Thyroid Function Affects the Risk of Post-stroke Depression in Patients With Acute Lacunar Stroke

Area of Science:

• Neurology
• Endocrinology
• Psychiatry

Background:

• Post-stroke depression (PSD) is a common complication following stroke.
• Thyroid dysfunction is increasingly recognized as a potential factor influencing mood disorders.
• Cerebral small vessel disease (cSVD) is prevalent in stroke patients and may affect neurological and psychological outcomes.

Purpose of the Study:

• To investigate the association between thyroid function profiles and PSD in patients with acute ischemic lacunar stroke.
• To evaluate the mediating role of cSVD in the relationship between thyroid function and PSD.

Main Methods:

• 372 patients with acute ischemic lacunar stroke were recruited.
• Serum thyroid hormones and antibodies were measured; cSVD markers were assessed.
• Depression severity was evaluated using the Hamilton Depression Scale; multivariate regression and mediation analyses were performed.

Main Results:

• 23.4% of patients developed PSD.
• Higher serum thyroid-stimulating hormone (TSH) levels were associated with increased PSD risk (OR=1.228).
• Cerebral small vessel disease burden was also significantly associated with PSD (OR=2.137), mediating 26.37% of the TSH-PSD association.

Conclusions:

• Serum TSH levels at admission may serve as a predictor for PSD in acute ischemic lacunar stroke.
• Cerebral small vessel disease plays a significant mediating role in the link between TSH and PSD.