• Stroke
• community participation
• gender
• long-term effects
• social participation

• Humans
• Male
• Female
• Aged
• Middle Aged
• Stroke/psychology
• Stroke Rehabilitation
• Sex Characteristics
• Sex Factors
• Aged, 80 and over
• Social Participation
• Depression/etiology

• P30 ES005022 NIEHS NIH HHS

• Excessive daytime sleepiness
• Polysomnography
• Sex differences
• Stroke

• Humans
• Male
• Female
• Retrospective Studies
• Middle Aged
• Ischemic Stroke/epidemiology
• Ischemic Stroke/complications
• Aged
• Disorders of Excessive Somnolence/epidemiology
• Disorders of Excessive Somnolence/diagnosis
• Disorders of Excessive Somnolence/etiology
• Risk Factors
• Sex Characteristics
• Databases, Factual
• Sex Factors
• Adult
• Polysomnography

• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project
• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project
• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project
• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project
• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project
• YZ2017111 the Yangzhou Natural Science Foundation-Youth Fund Project

• Cardiac arrest
• Depression
• Major adverse cardiovascular events
• Mortality
• Outcomes
• Stroke
• Type 2 myocardial infarction

• Gender
• Intracerebral hemorrhage
• Outcome
• Prognosis
• Sex

• Depression
• Inflammatory cytokines
• Post-stroke depression
• Stroke

• Humans
• Cytokines/genetics
• Depression/etiology
• Quality of Life
• Stroke/drug therapy
• Interleukin-6

• DNA methylation
• Nomogram
• Post-stroke depression

• United States
• Humans
• DNA Methylation
• Ischemic Stroke
• Depression/diagnosis
• Nomograms
• Stroke/complications

• China Kadoorie Biobank
• Medication use
• Risk factor control
• Sex-specific differences
• Stroke prevention

• depression
• epidemiology
• stroke

Sedentary behaviour among stroke inpatients may be due to high rates of depressive symptoms after stroke. Thus, efforts to address depressive symptoms among stroke inpatients are warranted to in turn lessen sedentary behaviour. Despite evidence that virtual reality (VR) is emerging as a method to help with depression, the use of VR to improve depression among inpatient stroke survivors has yet to be studied. In this paper, we report on the protocol investigating the feasibility of a VR entertainment system at improving depressive symptoms among stroke survivors receiving inpatient rehabilitation.

In this single-blind randomized controlled trial, 30 inpatient stroke survivors from the rehabilitation unit at Kelowna General Hospital will be randomized to either (1) intervention: 3 times per week of VR entertainment for duration of inpatient rehabilitation or (2) control: usual care. Individuals will be included if they have a confirmed diagnosis of stroke, are 19 years of age or older, able to provide informed consent, have physician clearance to participate in the study (medically stable or fit), or are able to understand English. Outcome measures to address depressive symptoms (primary outcome), sedentary behaviour, motivation, anxiety, stress, and happiness (secondary outcome) will be administered at two timepoints: (1) baseline (T1) and (2) post-intervention (T2). Study analyses will consider study feasibility indicators and clinical (statistical) outcomes. Means and standard deviations (for continuous variables) and frequencies and proportions (for categorical variables) will be used to summarize the variables. Feasibility indicators will be dichotomized into either ‘success’ if they meet the a priori criteria, or ‘revise’ if they do not meet the criteria. Intervention effects post-intervention (T2) for the primary and secondary clinical outcomes will be estimated using linear regression including baseline (T1) controlling for age and sex.

The results of this trial will add to our understanding of depression and sedentary behaviour among individuals receiving inpatient stroke rehabilitation as well as the feasibility of a VR entertainment program to improve depressive symptoms, which will in turn may lessen sedentary behaviour in inpatient stroke survivors.

ClinicalTrials.gov Identifier: NCT04011202 . First posted July 8, 2019 (study postponed from March 2020 to July 2021 due to COVID-19).

The online version contains supplementary material available at 10.1186/s40814-022-01189-8.

