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Jin Y, Huang YH, Chen YP, Zhang YD, Li J, Yang KC, Ye X, Jin LH, Wu J, Yuan CZ, Gao F, Tong LS. Combined effect of cortical superficial siderosis and cerebral microbleed on short-term and long-term outcomes after intracerebral haemorrhage. Stroke Vasc Neurol 2024; 9:429-438. [PMID: 37949481 DOI: 10.1136/svn-2023-002439] [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: 03/01/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND AND PURPOSE Cortical superficial siderosis (cSS) and cerebral microbleed (CMB) have distinct effects on intracerebral haemorrhage (ICH). We aim to investigate the combined effect of cSS and CMB on outcomes after ICH. METHODS Based on a single-centre stroke registry database, patients with spontaneous ICH who had CT scan within 48 hours after ictus and MRI subsequently were identified. Eligible patients were divided into four groups (cSS-CMB-, cSS-CMB+, cSS+CMB-, cSS+CMB+) according to cSS and CMB on susceptibility-weighted image of MRI. Primary outcomes were haematoma volume on admission and unfavourable outcome defined as modified Rankin Scale scores ≥3 at 3 months. Secondary outcomes were all-cause death, recurrence of stroke and ICH during follow-up (median follow-up 2.0 years, IQR 1.0-3.0 years). RESULTS A total of 673 patients were identified from 1044 patients with spontaneous ICH. 131 (19.5%) had cSS and 468 (69.5%) had CMB. Patients with cSS+CMB+ had the highest rate of poor outcome at 3 months, as well as all-cause death, recurrent stroke and ICH during follow-up. In cSS- patients, CMB was associated with smaller haematoma (β -0.13; 95% CI -0.22 to -0.03; p=0.009), but it still increased risks of recurrent ICH (OR 4.6; 95% CI 1.3 to 15.6; p=0.015) and stroke (OR 2.0; 95% CI 1.0 to 4.0; p=0.049). These effects of CMB became unremarkable in the context of cSS+. CONCLUSIONS Patients with different combinations of cSS and CMB have distinct patterns of short-term and long-term outcomes. Although CMB is related to restrained haematoma, it does not improve long-term outcomes. TRIAL REGISTRATION NUMBER NCT04803292.
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Affiliation(s)
- Yujia Jin
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yu-Hui Huang
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Yu-Ping Chen
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yao-Dan Zhang
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Jiawen Li
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Kai-Cheng Yang
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xianghua Ye
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Lu-Hang Jin
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jian Wu
- Department of Neurology, Tiantai People's Hospital of Zhejiang Province, Taizhou, China
| | | | - Feng Gao
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Lu-Sha Tong
- Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
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Zhou B, Mu K, Yu X, Shi X. Serum Levels and Clinical Significance of NSE, BDNF and CNTF in Patients with Cancer-associated Ischemic Stroke Complicated with Post-stroke Depression. ACTAS ESPANOLAS DE PSIQUIATRIA 2024; 52:474-483. [PMID: 39129688 PMCID: PMC11319750 DOI: 10.62641/aep.v52i4.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
BACKGROUND The incidence of post-stroke depression (PSD) may be higher in patients with cancer-associated ischemic stroke (CAIS). The pathogenesis of PSD is mainly related to the emotional injury of stroke and the inability of neurons to effectively repair. This study aims to explore the clinical significance of serum neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF) expression levels in CAIS patients. METHODS Clinical data of 106 patients with CAIS admitted to Jinhua Guangfu Oncology Hospital from January 2012 to December 2022 were retrospectively analyzed. Serum levels of NSE, BDNF and CNTF were measured in all patients after admission. Depression screening was performed by Hamilton Depression Scale-17 (HAMD-17) three months after intravenous thrombolysis. Patients with HAMD-17 score >7 were included in the PSD group (n = 44), and patients with HAMD-17 score ≤7 were included in the non-PSD group (n = 62). The general data and serum levels of NSE, BDNF and CNTF were compared between the two groups. According to HAMD-17 scores, patients in PSD group were further divided into mild depression group (8-16 points), moderate depression group (17-23 points) and severe depression group (≥24 points), and the serum levels of NSE, BDNF and CNTF were compared among the three groups. Pearson's correlation test was used to analyze the correlation between HAMD-17 scores and serum NSE, BDNF and CNTF levels in PSD patients. Logistic regression model was used to determine the influencing factors of PSD in CAIS patients. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive efficacy of serum NSE, BDNF, CNTF and their combination on PSD. RESULTS Among 106 CAIS patients, the incidence of PSD was 41.51% (44 cases), including 19 patients with mild PSD (43.18%), 14 patients with moderate PSD (31.82%), and 11 patients with severe PSD (25.00%). There were statistically significant differences in negative life events and complications after thrombolytic therapy between PSD and non-PSD patients (p < 0.05). The serum NSE level in PSD group was significantly higher than that in non-PSD group, and the serum BDNF and CNTF levels were notably lower than those in non-PSD group (all p < 0.001). The serum levels of NSE, BDNF and CNTF in patients with different severity of PSD were statistically significant (all p < 0.001). HAMD-17 scores in PSD patients were positively correlated with serum NSE levels (r = 0.676, p < 0.001) and negatively correlated with serum BDNF and CNTF levels (r = -0.661, p < 0.001; r = -0.401, p = 0.007, respectively). By binary logistic regression analysis, the levels of serum NSE, BDNF and CNTF were independent influencing factors for PSD in CAIS patients, among which NSE was a risk factor (odds ratio (OR) >1, p < 0.05), BDNF and CNTF were protective factors (OR <1, p < 0.05). CONCLUSION This study reveals for the first time that the levels of serum NSE, BDNF and CNTF are closely related to the occurrence and development of PSD in CAIS patients. In clinical CAIS patients with abnormal changes in the above indicators, in addition to anti-tumor treatment and improvement of neurological deficit symptoms, attention should also be paid to the symptoms of psychological disorders.
