The combination of plasma glutamate and physical impairment after acute stroke as a potential indicator for the early-onset post-stroke depression

•Subjects within 24 h of acute ischemic stroke were consecutively recruited in this study.•Plasma glutamate following acute ischemic stroke was an independent risk factor for the early onset of PSD.•The combination of reduced plasma glutamate and physical impairment was a potential diagnostic indicator for early-onset PSD.

ObjectsThe present study aimed to investigate the relationship of plasma glutamate levels with the early-onset of post-stroke depression (PSD) and to further explore the prognostic value of plasma glutamate combined with clinical characteristics for the early-onset PSD in the acute ischemic stroke patients.MethodsSeventy-four patients who admitted to the hospital within 24 h of acute ischemic stroke were consecutively recruited and followed up for 2 weeks. The Beck Depression Inventory (BDI) and 17-item Hamilton Depression Rating Scale (HAMD-17) were used to screen for depressive symptoms 14 days after stroke. Diagnoses of depression were made in accordance with DSM-IV. Plasma glutamate levels were determined by High Performance Liquid Chromatography (HPLC) on days 1 and 14 after stroke for all patients.ResultsPlasma glutamate levels were significantly lower in PSD patients than those of non-PSD patients on day 1 after stroke. ROC curve analyses revealed an AUC (area under the ROC curve) of 0.724 (95% CI: 0.584-0.863, p = 0.004) and of 0.669 (95% CI: 0.523-0.814, p = 0.030) for National Institute of Health Stroke Scale (NIHSS) scores and plasma glutamate levels on day 1 respectively. Combined ROC analyses using the two factors revealed the highest AUC of 0.804 (95% CI: 0.685-0.922, P < 0.0001).ConclusionsThese results indicated an association between the early-onset PSD and a low plasma glutamate level following acute ischemic stroke. The combination of reduced plasma glutamate levels and physical impairment (determined by NIHSS) 1 day after acute ischemic stroke was a potential diagnostic indicator for early-onset PSD.