardiology, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 215008, Suzhou, China.
| | - Jun Han
- Department of Infectious Diseases, Affiliated Wuxi Fifth Hospital of Jiangnan University, The Fifth People's Hospital of Wuxi, 214065, Wuxi, China.
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Zhang Y, Yang Y, Li H, Feng Q, Ge W, Xu X. Investigating the Potential Mechanisms and Therapeutic Targets of Inflammatory Cytokines in Post-stroke Depression. Mol Neurobiol 2024; 61:132-147. [PMID: 37592185 DOI: 10.1007/s12035-023-03563-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023]
Abstract
Post-stroke depression (PSD) affects approximately one-third of stroke survivors, severely impacting general recovery and quality of life. Despite extensive studies, the exact mechanisms underlying PSD remain elusive. However, emerging evidence implicates proinflammatory cytokines, including interleukin-1β, interleukin-6, tumor necrosis factor-alpha, and interleukin-18, play critical roles in PSD development. These cytokines contribute to PSD through various mechanisms, including hypothalamic-pituitary-adrenal (HPA) axis dysfunction, neurotransmitter alterations, neurotrophic factor changes, gut microbiota imbalances, and genetic predispositions. This review is aimed at exploring the role of cytokines in stroke and PSD while identifying their potential as specific therapeutic targets for managing PSD. A more profound understanding of the mechanisms regulating inflammatory cytokine expression and anti-inflammatory cytokines like interleukin-10 in PSD may facilitate the development of innovative interventions to improve outcomes for stroke survivors experiencing depression.
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Affiliation(s)
- Yutong Zhang
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Yuehua Yang
- Department of Neurology, Suzhou Yongding Hospital, Suzhou, 215028, China
| | - Hao Li
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Qian Feng
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Wei Ge
- Department of Neurology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221600, China.
| | - Xingshun Xu
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215000, China.
- Institute of Neuroscience, Soochow University, Suzhou, 215123, China.
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Soochow University, Suzhou, 215123, Jiangsu, China.
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Wang B, Ding XX, Zhang H, Liu ZM, Duan PB, Dong YF. Predictors of post-stroke depression: the perspective from the social convoy model. Psychogeriatrics 2023; 23:864-875. [PMID: 37464888 DOI: 10.1111/psyg.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Post-stroke depression (PSD) as one of the most common neuropsychiatric disorders after a stroke and is caused by many factors. However, the relationships among different factors and their potential contributions to PSD remain unclear. METHODS Two hundred and seventy-six patients were recruited into this study. The general information questionnaire, the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Family Assessment Device, the General Well-Being Scale, the Barthel Index, and the modified Rankin Scale were used to assess the condition of patients. Subsequently, we identify the main causes associated with the PSD and then performed a path analysis to clarify the direct, indirect and total effects among the variables. RESULTS We found that age, stroke with coronary heart disease, neurological function, family function, social support, and general well-being had a significant impact on PSD (P < 0.05). Of these, neurological function had the largest total effect on PSD (β = 0.451), social support contributed the most as a direct effect (β = -0.306), and family function showed the largest indirect effect (β = -0.264). CONCLUSION Individual, disease, and social-psychological factors all contributed to the development of PSD. We should pay more attention to comprehensive assessment, especially for those with poor neurological function, and lacking family or social support. In addition, it would be preferable to provide them with necessary support and care strategies to reduce the incidence of PSD.
