Depressive Symptoms Profiles and Cognitive Outcomes After Stroke

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2025-09-15 DOI:10.1002/brb3.70801

Giuseppe Scopelliti, Francesco Mele, Ilaria Cova, Federico Masserini, Valentina Cucumo, Giorgia Maestri, Alessia Nicotra, Arianna Forgione, Pierluigi Bertora, Simone Pomati, Emilia Salvadori, Leonardo Pantoni

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Abstract

Introduction

Post-stroke depressive symptoms are heterogeneous and variably associated with other psycho-cognitive features. We employed cluster analysis to identify distinct profiles of post-stroke depressive symptomatology and their association with cognitive performance.

Methods

We included consecutive patients undergoing neuropsychiatric evaluation 6 months after stroke. Cluster analysis incorporated the Center for Epidemiologic Studies Depression Scale, along with the apathy and anxiety items from the Neuropsychiatric Inventory questionnaire. Baseline clinical/neuroimaging variables and 6-months cognitive outcomes were compared across profiles.

Results

We included 189 patients with acute cerebrovascular events (median age 75.4 years, 62% male, 80% ischemic strokes). Three profiles emerged: (A) low-depressive symptoms (n = 108), (B) moderate-depressive symptoms plus anxiety (n = 41), (C) high-depressive symptoms plus apathy (n = 40). Regarding baseline predictors of 6-month depressive symptoms profiles, patients with high-depressive symptoms plus apathy exhibited lower Montreal Cognitive Assessment scores at baseline (16.0 vs. 21.5; adjusted odds ratio [adj.OR] per 1-point increase 0.91, 95% confidence interval [95% CI] 0.83–0.99) compared to patients with low-depressive symptoms; moderate-depressive symptoms plus anxiety patients had less cortical atrophy compared to both low-depressive symptoms (adj.OR 0.92, 95% CI 0.86–0.99) and high-depressive symptoms plus apathy (adj.OR 0.89, 95% CI 0.81–0.97) profiles. Regarding 6-month cognitive performance, high-depressive symptoms plus apathy patients showed higher rates of post-stroke dementia and attention/executive function impairment compared with the two other groups (both p < 0.05), and higher rates of language impairment compared with low-depressive symptoms profile (p < 0.05).

Conclusion

By integrating apathy and anxiety in our model, depressive symptoms after stroke emerged as heterogeneous neuropsychiatric syndromes, showing different baseline predictors and distinctive cognitive patterns.

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中风后抑郁症状和认知结果

脑卒中后抑郁症状是异质性的，与其他心理认知特征有不同的相关性。我们采用聚类分析来确定卒中后抑郁症状的不同特征及其与认知表现的关系。方法纳入中风后6个月接受神经精神评估的连续患者。聚类分析结合了流行病学研究中心抑郁量表，以及神经精神病量表问卷中的冷漠和焦虑项目。基线临床/神经影像学变量和6个月认知结果进行比较。结果纳入189例急性脑血管事件患者（中位年龄75.4岁，62%为男性，80%为缺血性卒中）。出现了三种情况：(A)轻度抑郁症状（n = 108）， (B)中度抑郁症状加焦虑（n = 41）， (C)重度抑郁症状加冷漠（n = 40）。关于6个月抑郁症状的基线预测因素，与低抑郁症状患者相比，高抑郁症状加冷漠的患者在基线时表现出较低的蒙特利尔认知评估得分（16.0比21.5；校正优势比[adj.OR]每增加1点0.91,95%可信区间[95% CI] 0.83-0.99）；中度抑郁症状加焦虑患者与低抑郁症状（or 0.92, 95% CI 0.86-0.99）和高抑郁症状加冷漠（or 0.89, 95% CI 0.81-0.97）患者相比，皮质萎缩较少。在6个月的认知表现方面，与其他两组相比，高抑郁症状加冷漠的患者卒中后痴呆和注意力/执行功能障碍的发生率更高（p < 0.05），与低抑郁症状的患者相比，语言障碍的发生率更高（p < 0.05）。结论通过将冷漠和焦虑整合到我们的模型中，卒中后抑郁症状成为异质性神经精神综合征，显示出不同的基线预测因子和独特的认知模式。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

期刊介绍： Brain and Behavior is supported by other journals published by Wiley, including a number of society-owned journals. The journals listed below support Brain and Behavior and participate in the Manuscript Transfer Program by referring articles of suitable quality and offering authors the option to have their paper, with any peer review reports, automatically transferred to Brain and Behavior. * [Acta Psychiatrica Scandinavica](https://publons.com/journal/1366/acta-psychiatrica-scandinavica) * [Addiction Biology](https://publons.com/journal/1523/addiction-biology) * [Aggressive Behavior](https://publons.com/journal/3611/aggressive-behavior) * [Brain Pathology](https://publons.com/journal/1787/brain-pathology) * [Child: Care, Health and Development](https://publons.com/journal/6111/child-care-health-and-development) * [Criminal Behaviour and Mental Health](https://publons.com/journal/3839/criminal-behaviour-and-mental-health) * [Depression and Anxiety](https://publons.com/journal/1528/depression-and-anxiety) * Developmental Neurobiology * [Developmental Science](https://publons.com/journal/1069/developmental-science) * [European Journal of Neuroscience](https://publons.com/journal/1441/european-journal-of-neuroscience) * [Genes, Brain and Behavior](https://publons.com/journal/1635/genes-brain-and-behavior) * [GLIA](https://publons.com/journal/1287/glia) * [Hippocampus](https://publons.com/journal/1056/hippocampus) * [Human Brain Mapping](https://publons.com/journal/500/human-brain-mapping) * [Journal for the Theory of Social Behaviour](https://publons.com/journal/7330/journal-for-the-theory-of-social-behaviour) * [Journal of Comparative Neurology](https://publons.com/journal/1306/journal-of-comparative-neurology) * [Journal of Neuroimaging](https://publons.com/journal/6379/journal-of-neuroimaging) * [Journal of Neuroscience Research](https://publons.com/journal/2778/journal-of-neuroscience-research) * [Journal of Organizational Behavior](https://publons.com/journal/1123/journal-of-organizational-behavior) * [Journal of the Peripheral Nervous System](https://publons.com/journal/3929/journal-of-the-peripheral-nervous-system) * [Muscle & Nerve](https://publons.com/journal/4448/muscle-and-nerve) * [Neural Pathology and Applied Neurobiology](https://publons.com/journal/2401/neuropathology-and-applied-neurobiology)