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Xiao M, Chen Y, Mu J. Innate immunity-mediated neuroinflammation promotes the onset and progression of post-stroke depression. Exp Neurol 2024; 381:114937. [PMID: 39197708 DOI: 10.1016/j.expneurol.2024.114937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 08/06/2024] [Accepted: 08/24/2024] [Indexed: 09/01/2024]
Abstract
Post-stroke depression (PSD) is a prevalent psychiatric disorder after stroke, with the incidence of approximately one-third among stroke survivors. It is classified as an organic mental disorder and has a well-documented association with stroke affecting various aspects of patients, such as the recovery of limb motor function, daily living self-care ability, and increasing the mortality of stroke survivors. However, the pathogenesis of PSD is not yet fully understood. Currently, immune inflammation is a research hotspot. This review focuses on the pathogenesis of PSD, particularly elucidating the role of inflammation in mediating neuroinflammation through innate immunity. Simultaneously, we highlight that peripheral inflammation following a stroke may trigger a detrimental cycle of neuroinflammation by activating innate immune pathways within the central nervous system, which could potentially contribute to the development of PSD. Lastly, we summarize potential treatments for PSD and propose targeting cytokines and innate immune pathways as novel therapeutic approaches.
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Affiliation(s)
- Mi Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Yixueyuan Road, Chongqing, China
| | - Yujie Chen
- Chongqing Clinical Research Center for Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jun Mu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Yixueyuan Road, Chongqing, China.
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Huang X, Zhang M, Wang J, Hu F. Association between interleukin-6 levels and stroke: a systematic review and meta-analysis. J Int Med Res 2024; 52:3000605241274626. [PMID: 39246071 PMCID: PMC11382220 DOI: 10.1177/03000605241274626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Abstract
OBJECTIVES We aimed to evaluate the association of interleukin-6 (IL-6) expression levels with stroke. METHODS According to the set search strategy, we systematically screened relevant studies using PubMed and extracted study results regarding IL-6 from the literature for comprehensive quantitative analysis to explore the relationship between IL-6 level and stroke risk. RESULTS This study included 15 publications with a total of 1696 participants, with 975 cases in the case group and 721 cases in the control group. Meta-analysis showed that IL-6 levels were significantly higher in the stroke population than those in the control group (standardized mean difference = 1.22, 95% confidence interval = 0.79-1.64). Subgroup analysis showed that there was no significant difference in heterogeneity for IL-6 detection methods between the two groups (I2 = 0, P = 0.47). The difference in heterogeneity test results regarding geographic region was statistically significant (I2 = 89.7%, P < 0.01). The results of heterogeneity testing for mean participant age were also statistically significant (I2 = 84.3%, P = 0.01). CONCLUSION The present study results showed that IL-6 may be significantly associated with stroke development.
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Affiliation(s)
- Xinyi Huang
- School of Public Health, Bengbu Medical University, Bengbu, China
| | - Manman Zhang
- School of Public Health, Bengbu Medical University, Bengbu, China
| | - Jiaojiao Wang
- School of Public Health, Bengbu Medical University, Bengbu, China
| | - Fuyong Hu
- School of Public Health, Bengbu Medical University, Bengbu, China
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3
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Zheng T, Jiang T, Li R, Zhu Y, Han Q, Wang M. Circulating interleukins concentrations and post-stroke depression: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111050. [PMID: 38844127 DOI: 10.1016/j.pnpbp.2024.111050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/06/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
Interleukins may play a role in supporting the diagnosis of post-stroke depression (PSD). Here, eight databases were employed to search for studies on circulating interleukins concentrations in patients with PSD. A total of 45 studies exploring circulating interleukins in PSD and stroke patients without depression (NPSD) were included in the retrieval database, including IL-1(5), IL-1β (10), IL-2(6), IL-6(35), IL-10(7), IL-17(5), IL-18(6). Then, the RevMan 5.4 software was used for meta-analysis. The results of the meta-analysis showed that the PSD patients have higher concentrations of IL-1, IL-4, IL-6, and lower concentrations of IL-10 than NPSD patients. Additionally, the circulating IL-1, IL-6, and IL-18 concentrations in PSD patients were significantly higher than those in NPSD patients in the acute phase; the circulating IL-6 and IL-17 concentrations in PSD patients were significantly higher than those in NPSD patients at discharge; the PSD patients have lower concentrations sin IL-2 but higher concentrations in IL-6 and IL-17 than NPSD patients at the 3rd and 6th month. Our research provides evidence that circulating interleukins may have clinical utility as a biomarker for identifying PSD.
