1
|
Xu M, Li W, He J, Wang Y, Lv J, He W, Chen L, Zhi H. DDCM: A Computational Strategy for Drug Repositioning Based on Support-Vector Regression Algorithm. Int J Mol Sci 2024; 25:5267. [PMID: 38791306 PMCID: PMC11121335 DOI: 10.3390/ijms25105267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Computational drug-repositioning technology is an effective tool for speeding up drug development. As biological data resources continue to grow, it becomes more important to find effective methods to identify potential therapeutic drugs for diseases. The effective use of valuable data has become a more rational and efficient approach to drug repositioning. The disease-drug correlation method (DDCM) proposed in this study is a novel approach that integrates data from multiple sources and different levels to predict potential treatments for diseases, utilizing support-vector regression (SVR). The DDCM approach resulted in potential therapeutic drugs for neoplasms and cardiovascular diseases by constructing a correlation hybrid matrix containing the respective similarities of drugs and diseases, implementing the SVR algorithm to predict the correlation scores, and undergoing a randomized perturbation and stepwise screening pipeline. Some potential therapeutic drugs were predicted by this approach. The potential therapeutic ability of these drugs has been well-validated in terms of the literature, function, drug target, and survival-essential genes. The method's feasibility was confirmed by comparing the predicted results with the classical method and conducting a co-drug analysis of the sub-branch. Our method challenges the conventional approach to studying disease-drug correlations and presents a fresh perspective for understanding the pathogenesis of diseases.
Collapse
Affiliation(s)
- Manyi Xu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Wan Li
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Jiaheng He
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Yahui Wang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Junjie Lv
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Weiming He
- Institute of Opto-Electronics, Harbin Institute of Technology, Harbin 150000, China;
| | - Lina Chen
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| | - Hui Zhi
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150000, China; (M.X.); (W.L.); (J.H.); (Y.W.); (J.L.)
| |
Collapse
|
2
|
Kumral E, Çetin FE, Özdemir HN, Çelikay H, Özkan S. Post-stroke aggressive behavior in patients wıth first-ever ischemic stroke: underlying clinical and imaging factors. Acta Neurol Belg 2024; 124:55-63. [PMID: 37442871 DOI: 10.1007/s13760-023-02319-6] [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: 02/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Aggression is defined as a complex behavior consisting of a combination of sensory, emotional, cognitive and motor elements. We aimed to examine the relationships between post-stroke aggressive behavior (PSAB) and neuropsychological and neuroimaging findings. METHODS 380 patients in the stroke unit were classified as aggressive or non-aggressive based on symptoms elicited by the Neuropsychiatric Inventory (NPI) and aggression screening questionnaire. RESULTS Aggressive behavior was detected in 42 (11.1%) of 380 patients who had a first ischemic stroke. Patients with PSAB were older than those without (338 patients) (66.98 + 13.68 vs. 62.61 + 13.06, P = 0.043). Hamilton depression and anxiety scales showed significantly higher rates of depression and anxiety in the PSAB group compared to the non-PSAB group (47.6% vs. 16.3% and 57.1% vs. 15.4%, respectively; P = 0.001). Lesion mapping analysis showed that lesions in patients with PSAB mostly included the lower parietal lobe and lateral frontal gyrus. Multiple regression analysis showed that gender (OR, 2.81; CI%, 1.24-6.39), lateral prefrontal infarction (OR, 6.43; CI%, 1.51-27.44), parietal infarction (OR, 2.98; CI%, 1.15-7.76), occipital infarction (OR, 2.84; CI%, 1.00-8.06), multiple infarcts (OR, 5.62; CI%, 2.27-13.93), anxiety (OR, 2.06; CI%, 0.89-4.81) and verbal memory deficit (OR, 4.21; CI%, 1.37-12.93) were significant independent predictors of PSAB. CONCLUSION The presence of PSAB may be related to neuropsychiatric symptoms such as high anxiety and verbal memory impairment, and neuroanatomical location of the lesions.
Collapse
Affiliation(s)
- Emre Kumral
- Neurology Department, Ege University Medical School Hospital, İzmir, Turkey.
