Comparing the Development of Post-stroke Depression Based on Location of Cerebral Artery Infarcts
Varun Rachakonda1, Anuttham Kandhadai2, Paul Brindley3
1Nova Southeastern University Kiran C. Patel College of Allopathic Medicine, 2University of Texas Medical Branch at Galveston, 3Psychiatry, University of Texas Medical Branch at Galveston
Objective:
This study aims to compare the rates of development of post-stroke depression in patients diagnosed with either a left or a right-sided middle cerebral artery stroke.
Background:
Post-stroke depression (PSD) is a prevalent and often overlooked consequence of stroke that can significantly impact the rehabilitation process and overall quality of life for stroke survivors. While PSD is a well-known sequel of stroke, there is limited research on the relationship between the location of cerebral infarction and the development of PSD.
Design/Methods:
A retrospective cohort study was conducted using the TriNetX database. Patients who had a history of depression prior to stroke were excluded. The cohorts were matched based on age, sex, race, ethnicity, BMI, cardio/cerebrovascular disease, degenerative diseases of the nervous system, mood disorders, and lifestyle risk factors. The development of depression within 1- year of their presentation with a stroke was compared between the two groups. Additionally, 1-year rates of suicidal ideation, suicide attempts, and mortality were analyzed between each group.
Results:
33,872 patients were included in each cohort. Compared to patients with left middle cerebral artery (LMCA) stroke, patients with right middle cerebral artery (RMCA) stroke had a significantly higher risk of developing depressive episodes (RR: 1.162, 95% CI: 1.096-1.232). Patients with RMCA stroke had significantly more episodes of suicidal ideation (RR: 1.38, 95% CI: 1.129-1.688). There was no significant difference in suicide attempts (RR: 1.269, 95% CI: 0.759- 2.122) and mortality between each group (RR: 1 95% CI: 0.966-1.035).
Conclusions:
This study reveals that patients with RMCA stroke are more likely to develop PSD than patients with LMCA stroke. Although patients with RMCA stroke do not have an increased risk of mortality, further research in PSD development is warranted to provide better comprehensive care.