Does stroke laterality predict major depression and cognitive impairment after stroke? Two-year prospective evaluation in the EMMA study

Author(s)

Baccaro, Alessandra ^[1] ; Wang, Yuan-Pang ^{[2, 3]} ; Brunoni, Andre Russowsky ^{[1, 2]} ; Candido, Miriam ^[1] ; Conforto, Adriana Bastos ^[4] ; Leite, Claudia da Costa ^{[5, 6, 7]} ; Lotufo, Paulo A. ^{[6, 1]} ; Bensenor, Isabela M. ^{[6, 1]} ; Goulart, Alessandra C. ^[1]

Affiliation

^[1] Univ Sao Paulo, Hosp Univ, Ctr Clin & Epidemiol Res, Av Prof Lineu Presses 2565, Butanta Cidade Univ, BR-05508000 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Hosp Clin, Med Sch, Inst Psychiat, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Lab Med Invest Psychopharmacol & Clin Psychophysi, Med Sch, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Hosp Clin, Med Sch, Dept Neurol, Sao Paulo - Brazil

^[5] Univ Sao Paulo, NAPNA, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Med Sch, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Inst Radiol & Oncol, Hosp Clin, Sao Paulo - Brazil

• Document type: Journal article
• Source: PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY; v. 94, AUG 30 2019.
• Web of Science Citations: 1

Abstract

Depression and cognitive impairment are common conditions following stroke. We aimed to evaluate stroke laterality as predictor of post-stroke depression (PSD) and cognitive impairment (PCI) in a stroke cohort. Major depression (Patient Health Questionnaire-9, score >= 10) and cognitive impairment (Modified Telephone Interview for Cognitive Status, score < 14) were evaluated at 6 months and yearly up to 2 years. Survival analyses were performed by Kaplan-Meier curves and Cox logistic regression models, adjusted for potential confounders (cumulative hazard ratio, HR; 95% confidence interval, CI), for the likelihood of subsequent PSD or PCI progression at 6 months and 2 years, according to stroke laterality (right hemisphere-reference). Among 100 stroke patients, we found 19% had PSD and 38% had PCI 2 years after stroke. Most participants (53%) presented right-sided stroke. However, right-sided stroke was not associated with PSD or PCI. Overall, left-sided stroke was an independent and long-term predictor of PCI, but not of major depression. Left-sided stroke was associated with a high probability of PCI (42.6% and 53.2%, respectively at 6 months and 2 years, p-log-rank: 0.002). The HR of PCI due to left-sided stroke was 3.25 (95% CI, 1.30-8.12) at 6 months and remained almost the same at 2 years (HR, 3.22;95% CI, 1.43-7.28). The risk of having worse cognition status increased by > 3 times, 2 years after stroke. The results support the hypothesis that involvement of networks in the left, but not in the right hemisphere, contribute to long-term cognitive impairment. Lesion laterality did not influence the risk of PSD. (AU)

• FAPESP's process: 15/17321-0 - PREDICTIVE VALUE OF BIOMARKERS AND NEUROIMAGING IN LONG-TERM EVOLUTION OF POST-STROKE DEPRESSION AND COGNITIVE IMPAIRMENT IN EMMA STUDY
• Grantee: Alessandra Carvalho Goulart
• Support Opportunities: Regular Research Grants