High serum levels of leptin are associated with post-stroke depression.

BACKGROUND: Depression is a frequent mood disorder that affects around 33% of stroke patients and has been associated with both poorer outcome and increased mortality. Our aim was to test the possible association between inflammatory and neurotrophic molecular markers and the development of post-stroke depression. METHOD: We studied 134 patients with a first episode of ischemic stroke without previous history of depression or speech disorders. We screened for the existence of major depression symptoms in accordance with DSM-IV criteria and a Yesavage Geriatric Depression Scale (GDS) score >11 at discharge and 1 month after stroke. At these times, serum levels of molecular markers of inflammation [interleukin (IL)-1beta, IL-6, intracellular adhesion molecule 1 (ICAM-1), tumor necrosis factor (TNF)-alpha, leptin and high-sensitivity C-reactive protein (hs-CRP)] and neurotrophic factors [brain-derived neurotrophic factor (BDNF)] were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Twenty-five patients (18.7%) were diagnosed as having major depression at discharge. Out of 104 patients who completed the follow-up period, 23 were depressed at 1 month (22.1%). Patients with major depression showed higher serum leptin levels at discharge [43.4 (23.4-60.2) v. 6.4 (3.7-16.8) ng/ml, p<0.001] and at 1 month after stroke [46.2 (34.0-117.7) v. 6.4 (3.4-12.2) ng/ml, p<0.001). Serum levels of leptin >20.7 ng/ml were independently associated with post-stroke depression [odds ratio (OR) 16.4, 95% confidence interval (CI) 5.2-51.5, p<0.0001]. Leptin levels were even higher in the eight patients who developed depression after discharge [114.6 (87.6-120.2) v. 7.2 (3.6-13.6) ng/ml, p<0.0001]. CONCLUSIONS: Serum leptin levels at discharge are found to be associated with post-stroke depression and may predict its development during the next month.

Marcadores moleculares de inflamación en la depresión post-ictus / Molecular markers of inflammation in post-stroke depression

Objetivo: evaluar la respuesta inflamatoria sistémica durante la fase aguda del ictus isquémico y establecer la relación entre los niveles de Factor Neurotrófico derivado del Cerebro (BDNF), IL-6, ICAM-1, el pronóstico del ictus y la incidencia de depresión. Material y métodos: Estudio prospectivo sobre 104 pacientes con primer episodio de ictus isquémico. Se recogieron antecedentes familiares de depresión y enfermedad psiquiátrica y datos familiares. Se realizó un TAC o RNM. La depresión se evaluó en el momento del alta y al mes, siguiendo el DSM IV. De muestras de sangre se obtuvieron los niveles de IL-6 e ICAM-1, BDNF. Resultados: De 104 pacientes, 54 presentaron depresión al alta y 25 depresión mayor. La depresión se relacionó con: sexo femenino, viudedad, vivir con los hijos y edad. No se halló relación con la gravedad del ictus, el grado de afectación funcional, la localización o el volumen del infarto. Tampoco entre los marcadores estudiados y la depresión tras el ictus. Conclusión: Los pacientes que desarrollan depresión tras el ictus, presentan peor pronóstico funcional, independiente del grado de afectación neurológica y de la localización de la lesión. No establecimos asociación entre la depresión y los marcadores de inflamación (AU)

Introduction: Depresión is frequent after stroke, finding an association with inflammation. Our aim is to evaluate the relationship between inflammation in acute phase of stroke and depression. Patients and methods: We included 134 patients with first ischemic stroke, excluding previous history of depression, and aphasia. Stroke severity was evaluated by NIHSS and functional outcome by modified Rankin Scale (mRS) and Barthel Index (BI). Depression was evaluated at discharge and at 1 month by DSM-IV criteria and Yesavage Scale, Serum levels of inflammatory molecules (IL-6, ICAM 1 and high-sensitive-CRP) and BDNF were determined at discharge. Results: 40,3% of patients showed depression at discharge and 48.1% at one month. Patients with depression at one month showed poor outcome (BI 70 [90,100] vs 100 [95,100]; p=0,001; mRS 2 [1,3] vs 1 [0,2]; p=0,03). Depression at discharge was independently associated with live with offspring (OR: 7,62; CI95% [1,35, 43,09]; p=0,022), and at one month with female sex (OR:5,47; CI95% [1,45,20,67]; p=0,012) and depression at discharge (OR: 9,36; CI95% [2,46,35,59]; p=0,002). We found no relationship between the molecular markers and the depression after stroke. Conclusion: No relationship was found between inflammation in acute phase and post-troke depression (AU)

Aplicación de la proteómica a las enfermedades neurológicas / Application of the proteomic to neurological diseases

La proteómica es un conjunto de técnicas que permiten la separación e identificación de las proteínas expresadas por una célula, tejido u organismo. La técnica central de esta disciplina es la electroforesis bidimensional, que permite llevar a cabo comparaciones cualitativas y cuantitativas de los patrones proteicos entre muestras dadas. El análisis diferencial de los patrones de expresión en distintas patologías neurológicas (ictus, Alzheimer, Parkinson, esclerosis lateral amiotrófica, Hungtington, epilepsia) permite la identificación de biomarcadores de diagnóstico y/o pronóstico. La posterior validación de estos marcadores llevaría a la identificación de nuevas dianas diagnósticas y terapéuticas

Proteomic is a set of tools that allows the separation and identification of proteins expressed by a cell, tissue or organism. Two-dimensional electrophoresis is the central tool that allows qualitative and quantitative comparisons of protein patterns between samples. Differential analysis of protein expression patterns in different neurological diseases (stroke, Alzheimer, Parkinson, amyotrophic lateral sclerosis, Hungtington, epilepsy) allows the identification of diagnostic and/or prognostic biomarkers. Subsequently, validation of these markers may help to identify new diagnostic and therapeutic targets

[Application of proteomics to neurological diseases]. / Aplicación de la proteómica a las enfermedades neurológicas.

Proteomic is a set of tools that allows the separation and identification of proteins expressed by a cell, tissue or organism. Two-dimensional electrophoresis is the central tool that allows qualitative and quantitative comparisons of protein patterns between samples. Differential analysis of protein expression patterns in different neurological diseases (stroke, Alzheimer, Parkinson, amyotrophic lateral sclerosis, Hungtington, epilepsy) allows the identification of diagnostic and/or prognostic biomarkers. Subsequently, validation of these markers may help to identify new diagnostic and therapeutic targets.