• Depressive symptoms
• Post-stroke depression (PSD)
• Sedentary behaviour
• Virtual reality (VR)

• ischemic stroke
• post-stroke depression
• predictors
• stroke

• Blood biomarkers
• Post-stroke depression
• Sex difference

• Biomarkers
• Brain-Derived Neurotrophic Factor
• Cohort Studies
• Depression/diagnosis
• Depression/etiology
• Depressive Disorder, Major/complications
• Depressive Disorder, Major/etiology
• Female
• Fibrinogen
• Humans
• Magnesium
• Male
• Prospective Studies
• Stroke/complications
• Stroke/psychology

• brain-derived neurotrophic factor
• cAMP response element-binding protein
• depression
• estrogen
• hippocampus
• stroke
• tyrosine kinase B

• R01 AG021980 NIA NIH HHS
• R01 NS057186 NINDS NIH HHS

• acute cerebral infarction
• affective disorder
• leukoencephalopathy
• post-stroke depression
• sex difference

Stroke is a major cause of long-term disability and death worldwide. Several studies have shown that women in general have more severe symptoms at arrival to hospital and are less likely to return home and independent living. Our aim with the present study was to update previous results concerning sex differences in baseline characteristics, stroke management, and outcome in a population study from Sahlgrenska University Hospital, Gothenburg, Sweden.

This study included patients with acute ischemic and hemorrhagic stroke in 2014 at Sahlgrenska University Hospital. All data were collected from The Swedish National Stroke Registry (Riksstroke).

The study population consisted of 1453 patients, with 46.7% females. Women were 5 years older than men. There was no sex difference in acute stroke severity. Frequency of revascularization was equal between men and women. The stroke mortality rate was the same between the sexes. At 3-months follow-up, women had a worse functional outcome and a higher frequency of depression and post-stroke fatigue.

Our results show that there are no sex differences in management of acute stroke. However, the cause of worse functional outcome in women at 3-months follow-up, independent of other risk factors, is not clear and warrants further investigations.

• differences
• prognosis
• sex
• stroke
• treatment

• K08 NS091499 NINDS NIH HHS
• R44 NS076272 NINDS NIH HHS

• Aged
• Aged, 80 and over
• Depression/epidemiology
• Female
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Factors
• Sex Characteristics
• Stroke/epidemiology
• Texas/epidemiology

• R01 NS038916 NINDS NIH HHS
• R01 NS070941 NINDS NIH HHS

• Age Factors
• Central Nervous System/injuries
• Central Nervous System/physiopathology
• Humans
• Neuroprotection/physiology
• Neuroprotective Agents/therapeutic use
• Sex Characteristics
• Stroke/physiopathology

• R01 NS101960 NINDS NIH HHS
• R01 NS109459 NINDS NIH HHS
• I01 BX002985 BLRD VA
• I01 BX004344 BLRD VA
• R01 NS099531 NINDS NIH HHS

• BDNF
• Cytokines
• Forced Swim Test
• Mesostriatal pathway
• Social interaction test
• T maze cost/benefit test

• depression
• meta-analysis
• myocardial infarction
• prevalence

• Depression/epidemiology
• Depression/etiology
• Female
• Humans
• Male
• Myocardial Infarction/psychology
• Prevalence

• China
• Chronic disease
• Depression
• United States

• Age Factors
• Animals
• Brain Ischemia/epidemiology
• Brain Ischemia/mortality
• Brain Ischemia/physiopathology
• Female
• Humans
• Incidence
• Male
• Prognosis
• Recovery of Function
• Sex Factors
• Stroke/epidemiology
• Stroke/mortality
• Stroke/physiopathology

• F30 NS098628 NINDS NIH HHS
• R01 NS055215 NINDS NIH HHS
• R37 NS096493 NINDS NIH HHS

• hallucinations
• neuropsychiatry
• schizophrenia
• stroke

The pathophysiology of post-stroke depression (PSD) is complex and may differ according to an individual’s mood immediately after stroke. Here, we compared the therapeutic response and clinical characteristics of PSD at a later stage between patients with and without depression immediately after stroke.

This study involved a post hoc analysis of data from EMOTION (ClinicalTrials.gov NCT01278498), a placebo-controlled, double-blind trial that examined the efficacy of escitalopram (10 mg/day) on PSD and other emotional disturbances among 478 patients with acute stroke. Participants were classified into the Baseline-Blue (patients with baseline depression at the time of randomization, defined per the Montgomery-Asberg Depression Rating Scale [MADRS] ≥8) or the Baseline-Pink groups (patients without baseline depression). We compared the efficacy of escitalopram and predictors of 3-month PSD (MADRS ≥8) between these groups.

There were 203 Baseline-Pink and 275 Baseline-Blue patients. The efficacy of escitalopram in reducing PSD risk was more pronounced in the Baseline-Pink than in the Baseline-Blue group (p for interaction=0.058). Several risk factors differentially affected PSD development based on the presence of baseline depression (p for interaction <0.10). Cognitive dysfunction was an independent predictor of PSD in the Baseline-Blue, but not in the Baseline-Pink group, whereas the non-use of escitalopram and being female were more strongly associated with PSD in the Baseline-Pink group.

