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Cerebral microbleeds and symptom severity of post-stroke depression: a magnetic resonance imaging study
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. tangwk@cuhk.edu.hk
Background:
Cerebral microbleeds (CMBs) are common in stroke survivors, although their clinical significance in the development of psychiatric conditions following stroke remains unknown. This study examines the association between post-stroke depression (PSD) symptom severity and CMBs.
Methods:
Amongst the 4088 patients with acute ischemic stroke who had been admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong, between December 2004 and May 2009, 994 patients were recruited. A psychiatrist administered the Structural Clinical Interview for DSM-IV to all 994 patients and made a diagnosis of PSD three months after the index stroke. PSD symptom severity was assessed with the 15-item Geriatric Depression Scale (GDS). Seventy-eight patients were found to have PSD. The presence and location of CMBs were evaluated with magnetic resonance imaging (MRI).
Results:
Seventy-eight patients (7.8%) had PSD. CMBs were identified in 20 PSD patients. Relative to the no-CMB group, the mean GDS score of patients with lobar CMBs was significantly higher (12.6±2.6 versus 10.4±2.5, p=0.01 after adjusting for age, sex, global cognitive functions, neurological deficits and white matter hyperintensities).
Limitations:
Patients with more severe stroke, those who died before the three-month follow-up and those who became depressed later were excluded, as were those unable to give their consent due to dementia or aphasia. These selection biases may limit the generalizability of the findings.
Conclusions:
The results suggest that lobar CMBs may contribute to PSD symptom severity. The importance of CMBs in the pathogenesis of other psychiatric disorders in stroke survivors and other patient populations warrants further investigation.
Insights
Cerebral microbleeds (CMBs) may worsen post-stroke depression (PSD) symptom severity, particularly lobar CMBs. Further research is needed to understand CMBs
Area of Science:
- Neurology
- Psychiatry
- Radiology
Background:
- Cerebral microbleeds (CMBs) are prevalent in stroke survivors but their role in psychiatric conditions post-stroke is unclear.
- This study investigated the association between post-stroke depression (PSD) severity and CMBs.
Purpose of the Study:
- To examine the relationship between the presence and location of CMBs and the severity of PSD symptoms.
Main Methods:
- 994 acute ischemic stroke patients were assessed for PSD using the Structural Clinical Interview for DSM-IV.
- PSD symptom severity was measured using the 15-item Geriatric Depression Scale (GDS).
- Cerebral microbleeds (CMBs) were identified using magnetic resonance imaging (MRI).
Main Results:
- 7.8% of patients developed PSD, with 20 PSD patients having CMBs.
- Patients with lobar CMBs exhibited significantly higher mean GDS scores compared to those without CMBs (12.6±2.6 vs. 10.4±2.5, p=0.01).
- This association remained significant after adjusting for age, sex, cognitive function, neurological deficits, and white matter hyperintensities.
Conclusions:
- Lobar CMBs may contribute to increased severity of post-stroke depression (PSD).
- The findings suggest a potential role for CMBs in the pathogenesis of PSD.
- Further investigation is warranted for CMBs' role in other psychiatric disorders in stroke survivors and other populations.