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Affiliation(s)
- Ting Zheng
- Department of Neurology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, China; The Second Clinical Medical School, Lanzhou University, Lanzhou 730030, China
| | - Taotao Jiang
- Department of Neurology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, China; The Second Clinical Medical School, Lanzhou University, Lanzhou 730030, China
| | - Rundong Li
- The Second Clinical Medical School, Lanzhou University, Lanzhou 730030, China
| | - Yanping Zhu
- Department of Neurology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, China
| | - Qian Han
- School of Public Health, Lanzhou University, Lanzhou 730030, China
| | - Manxia Wang
- Department of Neurology, The Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou 730030, China.
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Zhou H, Wei YJ, Xie GY. Research progress on post-stroke depression. Exp Neurol 2024; 373:114660. [PMID: 38141804 DOI: 10.1016/j.expneurol.2023.114660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
Stroke is a highly prevalent and widely detrimental cardiovascular disease, frequently resulting in impairments of both motor function and neural psychological capabilities, such as post-stroke depression (PSD). PSD is the most prevalent neuropsychological disorder among stroke patients, characterized by persistent emotional lowness and diminished interest as its primary features. This article summarizes the mechanism research, animal models and related treatments of PSD. Further improvements are needed in the screening of research subjects and the construction of animal models in the study of PSD. At the same time, in the study of the mechanism of PSD, we need to consider the interaction between multiple systems. The treatment of PSD requires more careful consideration. This can help us to find something new in the study of the mechanism of complex PSD, which provides a new direction for us to develop new treatment delivery.
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Affiliation(s)
- Hui Zhou
- The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Zhongshan Hospital), Hangzhou, Zhejiang Province, China
| | - Yu-Jiao Wei
- The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Zhongshan Hospital), Hangzhou, Zhejiang Province, China
| | - Guang-Yao Xie
- The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Zhongshan Hospital), Hangzhou, Zhejiang Province, China; The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
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5
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Korostovtseva LS, Kolomeichuk SN. Circadian Factors in Stroke: A Clinician's Perspective. Cardiol Ther 2023; 12:275-295. [PMID: 37191897 DOI: 10.1007/s40119-023-00313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Stroke remains one of the leading causes of mortality and long-term and permanent disability worldwide despite technological innovations and developments in pharmacotherapy. In the last few decades, the growing data have evidenced the role of the circadian system in brain vulnerability to damage, the development and evolution of stroke, and short-term and long-term recovery. On the other hand, the stroke itself can affect the circadian system via direct injury of specific brain structures involved in circadian regulation (i.e., hypothalamus, retinohypothalamic tracts, etc.) and impairment of endogenous regulatory mechanisms, metabolic derangement, and a neurogenic inflammatory response in acute stroke. Moreover, the disruption of circadian rhythms can occur or exacerbate as a result of exogenous factors related to hospitalization itself, the conditions in the intensive care unit and the ward (light, noise, etc.), medication (sedatives and hypnotics), and loss of external factors entraining the circadian rhythms. In the acute phase of stroke, patients demonstrate abnormal circadian variations in circadian biomarkers (melatonin, cortisol), core body temperature, and rest-activity patterns. The approaches aimed at the restoration of disrupted circadian patterns include pharmacological (melatonin supplementation) and non-medication (bright light therapy, shifting feeding schedules, etc.) interventions; however, their effects on short- and long-term recovery after stroke are not well understood.