Responses to escitalopram and predictors of PSD 3 months following stroke differed based on the presence of baseline depression. Our data suggest that PSD pathophysiology is heterogeneous; therefore, different therapeutic strategies may be needed to prevent PSD emergence following stroke.

• Anger
• Depression
• Emotional incontinence
• Escitalopram
• Stroke

• Iran
• depression
• meta-analysis
• outbreak
• stroke
• systematic review

• meta‐analysis
• poststroke depression
• sex
• systematic review
• the stroke lesion location

Post-stroke depression (PSD) is the most common neuropsychological sequela of stroke and occurs in approximately one-third of all stroke survivors. However, there are no well-established predictors of PSD. Depression in stroke patients is correlated with unfavorable outcomes. Meta-analyses of the relationship between PSD and lesion location have yielded contradictory results and have not adequately addressed the impact of cerebellar lesions. Furthermore, other brain regions associated with depression in patients with cerebellar stroke remain a matter of debate. For these reasons, this cross-sectional study investigated the relationship between PSD and lesion location in patients with isolated cerebellar stroke.

Twenty-four patients in the subacute rehabilitative period following a first-ever isolated cerebellar stroke were enrolled in the study. Depressive mood were evaluated using the Geriatric Depression Scale. Regions of interest were drawn manually on T1-weighted magnetic resonance images using MRIcron software, and data were normalized to a standard brain template in order to examine the neural correlates of depression using voxel-based lesion-symptom mapping analysis.

Voxel-wise subtraction and χ (Ayerbe et al., 2014) analyses indicated that damage to the left posterior cerebellar hemisphere was associated with depression. Significant correlations were also found between the severity of depressive symptoms and lesions in lobules VI, VIIb, VIII, Crus I, and Crus II of the left cerebellar hemisphere (P_corrected = 0.045). Our results suggest that damage to the left posterior cerebellum is associated with increased depressive mood severity in patients with isolated cerebellar stroke.

•

Post-stroke depression (PSD) could be associated with lesion location.

• Brain mapping
• Cerebellum
• Depression
• GDS, Geriatric Depression Scale
• MBI, modified Barthel index
• MMSE, Mini-Mental State Examination
• MNI, Montreal Neurological Institute
• MRI, magnetic resonance imaging
• PSD, post-stroke depression
• ROI, regions of interest
• SD, standard deviation
• Stroke
• VLSM, voxel-based lesion-symptom mapping

• Incidence
• Poststroke depression
• Risk factors
• Taiwan

• antidepressant
• pioglitazone
• post-stroke depression
• type 2 diabetes mellitus

• stroke
• depression
• gender
• stress

• Activities of Daily Living
• Affect
• Aged
• Depression/diagnosis
• Depression/etiology
• Depression/psychology
• Emotions
• Female
• France
• Humans
• Interviews as Topic
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Risk Factors
• Severity of Illness Index
• Sex Factors
• Stress, Psychological/diagnosis
• Stress, Psychological/etiology
• Stress, Psychological/psychology
• Stroke/complications
• Stroke/diagnosis
• Stroke/psychology
• Surveys and Questionnaires
• Time Factors

• P50 DA033945 NIDA NIH HHS
• RL5 DA024858 NIDA NIH HHS
• P50-DA033945 NIDA NIH HHS
• RL5-DA024858 NIDA NIH HHS

• Antianxiety medications
• Antidepressants
• Anxiety
• Cardiovascular risk
• Depression
• Ethnic differences
• HCHS/SOL
• Hispanics
• Latinos

• Adolescent
• Adult
• Aged
• Antidepressive Agents/administration & dosage
• Anxiety/ethnology
• Cardiovascular Diseases/ethnology
• Cross-Sectional Studies
• Depression/ethnology
• Drug Utilization
• Emigrants and Immigrants/statistics & numerical data
• Female
• Hispanic or Latino
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Factors
• Sex Distribution
• United States/epidemiology
• Young Adult

• N01HC65236 NHLBI NIH HHS
• N01HC65235 NHLBI NIH HHS
• N01-HC65237 NHLBI NIH HHS
• N01HC65234 NHLBI NIH HHS
• N01HC65233 NHLBI NIH HHS
• N01 HC065235 NHLBI NIH HHS
• N01-HC65235 NHLBI NIH HHS
• N01HC65237 NHLBI NIH HHS
• N01-HC65233 NHLBI NIH HHS
• N01-HC65234 NHLBI NIH HHS
• N01-HC65236 NHLBI NIH HHS

A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertension and diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.

