Association between serum retinoic acid levels and risk of post-stroke depression in patients with ischemic stroke

Previous studies suggest that retinoic acid (RA) can exert neuroprotective function in ischemic stroke. However, its role in post-stroke depression (PSD) has still been unclear. We sought to investigate the relationship between circulating RA levels and PSD in patients with ischemic stroke. From September 2018 to March 2019, we prospectively screened patients with ischemic stroke who were hospitalized within 7 days of symptoms onset. RA levels were measured after admission. All patients were followed up at 3 months after stroke. Diagnosis of PSD was made in line with the Chinese version of Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. PSD risk was estimated using multivariable regression models. In total, 352 ischemic stroke patients were enrolled for the final analysis. Up to 3 months after symptoms onset, 102 subjects experienced PSD. PSD patients showed significantly lower RA levels at baseline as compared to non-PSD patients. In univariate logistic analysis, reduced levels of RA was a significant predictor of PSD. These results were further confirmed in multivariate regression additionally controlled for possible relevant confounders. Our study shows that decreased serum RA levels at admission might be associated with 3-month PSD in ischemic stroke patients.