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Affiliation(s)
- Bin Wang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing-Xing Ding
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Heng Zhang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-Min Liu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Pei-Bei Duan
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yin-Feng Dong
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Jiang W, Jiang X, Yu T, Gao Y, Sun Y. Efficacy and safety of scalp acupuncture for poststroke depression: A meta-analysis and systematic review. Medicine (Baltimore) 2023; 102:e34561. [PMID: 37543780 PMCID: PMC10403033 DOI: 10.1097/md.0000000000034561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Poststroke depression (PSD) is a common clinical poststroke complication that adversely affects cognitive and physical function rehabilitation. Scalp acupuncture (SA) can significantly improve somatic dysfunction and emotional disorder in stroke patients. This meta-analysis aims to evaluate the effectiveness and safety of SA in the treatment of PSD. METHODS We conducted a comprehensive search of multiple electronic databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Internet, China Science and Technology Journal Database, Wan Fang Data Knowledge Service Platform, and China Biology Medicine databases until December 20, 2022, to identify randomized controlled trials investigating the efficacy of SA in the treatment of PSD. Two independent researchers screened the literature, extracted data, and assessed the risk of bias in the included studies based on the inclusion and exclusion criteria. We performed a meta-analysis of the eligible literature using RevMan 5.4.1 and Stata 15.0 software. RESULTS This study comprised a total of 14 randomized controlled trials, 10 of which used SA and 4 of which used SA in combination with electroacupuncture therapy. The results of the meta-analysis revealed that the effective rate of the SA group was significantly higher than that of the Western medicine group (relative risk = 1.09, 95% confidence interval (CI) [1.02, 1.16], P = .008). Moreover, compared to the Western medicine group, the SA group demonstrated significant improvements in Hamilton depression scale scores (mean difference = -2.29, 95% CI [-3.88, -0.70], P = .005) and neurological function deficit scores (mean difference = -3.06, 95% CI [-5.91, -0.21], P = .04). Additionally, the SA group has a lower incidence of adverse events than the western medicine group (relative risk = 0.12, 95% CI [0.05, 0.29], P < .00001). CONCLUSION SA has superior efficacy and safety compared to Western medicine for PSD. These findings suggest that SA could be a promising alternative treatment for the assessed condition. Due to the limited number and quality of the included literature, the above conclusions must be confirmed by additional high-quality research.
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Affiliation(s)
- Wenxi Jiang
- School of Graduate, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Xicheng Jiang
- School of Basic Medical, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Tianyang Yu
- Department of Acupuncture II, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Yang Gao
- School of Graduate, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
| | - Yuanzheng Sun
- Department of Acupuncture II, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
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Ruan Y, Deng X, Liu J, Xiao X, Yang Z. Identification of miRNAs in extracellular vesicles as potential diagnostic markers for pediatric epilepsy and drug-resistant epilepsy via bioinformatics analysis. Front Pediatr 2023; 11:1199780. [PMID: 37469680 PMCID: PMC10352456 DOI: 10.3389/fped.2023.1199780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
Background Pediatric epilepsy (PE) is a common neurological disease. However, many challenges regarding the clinical diagnosis and treatment of PE and drug-resistant epilepsy (DRE) remain unsettled. Our study aimed to identify potential miRNA biomarkers in children with epilepsy and drug-resistant epilepsy by scrutinizing differential miRNA expression profiles. Methods In this study, miRNA expression profiles in plasma extracellular vesicles (EV) of normal controls, children with drug-effective epilepsy (DEE), and children with DRE were obtained. In addition, differential analysis, transcription factor (TF) enrichment analysis, Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and target gene prediction were used to identify specifically expressed miRNAs and their potential mechanisms of action. Potential diagnostic markers for DRE were identified using machine learning algorithms, and their diagnostic efficiency was assessed by the receiver operating characteristic curve (ROC). Results The hsa-miR-1307-3p, hsa-miR-196a-5p, hsa-miR-199a-3p, and hsa-miR-21-5p were identified as diagnostic markers for PE, with values of area under curve (AUC) 0.780, 0.840, 0.832, and 0.816, respectively. In addition, the logistic regression model incorporating these four miRNAs had an AUC value of 0.940, and its target gene enrichment analysis highlighted that these miRNAs were primarily enriched in the PI3K-Akt, MAPK signaling pathways, and cell cycle. Furthermore, hsa-miR-99a-5p, hsa-miR-532-5p, hsa-miR-181d-5p, and hsa-miR-181a-5p showed good performance in differentiating children with DRE from those with DEE, with AUC values of 0.737 (0.534-0.940), 0.737 (0.523-0.952), 0.788 (0.592-0.985), and 0.788 (0.603-0.974), respectively. Conclusion This study characterized the expression profile of miRNAs in plasma EVs of children with epilepsy and identified miRNAs that can be used for the diagnosis of DRE.
