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Background <p>Post-stroke depression (PSD) is a frequent neuropsychiatric complication. It causes poor functional recovery and deficient long-term outcomes. Hypothalamic–pituitary–adrenal (HPA) axis dysregulation, mainly altered adrenocorticotropic hormone (ACTH) levels, may contribute to post-stroke neuropsychiatric complications. This study aimed to evaluate serum ACTH as a predictive biomarker for PSD and neurological outcomes in acute stroke patients.</p> Methods <p>Prospective longitudinal study enrolled acute stroke inpatients aged 18–80&#xa0;years presenting within 7&#xa0;days of stroke onset. Socio-demographic data, clinical history, and stroke characteristics were recorded. Serum ACTH was measured at 8 AM on the morning following admission. Neurological status was evaluated using the Modified Rankin Scale (mRS), and depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) at baseline and 3-month follow-up. Statistical analyses included correlation testing and multivariable logistic regression.</p> Results <p>Among 95 patients, PSD prevalence at 3&#xa0;months was 42.1%, and poor neurological outcome (mRS ≥ 3) occurred in 39.6%. Patients with PSD and those with poor mRS outcomes exhibited significantly higher ACTH levels (<i>p</i> &lt; 0.0001). ACTH showed strong correlations with 3-month PHQ-9 (r = 0.798) and 3-month mRS (r = 0.654). Multivariable analysis showed that serum ACTH levels were significantly associated with post-stroke depression and poor neurological recovery.</p> Conclusion <p>Serum ACTH was associated with post-stroke depression and poor neurological recovery following stroke. Early ACTH measurement can contribute to early detection and aid in timely psychological and rehabilitative interventions in acute stroke care.</p>

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Serum ACTH as a biomarker for neurological outcomes and post stroke depression in acute stroke patients in tertiary care hospitals: a prospective longitudinal study

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  • 发表日期：

    2026年4月29日

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  • Saipradeep Ravichandran,
  • Sivaprakash Sethupathi

摘要

Background

Post-stroke depression (PSD) is a frequent neuropsychiatric complication. It causes poor functional recovery and deficient long-term outcomes. Hypothalamic–pituitary–adrenal (HPA) axis dysregulation, mainly altered adrenocorticotropic hormone (ACTH) levels, may contribute to post-stroke neuropsychiatric complications. This study aimed to evaluate serum ACTH as a predictive biomarker for PSD and neurological outcomes in acute stroke patients.

Methods

Prospective longitudinal study enrolled acute stroke inpatients aged 18–80 years presenting within 7 days of stroke onset. Socio-demographic data, clinical history, and stroke characteristics were recorded. Serum ACTH was measured at 8 AM on the morning following admission. Neurological status was evaluated using the Modified Rankin Scale (mRS), and depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) at baseline and 3-month follow-up. Statistical analyses included correlation testing and multivariable logistic regression.

Results

Among 95 patients, PSD prevalence at 3 months was 42.1%, and poor neurological outcome (mRS ≥ 3) occurred in 39.6%. Patients with PSD and those with poor mRS outcomes exhibited significantly higher ACTH levels (p < 0.0001). ACTH showed strong correlations with 3-month PHQ-9 (r = 0.798) and 3-month mRS (r = 0.654). Multivariable analysis showed that serum ACTH levels were significantly associated with post-stroke depression and poor neurological recovery.

Conclusion

Serum ACTH was associated with post-stroke depression and poor neurological recovery following stroke. Early ACTH measurement can contribute to early detection and aid in timely psychological and rehabilitative interventions in acute stroke care.