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Published Online: 25 January 2018

Poststroke Depressive Symptoms Are Associated With Increased Oxidative Deoxyribonucleic Acid Damage

Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

Poststroke depression is independently associated with poor health outcomes, such as increased mortality, disability, anxiety, and lower quality of life. Identifying the potential biomarkers and detailed mechanisms of poststroke depression may improve the effectiveness of therapeutic intervention. In this cross-sectional study, the authors recruited patients with subacute ischemic stroke who were consecutively admitted for neurorehabilitation. Depression was assessed with the Patient Health Questionnaire–9 (PHQ-9), with a cutoff based on a summed-items score of 10. Polysomnography and laboratory tests for oxidative stress and inflammation were arranged. In total, 139 patients (97 men [69.8%] and 42 women [30.2%]; mean age: 63.2 years [±13.4]) with recent ischemic stroke were recruited and divided into two groups based on their depressive symptoms. Body mass index (BMI), the Barthel Index, percentage of antidepressant usage, and percentage of rapid eye movement (REM) sleep differed significantly between the two groups. The PHQ-9 score was significantly correlated with the levels of total antioxidant capacity, C-reactive protein, and urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG). Urinary 8-OHdG, a marker of oxidative stress to DNA, remained significantly and positively correlated with PHQ-9 scores after adjusting for BMI, sleep-onset latency, Barthel Index, mean oxyhemoglobin saturation, age, antidepressant usage, and percentage of REM sleep by using multivariate linear regression. Depressive symptoms were related to increased oxidative DNA damage in patients with subacute ischemic stroke. Urinary 8-OHdG may serve as a potential biomarker for poststroke depression. Further longitudinal studies are needed to elucidate the causal relationship between poststroke depression and elevated oxidative stress level.

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Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 139 - 144
PubMed: 29366374

History

Received: 31 May 2017
Revision received: 31 August 2017
Accepted: 19 September 2017
Published online: 25 January 2018
Published in print: Spring 2018

Keywords

  1. oxidative stress
  2. poststroke depression
  3. ischemia stroke

Authors

Details

Chung-Yao Chen, M.D. [email protected]
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-L C); and the Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-L C).
Chia-Ling Chen, M.D., Ph.D.
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-L C); and the Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-L C).
Yao-Hung Yang, M.D.
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-L C); and the Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-L C).
Chien-Hui Ho, M.D.
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-L C); and the Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-L C).
Wen-Chun Tseng, M.D
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-Y C, Y-H Y, C-H H, W-C T); the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C-L C); and the Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan (C-L C).

Notes

Send correspondence to Dr. Chen; email: [email protected]

Funding Information

Chang Gung Medical Research Council: CMRPG2E0013, 3B1441
Supported by the Chang Gung Medical Research Council (contract CMRPG2E0013, 3B1441).The authors report no financial relationships with commercial interests.

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