Exploring causal pathways linking cerebral small vessel diseases burden to poststroke depressive symptoms with...

Area of Science:

• Neurology
• Neuroimaging
• Psychiatry

Background:

• Cerebral small vessel diseases (SVD) are linked to poststroke depressive symptoms (PDS).
• Mechanisms connecting SVD burden and PDS remain unclear.
• This study investigates the clinical pathways between SVD burden and PDS.

Purpose of the Study:

• To elucidate the direct and indirect pathways linking SVD burden to PDS in stroke patients.
• To understand the mediating roles of infarct volume, stroke severity, and functional deficits.

Main Methods:

• Structural equation modeling (SEM) analyzed data from 563 ischemic stroke patients.
• MRI assessed SVD markers (lacunae, white matter hyperintensities, microbleeds, perivascular spaces) and infarct volumes.
• Depression (GDS), cognitive (MMSE), and physical function (mRS) were evaluated at 3 and 15 months post-stroke.

Main Results:

• SVD burden directly correlated with PDS at 3 months (path coefficient=0.11).
• PDS at 3 months mediated the SVD-PDS link at 15 months (path coefficient=0.48).
• Infarct volume and physical function mediated the SVD-PDS association at 3 months; cognitive and physical functions mediated it at 15 months.

Conclusions:

• SVD burden directly impacts PDS and exacerbates stroke-related factors contributing to PDS.
• The findings highlight SVD's multifaceted role in PDS development post-stroke.