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Purpose To explore the changes of structure of cerebellum,frontal lobe and limbic system(cingulate gyrus,hippocampus and amygdala)in poststroke depression(PSD)via diffusion tensor imaging,and to confirm that cerebellum was involved in the occurrence of PSD,and to study the correlation between cerebellum and traditional depression-related areas such as frontal lobe,limbic system(cingulate gyrus,hippocampus and amygdala).Materials and Methods A total of 39 patients with basal ganglia infarction for the first time from October 2020 to October 2021 in the First Affiliated Hospital of Jinzhou Medical University were evaluated by Hamilton depression scale(HAMD),and all subjects were divided into PSD group(19 cases)and non-PSD group(20 cases),and 20 people with no statistical difference in basic information were randomly selected as the normal control group.The fractional anisotropy(FA)values and apparent diffusion coefficient in region of interest via diffusion tensor imaging were measured.The FA values of lesion and contralateral region of interest were compared among the three groups,and the correlation between FA value and HAMD score was analyzed.Results The FA values of ROI in the prefrontal lobe,hippocampus,cingulate gyrus,corpus callosum,middle cerebellar peduncle,and inferior cerebellar crus in the PSD group were significantly different from those in the non-PSD group and normal control group(t=-0.12--0.06,all P<0.05).The FA values of cerebellum,frontal lobe and limbic system were significantly negatively correlated with HAMD scores(R2adjust=0.954,P<0.05).There was a positive correlation between the FA value of contralateral foot in the cerebellum of PSD patients and that of prefrontal lobe,hippocampus,cingulate gyrus and knee of corpus callosum(r=0.977,0.752,0.637 and 0.539,all P<0.05),respectively.Conclusion PSD patients may have changes in the white matter fiber tracts of the cerebellum,which are associated with traditional depressions.
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Objective:To evaluate the clinical efficacy of Chaihu Longgu Muli Decoction in the treatment of post-stroke depression.Methods:A total of 130 patients with post-stroke depression who met the inclusion criteria from April 2019 to December 2020 were enrolled in the study. The patients were randomly divided into two groups with 65 cases in each group. The control group was treated with Flupentixol and melitracen tablets on the basis of routine treatment, and the observation group was treated with Chaihu Longgu Muli Decoction on the basis of routine treatment. Both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment. The levels of serum Hcy and hs CRP, Plasma 5-HT and brain-derived neurotrophic factor (BDNF) were detected by ELISA, and the ratio of neutrophils to lymphoblasts (NLR) was recorded.Results:The response rate was 92.3% (60/65) in the observation group and 75.4% (49/65) in the control group. There was significant difference between the two groups ( χ2=6.87, P=0.009). After treatment, the serum Hcy [(11.87±1.56) μmol/L vs. (16.69±1.77) μmol/L, t=16.47] and hs-CRP [(7.81±1.66) mg/L vs. (16.45±4.87) mg/L, t=13.54] in the observation group were significantly lower than those in the control group ( P<0.01), and Plasma 5-HT [(150.41±17.54) μg/L vs. (123.24±16.02) μg/L, t=9.22], BDNF [(19.45±2.48) μg/L vs. (12.56 ± 2.23) μg/L, t=16.66] were significantly higher than those in the control group ( P<0.01). After treatment, the NLR and TCM syndrome scores in the observation group were significantly lower than those in the control group ( t values were 6.03 and 7.15, respectively, all Ps<0.01). Conclusion:The Chaihu Longgu Muli Decoction combined with western medicine treatment can correct the levels of Hcy, hs-CRP, 5-HT, BDNF and NLR in peripheral blood, alleviate the state of depression and anxiety of patients with post-stroke depression.
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@#Objective To explore the clinical effect,SAS and HAMD scale score and 5-HT level of patients with post-stroke depression treated by awakening the mind and opening the qi needle.Methods A total of 93 patients with poststroke depression were included in the study,all of whom were admitted to our hospital from September 2018 to October 2020.Patients were divided into the control group and the observation group by random number table method.Patients in the control group (46 cases) were given conventional western medicine treatment.We compared between two groups of patients before and after treatment,treatment of depression self-rating scale (SDS) and Hamilton depression scale (HAMD) score changes,serotonin (5-HT) level change and neural function defect scale (NHISS) score and active ability of daily life (ADL) scale,simple mental state examination (MMSE) score changes,serum interleukin 6 (IL-6),interleukin 8 (IL-8),tumor necrosis factor alpha (TNF alpha) level changes,adverse reaction conditions.Results The total effective rate (95.74%) in the observation group was higher than that in the control group (82.61%)(P<0.05).Before the treatment,two groups of patients with SDS,HAMD,5-HT,NHISS,ADL,MMSE,IL-6,IL-8 and TNF alpha index comparison(P>0.05),groups of patients after treatment,HAMD,SDS 5-HT,NHISS,ADL,MMSE,IL-6,IL-8,TNF alpha indexes are improved,such as observation group after treatment in patients with SDS,HAMD,5-HT,NHISS,ADL,MMSE,IL-6,IL-8 and TNF alpha indicators are superior to control group(P<0.05).The adverse reaction rate in the observation group (2.13%) was lower than that in the control group (15.22%)(P<0.05).Conclusion The method of “awakening the mind and opening the depression” has a significant clinical effect on post-stroke depression.The patients’ depressive symptoms are improved and the recovery is good.Meanwhile,it can also reduce the side effects of medication in patients.
