Tan Hong Kuang, Narasimhalu Kaavya, Ting Simon Kang Seng, Hameed Shahul, Chang Hui Meng, De Silva Deidre Anne, Chen Christopher Li Hsian, Tan Eng King
Duke-NUS Medical School, Singapore.
Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), Singapore.
Int J Stroke. 2023 Feb;18(2):163-172. doi: 10.1177/17474930221085880. Epub 2022 Apr 1.
A third of stroke patients suffer from post-stroke cognitive decline, depressive symptoms, and anxiety symptoms. B-vitamin supplementation provides a possible safe and affordable treatment to mitigate post-stroke neuropsychiatric sequelae via reducing homocysteine levels. Our study aims to examine the effect of B-vitamin supplementation in the prevention of post-stroke cognitive decline, depressive symptoms, and anxiety symptoms. Our secondary aims were to investigate associations between baseline factors and the three outcomes.
Patients were recruited as part of a Singaporean substudy of a randomized controlled trial that examined the effect of B-vitamin supplementation on recurrent cardiovascular events. Cognitive decline, depressive symptoms, and anxiety symptoms were assessed with neuropsychological assessments and Hospital Anxiety and Depression Scale 6 monthly. Cox regression analyses were performed to determine treatment efficacy. Logistic regression used to examine factors associated with cognitive decline, depressive symptoms, and anxiety symptoms.
A total of 707 were included in the analyses. Survival and hazards ratio analysis showed no treatment effect of B-vitamins on cognitive decline, depressive symptoms, and anxiety symptoms. Cognitive decline was only associated with age. Depressive symptoms were associated with large anterior cerebral infarcts and hyperlipidemia.
Our study showed no benefit of supplementation with B-vitamins for post-stroke cognitive decline, depressive symptoms, or anxiety symptoms. Depressive symptoms were associated with larger anterior cerebral infarcts, which may be reflective of the disability associated with larger infarcts.
三分之一的中风患者会出现中风后认知功能下降、抑郁症状和焦虑症状。补充B族维生素可能提供一种安全且经济实惠的治疗方法，通过降低同型半胱氨酸水平来减轻中风后的神经精神后遗症。我们的研究旨在探讨补充B族维生素对预防中风后认知功能下降、抑郁症状和焦虑症状的效果。我们的次要目的是研究基线因素与这三种结果之间的关联。
患者作为一项随机对照试验新加坡子研究的一部分被招募，该试验研究了补充B族维生素对复发性心血管事件的影响。每6个月通过神经心理学评估和医院焦虑抑郁量表对认知功能下降、抑郁症状和焦虑症状进行评估。进行Cox回归分析以确定治疗效果。使用逻辑回归来检查与认知功能下降、抑郁症状和焦虑症状相关的因素。
共有707人纳入分析。生存和风险比分析显示，B族维生素对认知功能下降、抑郁症状和焦虑症状没有治疗效果。认知功能下降仅与年龄有关。抑郁症状与大脑前叶大面积梗死和高脂血症有关。
我们的研究表明，补充B族维生素对中风后认知功能下降、抑郁症状或焦虑症状没有益处。抑郁症状与较大的大脑前叶梗死有关，这可能反映了较大梗死相关的残疾情况。
