The combination of plasma glutamate and physical impairment after acute stroke as a potential indicator for the early-onset post-stroke depression

摘要

Abstract Objects The present study aimed to investigate the relationship of plasma glutamate levels with the early-onset of post-stroke depression (PSD) and to further explore the prognostic value of plasma glutamate combined with clinical characteristics for the early-onset PSD in the acute ischemic stroke patients. Methods Seventy-four patients who admitted to the hospital within 24 h of acute ischemic stroke were consecutively recruited and followed up for 2 weeks. The Beck Depression Inventory (BDI) and 17-item Hamilton Depression Rating Scale (HAMD-17) were used to screen for depressive symptoms 14 days after stroke. Diagnoses of depression were made in accordance with DSM-IV. Plasma glutamate levels were determined by High Performance Liquid Chromatography (HPLC) on days 1 and 14 after stroke for all patients. Results Plasma glutamate levels were significantly lower in PSD patients than those of non-PSD patients on day 1 after stroke. ROC curve analyses revealed an AUC (area under the ROC curve) of 0.724 (95% CI: 0.584–0.863, p = 0.004) and of 0.669 (95% CI: 0.523–0.814, p = 0.030) for National Institute of Health Stroke Scale (NIHSS) scores and plasma glutamate levels on day 1 respectively. Combined ROC analyses using the two factors revealed the highest AUC of 0.804 (95% CI: 0.685–0.922, P 0.0001). Conclusions These results indicated an association between the early-onset PSD and a low plasma glutamate level following acute ischemic stroke. The combination of reduced plasma glutamate levels and physical impairment (determined by NIHSS) 1 day after acute ischemic stroke was a potential diagnostic indicator for early-onset PSD. Highlights ? Subjects within 24 h of acute ischemic stroke were consecutively recruited in this study. ? Plasma glutamate following acute ischemic stroke was an independent risk factor for the early onset of PSD. ? The combination of reduced plasma glutamate and physical impairment was a potential diagnostic indicator for early-onset PSD.