Level Of Serum BDNF In Post-stroke Depression Patients And Correlation Analysis Of Related Parameters

AIM:Post-stroke depression(PSD) is the most common psychiatric complication in cerebrovascular disease(CVD).Despite the prevalence of PSD varies in different countries,the prevalence of the PSD was high in general.Even though it was evident that PSD would attenuated the somatic and social function of post-stroke patients, which led to more impairment in cognitive function,low quality of living,and higher mortality and disability,many PSD patients had not been intervened appropriately in time because of low recognition and treatment rate.Early diagnosis and intervention of PSD not only will reduce clinical manifestation,facilitate the recovery of somatic and social function of individual,but also will decrease mortality and lighten the burden of care-giver.More and more researchers lay stress on the correlations of PSD and BDNF, for the pathogenesis of depressive disorder was highly related to the expression of BDNF.It has proved that BDNF level in blood serum changes with the same form as cerebrospinal fluid,the research on the assessment of BDNF level in blood serum and cerebrospinal fluid in PSD patients not only favored the understanding of the etiology of PSD,but also important to the early diagnosis and treatment of PSD.The present study aims to assess the serum BDNF level of PSD patients,and to explore the relation between BDNF level and cerebral apoplexic area,degree of depression,impairment of neural function,and quality of living.METHODS:41 initiate onset post-stroke patients were recruited from the inpatient department of neurology.All patients fulfilled the diagnostic criteria of cerebrovascular disease and confirmed from skull CT/MRI scanning.During the two weeks of hospitalization,blood sample was collected from each patient for the assessment of serum BDNF level.At the same time,Hamilton Depressive Scale(HAND-17),National Institute of Health Stroke Scale(NIHSS),Mini-Mental State Examination(MMSE),and Barthel index were applied to assess the somatic,social and cognitive functions of patients.Serum BDNF level was determined by enzyme-linked immunosorbent assay(ELISA).Data are presented as mean±SD.SPSS 15.0 were used in statistical analysis.Mean values between two groups were compared by a two-tailed Student t test.Spearman method was used for the correlation analysis of every two parameters.Differences were considered statistically significant at a value of P＜0.05.RESULTS:Of the total,17(41.46%) patients were diagnosed as PSD patients.Most of them were mild to moderate patients with a mean score of 20.41 in HAMD-17 scale.Brain imaging showed that depressive disorder was prone to comorbid with frontal area cerebral apoplexia.Compared to post-stroke patients without depressive disorder,PSD patients had significantly higher ratings in HAMD and NIHSS scale,and lower ratings in MMSE and Barthel index.These indicated that PSD patients were obviously impaired in cognitive functions,neural functions,and social functions.Significant correlations existed in HAMD-17 score and NIHSS(r=0.43,P＜0.01)or in HAMD-17 score and Barthel index(r=-0.45,P＜0.01) or in HAMD-17 score and MMSE score (r=-0.41,P＜0.01).Additionally the correlation analysis indicated that BDNF level was inversely related to HAMD-17 score(r=-0.38,P＜0.01) especially to anxiety/ somatization(r=-0.38,P＜0.05)and sleeping disorder factor score(r=-0.31,P＜0.05).CONCLUSIONSNo difference of prevalence was found in gender in PSD patients.The pathogenesis of PSD was related to the cerebral apoplexic area but not related to the type of cerebral apoplexia.More neural impairments were occurred in PSD patients, lead to further exacerbation of individual cognitive functions,daily capability and social functions.Serum BDNF level which inversely related to HAMD-17 score especially anxiety/somatization and sleeping disorder factor score,could be used as a biological marker to detect PSD during early stage of cerebrovascular disease.