Influence of inflammatory status in the acute phase of stroke on post-stroke depression.
Revue Neurologique. 2021-10-01; 177(8): 941-946
DOI: 10.1016/j.neurol.2020.11.005
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Liegey JS(1), Sagnier S(2), Debruxelles S(2), Poli M(2), Olindo S(2), Renou
P(2), Rouanet F(2), Moal B(3), Tourdias T(4), Sibon I(2).
Author information:
(1)Unité neurovasculaire, pôle de neurosciences cliniques, hôpital Pellegrin,
CHU de Bordeaux, Unité Bordeaux Segalen, 33076 Bordeaux, France. Electronic
address: .
(2)Unité neurovasculaire, pôle de neurosciences cliniques, hôpital Pellegrin,
CHU de Bordeaux, Unité Bordeaux Segalen, 33076 Bordeaux, France.
(3)CHU de Bordeaux, Bordeaux, France.
(4)Neuroradiologie, CHU de Bordeaux, Bordeaux, France.
BACKGROUND: Thirty percent of stroke patients will suffer from post-stroke
depression (PSD). Recent data suggest that inflammation accounts for a
substantial amount of depression. Our primary objective was to assess the
association between standard inflammation biomarkers in the acute phase of
stroke and PSD at three months. The secondary objective was to elaborate a
predictive model of PSD from clinical, biological and radiological data.
METHODS: We performed a retrospective analysis of a single-centre cohort of
stroke patients with a three-month follow-up. Serum levels of C-reactive protein
(CRP), fibrinogen, leukocyte count and neutrophil to lymphocyte ratio (NLR) were
tested at admission and at peak. Mood was assessed at three months using the
depression sub-scale of the Hospital Anxiety and Depression Scale (HADS).
Association between inflammation biomarkers and HADS was evaluated with
multi-linear regression adjusted on clinical and radiological parameters.
Logistic predictive models of PSD at three months, with and without inflammation
biomarkers, were compared.
RESULTS: Three hundred and forty-eight patients were included, of whom 20.06%
developed PSD. Baseline and peak values of all inflammatory markers were
associated with the severity of PSD at three months. Area under the curve for
the receiver operating characteristic curve of PSD prediction was 0.746 (CI 95%
0.592-0.803) with selected inflammation biomarkers and 0.744 (CI 95%
0.587-0.799) without.
CONCLUSION: Most inflammation biomarkers are weakly associated with PSD, adding
negligible value to predictive models. While they suggest the implication of
inflammation in PSD pathogenesis, they are useless for the prediction of PSD,
underscoring the need for more specific biomarkers.
Copyright © 2021 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.neurol.2020.11.005
PMID: 33610348 [Indexed for MEDLINE]