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Affiliation(s)
- Yucai Ruan
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Xuhui Deng
- Department of Neurology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Jun Liu
- Medical Research Center and Clinical Laboratory Medicine, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Xiaobing Xiao
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Zhi Yang
- Department of Pediatrics, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
- Department of Neurology, Yue Bei People’s Hospital, Shantou University Medical College, Shaoguan, China
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9
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Guo H, Ge YR, Dong YB, Zhao XC, Su GL, Wang JC. Effect of hyperbaric oxygen on post-stroke depression. World J Psychiatry 2023; 13:226-233. [PMID: 37303936 PMCID: PMC10251359 DOI: 10.5498/wjp.v13.i5.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND In patients with post-stroke depression (PSD) in diabetes, the situation may be more complex, requiring simultaneous treatment of blood glucose, depressive symptoms, and neurological dysfunction. Hyperbaric oxygen (HBO) therapy can improve tissue oxygen content and improve the situation of ischemia and hypoxia, thus playing a role in protecting brain cells and restoring the function of brain cells. However, there are few studies on HBO therapy for patients with PSD. This study explores the clinical efficacy of such therapy for stroke complicated with depression and diabetes mellitus, and to provide reference and basis for clinical treatment and development through the application of relevant rating scales and laboratory test indicators.
AIM To evaluate the clinical effects of HBO therapy on patients with diabetes with PSD.
METHODS A total of 190 diabetic patients with PSD were randomly divided into observation and control groups (95 patients per group). The control group received escitalopram oxalate 10mg once a day for eight weeks. In addition, the ob-servation group was also given HBO therapy, once a day, five times a week, for eight weeks. The Montgomery Depression Rating Scale (MADRS), National Institutes of Health Stroke Scale (NIHSS), hypersensitive C-reactive protein, tumor necrosis factor (TNF)-α, and fasting glucose levels were compared.
RESULTS There were no significant differences in age, sex, or depression course between the groups (P > 0.05). After HBO treatment, MADRS scores in both groups decreased significantly (14.3 ± 5.2), and were significantly lower in the control group (18.1 ± 3.5). After HBO treatment, NIHSS scores in both groups decreased significantly, and scores in the observation group (12.2 ± 4.0) decreased more than in the control group (16.1 ± 3.4), the difference was statistically significant (P < 0.001). The levels of hypersensitive C-reactive protein and TNF-α in both groups were significantly decreased, and the observation group was significantly lower than the control group (P < 0.001). Fasting blood glucose levels in both groups decreased significantly, and those in the observation group decreased more (8.02 ± 1.10) than in the control group (9.26 ± 1.04), with statistical significance (t = -7.994, P < 0.001).
CONCLUSION HBO therapy can significantly improve depressive symptoms and neurological dysfunction in patients with PSD, and reduce the levels of hypersensitive C-reactive protein, TNF-α and fasting blood glucose.
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Affiliation(s)
- Hong Guo
- Department of Psychology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yi-Ran Ge
- Department of Clinical Psychology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Yan-Bin Dong
- Department of Psychology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiao-Chuan Zhao
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Guan-Li Su
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jin-Cheng Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Tang S, Gao M, Cheng X, Ji L. Scientometric analysis of post-stroke depression research based on CiteSpace. Medicine (Baltimore) 2023; 102:e33633. [PMID: 37145004 PMCID: PMC10158871 DOI: 10.1097/md.0000000000033633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/06/2023] [Indexed: 05/06/2023] Open
Abstract
Post-stroke depression (PSD) has served as a severe and common complication leading to a higher level of mortality. Though various studies have been focused on PSD, limited research endeavor has been dedicated to bibliometric analysis in the past. In view of this, the current analysis serves to elucidate the latest status of global research and pinpoint the emerging area of interest for PSD, in order to support further investigation of the field. Publications related to PSD were retrieved from the Web of Science Core Collection database on September 24, 2022, and included in the bibliometric analysis. VOSviewer and CiteSpace software were used to visually analyze publication outputs, scientific cooperation, highly-cited references, and keywords to identify the current status and future trends in PSD research. A total of 533 publications were retrieved. The annual number of publications showed an increasing trend from 1999 to 2022. In terms of country and academic institution, the USA and Duke University have topped the list of PSD research respectively. Meanwhile, Robinson RG and Alexopoulos GS have been the most representative investigators of the field. In the past, researchers focused on the risk factors of PSD, late-life depression, and Alzheimer disease. In recent years, further research effort has been placed on meta-analysis, ischemic stroke, predictor, inflammation, mechanism, and mortality. In conclusion, in the past 20 years, PSD research has been progressing and gaining more attention. The bibliometric analysis successfully unveiled the field's major contributing countries, institutions, and investigators. Furthermore, current hot spots and future trends in the field of PSD were identified, which included meta-analysis, ischemic stroke, predictor, inflammation, mechanism, and mortality.
