Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2024; 14(7): 1080-1086
Published online Jul 19, 2024. doi: 10.5498/wjp.v14.i7.1080
Predictive value of intracranial high-density areas in neurological function
Zhi-Juan Lu, Jin-Xing Lai, Jing-Ru Huang, Shu-Hua Xie, Zhao-Hui Lai
Zhi-Juan Lu, Jin-Xing Lai, Jing-Ru Huang, Shu-Hua Xie, Zhao-Hui Lai, Department of Neurology, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi Province, China
Author contributions: Lai JX and Huang JR analyzed the data; Xie SH contributed new reagents/analytic tools; Lai ZH designed the research; Lu ZJ wrote the paper.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of Ganzhou People’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Data sharing statement: There are no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Hui Lai, MM, Department of Neurology, Ganzhou People’s Hospital, No. 16 Meiguan Avenue, Ganzhou 341000, Jiangxi Province, China.13879729792@163.com
Received: April 8, 2024
Revised: May 21, 2024
Accepted: June 5, 2024
Published online: July 19, 2024
Processing time: 94 Days and 18.6 Hours
Abstract
BACKGROUND

Intracranial high-density areas (HDAs) have attracted considerable attention for predicting clinical outcomes; however, whether HDAs predict worse neurological function and mental health remains controversial and unclear, which requires further investigation.

AIM

To investigate the predictive value of intracranial HDAs for neurological function and mental health after endovascular treatment.

METHODS

In this prospective study, 96 patients with acute ischemic stroke (AIS) who accepted endovascular mechanical thrombectomy (EMT) were included. The enrolled patients underwent cranial computed tomography (CT) examination within 24 hours after EMT. Clinical data in terms of National Institutes of Health Stroke Scale (NIHSS), the 3-month modified Rankin Scale (mRS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis.

RESULTS

Compared to patients without HDAs, patients with HDAs presented severe neurological deficits (admission NIHSS score: 18 ± 3 vs 19 ± 4), were more likely to have post-stroke disabilities (mRS < 3: 35% vs 62%), and suffered more severe depression (SDS score: 58 ± 16 vs 64 ± 13) and anxiety disorder (SAS score: 52 ± 8 vs 59 ± 10). Compared to patients with a good prognosis, patients with a poor prognosis presented severe neurological deficits (admission NIHSS score: 17 ± 4 vs 20 ± 3), were more likely to have HDAs on CT images (64% vs 33%), and suffered more severe depression (SDS score: 55 ± 19 vs 65 ± 11) and anxiety (SAS score: 50 ± 8 vs 58 ± 12). Multivariate analysis revealed that HDAs were independent negative prognostic factors.

CONCLUSION

In conclusion, HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.

Keywords: Acute ischemic stroke; Endovascular mechanical thrombectomy; High-density areas; Depressive disorder; Anxiety disorder

Core Tip: High-density areas (HDAs) have great potential in predicting clinical outcomes in patients with acute ischemic stroke (AIS). This prospective study focused on the association of intracranial HDAs with neurological function and mental health after endovascular mechanical thrombectomy for AIS. Through comprehensive evaluation of National Institutes of Health Stroke Scale, the 3-month modified Rankin Scale, self-rating depression scale, and self-rating anxiety scale scores, our study demonstrated that intracranial HDAs on computed tomography images predict poor prognosis and severe depressive and anxiety symptoms.