Research On Depression After Cerebral Infarction And Cardiac Autonomic Nerve Activity

Background and Objective: Post-stroke Depression is the most common psychiatric complications in cerebrovascular disease(CVD). The recognition of depression after cerebral infarction and its influencing factors are insufficient in clinic. The influence on cardiac autonomic nerve activity has also not been further studied. In this investigation, cardiac autonomic nerve activity is reflected by heart rate variability, through prospective case-control study, depression disorders and related factors after cerebral infarction are analysed and the role of cerebral infarction concomitant depression on HRV parameters are explored. Our study is helpful for the treatment, prognosis and prevention of the patients with cerebral infarction and depression.Methods: Inpatients with first episode cerebral infarction were chosen by adoption and exclusion standards in Department of Neurology of our hospital from April 2009 to June 2010. The clinical data of these patients were collected, Hamilton depression scale (HAMD-17) were used for the diagnosis of depression during the examination and follow-up visit. Twenty-four-hours dynamic electrocardiogram signals were analysed to obtain various parameters of Heart Rate Variability. Incidence of depressive disorders and influencing factors on depression in cerebral infarction were analysed .The difference in HRV parameters and other affective factors of HRV were compared among the group A (cerebral infarction with depression), group B(cerebral infarction without depression) and group C (health control).Results: 81 cases of cerebral infarction patients and 20 cases of health control were chosen for the trial. Twenty-four patients with depressive disorders in three months( 29.63%). The incidence of depression disorders closely related with NIHSS scores in admission, harmonious degree of family relationship, educational level , communication ability and bad habits (alcohol and/or smoking). And it did not closely correlated with age, sex , the location and numbers of lesions. The SDNN, HF, TP were lower and LF/HF was higher in the depression group than that in non-depression group. The differences were significant between the two groups(P< 0.05) . The only risk factor independently associated with cardiac autonomic nerve activity was depression in Cerebral infarction patients.Conclusions: Depressive disorder was a common manifestation in patients with cerebral infarction. The harmonious degree of family relationship, educational level, communication ability, bad habits (alcohol and/or smoking) and NIHSS scores in admission were independent factors in cerebral infarction with depression. Cardiac autonomic nerve dysfunction was more apparent in depression patients than that in non-depression after cerebral infarction. It showed a decrease of parasympathetic nervous activity and a increase of sympathetic nervous activity. The only risk factor independently associated with cardiac autonomic nerve activity was depression in Cerebral infarction patients.