Predictors of Depressive Mood in Patients With Isolated Cerebellar Stroke: A Retrospective Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To identify predictive factors of depressive mood in patients with isolated cerebellar stroke.Methods A retrospective chart review was performed in patients who had experienced their first isolated cerebellar stroke during 2002–2014. The patients were classified into two groups by the Geriatric Depression Scale (GDS) (non-depressive group, 0≤GDS≤16; depressive group, 17≤GDS≤30). Data on demographic and socioeconomic factors, comorbidities, functional level, cognitive and linguistic function, and stroke characteristics were collected. Significant variables in univariate analysis were analyzed using logistic regression.Results Fifty-two patients were enrolled, of whom 55.8% had depressive mood, were older (p=0.021), and had higher hypertension rates (p=0.014). Cognitive and linguistic functions did not differ between the two groups. The depressive group had higher ischemic stroke rates (p=0.035) and showed a dominant right posterior cerebellar hemisphere lesion (p=0.028), which was independently associated with depressive mood in the multiple logistic regression analysis (odds ratio, 5.081; 95% confidence interval, 1.261–20.479).Conclusion The risk of depressive mood after cerebellar stroke was increased in patients at old age, with a history of hypertension, ischemic stroke, and lesion of the right posterior cerebellar hemisphere. The most significant determining factor was stroke lesion of the right posterior cerebellar hemisphere. Early detection of risk factors is important to prevent and manage depressive mood after cerebellar stroke.
Abstract
Objective To identify predictive factors of depressive mood in patients with isolated cerebellar stroke.Methods A retrospective chart review was performed in patients who had experienced their first isolated cerebellar stroke during 2002–2014. The patients were classified into two groups by the Geriatric Depression Scale (GDS) (non-depressive group, 0≤GDS≤16; depressive group, 17≤GDS≤30). Data on demographic and socioeconomic factors, comorbidities, functional level, cognitive and linguistic function, and stroke characteristics were collected. Significant variables in univariate analysis were analyzed using logistic regression.Results Fifty-two patients were enrolled, of whom 55.8% had depressive mood, were older (p=0.021), and had higher hypertension rates (p=0.014). Cognitive and linguistic functions did not differ between the two groups. The depressive group had higher ischemic stroke rates (p=0.035) and showed a dominant right posterior cerebellar hemisphere lesion (p=0.028), which was independently associated with depressive mood in the multiple logistic regression analysis (odds ratio, 5.081; 95% confidence interval, 1.261–20.479).Conclusion The risk of depressive mood after cerebellar stroke was increased in patients at old age, with a history of hypertension, ischemic stroke, and lesion of the right posterior cerebellar hemisphere. The most significant determining factor was stroke lesion of the right posterior cerebellar hemisphere. Early detection of risk factors is important to prevent and manage depressive mood after cerebellar stroke.
참고문헌 (40)
- Hackett ML, "Part I: Frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies", Int J Stroke, 9, pp.1017~1025 (2014)
- Matsuzaki S, "The relationship between post-stroke depression and physical recovery", J Affect Disord, 176, pp.56~60 (2015)
- Choi-Kwon S, "Poststroke depression and emotional incontinence:factors related to acute and subacute stages", Neurology, 78, pp.1130~1137 (2012)
- De Ryck A, "Poststroke depression and its multifactorial nature: results from a prospective longitudinal study", J Neurol Sci, 347, pp.159~166 (2014)
- Tang WK, "Poststroke depression in Chinese patients: frequency, psychosocial, clinical, and radiological determinants", J Geriatr Psychiatry Neurol, 18, pp.45~51 (2005)
- Flaster M, "Poststroke depression: a review emphasizing the role of prophylactic treatment and synergy with treatment for motor recovery", Top Stroke Rehabil, 20, pp.139~150 (2013)
- Gabaldon L, "Poststroke depression: importance of its detection and treatment", Cerebrovasc Dis, 24(1), pp.181~188 (2007)
