Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study)

Autor(es)

Baccaro, Alessandra ^{[1, 2]} ; Wang, Yuan-Pang ^{[3, 4]} ; Candido, Miriam ^[1] ; Conforto, Adriana Bastos ^[5] ; Brunoni, Andre Russowsky ^{[1, 3]} ; Leite, Claudia da Costa ^{[6, 7, 8]} ; Filho, Geraldo Busatto ^{[6, 7, 2, 3]} ; Lotufo, Paulo A. ^{[7, 1]} ; Bensenor, Isabela M. ^{[7, 1]} ; Goulart, Alessandra Carvalho ^[1]

Afiliação do(s) autor(es)

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

^[2] Univ Sao Paulo, Med Sch, Dept Psiquiatria, Lab Psychiat Neuroimaging LIM21, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Med Sch, Hosp Clin, Inst Psychiat, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Med Sch, Lab Med Invest Psychopharmacol & Clin Psychophysi, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Med Sch, Hosp Clin, Dept Neurol, Sao Paulo - Brazil

^[6] Univ Sao Paulo, NAPNA, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Med Sch, Sao Paulo - Brazil

^[8] Univ Sao Paulo, Hosp Clin, Inst Radiol & Oncol, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Journal of Affective Disorders; v. 245, p. 72-81, FEB 15 2019.
• Citações Web of Science: 3

Resumo

Background: Post-stroke depression (PSD) and cognitive impairment (PCI) are common conditions. This study aims to describe the protocol and preliminary findings of an investigation into factors associated with PSD and PCI 1-3 months after stroke (subacute phase) in survivors from the Study of Stroke Mortality and Morbidity (EMMA study). Methods: Stroke patients underwent to clinical and neurological evaluations on admission to hospital. Cerebral magnetic resonance and biomarkers (serotonin, BDNF, IL-6 and IL-18) were carried out in the subacute phase. DSM-IV major depression for the diagnosis of PSD, cognitive functioning for the diagnosis of PCI and functional disability were also recorded at same time. Results: Of the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had first-ever stroke. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with `first episode' and 7.8% with `recurrent' depression). PCI was associated with low education (0-7 years of formal education: 75%) and ageing (median age: 70; interquartile range: 59-75 y-old). Left-sided stroke was more frequently associated with increased PCI than right-sided stroke (71.4% vs. 28.4%, p = 0.005). PSD was neither associated with stroke laterality nor tentorial area. Overall, biomarkers levels were not alterated in patients with PSD and PCI. Limitations: Findings are based on small sample and less disabled stroke participants, e.g. those without aphasia and deafness. Conclusions: Findings reinforce the need of early recognition and rehabilitation of PCI and PSD, mainly among those less educated and with left-sided stroke. PSD might occur through a pathophysiological pathway other than classical depression. (AU)

• Processo FAPESP: 15/17321-0 - Valor preditivo de biomarcadores e neuroimagem cerebral na evolução da depressão e prejuízo cognitivo pós-acidente vascular cerebral a longo prazo no estudo emma
• Beneficiário: Alessandra Carvalho Goulart
• Modalidade de apoio: Auxílio à Pesquisa - Regular