Periventricular White Matter Hyperintensity in Males is Associated with Post-Stroke Depression Onset at 3 Months

Xuan-Qiang Tu; Ze-Hua Lai; Yu Zhang; Kai-Qi Ding; Fei-Yue Ma; Guo-Yuan Yang; Ji-Rong He; Li-Li Zeng

doi:10.2147/NDT.S311207

Periventricular White Matter Hyperintensity in Males is Associated with Post-Stroke Depression Onset at 3 Months

Neuropsychiatr Dis Treat. 2021 Jun 8:17:1839-1857. doi: 10.2147/NDT.S311207. eCollection 2021.

Authors

Xuan-Qiang Tu^#¹, Ze-Hua Lai^#¹, Yu Zhang², Kai-Qi Ding¹, Fei-Yue Ma³, Guo-Yuan Yang¹, Ji-Rong He³, Li-Li Zeng¹

Affiliations

¹ Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
² Department of Neurology and Institute of Neurology, Ruijin Hospital North, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
³ Department of Neurology and Institute of Neurology, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This study aimed to explore the correlation between white matter hyperintensity (WMH) and post-stroke depression (PSD) at 3 months, and to further investigate sex differences in the pathogenesis of PSD.

Methods: A total of 238 consecutive patients with acute cerebral infarction were recruited. PSD was assessed at 2 weeks and at 3 months after stroke onset. All stroke cases were divided into four subgroups according to the diagnosis of depression at two time nodes: continuous depression; depression remission; late-onset PSD; and continuous non-depression. The Fazekas and Scheltens visual rating scales were adopted to assess WMH.

Results: Logistic regression revealed that the presence of periventricular white matter hyperintensity (PVWMH) at baseline in male patients was an independent risk factor for PSD at 3 months. Further subgroup analysis revealed that PVWMH was associated with late-onset PSD in males, but not with continuous depression 3 months after stroke. Male acute stroke patients with PVWMH at baseline were more likely to develop PSD at 3 months, especially late-onset PSD.

Conclusion: Our data suggest that sex differences may influence the pathogenesis of PSD.

Keywords: acute cerebral infarction; affective disorder; leukoencephalopathy; post-stroke depression; sex difference.

Grants and funding

This work was supported by the Hospital specialist development plan of health system in Huangpu District of Shanghai under Grant [number 2019pyzk01-1].