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Affiliation(s)
- Saixue Tang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- The Affiliated Hospital of Shandong University of TCM, Jinan, Shandong Province, China
| | - Mingzhou Gao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Xunshu Cheng
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Lijin Ji
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
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11
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Gurková E, Štureková L, Mandysová P, Šaňák D. Factors affecting the quality of life after ischemic stroke in young adults: a scoping review. Health Qual Life Outcomes 2023; 21:4. [PMID: 36653785 PMCID: PMC9850784 DOI: 10.1186/s12955-023-02090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To synthesize the body of knowledge on the factors influencing the quality of life (QoL) after ischemic stroke (IS) in young adults. METHODS Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA-ScR checklist for a scoping review was used in this paper. A total of 1197 studies were identified through a bibliographic search in Web of Science, MEDLINE, PsycInfo, ScienceDirect, Scopus, and ProQuest Science Database. Articles published between the years 2000-2021 were included. RESULTS A total of nine papers were finally selected to respond to the research question. Three studies were prospective longitudinal studies compared QoL between young stroke and age-matched controls from the general population. Across all the analysed studies, 14 variables potentially associated with QoL were identified. QoL in young patients is mainly affected by clinical outcomes after IS (scored by the modified Rankin scale and the Barthel index-favourable initial functional status and higher independence in ADL leads to higher QoL) and psychological factors (post-stroke fatigue and depression-higher levels of fatigue and depression lead to lower QoL). The reviewed studies emphasized the importance of functional outcomes, post-stroke depression, fatigue and anxiety and early return to work. CONCLUSION Further longitudinal studies are needed to identify the trajectory of post-stroke psychosocial symptoms over time and other potential predictors of unfavourable long-term QoL, thus specific young stroke rehabilitation and stroke self-management support programmes should be developed (address physical, psychological factors which influence the psychosocial adaptation post-stroke and the perception of the QoL).
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Affiliation(s)
- Elena Gurková
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Lenka Štureková
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Petra Mandysová
- grid.10979.360000 0001 1245 3953Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Hněvotínská 976/3, 775 15 Olomouc, Czech Republic
| | - Daniel Šaňák
- grid.10979.360000 0001 1245 3953Comprehensive Stroke Center, Department of Neurology, Palacký University Medical School and Hospital, Olomouc, Czech Republic
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Park JG. Update on Stroke Rehabilitation for Non-Motor Impairment. BRAIN & NEUROREHABILITATION 2022; 15:e13. [PMID: 36743206 PMCID: PMC9833475 DOI: 10.12786/bn.2022.15.e13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022] Open
Abstract
Various interventions exist to treat non-motor impairments caused by stroke. Adjuvant treatments such as non-invasive brain stimulation, virtual reality, computer-assisted training, neurostimulation, and biofeedback are being investigated and applied in the areas of cognitive dysfunction, language problems, visual disorders, dysphagia, mood disorders, and post-stroke pain. Most of these treatments have shown efficacy and symptom improvement, but further investigation is required to fully clarify their effects.