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@#Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.
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@#Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.
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Objective To investigate the efficacy of sertraline and nimodipine in treatment of stroke depression. Meth-ods Selected diagnosed post-stroke depression in our hospital from January 2011 to January 2013 as observed object. 60 cases of stroke depression were randomly divided into observation group and control group of 30 patients, were treated nutrition brain cells, the control group received sertraline 50~100 mg, observation group added in the nimodip-ine 30 mg / time, 3 times a day, sertraline 50~100mg, the course were 8 weeks. Before and after treatment, HAMD-17 score, the clinical efficacy of adverse reactions after treatment were compared between two groups. Results Before treatment , differences HAMD-17 score of were not statistically significant ( P> 0 . 05 ) , After 2 weeks of treatment , HAMD-17 score the observation group and control group of was significantly lower than before treatment,(P<0.05). Af-ter 4 weeks of treatment, HAMD-17 score of the observation group and control group was significantly lower than be-fore treatment and after 2 weeks of treatment,the difference was significant(P <0.05). After 6 weeks of treatment , the HAMD-17 observation group and control group score reduced than before treatment and after 2 weeks of treatment , reduced significantly than after 4 weeks of treatment, the difference was significant(P <0.05). Total efficiency of obser-vation group was 93.33%, the total efficiency of the control group was 70.00%, the difference of the effect was signifi-cant between two groups(P < 0.05). No case occurred during the observation group therapy anorexia, dry mouth , rash , and its complication rate of 10 % of the observation group , the control group complication rate of 40.00%, the differ-ence was significant between two groups(P < 0.05). Conclusion Sertraline and nimodipine treatment stroke depression has good efficacy, and safety, and it is worthy of promotion and application.
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A total of 192 poststroke patients with depression and anxiety were assigned randomly into study group (n =96) and control group (n =96).The study group received both capsules Shugan-jieyu and paroxetine while the control group paroxetine alone.Compared with the control group,scores of both Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were significantly different at the end of week 2 and 6 in the study group (P ＜ 0.05).The HAMD and HAMA deduction rate and the scores of mangled extremity severity,mini-mental state examination and modified Barthel index at the end of week 6 of the study group were better than those of the control group (all P ＜ 0.05).The combined use of capsules Shugan-jieyu and paroxetine could improve symptoms of depression and anxiety,offer a higher safety and accelerate the rehabilitation of extremity function.
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OBJECTIVE: To investigate the correlation between poststroke depression (PSD) and the cognitive impairment in the patients with subacute stroke. METHOD: The subjects were 53 patients with cerebral infarction (n=28) and cerebral hemorrhage (n=25). These patients had a mean age of 64.3. The mean onset time was 2.7 months. The location of stroke was in the right hemisphere in 24 subjects, left hemisphere in 23, and bilateral in 6. The severity of PSD was evaluated by Beck Depression Inventory (BDI), Korean Geriatric Depression Scale (KGDS), and Hamilton Rating Scale for Depression (HRS-D) and the evaluation of cognitive impairments was based on Computerized Neuro-psychological Test (CNT), Mini-Mental State Examination (MMSE). The Pearson correlation was used as a measure of the strength of association between cognitive impairments and PSD. Independent t-tests were calculated to compare differences in cognitive functioning according to hemispheric involvement. RESULTS: PSD was diagnosed in 33 of 53 patients by the BDI, in 28 of 43 patients by the KGDS and in 22 of 45 patients by the HRS-D. Scores in the verbal and visual learning domains of the CNT were significantly correlated with scores on the BDI, KGDS, and HRS-D, but scores on the MMSE were unrelated to any of these measures of depression. CONCLUSION: We suggest the use of the CNT in poststroke depression patients could be a useful tool from the viewpoint of differentiation of PSD patients with or without cognitive impairment and the diagnosis for poststroke depression should be conducted by self rating and objective assessments.
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Humans , Cerebral Hemorrhage , Cerebral Infarction , Depression , Learning , StrokeABSTRACT
Poststroke depression is very common and has been reported in as many as 40~50% of poststroke patients. The fluoxetine is one of the most frequently prescribed drugs for the treatment of poststroke depression. This serotonin selective reuptake inhibitor, known as generally safe and well tolerated drug, has been recently reported to induce mania. We report a case of fluoxetine-induced mania. A 64 year-old male, who has taken 10 mg of fluoxetine daily due to poststroke depression, presented elevated mood, hyperactivity, regressed behavior, excessive planning, sleep deterioration, and talkativeness abruptly. We were suspicious of fluoxetine- induced manic state and discontinued immediately fluoxetine without prescription of mood stabilizer. His symptoms had been ceased over two weeks.