• Depression
• Mood disorders
• Stroke
• Post-stroke depression
• Antidepressant medications
• Cerebrovascular disease

Comorbidity of depression and stroke significantly reduces the quality of life of patients after the stroke. Squeal after stroke also determines the quality of life and have impact on the occurrence of depression after the stroke. In our study we investigated the occurrence of depression in patients after different types and subtypes of stroke measured by the Hamilton scale compared to the level of disability measured by NIHSS scale.

The goal was to make a comparative analysis of depression after stroke, according to gender and age, side of the lesion and the severity of neurological deficit.

Material for our work are 210 patients with stroke treated at the Neurology Clinic, Clinical Center of Sarajevo University in 2012, 105 male and 105 female. The mean age of the patients was 67.12±9.5 years. Ischemic stroke was present in 65% cases. There was no statistically significant difference between ischemic and hemorrhagic stroke among genders. In case of hemorrhagic M-56.7%, F-43.3%; ischemic M-48.3%, F-51.7% (chi-square=6.563, p=0.082). Depression was more prevalent among younger patients (52-60 years) with 39.2% then in the group of older patients (61-70 years) with 32% of depressed. In relation to gender there was significantly more patients with depression among women compared to men (63.8:27.2%, chi-square=14.38, p=0.00019). Depression was more frequent in patients with stroke in the left hemisphere medial localization (63%). NIHSS scale average was 16.07 with the minimum of 11 and maximum of 22, F=52.56, p=0.001.

We can conclude that depression after stroke is more frequent in younger patients, female patients, patients with localized stroke in the medial left hemisphere and with higher disability score.

• Age Factors
• Aged
• Depression/diagnosis
• Depression/etiology
• Disability Evaluation
• Female
• Humans
• Male
• Middle Aged
• Sex Factors
• Stroke/complications

• acceptance of disability
• stroke
• taiwan

• Aged
• Behavior
• Cross-Sectional Studies
• Disabled Persons/psychology
• Female
• Humans
• Male
• Middle Aged
• Patient Participation/psychology
• Stroke/epidemiology
• Stroke/psychology
• Surveys and Questionnaires
• Taiwan/epidemiology

Objective. This analysis focuses on the effect of depression on the cost of hospitalization of stroke patients. Methods. Data on 17,010 stroke patients (primary diagnosis) were extracted from 2008 Tennessee Hospital Discharge Data System. Three groups of patients were compared: (1) stroke only (S^O, n = 7,850), (2) stroke + depression (S^+D, n = 3,965), and (3) stroke + other mental health diagnoses (S^+M, n = 5,195). Results. Of all adult patients, 4.3% were diagnosed with stroke. Stroke was more prevalent among blacks than whites (4.5% versus 4.2%, P < 0.001) and among males than females (5.1% versus 3.7%, P < 0.001). Nearly one-quarter of stroke patients (23.3%) were diagnosed with depression/anxiety. Hospital stroke cost was higher among depressed stroke patients (S^+D) compared to stroke only (S^O) patients ($77,864 versus $47,790, P < 0.001), and among S^+D, cost was higher for black males compared to white depressed males ($97,196 versus $88,115, P < 0.001). Similar racial trends in cost emerged among S^+D females. Conclusion. Depression in stroke patients is associated with increased hospitalization costs. Higher stroke cost among blacks may reflect the impact of comorbidities and the delay in care of serious health conditions. Attention to early detection of depression in stroke patients might reduce inpatient healthcare costs.

It has been widely suggested that depression negatively affects patients with cardiovascular disease. There are several pathophysiological mechanisms as well as behavioral processes linking depression and cardiac events. Improvements in nursing and medical care have prolonged survival of this patient population; however, this beneficial outcome has led to increased prevalence of depression. Since mortality rates in chronic heart failure patients remain extremely high, it might be as equally important to screen for depression and there are several valid and reliable screening tools that healthcare personnel could easily employ to identify patients at greater risk. Consultation should be provided by a multidisciplinary team, consisting of cardiologists, psychiatrists, and hospital or community nurses so as to carefully plan, execute, and evaluate medical intervention and implement lifestyle changes. We aim to systematically review the existing knowledge regarding current definitions, prognostic implications, pathophysiological mechanisms, and current and future treatment options in patients with depression and cardiovascular disease, specifically those with heart failure.

• depression
• poststroke
• stroke