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Affiliation(s)
- Lyudmila S Korostovtseva
- Sleep Laboratory, Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Str., St Petersburg, 197341, Russia.
| | - Sergey N Kolomeichuk
- Sleep Laboratory, Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Str., St Petersburg, 197341, Russia
- Laboratory of Genetics Institute of Biology, Karelian Research Centre, Russian Academy of Sciences, Almazov National Medical Research Centre, St Petersburg, Russia
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Yin S, Li N, Wang Y. Prognostic value of Type D personality for post-stroke depression in ischemic stroke patients. J Affect Disord 2023; 333:172-176. [PMID: 37086794 DOI: 10.1016/j.jad.2023.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Depression in patients with stroke has been a risk factor for adverse outcomes. Type D personality as a significant predictor of negative psychological status. However, the relationship with post-stroke depression (PSD) is still unclear. METHODS A prospective observational study of 533 patients with first-ever ischemic stroke was conducted between November 2020 and March 2021. Type D personality was assessed at baseline. The presence of depression was measured 3-month after discharge. RESULTS During 3-month follow-up, a total of 141 patients developed PSD. On multivariate logistic analysis, the main effect of negative affectivity (OR = 1.28, 95%CI = 1.03-1.61, p = 0.030) and social inhibition (OR = 1.25, 95%CI = 1.01-1.54, p = 0.039) showed significant correlation with PSD when Type D analyzed as continuous variables. Furthermore, positive effects were found for the negative affectivity and social inhibition interaction (OR = 1.31, 95 % CI =1.11-1.55, p = 0.001) on PSD. CONCLUSIONS Our findings suggest that Type D personality is high risk group of PSD. These findings highlight the importance of personalized interventions management in Type D individuals.
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Affiliation(s)
- Shi Yin
- Department of neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na Li
- Office of administration of the Public Health Institute of Harbin Medical University, Harbin, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Qiu X, Wang H, Lan Y, Miao J, Pan C, Sun W, Li G, Wang Y, Zhao X, Zhu Z, Zhu S. Explore the influencing factors and construct random forest models of post-stroke depression at 3 months in males and females. BMC Psychiatry 2022; 22:811. [PMID: 36539755 PMCID: PMC9764471 DOI: 10.1186/s12888-022-04467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is one of the most common neuropsychiatric complications after stroke. The occurrence, development and prognosis of PSD have long been different between males and females. The main purpose of this study was to explore the influencing factors of PSD at 3 months in males and females, and construct random forest (RF) models to rank the influencing factors. METHODS This is a prospective multicenter cohort study (Registration number: ChiCTR-ROC-17013993). Stroke patients hospitalized in the department of Neurology of three hospitals in Wuhan were enrolled from May 2018 to August 2019. Scale assessments were performed 24 hours after admission and 3 months after stroke onset. Binary logistic regression analysis was used for univariate and multivariate (stepwise backward method) analysis, when p was less than 0.05, the difference between groups was considered statistically significant. Lastly, the RF models were constructed according to the results of multivariate regression analysis. RESULTS This study found that several baseline variables were associated with PSD at 3 months in males and females. RF model ranked them as stroke severity (OR [odds ratio] =1.17, p < 0.001, 95%CI [confidence interval]:1.11-1.24), neuroticism dimension (OR = 1.06, p = 0.002, 95%CI:1.02-1.10), physical exercise (OR = 0.62, p = 0.007, 95%CI:0.44-0.88), sleeping time < 5 h (OR = 1.91, p = 0.006, 95% CI:1.20-3.04) and atrial fibrillation (OR = 4.18, p = 0.012, 95%CI:1.38-12.68) in males. In females, RF model ranked them as psychological resilience (OR = 0.98, p = 0.015, 95%CI:0.96-1.00), ability of daily living (OR = 0.98, p = 0.001, 95%CI:0.97-0.99), neuroticism dimension (OR = 1.11, p = 0.002, 95%CI:1.04-1.18) and subjective support (OR = 1.11, p < 0.001, 95%CI:1.05-1.78). CONCLUSION The study found influencing factors of PSD at 3 months were different in males and females, and construct RF models to rank them according to their importance. This suggests that clinicians should focus their interventions on sex-specific influencing factors in order to improve the prognosis of PSD patients. TRIAL REGISTRATION ChiCTR-ROC-17013993.