- Medical School, Department of Neurology, Stroke Unit, Ege University, Bornova, 35100, Izmir, Turkey.
| | | | | | - Hande Çelikay
- Neurology Department, Ege University Medical School Hospital, Neuropsychology Unit, İzmir, Turkey
| | - Sevinç Özkan
- Neurology Department, Ege University Medical School Hospital, Neuropsychology Unit, İzmir, Turkey
| |
Collapse
|
3
|
Su D, Zhang R, Wang X, Ding Q, Che F, Zhang W, Wu W, Li P, Tang B. A new multi-parameter imaging platform for in vivo drug efficacy evaluation of ischemic stroke. Talanta 2024; 266:125133. [PMID: 37659227 DOI: 10.1016/j.talanta.2023.125133] [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: 05/22/2023] [Revised: 08/06/2023] [Accepted: 08/26/2023] [Indexed: 09/04/2023]
Abstract
Ischemic stroke with high incidence and disability rate severely endangers human health. Current clinical treatment strategies are quite limited, new drugs for ischemic stroke are urgently needed. However, most existing methods for the efficacy evaluation of new drugs possess deficiencies of divorcing from the true biological context, single detection indicator and complex operations, leading to evaluation biases and delaying drug development process. In this work, leveraging the advantages of fluorescence imaging with non-invasive, real-time, in-situ, high selectivity and high sensitivity, a new multi-parameter simultaneous fluorescence imaging platform (MPSFL-Platform) based on two fluorescence materials was constructed to evaluate the efficacy of new drug for ischemic stroke. Through simultaneous fluorescence observing three key indicators of ischemic stroke, malondialdehyde (MDA), formaldehyde (FA), and monoamine oxidase A (MAO-A), the efficacy evaluations of three drugs for ischemic stroke were real-time and in-situ performed. Compared with edaravone and butylphthalide, edaravone dexborneol exhibited better therapeutic effect by using MPSFL-Platform. The successful establishment of MPSFL-Platform is serviceable to accelerate the conduction of preclinical trial and the exploration of pathophysiology mechanism for drugs related to ischemic stroke and other brain diseases, which is perspective to promote the efficiency of new drug development.
Collapse
Affiliation(s)
- Di Su
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China
| | - Ran Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China
| | - Xin Wang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China.
| | - Qi Ding
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China
| | - Feida Che
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China
| | - Wen Zhang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China
| | - Wei Wu
- Department of Neurology, Qi-Lu Hospital of Shandong University and Brain Science Research Institute, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
| | - Ping Li
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China.
| | - Bo Tang
- College of Chemistry, Chemical Engineering and Materials Science, Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong, Key Laboratory of Molecular and Nano Probes, Ministry of Education, Institutes of Biomedical Sciences, Shandong Normal University, Jinan, 250014, Shandong, People's Republic of China; Laoshan Laboratory, Qingdao, 266237, Shandong, People's Republic of China.
| |
Collapse
|
4
|
Papadopoulou A, Papadopoulos P, Grammatopoulou E, Kavga A, Koreli A, Mantoudi A, Stamou A, Gerogianni G, Zartaloudi A. Depressive Symptoms and Anger Expression Among Survivors After Stroke. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:257-266. [PMID: 37581799 DOI: 10.1007/978-3-031-31986-0_24] [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: 08/16/2023]
Abstract
INTRODUCTION Stroke is a frequent cause of death and one of the most common causes of disability and depression in the countries of the Western world. Depression is associated with limited functionality, reduced self-care, and increased mortality in patients with stroke. Anger often occurs in these patients and may disrupt the course of their recovery. AIM The investigation of the presence of depressive symptomatology, the expression of anger, and the degree of functioning/independence of patients after stroke. METHOD One hundred and ten patients after stroke completed the Center for Epidemiological Studies-Depression (CES-D) scale, the State-Trait Anger Expression Inventory, and the Barthel Index. RESULTS Patients who lived alone had a higher depressive symptomatology score than patients who did not live alone (p = 0.009). An increase in the total depressive symptomatology score was related to an increase in the anger expression score (p = 0.011), increase in anger-in score (p < 0.001), increase in anger-out score (p < 0.001), and decrease in anger control score (p = 0.001). Females had lower anger-in scores compared to men (p = 0.029). Individuals with a history of previous stroke had higher anger-out scores compared to people without a history of previous stroke (p = 0.025). An increase in the patient's functional/independence score was associated with an increase in anger control score (p = 0.015). CONCLUSIONS Early detection and management of depression and anger will facilitate patient's compliance to the rehabilitation program in order to achieve optimal therapeutic results and ensure a better quality of life.