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Affiliation(s)
- Jin Gee Park
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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13
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Depressive-like behaviors induced by chronic cerebral hypoperfusion associate with a dynamic change of GABA B1/B2 receptors expression in hippocampal CA1 region. Physiol Behav 2022; 254:113887. [PMID: 35724927 DOI: 10.1016/j.physbeh.2022.113887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/07/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022]
Abstract
Cerebral ischemia could induce depressive-like behaviors; however, the alteration of gamma-aminobutyric acid receptors type B (GABAB) receptors in these pathological processes has not been extensively investigated. The aim of the current study was to document the behavioral change and the alteration of GABAB receptors in chronic cerebral hypoperfusion. The permanent occlusion of the bilateral common carotid arteries (two-vessel occlusion, 2VO) was performed to induce chronic cerebral ischemia (CCH). The depressive-like behaviors were evaluated with sucrose preference test, novelty suppress feeding test as well as forced swim test at 4, 8, and 12 weeks after the 2VO surgery. The total, surface and intracellular expressions of GABAB subunit 1 (GABAB1) and subunit 2 (GABAB2) in hippocampal CA1 were quantified by western blot. The depressive-like behaviors were observed in rats suffered from 4, 8, and 12 weeks 2VO in sucrose preference test, novelty suppress feeding test and forced swim test. In addition, the surface and total expression of GABAB1 in CA1 was reduced at 4 weeks after 2VO rather than 8 or 12 weeks. While the surface and total expression of GABAB2 in CA1 was decreased throughout the ischemia timeline (4, 8, and 12 weeks). Taken together, our findings suggested the potential roles of GABAB1 and GABAB2 subunits involved in depressive-like behaviors caused by chronic cerebral hypoperfusion.
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Bui Q, Kaufman KJ, Munsell EGS, Lenze EJ, Lee JM, Mohr DC, Fong MWM, Metts CL, Tomazin SE, Pham V, Wong AWK. Smartphone assessment uncovers real-time relationships between depressed mood and daily functional behaviors after stroke. J Telemed Telecare 2022:1357633X221100061. [PMID: 35549589 PMCID: PMC9653506 DOI: 10.1177/1357633x221100061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The impact of depressed mood in daily life is difficult to investigate using traditional retrospective assessments, given daily or even within-day mood fluctuations in various contexts. This study aimed to use a smartphone-based ambulatory assessment to examine real-time relationships between depressed mood and functional behaviors among individuals with stroke. METHODS A total of 202 participants with mild-to-moderate stroke (90% ischemic, 45% female, 44% Black) completed an ecological momentary assessment five times per day for 2 weeks by reporting their depressed mood and functional behaviors regarding where, with whom, and what activity was spent. RESULTS Participants spent 28% of their wake-up time participating in passive leisure activities but spent the least time in physical (4%) and vocational (9%) activities. Depressed mood was concurrently lower when participants engaged in social activities (β = -0.023 ± 0.011) and instrumental activities of daily living (β = -0.061 ± 0.013); spent time with family members (β = -0.061 ± 0.014), spouses (β = -0.043, ± 0.016), friends (β = -0.094, ± 0.021), and coworkers (β = -0.050 ± 0.021); and were located in restaurants (β = -0.068 ± 0.029), and homes of family members (β = -0.039 ± 0.020) or friends (β = -0.069 ± 0.031). Greater depressed mood was associated with worse ratings in satisfaction, performance, and engagement of activities in concurrent (βs = -0.036 ± 0.003, -0.053 ± 0.003, -0.044 ± 0.003) and time-lagged models (βs = -0.011 ± 0.004, -0.012 ± 0.004, -0.013 ± 0.004). DISCUSSION Smartphone-based ambulatory assessment can elucidate functional behaviors and associated mood after stroke. Findings support behavioral activation treatments to schedule social and instrumental activities for stroke survivors to reduce their depressed mood.