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Affiliation(s)
- Baigui Zhou
- Department of Neurology, Zhejiang Jinhua Guangfu Oncology Hospital, 321000 Jinhua, Zhejiang, China
| | - Kun Mu
- Department of Neurology, Zhejiang Jinhua Guangfu Oncology Hospital, 321000 Jinhua, Zhejiang, China
| | - Xuzhou Yu
- Department of Respiratory Oncology, Zhejiang Jinhua Guangfu Oncology Hospital, 321000 Jinhua, Zhejiang, China
| | - Xiaoying Shi
- Department of Emergency, Zhejiang Jinhua Guangfu Oncology Hospital, 321000 Jinhua, Zhejiang, China
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Carhuapoma L, Murthy S, Shah VA. Outcome Trajectories after Intracerebral Hemorrhage. Semin Neurol 2024; 44:298-307. [PMID: 38788763 DOI: 10.1055/s-0044-1787104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Spontaneous intracerebral hemorrhage (ICH) is the most morbid of all stroke types with a high early mortality and significant early disability burden. Traditionally, outcome assessments after ICH have mirrored those of acute ischemic stroke, with 3 months post-ICH being considered a standard time point in most clinical trials, observational studies, and clinical practice. At this time point, the majority of ICH survivors remain with moderate to severe functional disability. However, emerging data suggest that recovery after ICH occurs over a more protracted course and requires longer periods of follow-up, with more than 40% of ICH survivors with initial severe disability improving to partial or complete functional independence over 1 year. Multiple other domains of recovery impact ICH survivors including cognition, mood, and health-related quality of life, all of which remain under studied in ICH. To further complicate the picture, the most important driver of mortality after ICH is early withdrawal of life-sustaining therapies, before initiation of treatment and evaluating effects of prolonged supportive care, influenced by early pessimistic prognostication based on baseline severity factors and prognostication biases. Thus, our understanding of the true natural history of ICH recovery remains limited. This review summarizes the existing literature on outcome trajectories in functional and nonfunctional domains, describes limitations in current prognostication practices, and highlights areas of uncertainty that warrant further research.
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Affiliation(s)
- Lourdes Carhuapoma
- Division of Neurosciences Critical Care, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Santosh Murthy
- Department of Neurology, Weil Cornell Medical College, New York
| | - Vishank A Shah
- Division of Neurosciences Critical Care, Departments of Neurology, Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Du X, Brooks D, Oh P, Marzolini S. Sex Differences in Depressive Symptoms in 1308 Patients Post-Stroke at Entry to Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2024; 44:202-211. [PMID: 38300273 DOI: 10.1097/hcr.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE The objective of this study was to determine whether a sex difference exists in the prevalence of post-stroke depressive symptoms (PSDS) at entry to cardiac rehabilitation (CR) and to determine the correlates of PSDS in all patients, and in women and men separately. METHODS People post-stroke at entry to CR from database records (2006-2017) were included. Bivariate analyses identified PSDS correlates (≥16 on the Center for Epidemiologic Studies Depression Scale) in all patients and women and men separately. RESULTS Patients (n = 1308, 28.9% women), mean age of 63.9 ± 12.9 yr, were 24.2 ± 9.9 mo post-stroke at CR entry. Among all patients, 30.0% had PSDS. A greater proportion of women than men had PSDS (38.6 vs 26.6%; P < .001). Correlates of PSDS in all patients were sex (women) (OR = 1.6: 95% CI, 1.14-2.12), being unemployed, ≤60 yr old, prescribed antidepressant medication, having lower cardiorespiratory fitness (peak oxygen uptake [V̇ o2peak ]), chronic obstructive pulmonary disease (COPD), higher body mass index (BMI), no transient ischemic attack, and longer time from stroke to CR entry (>12 mo). Correlates in women were being obese (BMI ≥ 30), 51-70 yr old, prescribed antidepressant medication, and not married. Correlates in men were being ≤60 yr old, unemployed, prescribed antidepressant medication, having lower V̇ o2peak , sleep apnea, COPD, and no hypertension. CONCLUSION Women were disproportionately affected by PSDS at entry to CR in bivariate and multivariable analyses. Women and men had mostly unique correlates of PSDS, indicating tailored strategies to address PSDS are required. PSDS disproportionately affected patients with longer delay to CR entry, suggesting efforts should target timely referral to facilitate earlier and repeated assessments and management.
