Pro-inflammatory cytokines are associated with the development of post-stroke depression in the acute stage of stroke: A meta-analysis

ABSTRACT

Background: Pro-inflammatory cytokines may be associated with post-stroke depression (PSD); however, results from different studies are inconsistent.

Objectives: To investigate whether pro-inflammatory cytokines are associated with the development of PSD in acute stroke.

Methods: PubMed, Embase, and Web of science were searched for relevant literature. Meta-analyzes were performed to determine whether the baseline blood concentrations of pro-inflammatory cytokines differed between acute stroke patients with and without depression. Sensitivity analyzes and regression analyzes were conducted to explore sources of heterogeneity.

Results: We included 889 acute stroke patients from eight original studies, 312 of whom developed PSD and 577 did not. The serum concentrations of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were higher in the PSD group, compared with the non-PSD group (IL-6: SMD = 1.26, 95% CI = [0.55, 1.97], P < 0.001; TNF-α: SMD = 0.61, 95% CI = [0.13, 1.10], P = 0.010).

Conclusions: This study indicates IL-6 and TNF-α as potential biomarkers of PSD in the acute stage of stroke and provides theoretical support for the early prevention and treatment of PSD.

KEYWORDS:

• Post-stroke depression
• cytokines
• meta-analysis
• interleukin-6
• tumor necrosis factor-alpha

Acknowlegments

We thank Jeremy Allen, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Additional information

Funding

This work was supported by the National Key Research and Development Program of China (grant No. 2017YFA0505700), the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (grant No. 2019PT320002), Scientific research and innovation experiment project of Chongqing Medical University (grant No CXSY201860 and CXSY201861) and the Natural Science Foundation Project of China (grant No. 81820108015).