Association Between Thyroid Hormones And Post-stroke Depression

IntroductionPost-stroke depression (poststroke depression, PSD) is a common complication in cerebral vascular disease, The depression can not only take affection about the quality of patients'life but also exacerbation of neurological impairment. The incidence is 25%-80%, and most focus on 28%-39%(1). In clinic, despair, sleep disorders, sports block, stress, anxiety and somatic symptoms appears as main manifestation. In 1921, Kraepelin describes the relationship between depressive disorders and stroke of his patients. Since then, mood disorder has been known as a specific complication of stroke.The viewpoint that PSD is the most common psychiatric problem has been widely recognized. A cross-sectional study shows that there are widespread neuropsychological symptoms in post-stroke patients:61% of them are depressive, others'manifastation:33% about stress,33% in eating disorder,28% be exciting,27% of nonchalance,23% in anxiety and 18% has insomia and so on(2). At present, PSD has became the hot issue in medical research increasingly.The knowledge about PSD has greatly increased during a number of researches that have be done by internal and external scholars. But there are limitations in these reseaches, especially many blanks in domestic field. PSD is a high-incidence complications of stroke,so the early discovery and constructive interventions are important in the treatment of functional recovery, shortening the course and reducing consumption of medical resources. It's has been found that there is relationship between PSD and thyroid hormone, basic research showing, thyroid hormones have been found not only plays a decisive role in the nervous system, particularly in the brain development and maturation process, but also acts on the nervous system that has benn maturative. Thyroid hormones can facilitation of catecholamines' effect, make sympathetic system excited.The reduce of thyroid hormones possiblely relate to the pathogenesis of PSD. In clinical research, most report that thyroid hormones is associated with the pathogenesis of PSD. In recent years, research on the hypothalamus-pituitary-thyroid has found that there are relationships between thyrotropin-level and the incidence of PSD. In order to show the changes about thyroid hormones level in stroke patients with depression This experiment for the study of thyroid hormone levels is carried out by 135 volunteers (including 45 PSD,45 stroke in patients with non-PSD,45 normol cases).. While the changes affect the occurrence of PSD.Materials and MethodsIn the 135 cases,45 cases are post-stroke depression patients (PSD),45 cases are simple stroke patients (non-PSD),45 cases are normal control. (Except research objects have had thyroid disease history and have taken drugs,that may disturbe the metabolism of thyroid,, before a mouth, and be conscious clearly with no obvious impairment in intellection and language comprehension and expression.) 90 cases of stroke patients are taken blood samples at the onset of the first 2 days and 21 days, while the control group are taken blood sampling once. Hormone-test:the blood 4 ml(fasting 12 h)from elbow vein,which during seperating serum,is kept in refrigerator at-21℃and be adopted RIA assay FT3, FT4, TSH in 1 week. The data is expressed by mean±standard error indicates, statistical analysis using t-test.ResultsBy comparing the PSD and non-PSD in stroke groups,the result is:the level of their T3 reduces, the level of T4 changes not obvious, the level of TSH is elevated.ConclusionIn patients with acute stroke, it's the change that the reduction of T3 and the elevated of TSH but not the changes of T4 is associated with the morbidity of PSD.