Collapse
Affiliation(s)
| | | | | | - Anna Kavga
- Department of Nursing, University of West Attica, Athens, Greece
| | - Alexandra Koreli
- Department of Nursing, University of West Attica, Athens, Greece
| | | | - Angeliki Stamou
- Department of Nursing, University of West Attica, Athens, Greece
| | | | | |
Collapse
|
5
|
Kutlubaev MA, Akhmetova AI, Ozerova AI. [Emotional disorders after stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:30-35. [PMID: 38148695 DOI: 10.17116/jnevro202312312230] [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: 12/28/2023]
Abstract
Emotional disorders are common among patients after stroke. They include anger, fear, emotional expression control (uncontrollable crying, laughing), emotional indifference (apathy), disorders of emotion recognition and emotional empathy. They might develop independently or as a presentation of depression, anxiety, catastrophic reaction, posttraumatic stress disorder etc. Treatment of post-stroke emotional disorders include pharmacotherapy, psychotherapy, neuromodulation.
Collapse
Affiliation(s)
| | | | - A I Ozerova
- Bashkir State Medical University, Ufa, Russia
| |
Collapse
|
6
|
Edelkraut L, López-Barroso D, Torres-Prioris MJ, Starkstein SE, Jorge RE, Aloisi J, Berthier ML, Dávila G. Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia. World J Psychiatry 2022; 12:450-469. [PMID: 35433325 PMCID: PMC8968505 DOI: 10.5498/wjp.v12.i3.450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) have been insufficiently examined in persons with aphasia (PWA) because most previous studies exclude participants with language and communication disorders.
AIM To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia.
METHODS Study 1 reviewed articles obtained from PubMed, PsycINFO, Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders. Study 2 examined language deficits and activities of daily living in 20 PWA (median age: 58, range: 28-65 years; 13 men) with the Western Aphasia Battery-Revised and the Barthel Index, respectively. Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales, including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale. In addition, an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves. This observational study is based on the baseline assessment of an intervention clinical trial (EudraCT: 2017-002858-36; ClinicalTrials.gov identifier: NCT04134416).
RESULTS The literature review revealed a broad spectrum of NPS in PWA, including depression, anxiety, apathy, agitation/aggression, eating and sleep disorders, psychosis, and hypomania/mania. These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA. Study 2 showed that the 20 participants had mild- to-moderate aphasia severity and were functionally independent. A wide range of comorbid NPS was found in the post-stroke aphasic population (median number of NPS: 5, range: 1-8). The majority of PWA (75%) had depressive symptoms, followed by agitation/aggression (70%), irritability (70%), anxiety (65%) and appetite/eating symptoms (65%). Half of them also presented symptoms of apathy, whereas euphoria and psychotic symptoms were rare (5%). Domain-specific scales revealed that 45% of participants had apathy and 30% were diagnosed with depression and anxiety.
CONCLUSION Concurrent NPS are frequent in the chronic period of post-stroke aphasia. Therefore, further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.
Collapse
Affiliation(s)
- Lisa Edelkraut
- Department of Psychobiology and Methodology of Behavioral Science, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga 29071, Spain
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
- Instituto de Investigación Biomédica de Málaga, University of Malaga, Malaga 29010, Spain
| | - Diana López-Barroso
- Department of Psychobiology and Methodology of Behavioral Science, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga 29071, Spain
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
- Instituto de Investigación Biomédica de Málaga, University of Malaga, Malaga 29010, Spain
| | - María José Torres-Prioris
- Department of Psychobiology and Methodology of Behavioral Science, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga 29071, Spain
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
- Instituto de Investigación Biomédica de Málaga, University of Malaga, Malaga 29010, Spain
| | - Sergio E Starkstein
- School of Psychiatry and Neurosciences, The University of Western Australia, Perth 6009, Australia
| | - Ricardo E Jorge
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, United States
| | - Jessica Aloisi
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
- Instituto de Investigación Biomédica de Málaga, University of Malaga, Malaga 29010, Spain
| | - Guadalupe Dávila
- Department of Psychobiology and Methodology of Behavioral Science, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga 29071, Spain
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga 29010, Spain
- Instituto de Investigación Biomédica de Málaga, University of Malaga, Malaga 29010, Spain
| |
Collapse
|
7
|
Abstract
Neuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive-compulsive disorder, and psychosis are less commonly encountered but potentially highly debilitating conditions that may be underrecognized. Early identification and treatment may mitigate functional impairment and improve quality of life. Evidence-based guidelines from the general population are often relied upon to guide treatment. Further research is needed to understand and tailor treatment of these disorders in the poststroke population.
