Cerebral microbleeds and suicidality in stroke.
OBJECTIVE
Cerebral microbleeds (CMBs) are common in stroke survivors. The clinical significance of CMBs in the development of suicidality (SI) following stroke is unknown. This study examined the association between SI and CMBs. The aim of the study reported here was to determine the relationship between CMBs and SI in ischemic stroke survivors.


METHODS
A cohort of 367 patients with acute ischemic stroke admitted to the stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. SI was assessed with the geriatric mental state examination at three months following the subjects' index stroke. Depressive symptoms were assessed using the geriatric depression scale (GDS). A qualified psychiatrist administered the Chinese version of the Structured Clinical Interview for DSM-IV to diagnose depressive disorders. The presence and location of CMBs were evaluated with magnetic resonance imaging (MRI).


RESULTS
Compared with the non-SI patients, SI patients were more likely to have CMBs in any brain region (36.6% vs. 20.2%, p = 0.017), specifically more lobar (29.3% vs. 13.5%, p = 0.008) and thalamic CMBs (19.5% vs. 7.5%, p = 0.018). Presence of CMBs (odds ratio was 2.5, p = 0.026) and lobar CMBs (odds ratio 2.6, p = 0.034) were independent predictors of SI in the multivariate analysis.


CONCLUSIONS
The results suggest that lobar CMBs may play roles in the development of SI. The importance of CMBs in the pathogenesis of SI in stroke survivors warrants further investigation.
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. tangwk@cuhk.edu.hk
Wai Kwong
WK
Tang
Yang Kun
YK
Chen
Hua Jun
HJ
Liang
Winnie C W
WC
Chu
Vincent C T
VC
Mok
Gabor S
GS
Ungvari
Ka Sing
KS
Wong
D000368:Aged; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology / Q000523:psychology*; D002540:Cerebral Cortex / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000473:pathology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020521:Stroke / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D059020:Suicidal Ideation; D013788:Thalamus / Q000473:pathology