title: Plasma levels of glutamate during stroke is associated with development of post-stroke depression.
abstract: BACKGROUND
  Depression is a frequent mood disorder that affects around 33% of stroke patient. Our aim was to test the possible association between plasma glutamate and the development of post-stroke depression (PSD) in Chinese patients.
  
  
  METHODS
  The subjects were first-ever acute ischemic stroke (AIS) patients who were hospitalized during the period from November 2011 to September 2013. Clinical information and stroke severity was collected at admission. Neurological and neuropsychological evaluations were conducted at the 3-month follow-up. Plasma glutamate levels were analyzed at baseline using liquid chromatography followed by tandem mass spectrometry. Glutamate oxaloacetate transaminase (GOT), glutamate-pyruvate transaminase (GPT) and blood markers were also tested. Multivariate analyses were performed using logistic regression models.
  
  
  RESULTS
  During the study period, 209 patients were included in the analysis. Seventy patients (33.5%) were diagnosed as having major depression at 3 month. Patients with major depression showed higher levels of plasma glutamate [299 (235-353) vs. 157 (108-206) μM, P<0.0001] and lower GOT [14 (11-20) vs. 21 (15-32)U/L, P<0.0001] at admission. In multivariate analyses, plasma glutamate and GOT were independent predictors of PSD at 3 months [odds ratio (OR): 1.03 (1.02-1.04), P<0.0001; 0.84 (0.75-0.97), P=0.003]. Plasma levels of glutamate >205 μM were independently associated with PSD (OR, 21.3; 95% CI, 8.28-67.36, P<0.0001), after adjustment for possible variables.
  
  
  CONCLUSIONS
  The present study demonstrates a strong relationship between plasma glutamate and GOT levels at admission and the development of PSD within 3 months. Further studies are necessary to confirm this association, which may open the way to the proposal of new therapeutic options.
authors.affiliation: Department of Neurology, Second Affiliated Hospital and Xin Qiao Hospital, Third Military Medical University, Chongqing 400037, China. Electronic address: neurobio1911@outlook.com.
authors.forename: Sai-Yu
authors.initials: SY
authors.lastname: Cheng
authors.affiliation: Department of Neurobiology, College of Basic Medical Sciences, Chongqing Key Laboratory of Neurobiology, Third Military Medical University, Chongqing 400038, China.
authors.forename: Yan-Dong
authors.initials: YD
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Second Affiliated Hospital and Xin Qiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, Second Affiliated Hospital and Xin Qiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Chen
authors.affiliation: Department of Neurology, Second Affiliated Hospital and Xin Qiao Hospital, Third Military Medical University, Chongqing 400037, China.
authors.forename: Ruo-Dan
authors.initials: RD
authors.lastname: Wang
authors.affiliation: Department of Physiology, Zunyi Medical College, Zunyi 563000, Guizhou Province, China.
authors.forename: Jun-Wei
authors.initials: JW
authors.lastname: Zeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D018698:Glutamic Acid / Q000097:blood*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000523:psychology
chemical_list: D018698:Glutamic Acid
keywords: Acute ischemic stroke; Chinese; Depression; Glutamate