title: [The association between plasma neurotransmitters levels and depression in acute hemorrhagic stroke].
abstract: OBJECTIVE
  To explore the relation between plasma neurotransmitters (Glutamic acid, GAA; γ-aminobutyric acid, GABA; 5-hydroxytryptamine, 5-HT; and noradrenaline, NE) and depression in acute hemorrhagic stroke.
  
  
  METHODS
  Objectives were screened from consecutive hospitalized patients with acute stroke. Fasting blood samples were taken on the day next to hospital admission, and neurotransmitters were examined by the liquid chromatography-high resolution mass spectrometry (LC-HRMS). The fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was used to diagnose depression at two weeks after onset of stroke. The modified Ranking Scale (mRS) was followed up at 1 year. Pearson test was used to analyse the correlation between serum concentration of neurotransmitters and the Hamilton Depression scale-17-items (HAMD-17) score. Logistic regression was used to analyse the relation of serum concentration of neurotransmitters and depression and outcome of stroke.
  
  
  RESULTS
  One hundred and eighty-one patients were included in this study. GABA significantly decreased [6.1(5.0-8.2) µg/L vs 8.1(6.3-14.7) µg/L, P < 0.05] in patients with depression in hemorrhagic stroke, and there was no significant difference in GAA, 5-HT, or NE. GABA concentration was negatively correlated with HAMD-17 score (r = -0.131, P < 0.05); while concentration of serum GABA rose by 1 µg/L, risk of depression in acute phase of hemorrhagic stroke was reduced by 5.6% (OR 0.944, 95%CI 0.893-0.997). While concentration of serum GAA rose by 1 µg/L, risk of worse outcome at 1 year was raised by 0.1%, although a statistic level was on marginal status (OR 1.001, 95%CI 1.000-1.002).
  
  
  CONCLUSIONS
  In patients with depression in the acute phase of hemorrhagic stroke, there was a significant reduction in plasma GABA concentration. GABA may have a protective effect on depression in acute phase of hemorrhagic stroke. Increased concentrations of serum GAA may increase the risk of worse outcomes at 1 year after stroke.
authors.affiliation: Department of Neurology of Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. Email:snowsen@126.com.
authors.forename: Huai-wu
authors.initials: HW
authors.lastname: Yuan
authors.forename: Ning
authors.initials: N
authors.lastname: Zhang
authors.forename: Chun-xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Yu-zhi
authors.initials: YZ
authors.lastname: Shi
authors.forename: Dong
authors.initials: D
authors.lastname: Qi
authors.forename: Ben-yan
authors.initials: BY
authors.lastname: Luo
authors.forename: Yong-jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000097:blood*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood*; D020521:Stroke / Q000097:blood*
chemical_list: D018377:Neurotransmitter Agents