Does the severity of depressive symptoms after stroke affect long-term survival? An 18-year follow-up

Cardiac history and post-stroke depression association in Chinese stroke survivors: a cross sectional study

A substantial body of evidence indicates that stroke is a primary cause of death and disability on a global scale. The presence of post-stroke depression has been demonstrated to exert a substantial influence on the prognosis of stroke patients, underscoring the imperative for the identification and early prevention of post-stroke depression. The objective of this study was to examine the association between cardiac history and post-stroke depression (PSD) in Chinese stroke patients, with the aim of identifying high-risk groups, promoting early intervention strategies, and enhancing patient prognosis. This study was based on data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), which included 933 respondents with a history of stroke. Univariate and multivariate logistic regression analyses were used to assess the effects of cardiac history and other variables on post-stroke depression (PSD). The results indicated a correlation between cardiac history and post-stroke depression (PSD). In addition, the data showed that gender, activities of daily living (ADLs), cognitive functioning, and life satisfaction also had an effect on post-stroke depression (PSD). The findings presented here indicate that patients with a history of cardiac disease are more likely to develop post-stroke depression. This provides valuable insights into the clinical management of stroke patients and the prevention of post-stroke depression. The emotional health assessment of such patients should be emphasized in clinical management, and appropriate psychological support and interventions should be provided to improve their overall prognosis.

Psychedelics for acquired brain injury: a review of molecular mechanisms and therapeutic potential

Acquired brain injury (ABI), such as traumatic brain injury and stroke, is a leading cause of disability worldwide, resulting in debilitating acute and chronic symptoms, as well as an increased risk of developing neurological and neurodegenerative disorders. These symptoms can stem from various neurophysiological insults, including neuroinflammation, oxidative stress, imbalances in neurotransmission, and impaired neuroplasticity. Despite advancements in medical technology and treatment interventions, managing ABI remains a significant challenge. Emerging evidence suggests that psychedelics may rapidly improve neurobehavioral outcomes in patients with various disorders that share physiological similarities with ABI. However, research specifically focussed on psychedelics for ABI is limited. This narrative literature review explores the neurochemical properties of psychedelics as a therapeutic intervention for ABI, with a focus on serotonin receptors, sigma-1 receptors, and neurotrophic signalling associated with neuroprotection, neuroplasticity, and neuroinflammation. The promotion of neuronal growth, cell survival, and anti-inflammatory properties exhibited by psychedelics strongly supports their potential benefit in managing ABI. Further research and translational efforts are required to elucidate their therapeutic mechanisms of action and to evaluate their effectiveness in treating the acute and chronic phases of ABI.

Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: A randomized controlled trial

OBJECTIVE

To investigate the effectiveness of joint mobilization (JM) combined with acupuncture (AC) for the treatment of pain, physical function and depression in poststroke patients.

METHODS

A total of 69 poststroke patients were randomly assigned to the JM+AC group (n = 23), the JM group (n = 23), and the control group (n = 23). Patients in the JM+AC group and the JM group received JM for 30 minutes, twice a week for 12 weeks, and the JM+AC group received AC for 30 minutes separately once a week. The control group did not receive JM or AC. Pain (visual analog scale, shoulder pain and disability index, Western Ontario and McMaster universities osteoarthritis index), physical function (range of motion, 10-m walking speed test, functional gait assessment, manual function test, activities of daily living scale, instrumental activities of daily living scale), and depression (center for epidemiologic studies depression scale, Beck depression inventory) were assessed for each patient before and after the 12 weeks of intervention.

RESULTS

Pain and physical function were improved significantly in the JM+AC group compared with the JM and control groups. Physical function and depression were improved significantly in the JM+AC and JM groups compared with the control group.

CONCLUSION

The treatment of JM combined with AC improved pain, depression, and physical function of poststroke patients with chronic neuropathic pain in this study. This valuable finding provides empirical evidence for the designing therapeutic interventions and identifying potential therapeutic targets.

High Prevalence of Poststroke Depression in Ischemic Stroke Patients in Ethiopia

Background

There is limited information and research carried out regarding the prevalence of poststroke depression (PSD) in the study area. Psychiatric disorders complicate a significant proportion of patients suffering from stroke. This of course have a great negative impact on our knowledge about poststroke depression in Ethiopia, and poststroke depression complicates a significant number of stroke patients and their rehabilitation.

Methods

A cross-sectional study on all patients aged above 18 years and diagnosed with stroke in the past two years who attended the neurology follow-up clinics of Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) was done by using a structured questionnaire containing Patient Health Questionnaire-9 (PHQ-9) depression screening tool.

Result

Of 84 patients who were eligible for the study, 32.2% of patients have depressive symptoms. Women (OR 0.001, 95% CI 0.12-0.87) and aphasic patients (OR 0.034, 95% CI 0.19-1.27) were more likely to have depressive symptoms.

Conclusion

Depressive symptoms after stroke are common in Ethiopian patients. Our study demonstrates female and aphasic patients are more likely to screen positive for PSD. Hence, screening all poststroke patients with different screening tools is practical, and further studies are needed to assess the validity of these screening tools and also to assess PSD as a predictor of stroke outcome.

Socioeconomic Factors Predicting Depression Differ in the Acute Stage and at 1 year After Ischemic Stroke or TIA

INTRODUCTION

Considerable depressive symptoms follow stroke in about one third of patients. Initial depressive symptoms may wane after the acute phase of stroke, but persisting depressive symptoms adversely affect rehabilitation and quality of life. We set forth to evaluate predictors of depressive symptoms with a focus on socioeconomic factors.

METHODS

We evaluated clinical features and socioeconomic characteristics in 233 consecutive patients with acute ischemic stroke or TIA. Depressive symptoms could be evaluated in 168 subjects in the acute phase with a repeated testing after a mean of 14.7 months via telephone interview in 116 patients. Survival status, scores on the Center for Epidemiologic Studies-Depression Scale (CES-D), Beck Depression Inventory (BDI) and disability (modified Rankin scale, mRS) were recorded.

RESULTS

In the acute phase, employment status (p = 0.037) and level of education (p = 0.048) whereas one year later dependency (mRS≥3, p = 0.002) and income (p = 0.012) were the significant predictors of the severity of depressive symptoms. A change from independent (mRS≤2) to dependent living predicted worsening depressive symptoms (p = 0.008), whereas improving to functional independence from an initially dependent condition was associated with diminishing depressive symptoms (p = 0.077 for CES-D and p = 0.044 for BDI) in the first year after an acute ischemic cerebrovascular event.

CONCLUSIONS

Predictors of the severity of depressive symptoms differed in the acute phase and at follow-up. In addition to disability, education and employment status in the acute phase and income in the late phase predict the severity of depressive symptoms after ischemic stroke or TIA.