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Total magnetic resonance imaging burden of cerebral small‐vessel disease is associated with post‐stroke depression in patients with acute lacunar stroke
Author(s) -
Zhang X.,
Tang Y.,
Xie Y.,
Ding C.,
Xiao J.,
Jiang X.,
Shan H.,
Lin Y.,
Li C.,
Hu D.,
Li T.,
Sheng L.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13213
Subject(s) - medicine , lacunar stroke , stroke (engine) , magnetic resonance imaging , depression (economics) , disease , cardiology , ischemic stroke , radiology , ischemia , mechanical engineering , macroeconomics , economics , engineering
Background and purpose Despite extensive studies on post‐stroke depression ( PSD ), the role of the total burden of cerebral small‐vessel disease ( cSVD ) in its pathogenesis remains unclear. Methods We conducted a magnetic resonance imaging ( MRI) ‐based cohort study to investigate the relationship between total MRI burden of cSVD and PSD among patients with first‐ever lacunar stroke. From June 2013 to January 2016, 374 patients were consecutively recruited. PSD was identified using the Chinese version of the Structured Clinical Interview for DSM ‐ IV . Brain MRI presence of silent lacunar infarcts, white‐matter lesions, cerebral microbleeds and enlarged perivascular spaces was summed to an ordinal score between 0 and 4. Multivariable logistic regression analysis was performed to determine the contribution of total MRI cSVD burden in the prediction of PSD. Results Ninety patients (24.1%) were diagnosed with PSD at 3 months after stroke. Only two MRI markers of cSVD , asymptomatic lacunar infarcts and white‐matter lesions, were related to PSD [odds ratio ( OR ), 3.167; 95% confidence interval ( CI ), 1.879–5.338; P = 0.001 and OR , 2.284; 95% CI, 1.403–3.713; P = 0.001, respectively]. Moreover, higher total MRI cSVD burden was an independent predictor for PSD (high tertile OR , 4.577; 95% CI, 2.400–8.728; P = 0.001) after adjusting for individual cSVD MRI marker and other potential confounders. Conclusions This study demonstrated that greater total MRI burden of cSVD may predict the presence of PSD in patients with acute lacunar stroke.