AbstractBackground and purpose:
Despite extensive studies on post-stroke depression (PSD), the role of the total burden of cerebral small-vessel disease (cSVD) in its pathogenesis remains unclear.Methods:
We conducted a magnetic resonance imaging (MRI)-based cohort study to investigate the relationship between total MRI burden of cSVD and PSD among patients with first-ever lacunar stroke. From June 2013 to January 2016, 374 patients were consecutively recruited. PSD was identified using the Chinese version of the Structured Clinical Interview for DSM-IV. Brain MRI presence of silent lacunar infarcts, white-matter lesions, cerebral microbleeds and enlarged perivascular spaces was summed to an ordinal score between 0 and 4. Multivariable logistic regression analysis was performed to determine the contribution of total MRI cSVD burden in the prediction of PSD.Results:
Ninety patients (24.1%) were diagnosed with PSD at 3 months after stroke. Only two MRI markers of cSVD, asymptomatic lacunar infarcts and white-matter lesions, were related to PSD [odds ratio (OR), 3.167; 95% confidence interval (CI), 1.879–5.338; P = 0.001 and OR, 2.284; 95% CI, 1.403–3.713; P = 0.001, respectively]. Moreover, higher total MRI cSVD burden was an independent predictor for PSD (high tertile OR, 4.577; 95% CI, 2.400–8.728; P = 0.001) after adjusting for individual cSVD MRI marker and other potential confounders.Conclusions:
This study demonstrated that greater total MRI burden of cSVD may predict the presence of PSD in patients with acute lacunar stroke.