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Affiliation(s)
- XiaoWei Du
- Author Affiliations: Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Ms Du and Drs Brooks, Oh, and Marzolini); Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada (Ms Du and Drs Oh and Marzolini); School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Dr Brooks); and Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada (Drs Oh and Marzolini)
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Lioutas VA, Katsanos AH, Shoamanesh A, Vahidy F, Heistand EC, Foster LD, Yeatts SD, Selim M. Cognitive Outcome after Acute Spontaneous Intracerebral Hemorrhage: Analysis of the iDEF Randomized Trial. Cerebrovasc Dis 2024:1-9. [PMID: 38583421 DOI: 10.1159/000538415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/01/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION The impact of intracerebral hemorrhage (ICH) on cognition and the determinants of cognitive recovery early after ICH remain elusive. In this post hoc analysis of the intracerebral hemorrhage deferoxamine (iDEF) trial, we examined the trajectories of cognitive impairment and the determinants of early cognitive recovery after ICH. METHODS We examined baseline factors associated with a 90-day cognitive outcome and constructed generalized linear mixed models to examine the trajectory of cognitive function over time among iDEF participants. Cognition was measured by the Montreal Cognitive Assessment (MoCA) scores on days 7, 30, and 90. RESULTS 291 were available for analysis under the trial's modified intention-to-treat definition (38% female, mean age 60.3 ± 12.0 years, median NIHSS 13, IQR 8-18). The median baseline ICH volume was 12.9 IQR (6.4-26.0) mL; 59 (20%) of the ICH cases were lobar, 120 (41%) had intraventricular extension. There was an overall significant increase in total MOCA score with time (p < 0.0001). Total MOCA score increased by an estimated 3.9 points (95% CI: 3.1, 4.7) between the day 7 and day 30 assessments and by an additional 2.9 points (95% CI: 2.2, 3.6) between the day 30 and day 90 assessments. Despite the overall improvement, 134 of 205 (65%) patients with an available 90-day MoCA score remained cognitively impaired with a score <26 on day 90. Older age, higher NIHSS score, baseline ICH volume, intraventricular hemorrhage, and perihematoma edema had an adjusted negative impact on cognitive recovery. CONCLUSIONS Although ICH survivors exhibit significant improvement of cognitive status over the first 3 months, cognitive performance remains impaired in the majority of patients. Among factors independently associated with worse cognitive recovery, higher baseline ICH, intraventricular blood and perihematomal edema volumes, are potential therapeutic targets that merit further exploration.