Collapse
Affiliation(s)
- Katlyn Nemani
- Departments of Neurology and Psychiatry, NYU Langone Health, New York, New York
| | - Lindsey Gurin
- Departments of Neurology, Psychiatry, and Rehabilitation Medicine, NYU Langone Health, New York, New York
| |
Collapse
|
8
|
Stolwyk RJ, Low T, Gooden JR, Lawson DW, O’Connell EL, Thrift AG, New PW. A longitudinal examination of the frequency and correlates of self-reported neurobehavioural disability following stroke. Disabil Rehabil 2020; 44:2823-2831. [DOI: 10.1080/09638288.2020.1840637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Renerus J. Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Tiffany Low
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - James R. Gooden
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - David W. Lawson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Elissa L. O’Connell
- Rehabilitation and Aged Care Services, Medicine Program, Monash Health, Cheltenham, Australia
| | - Amanda G. Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Peter W. New
- Rehabilitation and Aged Care Services, Medicine Program, Monash Health, Cheltenham, Australia
- Epworth-Monash Rehabilitation Medicine Unit, Monash University, Clayton, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia
| |
Collapse
|
9
|
Santos AC, Ferro JM. Profile of Anger in Acute Stroke: A Multifactorial Model of Anger Determinants. J Neuropsychiatry Clin Neurosci 2019; 31:159-164. [PMID: 30458665 DOI: 10.1176/appi.neuropsych.18030037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Higher levels of anger can have a major impact on treatment and recovery among stroke patients. METHODS The authors identified the presence of anger in patients with acute stroke, as well as state and trait anger and anger expression and control, and analyzed its association with demographic, clinical, brain lesion, and psychosocial variables. The authors screened anger prospectively in 114 consecutive patients by using the State-Trait Anger Expression Inventory-2, which enabled them to distinguish between the experience, expression, and control of anger. RESULTS State anger was detected in 21 (18%) patients, whereas trait anger was present in 22 patients (20%). The best regression model revealed that age, hypertension, complaints about environment, anxiety symptoms, and disability were independent predictive factors for anger (R2=54%). CONCLUSIONS Anger appears to be explained by prestroke variables such as age, hypertension, and the profile of anger, stroke itself as a sudden and potentially disabling condition, the environment, and the psychological and functional consequences of stroke.
Collapse
Affiliation(s)
- A Catarina Santos
- From the Department of Neurosciences and Mental Health, Hospital de Santa Maria-CHLN, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal (ACS, JMF); and the Hospital do Mar Cuidados Especializados Lisboa, Portugal. (ACS)
| | - José M Ferro
- From the Department of Neurosciences and Mental Health, Hospital de Santa Maria-CHLN, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal (ACS, JMF); and the Hospital do Mar Cuidados Especializados Lisboa, Portugal. (ACS)
| |
Collapse
|
10
|
Abstract
AIM In this narrative review we aimed to describe how stroke affects emotions and update the readers on the emotional disturbances that occur after stroke. METHODS We searched Medline from 1.1.2013 to 1.7.2019, personal files and references of selected publications. All retrieved systematic reviews and randomized controlled trials were included. Other references were selected by relevance. SUMMARY OF REVIEW The emotional response includes a reactive behavior with arousal, somatic, motivational and motor components, and a distinctive cognitive and subjective affective experience. Emotional category responses and experiences after stroke can show dissociations between the behavioral response and the cognitive and affective experiences. Emotional disturbances that often occur after stroke include fear, anger, emotional indifference, lack of understanding of other emotions, and lack of control of emotional expression. Emotional disturbances limit social reintegration of the persons with stroke and are a source of caregiver burnout. The evidence to support the management of the majority of emotional disorders in stroke survivors is currently weak and of low or very low methodologic quality. An exception are the disorders of emotional expression control where antidepressants can have a strong beneficial effect, by reducing the number and duration of the uncontrollable episodes of crying or laughing. CONCLUSION Our current knowledge of the emotional disorders that occurs in acute stroke patients and in stroke survivors is heterogeneous and limited. Joint efforts of different research approaches, methodologies and disciplines will improve our current understanding on emotional disorder after stroke and indicate rational pathways to manage them.
