Changes in serum inflammatory cytokines, erythropoietin, vascular endothelial growth factor and orexins predict early depression after ischemic stroke

This study aimed to investigate the serum level of monoamine neurotransmitters, inflammatory cytokines, leptin, EPO, VEGF, NGF and orexins in ischemic stroke patients with (n=38) and without (n=52) depression and explore the correlation between these parameters and post-stroke depression (PSD). When compared with non-PSD group, the VEGF, EPO, NE, 5-HT, DA and NGF reduced significantly (P < 0.05) and IL-6, TNFα, orexin-a and orexin-b increased significantly (P < 0.05) in PSD group. The leptin and IL-10 were comparable between two groups. The VEGF, EPO, NE, DA, NGF, IL-6, TNF-α, orexin-a, orexin-b, gender, MMSE score and HAMA score were risk factors of PSD in ischemic stroke patients. Logistic regression analysis showed PSD was independently related to HAMA score and orexin-b. These results indicate that in early PSD after initial ischemic stroke, inflammation is involved in the pathogenesis of PSD, and EPO, VEGF and factors able to promote neuroplasticity are protective on PSD. Orexin-b increase is closely related to PSD. The alteration in these parameters predicts the occurrence of PSD.