Correlation Analysis Of Depression After Hemorrhagic Stroke And Event-related Potentials

Objective:Post-stroke depression(PSD)is the most common psychiatric sequelae of stroke.Previous studies have indicated that PSD had a negative contribution to survival quality,neurological functional recovery and sociability recovery,which heavily burdens the healthcare system.However,most clinical studies include exclusively or predominantly ischemic stroke patients and very few studies have been reported on patients with hemorrhagic stroke.Due to the lack of objective diagnostic and evaluation criteria,most patients are underdiagnosed and undertreated.Event-Related Potential(ERP)is an electrophysiological measurement,which can objectively reflect the psychological state.Of these ERP components,MMN and P300 may be the most suitable biomarkers for PSD,as they’ve already been wildly explored in the diagnosis and efficacy evaluation of depression after ischemic stroke.Therefore,we analyzed the correlation between event-related potentials(MMN and P300)and depression severity,so as to verify whether MMN and P300 can provide diagnostic basis for depression after hemorrhagic stroke.Method:Patients with first-ever intracerebral hemorrhage treated in the Neurosurgery Department of the Third Hospital of Mianyang between October 2020 and October 2021 were consecutively screened for our study.All patients were confermed by cranial CT or cranial MRI.Stroke severity was assessed by the National Institutes of Health Stroke Scale(NIHSS)upon admission.Depression severity and cognitive function was assessed by the Montreal Cognitive Assessment(MoCA)and 17-item Hamilton Depression Scale(HAMD)respectively after two weeks of treatment.MMN and P300 were detected using Oddball paradigm.SPSS 25.0 software version was used for data analysis.The results of the categorical variables are shown as percentages.Continuous variables are expressed as the mean ± standard deviation(SD).A one-sample Kolmogorov-Smirnov Test was used to test data for normality.Analysis of variance(ANOVA)was used for comparisons between groups.To explore the relationship among different evaluations or the influences of different factors,the correlation was analyzed using Pearson’s correlation analysis if the data were normally distributed,or Spearman’s correlation analysis if not.P<0.05 was considered to be statistically significant.Result:1)A total of 74 patients with intracerebral hemorrhage(ICH)were included in our study.The results of neuropsychological scale were NIHSS scale score(10.7±5.5),HAMD scale score(9.7 ± 5.5)and MOCA scale score(23.3±5.7).Among them,thrity-two(43.2%)patients were diagnosed with PSD,and thirty-six(48.6%)patients were diagnosed with cognitive impairment.2)Pearson correlation analysis revealed that the HAMD scores of ICH patients were positively correlated with the latency of MMN and P300[(r=0.3 76,P=0.001),(r=0.325,P=0.005)],and negatively correlated with the amplitude of MMN and P300[(r=-0.385,P=0.001),(r=-0.311,P=0.007)].3)Pearson correlation analysis revealed that there was a negative correlation between HAMD scale scores and MOCA scale scores in patients with intracerebral hemorrhage(r=-0.347,P=0.002).Conclusion:1)Patients with hemorrhagic stroke were at high incidence rate of depression and cognitive impairment.2)Patients with more severe depression tend accompanied by more severe cognitive impairment.3)MMN and P300 can be used as objective electrophysiological indicators for depression after hemorrhagic stroke.The latency and amplitude of these ERP components can reflect depression severity to some extent,which may help early diagnosis of PSD for hemorrhagic stroke patients.