Cerebral Microbleeds as a Predictor of 1-Year Outcome of Poststroke Depression

• Published in: Stroke (1970) 2014, Vol.45 (1), p.77-81
• Main Authors: WAI KWONG TANG, YANGKUN CHEN, HUAJUN LIANG, CHIU WING CHU, Winnie, CHUNG TONG MOK, Vincent, GABOR SANDOR UNGVARI, KA SING WONG
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Asian Continental Ancestry Group; Biological and medical sciences; Cerebral Hemorrhage - psychology; Depression; Depressive Disorder - etiology; Depressive Disorder - psychology; Diffusion Magnetic Resonance Imaging; Female; Humans; Image Processing, Computer-Assisted; Logistic Models; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Miscellaneous; Mood disorders; Neurology; Neuropharmacology; Odds Ratio; Pharmacology. Drug treatments; Prognosis; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Recurrence; Risk Factors; Socioeconomic Factors; Stroke - complications; Stroke - psychology; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.113.002686

Cerebral microbleeds (CMBs) are common in stroke survivors and community-dwelling elderly. The clinical significance of CMBs in the outcome of poststroke depression (PSD) is unknown. This study examined the association between the 1-year outcome of PSD and CMBs. The study population comprised 774 Chinese patients with acute ischemic stroke who were admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong. Three and 15 months after the onset of the index stroke, a research assistant administered the locally validated 15-item Geriatric Depression Scale. PSD was defined as a Geriatric Depression Scale score of ≥7. Of the 213 patients with PSD at the 3-month follow-up, 135 (63.4%) attended the 15-month follow-up, at which time 89 (65.9%) patients remained depressed (nonremitters), and 46 (34.1%) had recovered (remitters). The presence and location of CMBs were evaluated with magnetic resonance imaging. In comparison with the remitters, nonremitters were more likely to have lobar CMBs (18.4% versus 4.3%; P=0.024). Lobar CMBs remained an independent predictor of PSD in the multivariate analysis, with an odds ratio of 4.96 (P=0.039). The results suggest that lobar CMBs may influence the outcome of PSD. The importance of CMBs in the clinical course of depression in stroke survivors warrants further investigation.