Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China.
Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, Guangdong, P.R. China.
Arch Phys Med Rehabil. 2020 Aug;101(8):1355-1366. doi: 10.1016/j.apmr.2020.04.011. Epub 2020 May 19.
To investigate the correlation between brain-derived neurotrophic factor (BDNF) and risk factors, as well as functional outcome in poststroke depression (PSD) or poststroke anxiety (PSA).
Cohort study.
Stroke patients admitted to an urban rehabilitation hospital.
Stroke patients (N=162) without any previous history of depression and anxiety.
Not applicable.
Sociodemographic information and comorbidities were recorded during hospital admission. Functional outcomes were assessed using FIM scores at time of admission and discharge. The influence of various factors such as BDNF and patient characteristics on functional outcome was investigated. Single-factor effect was examined using simple logistic regression, as was multi-factor effect using multiple logistic regression. The goodness-of-fit of those regression models was evaluated by the integrated area under ROC curve.
PSD was diagnosed in 61 (37.7%) patients, and PSA was diagnosed in 40 (24.7%). Multiple logistic analysis showed that BDNF, divorce or separation, and history of smoking were significantly associated with the occurrence of PSD but not with the occurrence of PSA. The model combining low BDNF level and divorce or separation improved the prediction for PSD. Among the variables analyzed for prediction of functional outcome, serum BDNF had a minimum correlation with motor FIM scores in PSD but no significant correlation with motor FIM scores in PSA.
BDNF is a valuable prediction for the occurrence of PSD but not for PSA. More strikingly, ischemic stroke patients who are divorced or separated with low serum BDNF have a much higher risk for PSD. BDNF has a minimum correlation with motor function outcome in PSD but no significant correlation with motor outcome in PSA.
探讨脑源性神经营养因子（BDNF）与卒中后抑郁（PSD）或卒中后焦虑（PSA）的危险因素及功能结局的相关性。
队列研究。
城市康复医院收治的卒中患者。
无抑郁和焦虑既往史的卒中患者（N=162）。
不适用。
入院期间记录社会人口学信息和合并症。入院和出院时采用功能独立性评定量表（FIM）评估功能结局。研究了 BDNF 等各种因素以及患者特征对功能结局的影响。采用简单逻辑回归分析单因素效应，采用多因素逻辑回归分析多因素效应。通过接受者操作特征曲线下的综合面积评估这些回归模型的拟合优度。
61 例（37.7%）患者被诊断为 PSD，40 例（24.7%）患者被诊断为 PSA。多因素逻辑分析显示，BDNF、离婚或分居以及吸烟史与 PSD 的发生显著相关，但与 PSA 的发生无关。结合低 BDNF 水平和离婚或分居的模型改善了 PSD 的预测。在分析用于预测功能结局的变量中，血清 BDNF 与 PSD 患者的运动 FIM 评分相关性最小，与 PSA 患者的运动 FIM 评分无显著相关性。
BDNF 是 PSD 发生的有价值预测指标，但不是 PSA 的预测指标。更引人注目的是，血清 BDNF 水平低且离异或分居的缺血性卒中患者发生 PSD 的风险更高。BDNF 与 PSD 患者的运动功能结局相关性最小，与 PSA 患者的运动结局无显著相关性。