- De Ryck A, "A prospective study on the prevalence and risk factors of poststroke depression", Cerebrovasc Dis Extra, 3, pp.1~13 (2013)
- De Ryck A, "Risk factors for poststroke depression: identification of inconsistencies based on a systematic review", J Geriatr Psychiatry Neurol, 27, pp.147~158 (2014)
- Strata P, "The emotional cerebellum", Cerebellum, 14, pp.570~577 (2015)
- O’Halloran CJ, "The cerebellum and neuropsychological functioning: a critical review", J Clin Exp Neuropsychol, 34, pp.35~56 (2012)
- Shah SA, "Posterior fossa abnormalities in major depression: a controlled magnetic resonance imaging study", Acta Psychiatr Scand, 85, pp.474~479 (1992)
- LeroiI, "Psychopathology in patients with degenerative cerebellar diseases: a comparison to Huntington’s disease", Am J Psychiatry, 159, pp.1306~1314 (2002)
- Frank B, "Humor, laughter, and the cerebellum:insights from patients with acute cerebellar stroke", Cerebellum, 12, pp.802~811 (2013)
- Kim H, "Normative data on the Korean version of the Western Aphasia Battery", J Clin Exp Neuropsychol, 26, pp.1011~1020 (2004)
- Linacre JM, "The structure and stability of the Functional Independence Measure", Arch Phys Med Rehabil, 75, pp.127~132 (1994)
- Sivrioglu EY, "Reliability and validity of the Geriatric Depression Scale in detection of poststroke minor depression", J Clin Exp Neuropsychol, 31, pp.999~1006 (2009)
- Ji Yang Kim, "Standardization of the Korean Version of the Geriatric Depression Scale: Reliability, Validity, and Factor Structure", PSYCHIATRY INVESTIGATION, 5(4), pp.232~238 (2008), 대한신경정신의학회
- Brown C, "Poststroke depression and functional independence: a conundrum", Acta Neurol Scand, 126, pp.45~51 (2012)
- Sit JW, "Associated factors of post-stroke depression among Hong Kong Chinese:a longitudinal study", Psychol Health Med, 12, pp.117~125 (2007)
- Farner L, "Depressive symptoms in stroke patients: a 13month follow-up study of patients referred to a rehabilitation unit", J Affect Disord, 127, pp.211~218 (2010)
- Ayerbe L, "Natural history, predictors, and associations of depression 5 years after stroke: the South London Stroke Register", Stroke, 42, pp.1907~1911 (2011)
- Paolucci S, "The Italian multicenter observational study on post-stroke depression (DESTRO)", J Neurol, 253, pp.556~562 (2006)
- Tang WK, "Cerebral microbleeds and depression in lacunar stroke", Stroke, 42, pp.2443~2446 (2011)
- Mirowsky J, "Age and depression", J Health Soc Behav, 33, pp.187~205 (1992)
- Hackett ML, "Predictors of depression after stroke: a systematic review of observational studies", Stroke, 36, pp.2296~2301 (2005)
- Alexopoulos GS, "Depression in the elderly", Lancet, 365, pp.1961~1970 (2005)
- Yao H, "Leukoaraiosis and dementia in hypertensive patients", Stroke, 23, pp.1673~1677 (1992)
- Wang L, "White matter lesions and depression: a systematic review and meta-analysis", J Psychiatr Res, 56, pp.56~64 (2014)
- Meurs M, "The associations of depression and hypertension with brain volumes: independent or interactive?", Neuroimage Clin, 8, pp.79~86 (2015)
- van de Port IG, "Determinants of depression in chronic stroke: a prospective cohort study", Disabil Rehabil, 29, pp.353~358 (2007)
- Stoodley CJ, "Functional topography in the human cerebellum: a meta-analysis of neuroimaging studies", Neuroimage, 44, pp.489~501 (2009)
- Damasio AR, "Subcortical and cortical brain activity during the feeling of self-generated emotions", Nat Neurosci, 3, pp.1049~1056 (2000)
- Middleton FA, "Cerebellar projections to the prefrontal cortex of the primate", J Neurosci, 21, pp.700~712 (2001)
- Grimm S, "Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder", Biol Psychiatry, 63, pp.369~376 (2008)
- Alalade E, "Altered cerebellar-cerebral functional connectivity in geriatric depression", PLoS One, 6, pp.e20035~ (2011)
- Baldacara L, "Is cerebellar volume related to bipolar disorder?", J Affect Disord, 135, pp.305~309 (2011)
- Hama S, "Sitting balance as an early predictor of functional improvement in association with depressive symptoms in stroke patients", Psychiatry Clin Neurosci, 61, pp.543~551 (2007)
- Wu S, "Psychological associations of poststroke fatigue: a systematic review and meta-analysis", Stroke, 45, pp.1778~1783 (2014)
- Cunha IT, "Performance-based gait tests for acute stroke patients", Am J Phys Med Rehabil, 81, pp.848~856 (2002)