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Affiliation(s)
- Xiuli Qiu
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - He Wang
- grid.33199.310000 0004 0368 7223Department of Medical Affair, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Yan Lan
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Jinfeng Miao
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Chensheng Pan
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Wenzhe Sun
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Guo Li
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Yanyan Wang
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Xin Zhao
- grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030 Hubei China
| | - Zhou Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Development of Post-Stroke Cognitive and Depressive Disturbances: Associations with Neurohumoral Indices. Curr Issues Mol Biol 2022; 44:6290-6305. [PMID: 36547090 PMCID: PMC9776624 DOI: 10.3390/cimb44120429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Neuropsychiatric complications, in particular cognitive and depressive disorders, are common consequences of ischemic stroke (IS) and complicate the rehabilitation, quality of life, and social adaptation of patients. The hypothalamic-pituitary-adrenal (HPA) system, sympathoadrenal medullary system (SAMS), and inflammatory processes are believed to be involved in the pathogenesis of these disorders. This study aimed to explore these systems in IS patients, including those with post-stroke cognitive and depressive disorders, within a year after IS. Indices of the HPA axis, inflammatory system, and SAMS were measured in blood serum (cortisol, interleukin-6 (IL-6)), plasma (adrenocorticotropic hormone), and saliva (cortisol, α-amylase). During one year after mild/moderate IS (NIHSS score 5.9 ± 4.3), serum cortisol and salivary α-amylase levels remained elevated in the total cohort. In the group with further cognitive decline, serum and salivary cortisol levels were elevated during the acute period of IS. In the group with poststroke depressive disorder, salivary α-amylase was constantly elevated, while serum IL-6 was minimal during the acute period. The results suggest prolonged hyperactivation of the HPA axis and SAMS after IS. Specifically, post-stroke cognitive impairment was associated with hyperactivation of the HPA axis during the acute IS period, while post-stroke depressive disorder was associated with the chronic inflammatory process and hyperactivation of SAMS during the follow-up period.
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Muacevic A, Adler JR, Gutlapalli SD, Prakash K, Swarnakari KM, Bai M, Manoharan MP, Raja R, Desai A, Desai DM, Arcia Franchini AP. Poststroke Depression, An Underrated Clinical Dilemma: 2022. Cureus 2022; 14:e32948. [PMID: 36712776 PMCID: PMC9879592 DOI: 10.7759/cureus.32948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/25/2022] [Indexed: 12/28/2022] Open
Abstract
It is known that the majority of patients are prone to develop depression following a stroke. Several biological factors, including the disruption of the hypothalamic and adrenal axis and changes in cortisol and interleukin 6 (IL6), are said to have an essential role in its development. Magnetic resonance imaging (MRI) scans point toward white matter lesions and lacunar infarcts as the primary pathological culprit. People affected by poststroke depression (PSD) are more likely to commit suicide or develop another ischemic event after the initial episode, which can likely increase the mortality related to PSD and stroke. Selective serotonin reuptake inhibitors (SSRIs) are the mainstay of treatment for PSD. However, it has a poor safety profile and is not very productive, making the use of SSRIs controversial, and further studies are required to prove its benefits concerning PSD. This literature review discusses the importance of PSD, how it impacts the quality of life of people affected by stroke, and its treatment.
