Cerebral microbleeds as a predictor of 1-year outcome of poststroke depression

Stroke. 2014 Jan;45(1):77-81. doi: 10.1161/STROKEAHA.113.002686. Epub 2013 Oct 31.

Abstract

Background and purpose: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: depression; magnetic resonance imaging; outcome measures; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian People
  • Cerebral Hemorrhage / psychology*
  • Depressive Disorder / etiology
  • Depressive Disorder / psychology*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Odds Ratio
  • Prognosis
  • Recurrence
  • Risk Factors
  • Socioeconomic Factors
  • Stroke / complications
  • Stroke / psychology*
  • Treatment Outcome