ABSTRACT
Objective:The study aimed to investigate the association between lesion location and post-stroke depression (PSD) in acute ischemic stroke patients.Methods:In this case-control study, acute ischemic stroke patients were recruited from the Department of Neurology, First Affiliated Hospital of the University of Science and Technology of China (USTC), between September 2020 and June 2021. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, the patients were divided into the PSD and non-PSD groups. The 24-item Hamilton Rating Scale (HAMD) was used to evaluate the severity of depression. The Student′s t-test, Mann-Whitney test, and Chi-square test were used to compare the clinical baseline characteristics of PSD and non-PSD groups. Voxel-based lesion-symptom mapping (VLSM) was applied to investigate the association between lesion location and depression occurrence and severity. Results:A total of 70 and 173 patients were admitted to the PSD and non-PSD groups, respectively. The mean age of patients was 59 years (23-86). There were 153 males and 90 females. Univariate analysis showed a significant difference only in Hamilton Anxiety ( P=0.025) and Depression ( P<0.001) scores between the PSD and non-PSD groups. VLSM analysis identified clusters within the anterior cingulate gyrus ( Z=-3.05, P<0.001), left hippocampus ( Z=-3.15, P<0.001), and left lingual lobe ( Z=-3.08, P<0.001) where lesions were significantly associated with PSD. Additionally, the severity of PSD was associated with damage in the anterior cingulate gyrus ( Z=-3.64, P<0.001), left hippocampus ( Z=-3.51, P<0.001), left lingual lobe ( Z=-4.18, P<0.001), and pericalcarine cortex ( Z=-3.65, P<0.001). Conclusion:VLSM demonstrated that lesion location could be used to predict the occurrence of PSD in patients with acute ischemic stroke.
ABSTRACT
The brain-gut axis is an important pathway for the interaction between the central nervous system and the gastrointestinal tract. Ischemic stroke can promote the imbalance and displacement of intestinal flora, and the intestinal flora and its metabolites in turn can affect the occurrence, development and outcome of ischemic stroke. This article reviews the related literature on ischemic stroke and intestinal flora, in order to review the relationship between the two and related mechanisms, and to prospect the stroke treatment of targeting intestinal flora.
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Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and susceptibility to large-artery atherosclerotic stroke ( LAA ). Methods A total of 1 010 patients with LAA registered in Nanjing Stroke Registry Program between August 2013 and May 2017 were retrieved, and 1 121 healthy residents were selected as controls. Two single nucleotide polymorphisms of rs2073617 and rs3134069 of OPG gene were genotyped by SNPscan technique. Multivariate logistic regression analysis was used to analyze the relationship between rs2073617/rs3134069 and susceptibility to LAA. Results Multivariate logistic regression analysis indicated that the rs3134069 C allele (odds ratio [OR] 1.39, 95%confidence interval [CI] 1.13-1.71; P=0.002) and its corresponding CC/CA genotype (OR 1.43, 95% CI 1.14-1.80; P=0.002) were the independent risk factors for LAA. Stratification analysis showed that this association was more pronounced in the subgroups of olderly (≥60 years), those with hypertension, smoking or without diabetes and hyperlipidemia. In addition, haplotype analysis showed that G-C haplotype of rs2073617/rs3134069 was also an independent risk factor for LAA onset (OR 1.36, 95% CI 1.10-1.68; P=0.005). Conclusion OPG gene polymorphisms are associated with the susceptibility to LAA.