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Apelin-13 attenuates cerebral ischemia/reperfusion injury through regulating inflammation and targeting the JAK2/STAT3 signaling pathway. J Chem Neuroanat 2022; 126:102171. [DOI: 10.1016/j.jchemneu.2022.102171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022]
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Anzolin AP, Feiten JG, Bristot G, Possebon GMP, Fleck MPDA, Caldieraro MA, Kauer-Sant'Anna M. Earlier age of onset is associated with a pro-inflammatory state in major depressive disorder. Psychiatry Res 2022; 314:114601. [PMID: 35749859 DOI: 10.1016/j.psychres.2022.114601] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
Major depressive disorder (MDD) is a common condition that affects the general population over a wide range of ages, regardless of gender and social background. Early-onset of MDD in adulthood, between ages of 18 and 30 years, is associated with worse outcomes and increased years of disability. Stress load and physical health have been associated with age of onset in MDD. We aim to investigate whether early onset MDD might be associated with changes in systemic inflammatory markers. We examined levels of following cytokines: IL-1β, IL-6, IL-10 and TNFα in 234 patients with MDD. Higher serum levels of TNFα and IL-1β are associated with the early onset of the disorder in patients with MDD. IL-6 levels were also higher in the early onset group and IL-10 levels were higher in the late onset group, but with no significant difference. Changes in the anti-inflammatory/pro-inflammatory balance have been described in mood disorders and may be implicated in its severity and pattern of progression. Our findings reinforce that higher serum levels of IL-1β and TNFα may be associated with the earlier onset subgroup of MDD patients. Future research that target inflammatory markers of immune modulation may be, key in the search for novel preventative therapeutics.
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Affiliation(s)
- Ana Paula Anzolin
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Giovana Bristot
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Gabriela Maria Pereira Possebon
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Marcelo Pio de Almeida Fleck
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marco Antonio Caldieraro
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil
| | - Marcia Kauer-Sant'Anna
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
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12
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Zhou L, Wang T, Yu Y, Li M, Sun X, Song W, Wang Y, Zhang C, Fu F. The etiology of poststroke-depression: a hypothesis involving HPA axis. Biomed Pharmacother 2022; 151:113146. [PMID: 35643064 DOI: 10.1016/j.biopha.2022.113146] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/06/2022] [Accepted: 05/15/2022] [Indexed: 11/30/2022] Open
Abstract
Approximately, one in three ischemic stroke survivors suffered from depression, namely, post-stroke depression (PSD). PSD affects functional rehabilitation and may lead to poor quality of life of patients. There are numerous explanations about the etiologies of PSD. Here, we speculated that PSD are likely to be the result of specific changes in brain pathology. We hypothesized that the stroke-induced hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis plays an important role in PSD. Stroke initiates a complex sequence of events in neuroendocrine system including HPA axis. The HPA axis is involved in the pathophysiology of depression, especially, the overactivity of the HPA axis occurs in major depressive disorder. This review summarizes the possible etiologies of PSD, focusing on the stroke-induced activation of HPA axis, mainly including the stress followed by severe brain damage and the proinflammatory cytokines release. The role of hyperactive of HPA axis in PSD was discussed in detail, which includes the role of high level corticotropin-releasing hormone in PSD, the effects of glucocorticoids on the alterations in specific brain structures, the expression of enzymes, excitotoxicity, the change in intestinal permeability, and the activation of microglia. The relationship between neuroendocrine regulation and inflammation was also described. Finally, the therapy of PSD by regulating HPA axis, neuroendocrine, and immunity was discussed briefly. Nevertheless, the change of HPA axis and the occurring of PSD maybe interact and promote on each other, and future investigations should explore this hypothesis in more depth.
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Affiliation(s)
- Lin Zhou
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Tian Wang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Yawen Yu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Mingan Li
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Xiaohui Sun
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Wenhao Song
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Yunjie Wang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Ce Zhang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China
| | - Fenghua Fu
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai, Shandong 264005, PR China.
