Clinical Study Of Botulinum Toxin A In The Treatment Of Poststroke Depression

Identifying the risk Factors of post stroke depressionObjective:This study mainly explored the related factors of post stroke depression(PSD)in patients with acute ischemic stroke.Methods:182 patients with ischemic stroke who were hospitalized in neurology department of our hospital from August 2018 to December 2018 were collected and confirmed by cranial MRI.Sex,age,past medical history,laboratory examination and imaging results were collected within 1 week of onset.NIHSS score and mRS score were improved after admission.NIHSS score,mRS score and Hamilton Depression Scale(17 items)score were improved at 2 weeks of onset.According to the Hamilton scale score,patients with ischemic stroke were divided into post-stroke depression(PSD)group and post-stroke non-depression group.The incidence of PSD was calculated,the data of the two groups were compared,and the related factors affecting the occurrence of PSD were analyzed.Results:182 patients were enrolled in this study.At 2 weeks,47 patients developed PSD,the incidence of which was 25.82%.NIHSS score and mRS score at two weeks after onset,and direct bilirubin were related to the occurrence of PSD(P<0.05).There was no significant difference between PSD and stroke site,hypertension,diabetes mellitus,coronary heart disease,gender,uric acid,glycated hemoglobin,fasting blood sugar,creatinine,systolic blood pressure,diastolic blood pressure,total bilirubin,indirect bilirubin,average platelet volume,C-reactive protein,homocysteine,triglyceride and low density lipoprotein(P>0.05).Multivariate regression analysis indicated that age,NIHSS score at admission,NIHSS score at two weeks and direct bilirubin were risk factors for PSD.Conclusions:The occurrence of post stroke depression is related to age,NIHSS score and mRS score at admission,NIHSS score and mRS score at two weeks of onset,and direct bilirubin.Age,NIHSS score at admission,NIHSS score at two weeks and direct bilirubin were risk factors for PSD at two weeks of onset of ischemic stroke.Clinical study of botulinum toxin A in the treatment of poststroke depressionObjective:The purpose of this study is to explore the efficacy and safety of botulinum toxin A in the treatment of post stroke depression in stroke patients.Methods:Patients diagnosed as post stroke depression in neuroclinic or neurology ward were treated with botulinum toxin A or sertraline.The patients were followed up for 2,4 and 8 weeks after treatment,and the HAMD score,HAMA score,SDS score and SAS score were evaluated.The scores of the two groups were compared and the adverse reactions were recorded.Results:1.Twenty-two patients were enrolled in this study.Twelve patients in the botulinum toxin A treatment group(2 patients with recurrent cerebral infarction within 2 weeks,excluded)had an average age of 68.8±7.53 years,and 10 patients in the sertraline group had an average age of 64.80±8.15 years).There was no significant difference in age between the two groups(P>0.05).There was no significant difference in HAMD score,HAMA score,SDS score and SAS score between botulinum toxin A group and sertraline group before treatment,2,4 and 8 weeks after treatment(F(3,72)=0.2289,P=0.876>0.05,F(3,72)=0.07628,P=0.9726>0.05,F(3,72)=0.05159,P=0.9844>0.05,F(3,72)=0.1392,P=0.9362>0.05).The HAMD score,HAMA score,SDS score and SAS score of the patients in the botulinum toxin A treatment group decreased after 2,4 and 8 weeks of treatment.The HAMD score,SDS score and SAS score had statistical difference at the 8th week(F(2.085,8.77)=6.453,P=0.0059<0.05,F(2.161,19.45)=12.83,P=0.0002<0.05,F(1.402,12.64)=6.688,P<0.0162,<0.05),respectively.There was no significant difference in HAMA score(F(1.907,17.16)=1.286,P?0.507>0.05).Conclusions:Botulinum toxin A is a safe and effective treatment for post-stroke depression,which is equivalent to sertraline and has no serious side effects.