Collapse
Affiliation(s)
- José M Ferro
- Serviço de Neurologia, Departamento de Neurociências e Saúde Mental, Hospital Santa Maria-,Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana C Santos
- Hospital do Mar - Cuidados Especializados Lisboa, Bobadela, Portugal
| |
Collapse
|
11
|
Stolwyk RJ, O'Connell E, Lawson DW, Thrift AG, New PW. Neurobehavioral disability in stroke patients during subacute inpatient rehabilitation: prevalence and biopsychosocial associations. Top Stroke Rehabil 2018; 25:1-8. [PMID: 30213238 DOI: 10.1080/10749357.2018.1499301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES There are scarce data on post-stroke neurobehavioral disability (NBD). The aim of this study was to identify the prevalence of NBD in a subacute inpatient stroke population and examine potential associations with demographic, stroke-related, functional and psychosocial variables. METHODS 82 survivors of stroke were consecutively recruited during their inpatient rehabilitation admission. Nursing staff rated NBD in patients using the St Andrews -Swansea Neurobehavioral Outcome Scale (SASNOS). Measures of patient functional independence (FIM), cognition (MoCA), and mood symptoms (HADS) were collected in addition to nursing reports of whether observed NBD negatively impacted on the patient or those around them. RESULTS NBD relating to interpersonal relationships (44.4% of participants) and cognition (52.4%) were highly prevalent within the sample while NBD relating to inhibition (1.2%), aggression (3.6%), and communication (2.5%) were relatively rare. Presence of NBD was significantly associated with reduced functional independence (rs=0.39, p < 0.01) and associated with trends in cognitive impairment (rs=0.29, p = 0.03), increased anxiety (rs=-0.43, p = 0.02) and depressive symptoms (rs=-0.43, p = 0.02). Presence of NBD was significantly correlated with negative impact to the patient and those around them across all SASNOS domains (rs range 0.42 - 0.45, all p ≤ 0.01). CONCLUSIONS NBD is common within a subacute stroke inpatient population, particularly interpersonal and cognitive difficulties and preliminary analyses indicate associations with reduced functional ability, cognition and mood. There is a need to provide education and support to clinicians to facilitate routine assessment and management of NBD following stroke.
Collapse
Affiliation(s)
- Renerus J Stolwyk
- a Monash Institute of Cognitive and Clinical Neurosciences , School of Psychological Sciences, Monash University , Melbourne , Victoria , Australia
- b Monash-Epworth Rehabilitation Research Centre , Melbourne , Victoria , Australia
| | - Elissa O'Connell
- c Rehabilitation and Aged Care Services , Medicine Program, Monash Health , Melbourne , Australia
| | - David W Lawson
- a Monash Institute of Cognitive and Clinical Neurosciences , School of Psychological Sciences, Monash University , Melbourne , Victoria , Australia
- b Monash-Epworth Rehabilitation Research Centre , Melbourne , Victoria , Australia
| | - Amanda G Thrift
- d Department of Medicine, School of Clinical Sciences at Monash Health , Monash University , Melbourne , Victoria , Australia
| | - Peter W New
- e Epworth-Monash Rehabilitation Medicine Unit , Monash University , Melbourne , Victoria , Australia
- f Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , Victoria , Australia
| |
Collapse
|
12
|
Lee EJ, Oh MS, Kim JS, Chang DI, Park JH, Cha JK, Heo JH, Sohn SI, Kim DE, Kim HY, Kim J, Seo WK, Lee J, Park SW, Kim YJ, Lee BC. Serotonin transporter gene polymorphisms may be associated with poststroke neurological recovery after escitalopram use. J Neurol Neurosurg Psychiatry 2018; 89:271-276. [PMID: 29030421 DOI: 10.1136/jnnp-2017-316882] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/13/2017] [Accepted: 09/28/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Selective serotonin reuptake inhibitors (SSRIs) putatively improve neurological recovery after stroke. We aimed to investigate whether serotonin transporter (SERT) gene polymorphisms are related to the responsiveness to SSRIs in the poststroke neurological recovery. METHODS This was a post hoc analysis of the EMOTION study (ClinicalTrials.gov NCT01278498), a randomised, placebo-controlled, double-blind trial examining the efficacy of escitalopram on emotional and neurological disturbances after acute stroke. Patients with no/minimal disability initially (modified Rankin Scale (mRS) 0-1) were excluded. Of the participants, 301 underwent genetic studies of the STin2 (a variable number tandem repeat (VNTR) in intron 2) (STin2 12/10 and STin2 12/12 genotypes) and 5-HTTLPR (a variable-length repeat in the promoter region) polymorphisms of SERT. We explored whether neurological function (National Institutes of Health Stroke Scale (NIHSS) score and mRS) at 3 months would differ according to SERT polymorphisms within each treatment arm (escitalopram and placebo). RESULTS Among the escitalopram users (n=159), neurological function in subjects with STin2 12/10 (n=29) improved significantly more than that in STin2 12/12 carriers (n=130) at 3 months. After adjusting for age, initial NIHSS and depression, STin2 12/10 independently predicted a good clinical outcome (mRS 0-1) (OR 2.99, 95% CI 1.04 to 8.58) at 3 months. However, differences between STin2 polymorphisms were not shown in the placebo group (n=142). 5-HTTLPR polymorphisms were not associated with neurological recovery in any treatment group. CONCLUSION STin2 VNTR polymorphisms may be associated with poststroke neurological recovery after SSRI therapy. Further studies are needed to identify the role of serotonin in neurological recovery after stroke.
