Comprehensive psychological and neurological rehabilitation for post-stroke depression: A retrospective comparative study with biomarker exploration

Table 6 Depression severity subgroup analysis: Rehabilitation outcomes and biomarker trajectories

Characteristic	Mild (n = 62) HAMD 8-16	Moderate (n = 72) HAMD 17-23	Severe (n = 44) HAMD ≥ 24	P trend
Baseline HAMD-17	11.5 ± 2.2	19.8 ± 1.8	26.5 ± 3.0	< 0.001
Admission NIHSS	5.8 ± 2.0	8.8 ± 2.8	11.5 ± 3.2	< 0.001
Dominant hemisphere, %	50.0	62.5	72.7	0.018
Frontal lobe involvement, %	22.6	33.3	47.7	0.012
CRG remission rate (%)	82.4	62.5	38.5	< 0.001
CG remission rate (%)	40.5	21.7	10.5	< 0.001
12-week MBI	80.5 ± 11.8	72.5 ± 13.0	62.8 ± 14.5	< 0.001
Post-intervention biomarker changes (CRG only)
ΔNPY (pg/mL)	26.8 ± 8.5	21.2 ± 7.8	14.5 ± 6.5	< 0.001
ΔBDNF (ng/mL)	12.5 ± 3.8	8.8 ± 3.2	5.5 ± 2.8	< 0.001
ΔIL-1β (pg/mL)	-5.8 ± 2.0	-4.2 ± 1.8	-2.5 ± 1.5	< 0.001
ΔTNF-α (pg/mL)	-7.2 ± 2.5	-5.5 ± 2.2	-3.2 ± 1.8	< 0.001
Baseline NPY (pg/mL)	82.5 ± 14.5	72.8 ± 15.2	62.5 ± 13.8	< 0.001
Fazekas total score	2.2 ± 1.0	3.0 ± 1.2	4.0 ± 1.3	< 0.001
Family involvement (FSQ)	35.8 ± 6.8	30.5 ± 7.5	26.8 ± 7.0	< 0.001

P trend calculated by Jonckheere-Terpstra test for ordered alternatives. Δ denotes post-intervention minus baseline change in comprehensive rehabilitation group. HAMD: Hamilton Depression Rating Scale; NIHSS: National Institutes of Health Stroke Scale; CRG: Comprehensive rehabilitation group; CG: Control group; MBI: Modified Barthel Index; NPY: Neuropeptide Y; BDNF: Brain-derived neurotrophic factor; IL: Interleukin; TNF: Tumor necrosis factor; FSQ: Family support questionnaire.