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Xu M, Wu G. The Clinical Significance of Serum IL-33 and sST2 Alterations in the Post-Stroke Depression. J Multidiscip Healthc 2021; 14:2009-2015. [PMID: 34354360 PMCID: PMC8331084 DOI: 10.2147/jmdh.s310524] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/16/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction This study was to test whether the serum levels of IL-33 and sST2 are correlated with the development of depression after acute ischemic stroke. Methods Patients diagnosed with acute ischemic stroke were selected. This study took the 24-item Hamilton Depression Rating Scale (HAMD) (score ≥20) as the diagnostic criteria for depression. On the 21st day after admission, patients who met the depression diagnostic criteria were included in the depression group, and patients who failed to meet the diagnostic criteria were included in the non-depression group. The serum levels of IL-33, sST2 and hsCRP were measured by enzyme-linked immunosorbent assay (ELISA). Results On 1st day after stroke, compared with the non-depression group, there was no significant difference in the serum IL-33, sST2 and hsCRP levels in the depression group; on 21st day after stroke, compared with the non-depression group, the serum IL-33 and hsCRP levels were significantly increased, while the sST2 level was significantly decreased in the depression group. Correlation analysis showed that IL-33 was positively correlated with the depression quantitative score and hsCRP, while sST2 was negatively correlated with the depression quantitative score and hsCRP. Regression analysis showed that IL-33 and sST2 were independent risk factors for the depression after acute ischemic stroke. Discussion The abnormal alterations of serum IL-33 and sST2 levels in the stroke patients may serve as one of the risk factors for the occurrence and exacerbation of the depression, and its mechanism may be related to the promotion of inflammatory factor production in vivo.
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Affiliation(s)
- Meirong Xu
- Department of Geriatrics, The Second Affiliated Hospital of Hubei University of Science and Technology, Xianning, 437100, Hubei Province, People's Republic of China
| | - Ganlin Wu
- Department of Medicine, School of Clinical Medicine Sciences, Hubei University of Science and Technology, Xianning, 437100, Hubei Province, People's Republic of China.,National Demonstration Center for Experimental General Medicine Education (Hubei University of Science and Technology), Xianning, 437100, Hubei Province, People's Republic of China
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Wijeratne T, Sales C, Wijeratne C, Jakovljevic M. Happiness: A Novel Outcome Measure in Stroke? Ther Clin Risk Manag 2021; 17:747-754. [PMID: 34349515 PMCID: PMC8327473 DOI: 10.2147/tcrm.s307587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/06/2021] [Indexed: 12/02/2022] Open
Abstract
In this narrated review, we draw attention to the use of happiness as a novel outcome measure in clinical research studies regarding patients with stroke. Commonly used outcome measures in clinical trials in stroke rehabilitation include the modified Rankin Score (mRS), Functional Impairment Measures (FIM), Barthel Index and quality of life (QoL). Despite being a part of QoL, happiness is arguably a significant construct on its own. While QoL assesses perceptions of various extrinsic aspects of life, happiness may be used as a measure of subjective enjoyment of life after an illness. We review the literature discussing the use of happiness as a formal outcome measure in stroke care and subacute and long-term stroke rehabilitation. Ultimately we recommend the wider use of happiness as an outcome measure where appropriate in these settings. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/iJY-DFLp2WU
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Affiliation(s)
- Tissa Wijeratne
- Department of Neurology, Sunshine Hospital, Western Health, St. Albans, VIC, Australia.,Department of Psychology & Counselling, School of Psychology & Public Health, La Trobe University, Bundoora, VIC, Australia.,Department of Medicine, AIMSS, Melbourne Medical School, University of Melbourne, Sunshine Hospital, St Albans, VIC, Australia.,Department of Medicine, University of Rajarata, Salypura, Anuradhapuraya, Sri Lanka
