Cytokine changes in the pathophysiology of poststroke depression

Objective: Poststroke depression (PSD) is a frequent psychiatric sequela after stroke, and its influence is detrimental. However, the etiology of PSD is still not clear. Although many studies have indicated that immune dysregulation plays an important role in the pathophysiology of depression, it is still unknown if PSD involves the same mechanism. Thus, the current study objectives were to evaluate whether there were cytokine changes when patients with ischemic stroke suffered from PSD. Method: We included ischemic stroke patients without depression when the stroke occurred and followed them for I year. The Hamilton Depression Rating Scale score and cytokines were assessed at baseline and at the 1st, 3rd, 6th, 9th and 12th months after stroke. Results: One hundred four patients with ischemic stroke participated and completed the study, and 12 suffered from PSD during the 1-year study period. There were significant increases in the cytokines interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-alpha) and interferon-gamma, and the ratios of IL-6/IL-10 and TNF-alpha/IL-10 were also elevated. Interleukin-1 beta was too low to show any difference. Conclusion: Our study suggested that immune imbalance plays a possible role in the pathophysiology of PSD and that IL-6 and TNF-alpha are key cytokines. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved.