Research paperMalondialdehyde: A novel predictive biomarker for post-stroke depression

- An association between oxidative stress and post-stroke depression is proposed.
- Elevated serum levels of malondialdehyde after admission within 24 h are independently associated with the development of 1-month post-stroke depression.
- No association between serum antioxidant enzymes and depression after stroke is found.

BackgroundThere is evidence that stroke is accompanied by oxidative stress. However, the links between oxidative stress and depression in stroke patients are poorly understood. This study examines whether post-stroke depression (PSD) is associated with oxidative stress.MethodsOverall, 216 acute stroke patients were consecutively recruited and followed up for 1 month. Blood specimens were collected within 24 h after admission and measured for the following oxidative stress biomarkers: malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX). All enrolled patients were divided into the PSD group or the non-PSD group according to an assessment of clinical depression. One hundred normal control subjects were also recruited.ResultsThere was a positive correlation between serum MDA levels and HAMD scores in stroke patients (r=0.536, p<0.001). Based on the Receiver-operating characteristic (ROC) curve, the optimal cutoff value of serum MDA levels as an indicator for an auxiliary diagnosis of PSD was projected to be 2.898 nmol/ml, which yielded a sensitivity of 77.9% and a specificity of 81.1%, with an area under the curve of 0.883 (95% CI, 0.836-0.929). Elevated MDA (≥2.898 nmol/ml) was an independent predictive marker of PSD (odds ratio OR=24.295; 95% CI, 9.461-62.388; p<0.001, adjusted for relevant confounders).LimitationsWe excluded patients with severe aphasia or with serious conditions. In addition, the information for dietary intake was not recorded, which may influence oxidative stress levels.ConclusionOur study demonstrated that an elevated serum MDA level at admission was positively associated with an increased risk of developing depression after acute stroke, especially minor stroke.