| | - Carmela Sales
- Department of Neurology, Sunshine Hospital, Western Health, St. Albans, VIC, Australia.,Department of Psychology & Counselling, School of Psychology & Public Health, La Trobe University, Bundoora, VIC, Australia
| | | | - Mihajlo Jakovljevic
- Department Global Health Economics & Policy, University of Kragujevac Faculty of Medical Sciences, Kragujevac, Serbia.,Institute of Comparative Economic Studies, Hosei University Faculty of Economics, Tokyo, Japan
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15
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Predictive Value of Red Blood Cell Distribution Width in Poststroke Depression. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:8361504. [PMID: 34335867 PMCID: PMC8315889 DOI: 10.1155/2021/8361504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/03/2021] [Indexed: 12/28/2022]
Abstract
Purpose Red blood cell distribution width (RDW) is increased in a variety of inflammatory-related diseases. However, there is no report of its clinical significance in poststroke depression (PSD). This study explores the clinical significance of RDW in PSD patients. Methods A total of 185 patients with first-ever acute ischaemic stroke (AIS) in the Second Hospital of Anhui Medical University were chosen as subjects. A retrospective observational study was conducted from February 2019 to February 2020. PSD patients were diagnosed at 6 months after stroke based on the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Clinical and laboratory data were obtained from all patients. Coefficient of Variation (RDW-CV) and standard deviation (RDW-SD) were used to statistically report the performance of red blood cell distribution width. Results At the 6-month follow-up, 46 patients were diagnosed with PSD. Compared with non-PSD patients, PSD patients exhibited an increase in RDW-CV and RDW-SD, which positively correlated with serum interleukin 6 (IL-6) concentrations. In PSD patients, only RDW-SD demonstrated a consistent positive association with the Hamilton Rating Scale for Depression (HAM-D) scores at 6 months after admission. RDW-CV, RDW-SD, and IL-6 were recognized as independent predictors of PSD. The area under the receiver operating characteristic (ROC) curve (AUC) of RDW-SD was 0.796 (95% CI: 0.731-0.852) for the prediction of PSD, which was superior to that of RDW-CV. The specificity for predicting PSD was 60.43%, and the sensitivity was 91.30% if RDW-SD was higher than 43.80 fL. Conclusions RDW-SD is a simple, inexpensive, rapid, and easily accessible parameter that can be used to predict PSD in patients with stroke.
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Chen Y, Pu J, Liu Y, Tian L, Chen X, Gui S, Xu S, Song X, Xie P. Pro-inflammatory cytokines are associated with the development of post-stroke depression in the acute stage of stroke: A meta-analysis. Top Stroke Rehabil 2020; 27:620-629. [PMID: 32316861 DOI: 10.1080/10749357.2020.1755813] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Pro-inflammatory cytokines may be associated with post-stroke depression (PSD); however, results from different studies are inconsistent.Objectives: To investigate whether pro-inflammatory cytokines are associated with the development of PSD in acute stroke.Methods: PubMed, Embase, and Web of science were searched for relevant literature. Meta-analyzes were performed to determine whether the baseline blood concentrations of pro-inflammatory cytokines differed between acute stroke patients with and without depression. Sensitivity analyzes and regression analyzes were conducted to explore sources of heterogeneity.Results: We included 889 acute stroke patients from eight original studies, 312 of whom developed PSD and 577 did not. The serum concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were higher in the PSD group, compared with the non-PSD group (IL-6: SMD = 1.26, 95% CI = [0.55, 1.97], P < 0.001; TNF-α: SMD = 0.61, 95% CI = [0.13, 1.10], P = 0.010).Conclusions: This study indicates IL-6 and TNF-α as potential biomarkers of PSD in the acute stage of stroke and provides theoretical support for the early prevention and treatment of PSD.