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Affiliation(s)
- Quoc Bui
- Division of Biostatistics, Washington University School of Medicine, St Louis, MO, USA
| | - Katherine J Kaufman
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Elizabeth GS Munsell
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - David C Mohr
- Center for Behavioral Intervention Technologies and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mandy WM Fong
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Psychology and Patient Family Counseling, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher L Metts
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Stephanie E Tomazin
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Vy Pham
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Alex WK Wong
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation and Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Qinlin F, Bingqiao W, Linlin H, Peixia S, Lexing X, Lijun Y, Qingwu Y. miR-129-5p targets FEZ1/SCOC/ULK1/NBR1 complex to restore neuronal function in mice with post-stroke depression. Bioengineered 2022; 13:9708-9728. [PMID: 35435132 PMCID: PMC9191875 DOI: 10.1080/21655979.2022.2059910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Post-stroke depression (PSD) seriously affects the normal life of patients. Based on the previous sequencing results, this study selected miR-129-5p as the research object, which was significantly reduced in the PSD model by screening. To clarify the regulatory role of miR-129-5p, this study overexpressed and interfered with miR-129-5p in neuronal cells cultured in vitro, tested its effect on neuronal cell autophagy, and determined expressions of fasciculation and elongation protein zeta-1 (FEZ1), short coiled-coil protein (SCOC), unc-51 like autophagy activating kinase 1 (ULK1) and autophagy cargo receptor (NBR1) autophagy-related proteins. The dual-luciferase reporter system and immunoprecipitation were applied to detect the molecular regulatory mechanism of miR-129-5 and FEZ1, SCOC, ULK1 and NBR1. Findings of the present study revealed that the autophagy of neuronal cells was markedly decreased by overexpressing miR-129-5p (p < 0.05), and expressions of FEZ1, SCOC, ULK1 and NBR1 were substantially reduced (p < 0.05). The dual-luciferase reporter system results indicated that FEZ1, SCOC, ULK1 and NBR1 were all miR-129-5p target genes. Furthermore, immunoprecipitation assay revealed that SCOC, ULK1 and NBR1 could directly bind to the FEZ1 protein. The experiments at an animal level demonstrated that miR-129-5p could effectively alleviate the behavioral indicators of PSD model mice. Taken together, this study testified that SCOC/ULK1/NBR1 proteins could directly bind to FEZ1 to form protein complex, and all of the four proteins FEZ1/SCOC/ULK1/NBR1 were miR-129-5p target genes. miR-129-5p overexpression could effectively restore the behavioral characteristics of model mice, and reduce the autophagy-related proteins FEZ1/SCOC/ULK1/NBR1.
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Affiliation(s)
- Fan Qinlin
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
| | - Wang Bingqiao
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
| | - Hu Linlin
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
| | - Shi Peixia
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
| | - Xie Lexing
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
| | - Yang Lijun
- Department of General orthopedics, Chongqing Public Health Medical Treatment Center, Chongqing, China
| | - Yang Qingwu
- Department of Neurology, Second Affiliated Hospital of Army Medical UniversityChongqing, China
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16
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Effects of auricular acupressure on depression in stroke patients: A single-blind randomized controlled trial. Complement Ther Clin Pract 2022; 48:101596. [DOI: 10.1016/j.ctcp.2022.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022]
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17
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Qinlin F, Qi X, Qiong C, Lexing X, Peixia S, Linlin H, Yupu D, Lijun Y, Qingwu Y. Differential expression analysis of microRNAs and mRNAs in the mouse hippocampus of post-stroke depression (PSD) based on transcriptome sequencing. Bioengineered 2022; 13:3582-3596. [PMID: 35100085 PMCID: PMC8973717 DOI: 10.1080/21655979.2022.2027061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
To clarify the differential expressions of microRNAs and mRNAs in a PSD model, this study employed PSD mice for model construction by injecting vasoconstrictor ET-1 (angioendothelin-1) into the medial prefrontal cortex (mPFC) of mice. The animals underwent elevated plus maze test, open field test, tail suspension test, and forced swimming test subsequently. Transcriptome sequencing was performed to analyze the differentially expressed mRNAs and microRNAs. The results showed that open arm entries and time of PSD mice were markedly decreased. Times of the entry to center for mice in the model group were apparently decreased. The climbing time of mice in the model group was greatly decreased. The behavior of PSD mice indicated a marked change, and several indicators of the behavioral tests were significantly lower than those of the control group. Transcriptome sequencing analysis demonstrated that expressions of 1 206 genes and 21 microRNAs were markedly upregulated in model group, whereas expressions of 2 113 genes and 32 microRNAs were markedly downregulated. GO analysis revealed that the differentially expressed genes were mainly involved in regulatory pathways of single-multicellular organism process, developmental process, cell periphery, plasma membrane, and neuron projection. Meanwhile, KEGG analysis results indicated that the differentially expressed genes mostly participated in signaling pathways of neuroactive ligand-receptor interaction, calcium signaling pathway, and cytokine-cytokine receptor interaction. In conclusion, differentially expressed microRNAs and mRNAs were screened, which offers a theoretical foundation for further investigation of molecular mechanisms and novel insight for the early identification, prevention, and treatment of PSD.
