Koh Dong Jin, Kim Na Young, Kim Yong Wook
Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine & Severance Hospital, Seoul, Korea.
Ann Rehabil Med. 2016 Jun;40(3):412-9. doi: 10.5535/arm.2016.40.3.412. Epub 2016 Jun 29.
To identify predictive factors of depressive mood in patients with isolated cerebellar stroke.
A retrospective chart review was performed in patients who had experienced their first isolated cerebellar stroke during 2002-2014. The patients were classified into two groups by the Geriatric Depression Scale (GDS) (non-depressive group, 0≤GDS≤16; depressive group, 17≤GDS≤30). Data on demographic and socioeconomic factors, comorbidities, functional level, cognitive and linguistic function, and stroke characteristics were collected. Significant variables in univariate analysis were analyzed using logistic regression.
Fifty-two patients were enrolled, of whom 55.8% had depressive mood, were older (p=0.021), and had higher hypertension rates (p=0.014). Cognitive and linguistic functions did not differ between the two groups. The depressive group had higher ischemic stroke rates (p=0.035) and showed a dominant right posterior cerebellar hemisphere lesion (p=0.028), which was independently associated with depressive mood in the multiple logistic regression analysis (odds ratio, 5.081; 95% confidence interval, 1.261-20.479).
The risk of depressive mood after cerebellar stroke was increased in patients at old age, with a history of hypertension, ischemic stroke, and lesion of the right posterior cerebellar hemisphere. The most significant determining factor was stroke lesion of the right posterior cerebellar hemisphere. Early detection of risk factors is important to prevent and manage depressive mood after cerebellar stroke.
确定孤立性小脑卒中患者抑郁情绪的预测因素。
对2002年至2014年期间首次发生孤立性小脑卒中的患者进行回顾性病历审查。根据老年抑郁量表(GDS)将患者分为两组(非抑郁组,0≤GDS≤16;抑郁组,17≤GDS≤30)。收集有关人口统计学和社会经济因素、合并症、功能水平、认知和语言功能以及卒中特征的数据。对单变量分析中的显著变量进行逻辑回归分析。
共纳入52例患者,其中55.8%有抑郁情绪,年龄较大(p=0.021),高血压发病率较高(p=0.014)。两组间认知和语言功能无差异。抑郁组缺血性卒中发生率较高(p=0.035),且右侧小脑半球后部病变占优势(p=0.028),在多因素逻辑回归分析中,这与抑郁情绪独立相关(比值比,5.081;95%置信区间,1.261 - 20.479)。
老年、有高血压病史、缺血性卒中和右侧小脑半球后部病变的患者,小脑卒中后出现抑郁情绪的风险增加。最显著的决定因素是右侧小脑半球后部的卒中病变。早期发现危险因素对于预防和管理小脑卒中后的抑郁情绪很重要。