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Affiliation(s)
- Vasileios-Arsenios Lioutas
- Stroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Aristeidis H Katsanos
- Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada
| | - Ashkan Shoamanesh
- Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada
| | - Farhaan Vahidy
- Department of Neurosurgery Houston Methodist, Houston, Texas, USA
- Department of Population Health Sciences Weill Cornell Medicine, New York, New York, USA
| | - Elizabeth C Heistand
- Stroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Lydia D Foster
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sharon D Yeatts
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Magdy Selim
- Stroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Tang S, Gao M, Cheng X, Ji L. Scientometric analysis of post-stroke depression research based on CiteSpace. Medicine (Baltimore) 2023; 102:e33633. [PMID: 37145004 PMCID: PMC10158871 DOI: 10.1097/md.0000000000033633] [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: 02/27/2023] [Accepted: 04/06/2023] [Indexed: 05/06/2023] Open
Abstract
Post-stroke depression (PSD) has served as a severe and common complication leading to a higher level of mortality. Though various studies have been focused on PSD, limited research endeavor has been dedicated to bibliometric analysis in the past. In view of this, the current analysis serves to elucidate the latest status of global research and pinpoint the emerging area of interest for PSD, in order to support further investigation of the field. Publications related to PSD were retrieved from the Web of Science Core Collection database on September 24, 2022, and included in the bibliometric analysis. VOSviewer and CiteSpace software were used to visually analyze publication outputs, scientific cooperation, highly-cited references, and keywords to identify the current status and future trends in PSD research. A total of 533 publications were retrieved. The annual number of publications showed an increasing trend from 1999 to 2022. In terms of country and academic institution, the USA and Duke University have topped the list of PSD research respectively. Meanwhile, Robinson RG and Alexopoulos GS have been the most representative investigators of the field. In the past, researchers focused on the risk factors of PSD, late-life depression, and Alzheimer disease. In recent years, further research effort has been placed on meta-analysis, ischemic stroke, predictor, inflammation, mechanism, and mortality. In conclusion, in the past 20 years, PSD research has been progressing and gaining more attention. The bibliometric analysis successfully unveiled the field's major contributing countries, institutions, and investigators. Furthermore, current hot spots and future trends in the field of PSD were identified, which included meta-analysis, ischemic stroke, predictor, inflammation, mechanism, and mortality.
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Affiliation(s)
- Saixue Tang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- The Affiliated Hospital of Shandong University of TCM, Jinan, Shandong Province, China
| | - Mingzhou Gao
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Xunshu Cheng
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Lijin Ji
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1351] [Impact Index Per Article: 1351.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Jin YJ, Li JW, Wu J, Huang YH, Yang KC, An HN, Yuan CZ, Gao F, Tong LS. Cortical superficial siderosis, hematoma volume, and outcomes after intracerebral hemorrhage: a mediation analysis. Front Neurol 2023; 14:1122744. [PMID: 37213900 PMCID: PMC10196120 DOI: 10.3389/fneur.2023.1122744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Background Previous studies have shown that cortical superficial siderosis (cSS) can increase hematoma volume and predict poor outcomes following primary intracerebral hemorrhage (ICH). Objective We aimed to determine whether a large hematoma volume was the essential factor contributing to worse outcomes of cSS. Methods Patients with spontaneous ICH underwent a CT scan within 48 h after ictus. Evaluation of cSS was performed using magnetic resonance imaging (MRI) within 7 days. The 90-day outcome was assessed using the modified Rankin Scale (mRS). In addition, we investigated the correlation between cSS, hematoma volume, and 90-day outcomes using multivariate regression and mediation analyses. Results Among the 673 patients with ICH [mean (SD) age, 61 (13) years; 237 female subjects (35.2%); median (IQR) hematoma volume, 9.0 (3.0-17.6) ml], 131 (19.5%) had cSS. There was an association between cSS and larger hematoma volume (β = 4.449, 95% CI 1.890-7.009, p < 0.001) independent of hematoma location and was also related to worse 90-day mRS (β = 0.333, 95% CI 0.008-0.659, p = 0.045) in multivariable regression. In addition, mediation analyses revealed that hematoma volume was an essential factor mediating the effect of cSS on unfavorable 90-day outcomes (proportion mediated:66.04%, p = 0.01). Conclusion Large hematoma volume was the major charge of directing cSS to worse outcomes in patients with mild to moderate ICH, and cSS was related to a larger hematoma in both lobar and non-lobar areas. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT04803292, identifier: NCT04803292.