Collapse
Affiliation(s)
- Eun-Jae Lee
- Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Mi-Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jong S Kim
- Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Dae-Il Chang
- Department of Neurology, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jong-Ho Park
- Department of Neurology, Seonam University, Myongji Hospital, Goyang, Republic of Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, Republic of Korea
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University, Severance Hospital, Seoul, Republic of Korea
| | - Sung-Il Sohn
- Department of Neurology, Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University, Ilsan hospital, Goyang, Republic of Korea
| | - Hahn Young Kim
- Department of Neurology, Konkuk University School of Medicine, Seul, Republic of Korea
| | - Jei Kim
- Department of Neurology, Chungnam University Hospital, Daejeon, Republic of Korea
| | - Woo-Keun Seo
- Department of Neurology, Korea University, Guro Hospital, Seoul, Republic of Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Sang-Won Park
- Department of Neurology, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Yun Joong Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | | |
Collapse
|
13
|
Ko M, Choi‐Kwon S, Jun S, Kim JH, Cho K, Nah H, Song H, Kim JS. Poststroke emotional disturbances and a tryptophan hydroxylase 2 gene polymorphism. Brain Behav 2018; 8:e00892. [PMID: 29484259 PMCID: PMC5822583 DOI: 10.1002/brb3.892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/22/2017] [Accepted: 11/15/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives Emotional dysfunction is a common finding in stroke patients. Despite reports on serotonergic involvement in the etiology of poststroke emotional dysfunction (PSED), the role of serotonin synthesizing tryptophan hydroxylase 2 (TPH2) genes in the development of PSED remains unclear. Methods Genotyping of TPH2 rs4641528 and rs10879355 was performed from genomic DNA of 383 stroke patients collected previously and stored at -70°C. Potential associations between TPH2 genes and poststroke depression (PSD), poststroke emotional incontinence (PSEI), and poststroke anger proneness (PSAP) were investigated 3 months poststroke. Results Among the 383 patients, 69 (18%) had PSD, 41 (11%) had PSEI, and 93 (24%) had PSAP. The TPH2 rs4641528 genotype frequencies differed significantly between patients with and without either PSD or PSEI, although no significant differences were found between the patients with and without PSAP. In multiple logistic regression analysis, PSD was related to the National Institutes of Health Stroke Scale (NIHSS) score at admission (95% confidence interval [CI]: 1.047-1.230, p < .01), modified Rankin scale score at 3 months (95% CI: 0.135-0.848, p < .05), and TPH2 rs4641528 C allele (95% CI: 1.039-5.631, p < .05), whereas PSEI was associated only with the NIHSS score at admission (95% CI: 1.053-1.259, p < .01) and the TPH2 rs4641528 C allele (95% CI: 1.029-11.678, p < .05). Conclusions Our findings suggest that the TPH2 rs4641528 C allele may play a role in the pathogenesis of PSD and PSEI but not PSAP in Korean stroke patients.
Collapse
Affiliation(s)
- Mihye Ko
- College of NursingThe Research Institute of Nursing ScienceSeoul National UniversitySeoulSouth Korea
| | - Smi Choi‐Kwon
- College of NursingThe Research Institute of Nursing ScienceSeoul National UniversitySeoulSouth Korea
| | - Sang‐Eun Jun
- College of NursingKeimyung UniversityDaeguSouth Korea
| | - Ju Han Kim
- College of MedicineSeoul National UniversitySeoulSouth Korea
| | - Kyung‐Hee Cho
- Department of NeurologyKorea UniversitySeoulSouth Korea
| | | | - Hasup Song
- University of UlsanAsan Medical CenterSeoulSouth Korea
| | - Jong S. Kim
- University of UlsanAsan Medical CenterSeoulSouth Korea
| |
Collapse
|
14
|
Abstract
INTRODUCTION Mood and emotional disturbances are common in stroke patients. Out of diverse post-stroke emotional disturbances, depression, anxiety, emotional incontinence, anger proneness, and fatigue are frequent and important symptoms. These symptoms are distressing for both the patients and their caregivers, and negatively influence the patient's quality of life. The emotional symptoms are not apparent and are therefore often neglected by neurologists. Their phenomenology, predicting factors, and pathophysiology have been under-studied, and are under-recognized. In addition, well-designed clinical trials targeting on these symptoms are rare. Areas covered: This review will describe some of the most common or relevant post-stroke mood and emotional disturbances. The phenomenology, factors or predictors, and presumed etio-pathogenesis will be described. Current pharmacological and non-pharmacological management strategies of these diverse emotional disturbances will be discussed based on different pathophysiological mechanisms. Expert commentary: It is fortunate that these mood and emotional disturbances can be treated by various methods, including pharmacological and non-pharmacological therapy. To administer the appropriate therapy, we must understand the similarities and differences in the pathophysiological mechanisms associated with these emotional symptoms.
