Post-stroke depression (PSD) is a common psychiatric complication of stroke that is associated with a poor outcome in stroke patients. Our aim was to assess the association between the serum magnesium levels and the presence of PSD in Chinese patients. Two hundred nine stroke patients were included in the study. Depressive symptoms were measured by the 17-Hamilton Rating Scale for Depression at 3 months after stroke. Based on the depressive symptoms, diagnoses of depression were made in line with the DSM-IV criteria for PSD. Serum magnesium levels were evaluated using the dimethyl aniline blue colorimetric method at admission. Multivariate analyses were conducted using logistic regression models. Further, 120 normal subjects were recruited, and their serum magnesium levels were also measured as control. At 3 months, fifty-nine patients (28.2%) were diagnosed as PSD. The serum magnesium levels were significantly lower in both PSD patients and non-PSD patients than in normal subjects (p < 0.001). Indeed, patients with PSD showed lower serum magnesium levels (p < 0.001) than did non-PSD patients at admission. In the multivariate analyses, after adjusting for potential variables, we found that an increased risk of PSD was associated with serum magnesium levels ≤ 0.84mmol/L (OR 2.614, 95% CI 1.178-5.798, p=0.018). Low serum magnesium levels at admission were found to be associated with the presence of PSD at 3 months after stroke.
Gu Yingying,Zhao Kai,Luan Xiaoqian, et al. Association between Serum Magnesium Levels and Depression in Stroke Patients[J]. Aging and disease,
2016, 7(6): 687-690.
Table 1 Baseline clinical characteristics in patients with and without post-stroke depression at 3-months.
Non-PSD (n=150)
PSD (n=59)
p
Mg2+ category, n (% of total population)
0.013
Low tertile (≤0.84mmol/L)
45(30.0%)
30(50.8%)
0.005
Intermediate tertile (0.85-0.89 mmol/L)
59(39.3%)
19(32.2)
0.337
High tertile (≥0.90mmol/L)
46(30.7%)
10(16.9%)
0.044
Table 2 Magnesium levels tertiles of patients
Variables
OR (95% CI)
p
Magnesium
0.006
Low tertile
2.614 (1.178-5.798)
0.018
High tertile
0.579 (0.225-1.494)
0.259
sex
3.447 (1.702-6.981)
0.001
NIHSS on admission
1.151 (0.969-1.369)
0.110
mRS at discharge
1.534 (1.033-2.278)
0.34
DM
1.495 (0.734-3.044)
0.267
Table 3 Multivariate logistic model of the clinical determinants of PSD
[1]
Hackett ML, Yapa C, Parag V, Anderson CS (2005). Frequency of depression after stroke - A systematic review of observational studies. Stroke, 36: 1330-1340
[2]
Ayerbe L, Ayis S, Crichton S, Wolfe CDA, Rudd AG (2014). The long-term outcomes of depression up to 10 years after stroke; the South London Stroke Register. J Neurol Neurosurg Psychiatry, 85: 514-521
[3]
Ayerbe L, Ayis S, Wolfe CD, Rudd AG (2013). Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry, 202: 14-21
[4]
Winther G, Pyndt Jorgensen BM, Elfving B, Nielsen DS, Kihl P, Lund S, et al. (2015). Dietary magnesium deficiency alters gut microbiota and leads to depressive-like behaviour. Acta Neuropsychiatr, 27: 168-176
[5]
Pochwat B, Szewczyk B, Sowa-Kucma M, Siwek A, Doboszewska U, Piekoszewski W, et al. (2014). Antidepressant-like activity of magnesium in the chronic mild stress model in rats: alterations in the NMDA receptor subunits. Int J Neuropsychopharmacol, 17: 393-405
[6]
Sluijs I, Czernichow S, Beulens JW, Boer JM, van der Schouw YT, Verschuren WM, et al. (2014). Intakes of potassium, magnesium, and calcium and risk of stroke. Stroke, 45: 1148-1150
[7]
Nie ZL, Wang ZM, Zhou B, Tang ZP, Wang SK (2013). Magnesium intake and incidence of stroke: meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis, 23: 169-176
[8]
Larsson SC, Virtamo J, Wolk A (2011). Potassium, calcium, and magnesium intakes and risk of stroke in women. Am J Epidemiol, 174: 35-43
[9]
Adebamowo SN, Spiegelman D, Flint AJ, Willett WC, Rexrode KM (2015). Intakes of magnesium, potassium, and calcium and the risk of stroke among men. Int J Stroke, 10: 1093-1100
[10]
Cheng SY, Zhao YD, Li J, Chen XY, Wang RD, Zeng JW (2014). Plasma levels of glutamate during stroke is associated with development of post-stroke depression. Psychoneuroendocrinology, 47: 126-135
[11]
Li J, Zhao YD, Zeng JW, Chen XY, Wang RD, Cheng SY (2014). Serum Brain-derived neurotrophic factor levels in post-stroke depression. J Affect Disord, 168: 373-379
[12]
Hamilton M (1960). A rating scale for depression. J Neurol Neurosurg Psychiatry, 23: 56-62
[13]
Nowak L, Bregestovski P, Ascher P, Herbet A, Prochiantz A (1984). Magnesium gates glutamate-activated channels in mouse central neurones. Nature, 307: 462-465
[14]
Moykkynen T, Uusi-Oukari M, Heikkila J, Lovinger DM, Luddens H, Korpi ER (2001). Magnesium potentiation of the function of native and recombinant GABA(A) receptors. Neuroreport, 12: 2175-2179
[15]
Autry AE, Adachi M, Nosyreva E, Na ES, Los MF, Cheng PF, et al. (2011). NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses. Nature, 475: 91-95
[16]
Pittenger C, Sanacora G, Krystal JH (2007). The NMDA receptor as a therapeutic target in major depressive disorder. CNS Neurol Disord Drug Targets, 6: 101-115
2016,
Vol. 7
