Depressive symptoms profile and dementia risk after spontaneous intracerebral haemorrhage.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-09-26 DOI:10.1177/23969873241284725

Giuseppe Scopelliti, Maéva Kyheng, Barbara Casolla, Grégory Kuchcinski, Grégoire Boulouis, Solène Moulin, Julien Labreuche, Hilde Hénon, Marco Pasi, Charlotte Cordonnier

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引用次数: 0

Abstract

Introduction: Depressive symptoms are commonly reported after spontaneous intracerebral haemorrhage (ICH) and frequently associated with cognitive decline. Using hierarchical clustering analysis (HCA), we aimed to identify different post-ICH depressive symptoms profiles and to evaluate their association with dementia risk.

Methods: We included consecutive patients from the prospective Prognosis of Intracerebral Haemorrhage (PITCH) study who survived 6 months after the ICH. We performed HCA using depressive symptoms severity (assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS)), along with the presence of apathy and anxiety (screened using Neuropsychiatric Inventory questionnaire). Baseline clinical/neuroimaging characteristics and risk of incident dementia were compared between different profiles using univariate and multivariable models.

Results: Of 265 six-month ICH survivors, 221 (83%) underwent neuropsychiatric screening (mean age 65.5 years; 57% male). Using HCA, 3 profiles were identified: (1) without significant depressive symptoms (n = 152; median MADRS score = 2 [IQR 0-4]); (2) depressive symptoms with predominant apathy (n = 41; median MADRS score = 15 [IQR 5-20], 68% with apathy); (3) depressive symptoms profile with predominant anxiety (n = 28; median MADRS score = 17 [IQR 9-25]; 100% with anxiety). Compared to patients without depressive symptoms, patients with depressive symptoms and predominant apathy (but not those with predominant anxiety) were more likely to have cerebral atrophy (OR = 2.4, 95% CI = 1.4-4.2) and had significantly higher long-term new-onset dementia risk (adjusted hazard ratio = 2.2, 95% CI = 1.3-3.8).

Conclusion: Screening for apathy and anxiety on top of depressive symptoms might help identifying patients at risk for dementia. Future studies on treatment should account for different post-ICH depressive symptoms profiles that may impact on cognitive function.

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自发性脑出血后的抑郁症状概况和痴呆症风险。

简介：抑郁症状是自发性脑出血（ICH）后的常见症状，通常与认知能力下降有关。我们采用分层聚类分析（HCA），旨在确定不同的 ICH 后抑郁症状特征，并评估它们与痴呆风险的关系：我们纳入了前瞻性脑出血预后（PITCH）研究中在 ICH 后存活 6 个月的连续患者。我们使用抑郁症状严重程度（使用蒙哥马利-奥斯伯格抑郁评定量表（MADRS）进行评估）以及是否存在冷漠和焦虑（使用神经精神量表问卷进行筛查）进行了 HCA 评估。采用单变量和多变量模型比较了不同类型患者的基线临床/神经影像学特征和痴呆症发病风险：在 265 名存活六个月的 ICH 患者中，221 人（83%）接受了神经精神病学筛查（平均年龄 65.5 岁；57% 为男性）。通过 HCA 筛选，确定了 3 种情况：(1）无明显抑郁症状（152 人；MADRS 中位数评分 = 2 [IQR0-4]）；（2）抑郁症状以冷漠为主（41 人；MADRS 中位数评分 = 15 [IQR5-20]，68% 患有冷漠）；（3）抑郁症状以焦虑为主（28 人；MADRS 中位数评分 = 17 [IQR9-25]；100% 患有焦虑）。与无抑郁症状的患者相比，有抑郁症状且以冷漠为主的患者（但不包括以焦虑为主的患者）更有可能出现脑萎缩（OR = 2.4，95% CI = 1.4-4.2），且长期新发痴呆症的风险明显更高（调整后危险比 = 2.2，95% CI = 1.3-3.8）：结论：在抑郁症状的基础上筛查冷漠和焦虑可能有助于识别痴呆症高危患者。未来的治疗研究应考虑到ICH后不同抑郁症状对认知功能的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.