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Affiliation(s)
- Yue Chen
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lu Tian
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiang Chen
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Siwen Gui
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Shaohua Xu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemian Song
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Xie
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Zhou J, Chen L, Chen B, Huang S, Zeng C, Wu H, Chen C, Long F. Increased serum exosomal miR-134 expression in the acute ischemic stroke patients. BMC Neurol 2018; 18:198. [PMID: 30514242 PMCID: PMC6278025 DOI: 10.1186/s12883-018-1196-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/06/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The exosomal miRNAs have been emerged as biomarkers and therapeutic targets for various diseases, however, the function of exosomal miRNAs in stroke remains largely unknown. METHODS The blood samples from acute ischemic stroke (AIS) patients and normal controls were collected. The exosomes were isolated from the blood samples, which were confirmed by electron microscopy and western blot with the specific exosomes biomarker CD9, CD63 and Tsg101. RESULTS RT-qPCR analysis showed that exosomal miR-134 was significantly increased in AIS patients within 24 h after stroke onset compared with that of control group. Highly expressed exosomal miR-134 was correlated with the National Institutes of Health Stroke Scale (NIHSS) scores, infarct volume and positively associated with the worse prognosis of the stroke patients. Additionally, the exosomal miR-134 was strong positively correlated with the expression of serum interleukin 6 (IL-6) and plasma high-sensitivity C relative protein (hs-CRP). The receiver operating characteristic (ROC) curve suggested that miR-134 might be a potential factor to discriminate AIS patients from non-stroke controls. CONCLUSIONS The exosomal miR-134 as a possible novel biomarker for the diagnosis and prognosis of stroke.
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Affiliation(s)
- Jingxia Zhou
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Lin Chen
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Bocan Chen
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Shaozhu Huang
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Chaosheng Zeng
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Hairong Wu
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Cong Chen
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Faqing Long
- Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China.
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Zou W, Feng R, Yang Y. Changes in the serum levels of inflammatory cytokines in antidepressant drug-naïve patients with major depression. PLoS One 2018; 13:e0197267. [PMID: 29856741 PMCID: PMC5983476 DOI: 10.1371/journal.pone.0197267] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 04/30/2018] [Indexed: 01/09/2023] Open
Abstract
Major depressive disorder (MDD) is a common condition that afflicts the general population across a broad spectrum of ages and social backgrounds. The inflammatory hypothesis of depression posits that immune hyperactivation and dysregulated cytokine production are involved in depression. To investigate cytokine profiles in patients with MDD, we examined the levels of the pro-inflammatory cytokines interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α, and those of the anti-inflammatory cytokines IL-10 and transforming growth factor (TGF)-β1 in antidepressant drug-naïve patients with MDD. Compared to healthy controls, patients with MDD had significantly higher levels of IL-1β, IL-10, and TNF-α, but significantly lower levels of IL-8. There were no significant differences in the levels of IL-6 or TGF-β1. We found linear correlations between IL-1β, TNF-α, and IL-8, and the severity of depression, as well as between IL-8 and anxiety level in patients with comorbid anxiety disorder. In addition, higher IL-1β and TNF-α levels were associated with higher Hamilton Depression Rating Scale (HAMD) scores, while higher IL-8 levels were associated with lower HAMD and Hamilton Anxiety Rating Scale scores. Here we present evidence of changes in cytokine levels in antidepressant drug-naïve patients with MDD. Abnormal expression of inflammatory cytokines in patients with depression suggests that depression activates an inflammatory process. Immunological abnormalities may be involved in the pathophysiology of depression.
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Affiliation(s)
- Wei Zou
- Department of Neurology and Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Renjie Feng
- Department of Neurology and Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Yang
- Department of Neurology and Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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19
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Kwon HK, Lee SJ. [The Effect of a Movie-Based Nursing Intervention Program on Rehabilitation Motivation and Depression in Stroke Patients]. J Korean Acad Nurs 2017; 47:345-356. [PMID: 28706169 DOI: 10.4040/jkan.2017.47.3.345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 02/13/2017] [Accepted: 03/19/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. METHODS The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The moviebased nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. RESULTS After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. CONCLUSION The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.
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Affiliation(s)
- Hye Kyung Kwon
- Department of Nursing, Graduate School of Chung-Ang University, Seoul, Korea
| | - Sook Ja Lee
- College of Nursing, Korea University, Seoul, Korea.
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