Depressive Symptoms Profiles and Cognitive Outcomes After Stroke

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.