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Post-stroke depression presents diverse profiles, including distinct groups with apathy or anxiety. These syndromes correlate with specific cognitive impairments and baseline predictors, influencing outcomes like dementia and executive dysfunction.

Keywords:
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Area of Science:

  • Neuroscience
  • Psychiatry
  • Gerontology

Background:

  • Post-stroke depressive symptoms are heterogeneous.
  • These symptoms variably associate with psycho-cognitive features.
  • Identifying distinct depressive profiles is crucial for understanding post-stroke recovery.

Purpose of the Study:

  • To identify distinct profiles of post-stroke depressive symptomatology using cluster analysis.
  • To investigate the association between these profiles and cognitive performance.
  • To determine baseline predictors and 6-month cognitive outcomes for each profile.

Main Methods:

  • Cluster analysis of the Center for Epidemiologic Studies Depression Scale, apathy, and anxiety items.
  • Inclusion of 189 patients evaluated 6 months post-stroke.
  • Comparison of baseline clinical/neuroimaging variables and 6-month cognitive outcomes across identified profiles.

Main Results:

  • Three distinct profiles emerged: low depressive symptoms (n=108), moderate depressive symptoms plus anxiety (n=41), and high depressive symptoms plus apathy (n=40).
  • High depressive symptoms plus apathy associated with lower baseline cognitive scores (MoCA) and higher rates of post-stroke dementia and executive dysfunction.
  • Moderate depressive symptoms plus anxiety linked to less cortical atrophy and distinct cognitive patterns compared to other groups.

Conclusions:

  • Depressive symptoms post-stroke represent heterogeneous neuropsychiatric syndromes when apathy and anxiety are integrated.
  • Distinct profiles exhibit different baseline predictors.
  • These syndromes are associated with specific cognitive impairment patterns, impacting recovery and long-term outcomes.