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Affiliation(s)
- Yu-jia Jin
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jia-wen Li
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jian Wu
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yu-hui Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Kai-cheng Yang
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Hong-na An
- Department of Neurology, The 2nd People's Hospital of Quzhou, Quzhou, China
| | - Chang-zheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Gao
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
- Feng Gao
| | - Lu-sha Tong
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
- *Correspondence: Lu-sha Tong
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Zhang F, Ping Y, Jin X, Hou X, Song J. White matter hyperintensities and post-stroke depression: A systematic review and meta-analysis. J Affect Disord 2023; 320:370-380. [PMID: 36209775 DOI: 10.1016/j.jad.2022.09.166] [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: 09/05/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Post-stroke depression (PSD) is the most common emotional problem following a stroke. White matter hyperintensities (WMHs) are often reported in patients with a stroke, and are often divided into deep WMHs (DWMHs) and periventricular WMHs (PVWMHs). The relationship between WMHs and PSD remains controversial. This review aims to resolve this controversy. METHODS A systematic search of electronic databases was conducted for studies. We extracted the relevant data and evaluated the study quality by using the Newcastle-Ottawa Scale. We pooled odds ratios (OR) for the same type of WMHs that were present in the relevant PSD period. RESULTS 15 studies (n = 4133 patients) met our inclusion criteria. In the acute phase, WMHs, DWMHs, severe WMHs, and severe DWMHs were not significant risk factors for incident depression, but PVWMHs (pooled OR, 1.21; 95 % CI, 1.01-1.44) and severe PVWMHs (pooled OR, 1.72; 95 % CI, 1.12-2.65) had a significant association with PSD. In the subacute phase, DWMHs, DWMHs, and severe WMHs were not significantly associated with PSD, but PVWMHs (pooled OR, 2.44; 95 % CI, 1.25-4.76) showed a significant association with PSD. In the chronic phase, severe PVWMHs had no significant association with PSD, while WMHs (pooled OR, 1.063; 95 % CI, 1.03-1.09), DWMHs (pooled OR, 1.40; 95 % CI, 1.11-1.76), PVWMHs (pooled OR, 1.28; 95 % CI, 1.11-1.48), and severe DWMHs (pooled OR, 1.52; 95 % CI, 1.12-2.05) showed a significant association with PSD. CONCLUSION We found a significant association between WMHs/DWMHs/PVWMHs and PSD in the chronic post-stroke phase. PVWMHs had a stronger correlation with PSD in each period after stroke than WMHs and DWMHs. High-quality prospective studies are still needed to fully resolve this relationship.
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Affiliation(s)
- Feng Zhang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China; Henan Key Lab of Biological Psychiatry, Henan International Joint Laboratory of Psychiatry and Neuroscience, Xinxiang Medical University, China
| | - Yukun Ping
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China; Henan Key Lab of Biological Psychiatry, Henan International Joint Laboratory of Psychiatry and Neuroscience, Xinxiang Medical University, China
| | - Xuejiao Jin
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China; Henan Key Lab of Biological Psychiatry, Henan International Joint Laboratory of Psychiatry and Neuroscience, Xinxiang Medical University, China
| | - Xiaoli Hou
- General Hospital of Pingmei Shenma Group, Pingdingshan, China
| | - Jinggui Song
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China; Henan Key Lab of Biological Psychiatry, Henan International Joint Laboratory of Psychiatry and Neuroscience, Xinxiang Medical University, China.
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Wen QH, Liu Y, Chen HD, Wu JL, Liang LJ, He WZ, Wang Y, Huang GP. Relationship Between Depression After Hemorrhagic Stroke and Auditory Event-Related Potentials in a Chinese Patient Group. Neuropsychiatr Dis Treat 2022; 18:1917-1925. [PMID: 36065387 PMCID: PMC9440680 DOI: 10.2147/ndt.s362824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Post-stroke depression (PSD) is the most common psychiatric sequelae of stroke. Numerous studies revealed that event-related potentials (ERP) can reflect depression severity to a certain extent, while there is almost no research on depression after hemorrhagic stroke. Therefore, we employed a prospective cross-sectional study to explore the relationship between ERP and depression after hemorrhagic stroke. METHODS A total of 74 patients with intracranial hemorrhage were included in this study. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale (NIHSS) on admission. Depression severity and cognitive impairment were measured using the 17-item Hamilton Depression Scale (HAMD-17) and the Chinese version of the Montreal Cognitive Assessment (MoCA) after two weeks of treatment. All patients were conducted auditory Oddball paradigm for event-related potential mismatch negativity (MMN) and P300. RESULTS In total, 36 patients were diagnosed with PSD at the two weeks of treatment, for a percentage of 48.6%. Depression severity of ICH patients correlated positively with both the latency of MMN (r = 0.376, P = 0.001) and P300 (r = 0.325, P = 0.005), and correlated negatively with both the amplitude of MMN (r=-0.385, P = 0.001) and P300 (r=-0.311, P = 0.007). Depression severity was negatively correlated with cognitive function after hemorrhagic stroke (r=-0.347, P = 0.002). CONCLUSION The latency and amplitude of MMN and P300 can well reflect the degree of depression after hemorrhagic stroke, which may help in the early diagnosis and effective treatment of PSD.
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Affiliation(s)
- Qian-Hui Wen
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China.,Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Yang Liu
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Hu-Dan Chen
- Department of Psychiatry, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Jun-Lin Wu
- Department of Psychiatry, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China
| | - Li-Jun Liang
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Wen-Zhi He
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Yao Wang
- Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
| | - Guo-Ping Huang
- Department of Neurosurgery, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, People's Republic of China.,Faculty of Psychiatry and Mental Health, North Sichuan Medical College, Nanchong, People's Republic of China
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