| BackgroundAfter a stroke,many patients experience changes in their emotional behavior.About one third of stroke survivors are affected by post-stroke depression(PSD).PSD can not only significantly delay the course of stroke recovery and affect the outcome of rehabilitation,but also increase the death rate of stroke patients,making it a serious social and public health problem.Currently,there is no effective diagnostic method for PSD.The clinical diagnosis of PSD mainly relies on the assessment of Hamilton and other related depression scales,and its diagnostic effect is often not satisfactory.Therefore,it is urgently to find a new diagnostic method to identify PSD.Until now,no consensus has been reached on the etiological mechanism of PSD,and the hypothesis of remote white matter microstructure changes caused by infarction has been accepted by most scholars.Therefore,the study based on diffusion tensor imaging(DTI)of PSD patients may provide new ideas for the early diagnosis of PSD.ObjectiveMagnetic resonance DTI was used to analyze changes in white matter microstructure associated with PSD.MethodsIn April 2016 to February 2017 consecutive included in the first affiliated hospital of xinxiang medical college neurology starting 44 patients with ischemic stroke.All participants were right-handed and all subjects participated after signing the informed consent approved by the ethics committee.The onset(90±7 days)for all participants to Hamilton depression rating scale(HAMD-17),simple intelligence scale for Mini-mental state examination,Montreal cognitive assessment scale,Barthel daily life index evaluation,National institutes of health stroke scale(NIHSS)and DTI examination.The HAMD score of patients in the post-stroke depression group was > 7,while that of patients in the simple stroke group was ? 7.The diagnosis of depression conforms to the diagnostic criteria of Diagnosis and Statistics Manual of Mental Diseases,Fourth Edition.Finally,21 patients(10 females,11 males,with an average age of 56.4±10.2y)were included in the PSD group,and 23 patients(8 females,15 males,with an average age of 60.2±9.8y)were included in the non-PSD group.The difference of anisotropic fraction(FA),one of the DTI parameters of region of interest(ROI),between PSD group and nonPSD group was compared.Result1.Comparison of baseline information between PSD group and non-PSD group: 21 cases in PSD group,average score of HAMD(12.76 ±3.16),23 cases in non-PSD group,average score of HAMD(2.96 ±1.90).There were no significant differences in general demographic characteristics,such as age,sex,educational years,cognitive function and daily living ability between the two groups.The NIHSS score of PSD group was higher than that of non-PSD group(P < 0.05).2.The results of 57 ROIs FA values between PSD group and non-PSD group showed that the FA values of left and right anterior cingulate cortex in PSD group were lower than those in non-PSD group(P < 0.05).3.The correlation between HAMD score and HAMD score of left anterior cingulate cortex in PSD group was analyzed.The results showed that there was a positive correlation between FA value of left anterior cingulate cortex and HAMD score(r=0.479,P=0.028),and a negative correlation between FA value of right anterior cingulate cortex and HAMD score(r=-0.540,P=0.011).4.The correlation between HAMD score and NIHSS score in PSD group was analyzed.The results showed that there was a positive correlation between HAMD score and NIHSS score in PSD group(r = 0.505,P < 0.05).5.The correlation between FA value of right anterior cingulate gyrus and NIHSS score in PSD group was analyzed.The results showed that there was no significant correlation between FA value of right anterior cingulate gyrus and NIHSS score(r=0.027,P=0.479).ConclusionsThe changes of anterior cingulate cortex in patients with PSD are closely related to the occurrence of PSD,and may be the structure basis for PSD besides infarction. |
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