Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study)

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author BACCARO, Alessandra FMUSP-HC
WANG, Yuan-Pang FMUSP-HC
CANDIDO, Miriam
CONFORTO, Adriana Bastos FMUSP-HC
BRUNONI, Andre Russowsky FMUSP-HC
LEITE, Claudia da Costa FMUSP-HC
FILHO, Geraldo Busatto FMUSP-HC
LOTUFO, Paulo A. FMUSP-HC
BENSENOR, Isabela M. FMUSP-HC
GOULART, Alessandra Carvalho FMUSP-HC
dc.date.issued 2019
dc.identifier.citation JOURNAL OF AFFECTIVE DISORDERS, v.245, p.72-81, 2019
dc.identifier.issn 0165-0327
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/30825
dc.description.abstract Background: Post-stroke depression (PSD) and cognitive impairment (PCI) are common conditions. This study aims to describe the protocol and preliminary findings of an investigation into factors associated with PSD and PCI 1-3 months after stroke (subacute phase) in survivors from the Study of Stroke Mortality and Morbidity (EMMA study). Methods: Stroke patients underwent to clinical and neurological evaluations on admission to hospital. Cerebral magnetic resonance and biomarkers (serotonin, BDNF, IL-6 and IL-18) were carried out in the subacute phase. DSM-IV major depression for the diagnosis of PSD, cognitive functioning for the diagnosis of PCI and functional disability were also recorded at same time. Results: Of the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had first-ever stroke. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with 'first episode' and 7.8% with 'recurrent' depression). PCI was associated with low education (0-7 years of formal education: 75%) and ageing (median age: 70; interquartile range: 59-75 y-old). Left-sided stroke was more frequently associated with increased PCI than right-sided stroke (71.4% vs. 28.4%, p = 0.005). PSD was neither associated with stroke laterality nor tentorial area. Overall, biomarkers levels were not alterated in patients with PSD and PCI. Limitations: Findings are based on small sample and less disabled stroke participants, e.g. those without aphasia and deafness. Conclusions: Findings reinforce the need of early recognition and rehabilitation of PCI and PSD, mainly among those less educated and with left-sided stroke. PSD might occur through a pathophysiological pathway other than classical depression.
dc.description.sponsorship · Sao Paulo Research Foundation (FAPESP), Sao Paulo, SP, Brazil [2015/17321-0]
dc.language.iso eng
dc.publisher ELSEVIER SCIENCE BV
dc.relation.ispartof Journal of Affective Disorders
dc.rights restrictedAccess
dc.subject Stroke; Post-stroke depression; Cognitive impairment; Neuroimaging; Biomarkers
dc.subject.other transient ischemic attack; neurotrophic factor levels; mental-state-examination; lesion location; mood disorders; neurological disorders; telephone interview; 1st-ever stroke; dynamic changes; assessment moca
dc.title Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study)
dc.type article
dc.rights.holder Copyright ELSEVIER SCIENCE BV
dc.description.group LIM/15
dc.description.group LIM/20
dc.description.group LIM/21
dc.description.group LIM/23
dc.description.group LIM/27
dc.description.group LIM/44
dc.description.group LIM/51
dc.identifier.doi 10.1016/j.jad.2018.10.003
dc.identifier.pmid 30368073
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author BACCARO, Alessandra:FM:
hcfmusp.author WANG, Yuan-Pang:HC:IPQ
hcfmusp.author CONFORTO, Adriana Bastos:HC:ICHC
hcfmusp.author BRUNONI, Andre Russowsky:HC:IPQ
hcfmusp.author LEITE, Claudia da Costa:FM:MDR
hcfmusp.author FILHO, Geraldo Busatto:FM:MPS
hcfmusp.author LOTUFO, Paulo A.:FM:MCM
hcfmusp.author BENSENOR, Isabela M.:FM:MCM
hcfmusp.author GOULART, Alessandra Carvalho:HU:SCPACEX-62
hcfmusp.author.external · CANDIDO, Miriam:Univ Sao Paulo, Hosp Univ, Ctr Clin & Epidemiol Res, Av Prof Lineu Prestes 2565,Butantan Cidade Univ, BR-05508000 Sao Paulo, SP, Brazil
· GOULART, Alessandra Carvalho:Univ Sao Paulo, Hosp Univ, Ctr Clin & Epidemiol Res, Av Prof Lineu Prestes 2565,Butantan Cidade Univ, BR-05508000 Sao Paulo, SP, Brazil
hcfmusp.origem.id WOS:000456697100009
hcfmusp.origem.id 2-s2.0-85055257825
hcfmusp.publisher.city AMSTERDAM
hcfmusp.publisher.country NETHERLANDS
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dc.description.index MEDLINE
dc.identifier.eissn 1573-2517
hcfmusp.citation.scopus 2
hcfmusp.citation.wos 1
hcfmusp.affiliation.country Brasil


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