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Humans , Male , Bipolar Disorder , Depression , Fluoxetine , Prescriptions , SerotoninABSTRACT
@#Objective To observe the nucha electrical acupuncture Intervening at early times preventing the occurrence of poststroke depression(PSD)in acute cerebral infarction(ACI)patients.MethodsACI patients whose scores of Hamilton Rating Scale for Depression(HAMD-24)were not above to the the level of mild depression were divided into acupuncture group(30 cases)and control group(30 cases).They were assessed with HAMD-24 before and after treatment respectively.ResultsThere were 5 cases in acupuncture group whose scores of HAMD-24 were above the level of depression,which were mild in 3 cases,medium in 1 case,severe in 1 cases.While there were 12 cases in control group,which were mild in 6 cases,medium in 4 cases,severe in 2 cases(P<0.05).ConclusionThe nucha electrical acupuncture intervening early can reduce the incidence and relieve the degree of PSD.
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@# Objective To observe the effects of citalopram and physical therapy on poststroke depression(PSD).Methods72 patients with PSD were randomly divided into medicine group(n=36)and control group(n=36).The patients in the control group were treated only with physical therapy and the patients in the medicine group were treated with Citalopram and physical therapy.All patients were assessed with Zung Self-Rating Depression Scale(ZSDS)and Modified Barthel index(MBI)before and after treatment.ResultsAfter treatment,the Zung score in both groups decreased significantly(P<0.01).Meanwhile,the medicine group showed significantly less depression than the control group(P<0.05).The score of MBI was also significantly increased after treatment(P<0.01)in both group,but there was no significant difference between two groups(P>0.05).ConclusionCitalopram combined with physical therapy is effective on PSD.
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0.05).However,there were significances between the two groups in HAMD scores at 1 and 2 weeks after treatment(P
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Depression is a frequently developed psychiatric symptom after stroke. Poststroke depression(PSD) causes not only psychological distress related to depression but also other disturbances in many areas such as cognitive function, activities of daily living and quality of life. Therefore, a comprehensive understanding of accurate detection and appropriate treatment of depression is mandatory in patients with stroke. This review focused on the current knowledge of PSD.
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Humans , Activities of Daily Living , Depression , Diagnosis , Quality of Life , StrokeABSTRACT
BACKGROUND: To identify the prevalence and risk factors of poststroke depression(PSD) in patients admitted to department of rehabilitation medicine after stroke, to compare functional recovery of depressed patients and that of non-depressed patients, and to recognize the most useful depression scale that can predict functional recovery. METHOD: Of the hospitalized stroke patients in the department of Rehabilitation Medicine, 24 patients who were communicable were included in this study. To evaluate PSD, Beck depression inventory(BDI) and Korean form of Geriatric depression scale(KGDS) were used as self-rating scales. Hamilton depression scale(HAM-D) was used as an objective scale. Functional Independence measure(FIM) was measured at admission and discharge to evaluate functional recovery. RESULTS: In the 24 subjects, 17 patients(70.8%) and 9 patients(37.5%) were depressive by BDI and HAM-D. Of the 19 elderly patients, 16(84.2%) were depressive by KGDS. Factors such as age, level of education, religion, etiology or location of stroke were not significantly associated with PSD. And FIMscores were not significantly different in the depressed patients and non-depressed patients. The correlation coefficients of BDI, KGDS, HAM-D and FIMgain or efficiency were not statistically significant. CONCLUSION: The prevalence of PSDwas high in our study, but no association was found between PSD and functional recovery.
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Aged , Humans , Depression , Education , Hip , Inpatients , Prevalence , Rehabilitation , Risk Factors , Stroke , Weights and MeasuresABSTRACT
Objective:To study the efficacy of paroxetine and psychotherapy in patients with poststroke de- pression and anxiety.Methods:81 patients who met the CCMD-3 criteria of depression and anxiety after acute brain stroke were recruited and randomized into 3 groups.Group A was treated with routine antistroke medication and paroxetine;Group B was treated with routine antistroke medications,paroxetine plus psychotherapy;Group C(con- trol)was treated with routine antistroke medication.All patients were treated for 6 weeks and evaluated with SSS, HAMD,HAMA as measures of efficacy and side effects.Results:The comorbidity rate of poststroke depression and anxiety was 65.9%.According to the reduction of SSS,HAMD and HAMA scores,and increase of BI score,signifi- cant improvement has been showed in all patients.There was significant difference among group A,B and the control group(P