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Cerebral microbleeds as a predictor of 1-year outcome of poststroke depression
Wai Kwong Tang1, Yangkun Chen, Huajun Liang
1From the Department of Psychiatry (W.K.T., H.L.), Department of Imaging and Interventional Radiology (W.C.W.C.), and Department of Medicine and Therapeutics (V.C.T.M., K.S.W.), Chinese University of Hong Kong, Hong Kong SAR, China; Department of Neurology, Dongguan People's Hospital, Dongguan, Guangdong, P.R. China (Y.C.); The University of Notre Dame Australia/Marian Centre, Perth, Australia (G.S.U.); and School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Australia (G.S.U.).
Background And Purpose:
Cerebral microbleeds (CMBs) are common in stroke survivors and community-dwelling elderly. The clinical significance of CMBs in the outcome of poststroke depression (PSD) is unknown. This study examined the association between the 1-year outcome of PSD and CMBs.
Methods:
The study population comprised 774 Chinese patients with acute ischemic stroke who were admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong. Three and 15 months after the onset of the index stroke, a research assistant administered the locally validated 15-item Geriatric Depression Scale. PSD was defined as a Geriatric Depression Scale score of ≥7. Of the 213 patients with PSD at the 3-month follow-up, 135 (63.4%) attended the 15-month follow-up, at which time 89 (65.9%) patients remained depressed (nonremitters), and 46 (34.1%) had recovered (remitters). The presence and location of CMBs were evaluated with magnetic resonance imaging.
Results:
In comparison with the remitters, nonremitters were more likely to have lobar CMBs (18.4% versus 4.3%; P=0.024). Lobar CMBs remained an independent predictor of PSD in the multivariate analysis, with an odds ratio of 4.96 (P=0.039).
Conclusions:
The results suggest that lobar CMBs may influence the outcome of PSD. The importance of CMBs in the clinical course of depression in stroke survivors warrants further investigation.
Insights
Lobar cerebral microbleeds (CMBs) are linked to persistent poststroke depression (PSD) in stroke survivors. These microbleeds may predict a poorer outcome for depression, suggesting further research is needed.
Area of Science:
- Neurology
- Psychiatry
- Radiology
Background:
- Cerebral microbleeds (CMBs) are prevalent in elderly individuals and stroke survivors.
- The impact of CMBs on the long-term outcome of poststroke depression (PSD) remains unclear.
Purpose of the Study:
- To investigate the association between the presence and location of CMBs and the 1-year outcome of PSD.
Main Methods:
- A cohort of 774 Chinese patients with acute ischemic stroke was studied.
- Poststroke depression was assessed using the Geriatric Depression Scale at 3 and 15 months post-stroke.
- Cerebral microbleeds were identified and located using magnetic resonance imaging.
Main Results:
- Patients with persistent PSD (nonremitters) were more likely to have lobar CMBs compared to those who recovered (remitters).
- Lobar CMBs were identified as an independent predictor of non-remitted PSD, with an odds ratio of 4.96.
Conclusions:
- Lobar CMBs appear to influence the outcome of poststroke depression.
- Further research is warranted to understand the role of CMBs in the clinical course of depression among stroke survivors.
