High Serum Levels of iNOS and MIP-1α are Associated with Post-Stroke Depression

Purpose: Post-stroke depression (PSD) is one of the emotional disorders after the onset of stroke. Many studies have indicated that inflammatory processes can promote the occurrence and development of PSD. The purpose of our study was to explore the potential relationship between PSD and two inflammatory biomarkers: inducible nitric oxide synthase (iNOS) and macrophage inflammatory protein 1 alpha (MIP-1 alpha). Methods: In total, 80 patients diagnosed with depression after the first-ever acute ischemic stroke were enrolled in PSD group consecutively. During the same period, 40 non-depressed patients following the first-ever acute ischemic stroke and 40 healthy control subjects were recruited as non-PSD group and normal group, respectively. All participants have performed serum iNOS and MIP-1 alpha level examination with enzyme-linked immunosorbent assay (ELISA). The severity of depressive symptoms was evaluated by the 24-item Hamilton Depression Scale (HAMD-24). Results: Serum iNOS and MIP-1 alpha levels were significantly higher in PSD group than those in non-PSD and normal groups (P < 0.001). Serum iNOS and MIP-1 alpha levels of PSD patients with varying degrees of depression were significantly different, serum iNOS and MIP-1 alpha levels became higher as the depressive symptoms became more severe (P < 0.05). There was a positive correlation between the elevated levels of iNOS, MIP-1 alpha and HAMD scores (r = 0.262, 0.209, P < 0.05). Logistic regression analysis showed that both serum iNOS and MIP1 alpha levels were independently associated with PSD (OR = 2.790, 95% CI: 0.712-10.933, P < 0.05 and OR = 1.922, 95% CI: 0.648-9.815, P < 0.05, respectively) after adjustment for possible relevant confounders. Conclusion: High serum levels of iNOS and MIP-1 alpha were found to be associated with the development of PSD and closely related to its severity.