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Affiliation(s)
- Fan Qinlin
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xie Qi
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Chen Qiong
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xie Lexing
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Shi Peixia
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Hu Linlin
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Diao Yupu
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yang Lijun
- Chongqing Public Health Medical Treatment Center, Chongqing, China
| | - Yang Qingwu
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, China
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Risk Factors for Depressive Symptoms in Korean Adult Stroke Survivors: The Korea National Health and Nutrition Examination Survey IV-VII (2007-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158178. [PMID: 34360469 PMCID: PMC8346056 DOI: 10.3390/ijerph18158178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022]
Abstract
Depressive symptoms are common in stroke survivors, and they are associated with poor outcomes. Therefore, this study aimed to investigate the depressive symptoms in stroke survivors and the risk factors for depressive symptoms in stroke survivors. We included 33,991 participants who were 19 years or older and had completed a questionnaire about the history of stroke from the Korea National Health and Nutrition Examination Survey (KNHANES) IV–VII (from 2007 to 2018). The mean Patient Health Questionnaire-9 score and the prevalence of major depression, depressive symptoms, antidepressant treatment, suicidal ideation, and suicide attempts were significantly higher in stroke survivors than in non-stroke participants (4.4 vs. 2.6, 16.2% vs. 5.3%, 24.7% vs. 9.3%, 3.8% vs. 1.4%, 21.7% vs. 4.8%, and 2.5% vs. 0.6%, respectively, all p < 0.001). Complex sample multivariate logistic regression analysis revealed that the female sex, unemployment, a low education level, a low family income, and activity limitations were independent risk factors for depressive symptoms in stroke survivors. Activity limitations showed the highest odds ratio among the independent factors, and its causes were further analyzed. The most common causes of activity limitations were stroke sequelae and musculoskeletal problems. To reduce depressive symptoms in stroke survivors, attention needs to be paid to minimizing stroke sequelae and musculoskeletal problems along with regular screening for depressive symptoms.
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Zhang W, Liu Y, Yu J, Zhang Q, Wang X, Zhang Y, Gao Y, Ye L. Exercise interventions for post-stroke depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24945. [PMID: 33663134 PMCID: PMC7909154 DOI: 10.1097/md.0000000000024945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is one of the most common neuropsychiatric complications after stroke and is associated with increased risk of death and poor functional outcomes. Strong evidence shows that exercise has benefits for depression. However, it is not clear whether exercise has benefits specifically for PSD. This study aims to explore the effects of exercise on PSD and to establish safe and effective exercise prescriptions. METHODS AND ANALYSIS The PubMed, Cochrane Library and EMBASE, databases will be searched using prespecified search strategies. Randomized controlled trials and non-randomized prospective controlled cohort studies regarding exercise for PSD will be included. The primary outcomes are depression scale and stroke outcome. The secondary outcomes are the occurrence of adverse events, cognitive function, quality of life indices, and the expression of nerve cell factors. The methodological quality of each study will be evaluated by the physiotherapy evidence database scale. The heterogeneity will be evaluated using the I2 test. If I2 > 50%, random effects models will be used in the analysis; otherwise, fixed effects models will be used to pool the data. RESULTS This study will assess the efficacy and safety of exercise for PSD. CONCLUSIONS Our findings will be helpful for clinicians to re-examine the clinical decision-making in the treatment of PSD, by assessing the efficacy of a promising treatment modality for patients with PSD. ETHICS AND DISSEMINATION Ethical approval is not required because this study is a secondary analysis. The results of this study will be disseminated through journals and academic exchanges. SYSTEMATIC REVIEW REGISTRATION NUMBER INPLASY202110100.
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