Post-stroke Arrhythmia Could Be a Potential Predictor for Post-stroke Depression

Overview

Journal Sci Rep

Specialty Science

Date 2024 Apr 20

PMID 38643303

Authors

Tao Xu

Fangying Dong

Muhua Zhang

Kewu Wang

Tian Xu

Shudong Xia

Chao Feng

Affiliations

Soon will be listed here.

Abstract

Post-stroke depression (PSD) is regarded as the consequence of multiple contributors involving the process of cognition, mood and autonomic system, with the specific mechanism unclear yet. As a common type of stroke-heart syndromes, post-stroke arrhythmia shared some common pathogenesis with PSD. We presumed that post-stroke arrhythmia might be an early distinguishable marker for the presence of PSD and aimed to verity their association in this study. Patients with first-ever ischemic stroke were enrolled. The presence of post-stroke ectopic arrhythmia and the symptoms of arrhythmia were recorded with anti-arrhythmia drugs prescribed when necessary. Patients were followed up 3 months later to identify their presence and severity of PSD using Hamilton Depression Scale (HAMD) and also presence and severity of arrhythmia. Characteristics including the prevalence of various types of arrhythmias were compared between PSD and non-PSD groups. The HAMD scores were compared between patients with and without arrhythmia in PSD group. Logistic regression was used to identify the independent predictor of PSD. Patients with PSD had higher prevalence of post-stroke arrhythmia especially newly-detected arrhythmia, symptomatic arrhythmia and poor-controlled arrhythmia. In PSD group, patients of post-stroke arrhythmia had higher scores of HAMD than those without arrhythmia. Presence of newly-detected, symptomatic and poor-controlled arrhythmias were independent predictor of PSD. post-stroke arrhythmia especially newly-detected arrhythmia and symptomatic arrhythmia could be an early predictor of PSD. Successful control of arrhythmia was associated with reduced prevalence and severity of PSD.

References

Saini V, Guada L, Yavagal D . Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology. 2021; 97(20 Suppl 2):S6-S16. DOI: 10.1212/WNL.0000000000012781. View

Peacock J, Whang W . Psychological distress and arrhythmia: risk prediction and potential modifiers. Prog Cardiovasc Dis. 2013; 55(6):582-9. PMC: 4014636. DOI: 10.1016/j.pcad.2013.03.001. View

Wang W, Jiang B, Sun H, Ru X, Sun D, Wang L . Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults. Circulation. 2017; 135(8):759-771. DOI: 10.1161/CIRCULATIONAHA.116.025250. View

Cai W, Mueller C, Li Y, Shen W, Stewart R . Post stroke depression and risk of stroke recurrence and mortality: A systematic review and meta-analysis. Ageing Res Rev. 2019; 50:102-109. DOI: 10.1016/j.arr.2019.01.013. View

Zeng Y, Wu M, Geng D, Cheng L, Zhou S, Fan K . Early-Onset Depression in Stroke Patients: Effects on Unfavorable Outcome 5 Years Post-stroke. Front Psychiatry. 2021; 12:556981. PMC: 8267172. DOI: 10.3389/fpsyt.2021.556981. View

Zhanina M, Druzhkova T, Yakovlev A, Vladimirova E, Freiman S, Eremina N . Development of Post-Stroke Cognitive and Depressive Disturbances: Associations with Neurohumoral Indices. Curr Issues Mol Biol. 2022; 44(12):6290-6305. PMC: 9776624. DOI: 10.3390/cimb44120429. View

Richardson E, Spinks C, Davis A, Turner C, Atherton J, McGaughran J . Psychosocial Implications of Living with Catecholaminergic Polymorphic Ventricular Tachycardia in Adulthood. J Genet Couns. 2017; 27(3):549-557. DOI: 10.1007/s10897-017-0152-1. View

Zhang X, He X, Wu L, Liu C, Wu W . Altered Functional Connectivity of Amygdala with the Fronto-Limbic-Striatal Circuit in Temporal Lobe Lesion as a Proposed Mechanism for Poststroke Depression. Am J Phys Med Rehabil. 2018; 98(4):303-310. DOI: 10.1097/PHM.0000000000001081. View

Buckley B, Harrison S, Hill A, Underhill P, Lane D, Lip G . Stroke-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications Following Stroke. Stroke. 2022; 53(5):1759-1763. DOI: 10.1161/STROKEAHA.121.037316. View

10.

Raghu A, Parker T, van Wyk A, Green A . Insula stroke: the weird and the worrisome. Postgrad Med J. 2019; 95(1127):497-504. DOI: 10.1136/postgradmedj-2019-136732. View

11.

Redmond C, Bushnell C, Duncan P, DAgostino Jr R, Ambrosius W, Bishop L . Association of in-hospital depression and anxiety symptoms following stroke with 3 months- depression, anxiety and functional outcome. J Clin Neurosci. 2022; 98:133-136. DOI: 10.1016/j.jocn.2022.02.010. View

12.

Shi Y, Xiang Y, Wu S, Zhang N, Zhou J, Bai Y . The relationship between frontal lobe lesions, course of post-stroke depression, and 1-year prognosis in patients with first-ever ischemic stroke. PLoS One. 2014; 9(7):e100456. PMC: 4086722. DOI: 10.1371/journal.pone.0100456. View

13.

Scheitz J, Sposato L, Schulz-Menger J, Nolte C, Backs J, Endres M . Stroke-Heart Syndrome: Recent Advances and Challenges. J Am Heart Assoc. 2022; 11(17):e026528. PMC: 9496419. DOI: 10.1161/JAHA.122.026528. View

14.

Won E, Kim Y . Stress, the Autonomic Nervous System, and the Immune-kynurenine Pathway in the Etiology of Depression. Curr Neuropharmacol. 2016; 14(7):665-73. PMC: 5050399. DOI: 10.2174/1570159x14666151208113006. View

15.

Giammello F, Cosenza D, Casella C, Granata F, DellAera C, Fazio M . Isolated Insular Stroke: Clinical Presentation. Cerebrovasc Dis. 2020; 49(1):10-18. DOI: 10.1159/000504777. View

16.

Das J, G K R . Post stroke depression: The sequelae of cerebral stroke. Neurosci Biobehav Rev. 2018; 90:104-114. DOI: 10.1016/j.neubiorev.2018.04.005. View

17.

Wei N, Yong W, Li X, Zhou Y, Deng M, Zhu H . Post-stroke depression and lesion location: a systematic review. J Neurol. 2014; 262(1):81-90. DOI: 10.1007/s00415-014-7534-1. View

18.

Paul N, Das S, Hazra A, Ghosal M, Ray B, Banerjee T . Depression among stroke survivors: a community-based, prospective study from Kolkata, India. Am J Geriatr Psychiatry. 2013; 21(9):821-31. DOI: 10.1016/j.jagp.2013.03.013. View

19.

Wei C, Zhang F, Chen L, Ma X, Zhang N, Hao J . Factors associated with post-stroke depression and fatigue: lesion location and coping styles. J Neurol. 2015; 263(2):269-276. PMC: 4751197. DOI: 10.1007/s00415-015-7958-2. View

20.

Sposato L, J Hilz M, Aspberg S, Murthy S, Bahit M, Hsieh C . Post-Stroke Cardiovascular Complications and Neurogenic Cardiac Injury: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020; 76(23):2768-2785. DOI: 10.1016/j.jacc.2020.10.009. View