Collapse
Affiliation(s)
- Jong S Kim
- a Department of Neurology , University of Ulsan, Asan Medical Center , Seoul , Republic of Korea
| |
Collapse
|
15
|
Abstract
OBJECTIVE To assess the relationship between states of anger and stroke. METHODS Systematic review of the literature. RESULTS In total, 21 papers were selected for the systematic review of data published on the subject of anger and stroke. A state of anger may be a risk factor for stroke, as well as a consequence of brain lesions affecting specific areas that are caused by a stroke. Scales to assess anger varied among authors. There was no consensus regarding the area of brain lesions that might lead to a state of anger. Although some authors agreed that lesions on the right side led to angrier behaviour, others found that lesions on the left side were more relevant to anger. Likewise, there was no consensus regarding the prevalence of anger pre or post-stroke. Some authors did not even find that these two conditions were related. CONCLUSION Although most authors have accepted that there is a relationship between anger and stroke, studies with uniform methodology need to be conducted if this association is to be properly evaluated and understood.
Collapse
|
16
|
Lau CG, Tang WK, Liu XX, Liang HJ, Liang Y, Wong A, Mok V, Ungvari GS, Wong KS, Kim JS, Paradiso S. Poststroke agitation and aggression and social quality of life: a case control study. Top Stroke Rehabil 2016; 24:126-133. [PMID: 27603431 DOI: 10.1080/10749357.2016.1212564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Aggression and agitation are common after a stroke. The association between agitation/aggression following stroke and Health-Related Quality of Life (HRQoL) in stroke survivors is unknown. This study aimed to examine the association between agitation/aggression and HRQoL in Chinese stroke survivors. METHODS Three hundred and twenty-four stroke patients entered this cross-sectional study. Agitation/aggression was assessed using the Chinese version of Neuropsychiatric Inventory (CNPI). HRQoL was measured with the Stroke Specific Quality of Life (SSQoL). RESULTS Three months after the index stroke, agitation/aggression was found in 60 (18.5%) patients. In the agitation/aggression group, 44 patients (73.3%) showed passive agitation/aggression, whereas 16 (26.7%) displayed passive and active agitation/aggression. No patients showed only active agitation/aggression. Patients with agitation/aggression were more likely to have history of diabetes and greater severity of depression, as well as lower SSQoL total score and Personality Changes and Social Role scores. Controlling for diabetes and depression severity did not alter the above results. The Energy and Thinking scores of the SSQoL were significantly lower in the passive/active agitation/aggression group relative to the passive agitation/aggression group (adjusted for CNPI aggression/agitation score). CONCLUSION In this study sample, agitation/aggression was preponderantly of the passive type and was associated with poorer HRQoL independently from depression or medical conditions. Patients with both passive and active agitation/aggression had lower Quality of Life (QoL) than patients with only passive agitation/aggression. The causality of the association between low QoL and agitation/aggression needs to be explored in future studies.
