title: Total magnetic resonance imaging burden of cerebral small-vessel disease is associated with post-stroke depression in patients with acute lacunar stroke.
abstract: Despite extensive studies on post-stroke depression (PSD), the role of the total burden of cerebral small-vessel disease (cSVD) in its pathogenesis remains unclear.
  
  
  
  We conducted a magnetic resonance imaging (MRI)-based cohort study to investigate the relationship between total MRI burden of cSVD and PSD among patients with first-ever lacunar stroke. From June 2013 to January 2016, 374 patients were consecutively recruited. PSD was identified using the Chinese version of the Structured Clinical Interview for DSM-IV. Brain MRI presence of silent lacunar infarcts, white-matter lesions, cerebral microbleeds and enlarged perivascular spaces was summed to an ordinal score between 0 and 4. Multivariable logistic regression analysis was performed to determine the contribution of total MRI cSVD burden in the prediction of PSD.
  
  
  
  Ninety patients (24.1%) were diagnosed with PSD at 3 months after stroke. Only two MRI markers of cSVD, asymptomatic lacunar infarcts and white-matter lesions, were related to PSD [odds ratio (OR), 3.167; 95% confidence interval (CI), 1.879-5.338; P = 0.001 and OR, 2.284; 95% CI, 1.403-3.713; P = 0.001, respectively]. Moreover, higher total MRI cSVD burden was an independent predictor for PSD (high tertile OR, 4.577; 95% CI, 2.400-8.728; P = 0.001) after adjusting for individual cSVD MRI marker and other potential confounders.
  
  
  
  This study demonstrated that greater total MRI burden of cSVD may predict the presence of PSD in patients with acute lacunar stroke.
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: C
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: J
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: X
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Radiology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: H
authors.initials: H
authors.lastname: Shan
authors.affiliation: Department of Radiology, Hainan General Hospital, Haikou, Hainan, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: C
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: D
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: T
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Neurology, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
authors.forename: L
authors.initials: L
authors.lastname: Sheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001822:Body Burden; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000523:psychology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000000981:diagnostic imaging* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D059409:Stroke, Lacunar / Q000150:complications / Q000000981:diagnostic imaging* / Q000523:psychology; D066127:White Matter / Q000000981:diagnostic imaging
keywords: cerebral microbleed; enlarged perivascular space; lacunar stroke; post-stroke depression; white-matter lesion