Neuroimaging Study Of Post-stroke Depression

Objectives 1.Using susceptibility weighted imaging(SWI)to explore the distribution characteristics of cerebral microbleeds(CMBs)in patients with post-stroke depression(PSD)and its correlation with PSD.2.ASPECTS(Alberta Stroke Program early CT Score)is a score that evaluates changes in acute cerebral ischemia and predicts clinical outcomes.MRI data are used to explore the correlation between ASPECT score,specific stroke location and PSD,providing a basis for early recognition of PSD.Methods 1.A total of 161 patients with acute or previous history of cerebral infarction who were admitted to the Department of Neurology of Hebei Province People’s Hospital from April 2017 to June 2019 were selected for the Hamilton depression scale(HAMD)evaluation,≥ 8 patients were classified as having depression,and 45 patients in the depression group and 116 patients in the non-depression group.According to the SWI image to evaluate the number,location and distribution characteristics of CMBs.2.From April 2017 to June 2019,116 patients with acute cerebral infarction who were treated in the Department of Neurology of Hebei Province People’s Hospital were selected for HAMD evaluation,≥8 patients were classified as having depression,and 35 patients in the depression group and 81 patients in the non-depression group.ASPECT score were obtained for the two groups according to MRI,and the stroke sites were divided into 1)left,right and bilateral 2)frontotemporal lobe,parietal occipital lobe,basal ganglia area and subtentorial(brain stem and cerebellum).Both subjects collected clinical data including age,sex,history of hypertension,history of diabetes,history of coronary heart disease,National Institutes of Health Stroke Scale(NIHSS)and Mini-getting the State Examination(MMSE).SPSS21.0 software was used for statistical analysis of the data.Results 1.1)Among 161 patients with stroke,45(28.0%)were in the PSD group and 79(49.1%)were in CMBs.Compared with the non-PSD group,the detection rate of CMBs in the PSD group was higher,but the difference between the two groups was not statistically significant(P>0.05);the incidence of CMBs in lobar area was higher in PSD group(48.9%/25.9%),and the difference between the two groups was statistically significant(P<0.05).The proportion of females(51.1%/28.4%)and median NIHSS score(2/1)in PSD group were higher,the difference was statistically significant(P<0.05).There was no significant difference in age,history of hypertension,history of diabetes,history of coronary heart disease and MMSE(P>0.05).2)Multivariate logistic regression analysis showed that cerebral lobe CMBs were still independent risk factors for PSD(OR=3.155,95%CI: 1.481-6.722,P=0.003).3)Compared with the non-PSD group,there were 18 cases with no CMBs(40.0%/55.2%),12 cases with mild CMBs(26.7%/27.6%),9 cases with moderate CMBs(20.0%/7.7%),and 6 cases with severe CMBs(13.3%/9.5%)in the PSD group,and the correlation between CMBs severity and PSD was statistically significant(Z=2.022,P=0.043).2.1)Among the 116 patients with acute stroke,35 patients with PSD(30.2%).ASPECT score in the PSD group was lower than that in the non-PSD group(median 11/12),and the difference between the two groups was statistically significant(P<0.05).Compared with the non-PSD group,18 patients in the left lesion group(51.4%/44.4%),8 patients in the right lesion group(22.9%/37.1%),and 9 patients in the bilateral lesion group(25.7%/18.5%)were in the PSD group,but the difference was not statistically significant(P>0.05).There were 24 cases in the frontotemporal lobe group(68.6%/38.3%),10 cases in the parietal occipital lobe group(28.6%/29.6%),14 cases in the basal ganglia group(40.0%/44.4%),and 7 cases in the subtentorial group(20.0%/21.0%),among which the difference in the frontotemporal group was statistically significant(P<0.05).3)Multivariate logistic regression analysis showed that,the frontal temporal lobe lesion was an independent risk factor for PSD(OR=3.185,95%CI :1.083 ~ 9.363,P=0.035).ASPECT score was not independently correlated with PSD(OR=0.972,95%CI:0.596 ~ 1.584,P=0.908).Conclusions 1.PSD is related to the number of CMBs;2.Cerebral lobe CMBs,the severity of neurological deficit on admission and female are independent risk factors for PSD.3.The ASPECT score of PSD patients is low,and frontotemporal lobe infarction is independently related to the occurrence of PSD.Figure 0;Table 7;Reference 164...