Collapse
Affiliation(s)
- Chieh Grace Lau
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Wai Kwong Tang
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Xiang Xin Liu
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Hua Jun Liang
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Yan Liang
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Adrian Wong
- b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Vincent Mok
- b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Gabor S Ungvari
- c School of Psychiatry & Clinical Neurosciences , University of Western Australia , Perth , Australia.,d Department of Psychiatry , University of Notre Dame Australia/Marian Centre , Perth , Australia
| | - Ka Sing Wong
- b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China
| | - Jong S Kim
- e Department of Neurology , Asan Medical Center, University of Ulsan , Seoul , Korea
| | - Sergio Paradiso
- f Una Mano per la Vita - Association of Families and their Doctors , Catania , Italy.,g Facultad de Psicología , Universidad Diego Portales , Santiago , Chile
| |
Collapse
|
17
|
Kim JS. Post-stroke Mood and Emotional Disturbances: Pharmacological Therapy Based on Mechanisms. J Stroke 2016; 18:244-255. [PMID: 27733031 PMCID: PMC5066431 DOI: 10.5853/jos.2016.01144] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 09/07/2016] [Accepted: 09/08/2016] [Indexed: 11/11/2022] Open
Abstract
Post-stroke mood and emotional disturbances are frequent and diverse in their manifestations. Out of the many post-stroke disturbances, post-stroke depression, post-stroke anxiety, post-stroke emotional incontinence, post-stroke anger proneness, and post-stroke fatigue are frequent and important symptoms. These symptoms are distressing for both the patients and their caregivers, and negatively influence the patient's quality of life. Unfortunately, these emotional disturbances are not apparent and are therefore often unnoticed by busy clinicians. Their phenomenology, predicting factors, and pathophysiology have been under-studied, and are under-recognized. In addition, well-designed clinical trials regarding these symptoms are rare. Fortunately, these mood and emotional disturbances may be treated or prevented by various methods, including pharmacological therapy. To administer the appropriate therapy, we have to understand the phenomenology and the similarities and differences in the pathophysiological mechanisms associated with these emotional symptoms. This narrative review will describe some of the most common or relevant post-stroke mood and emotional disturbances. The phenomenology, factors or predictors, and relevant lesion locations will be described, and pharmacological treatment of these emotional disturbances will be discussed based on presumable pathophysiological mechanisms.
Collapse
Affiliation(s)
- Jong S. Kim
- Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, Korea
| |
Collapse
|
18
|
Validation and Cross-Cultural Adaptation of a Chinese Version of the Emotional and Social Dysfunction Questionnaire in Stroke Patients. Clin Nurs Res 2016; 26:763-782. [DOI: 10.1177/1054773816638823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objectives of this study were to develop a cross-cultural Chinese version of the Emotional and Social Dysfunction Questionnaire (ESDQ-C) and test its validity and reliability among Chinese-speaking stroke patients. Various methods were used to develop the ESDQ-C. A cross-sectional study was used to examine the validity and reliability of the developed questionnaire, which consists of 28 items belonging to six factors, anger, helplessness, emotional dyscontrol, indifference, inertia and fatigue, and euphoria. Satisfactory convergence and known-group validities were confirmed by significant correlations of the ESDQ-C with the Profile of Mood States–Short Form ( p < .05) and with the Hospital Anxiety and Depression Scale ( p < .05). The internal consistency was represented by Cronbach’s alpha, which was .96 and .79 to .92 for the entire scale and subscales, respectively. Appropriate application of the ESDQ-C will be helpful to identify critical adjustment-related types of distress and patients who experience difficulty coping with such distress.
Collapse
|
19
|
Affiliation(s)
- A H V Schapira
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK.
| |
Collapse
|
20
|
Huang HC, Huang LK, Hu CJ, Chang CH, Lee HC, Chi NF, Shyu ML, Chang HJ. The mediating effect of psychological distress on functional dependence in stroke patients. J Clin Nurs 2014; 23:3533-43. [DOI: 10.1111/jocn.12606] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Hui-Chuan Huang
- Graduate Institute of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
- Department of Nursing; Cardinal Tien Junior College of Healthcare & Management; New Taipei City Taiwan
| | - Li-Kai Huang
- Department of Neurology; Taipei Medical University-Shuang Ho Hospital; New Taipei City Taiwan
| | - Chaur-Jong Hu
- Department of Neurology; Taipei Medical University-Shuang Ho Hospital; New Taipei City Taiwan
- Department of Neurology; School of Medicine; Taipei Medical University; Taipei Taiwan
| | - Chien-Hung Chang
- Stroke Center and Department of Neurology; Chang Gung Memorial Hospital; Linkou Medical Center College of Medicine; Chang Gung University; Kueishan Taoyuan Taiwan
- Department of Electrical Engineering; College of Engineering; Chang Gung University; Kueishan Taoyuan Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry and Medical Humanity; School of Medicine; College of Medicine; Taipei Medical University; Taipei Taiwan
- Department of Psychiatry; Taipei Medical University-Shuang Ho Hospital; New Taipei City Taiwan
| | - Nai-Fang Chi
- Department of Neurology; Taipei Medical University-Shuang Ho Hospital; New Taipei City Taiwan
- Department of Neurology; School of Medicine; Taipei Medical University; Taipei Taiwan
| | - Meei-Ling Shyu
- School of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| | - Hsiu-Ju Chang
- School of Nursing; College of Nursing; Taipei Medical University; Taipei Taiwan
| |
Collapse
|