A Pilot Study of Remote Ischemic Conditioning in Preventing Post-Stroke Depression

Wanyan Li,1 Yankun Qin,1 Jinglei Wang,1 Lin Li,1 Junfeng Gao,1 Xiaowei Xu,1 Zhaohua Wu,1 Xunming Ji,2 Yanhong Wang,3 Keming Gao,4,5 Ming Ren,6 Xiangzhong Shao1 1Department of Neurology, Affiliated Haian Hospital of Nantong University, Nantong, Jiangsu, People’s Republic of China; 2Department of Neurology, Beijing Xuanwu Hospital, Beijing, People’s Republic of China; 3Department of Neurology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; 5Case Western Reserve University School of Medicine, Cleveland, OH, USA; 6Department of Neurology, Shanghai Blue Cross Brain Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Wanyan Li, Email [email protected]: Post-stroke depression (PSD) constitutes a significant complication that influences both patient survival and functional recovery following a stroke. Despite its prevalence, PSD still lacks a long-term, safe and effective treatment measure. Remote ischemic conditioning (RIC) is a simple and noninvasive procedure that exert neuroprotective effects. This pilot study aims to investigate the efficacy, safety, and feasibility of RIC as a preventive measure against PSD.Methods: Acute ischemic stroke patients within 15 days post-event were considered eligible for study enrollment. Fifty participants were recruited and underwent daily RIC treatments for a 12-month period. Depressive symptoms were assessed utilizing the Patient Health Questionnaire-9 (PHQ-9) and the Hamilton Depression Rating Scale (HAMD) at baseline, as well as at 1, 3, 6, and 12-months post-intervention.Results: The study found a gradual improvement in depressive symptoms among the 50 patients who completed the study over the 12-month treatment period, as evidenced by a consistent decline in pertinent scores. Moreover, merely two patients experienced mild adverse reactions.Conclusion: The study’s outcomes indicate that RIC is safe, well-tolerated, and feasible as a preventive measure for PSD. Consequently, it is advisable to conduct a comprehensive randomized controlled trial to further evaluate the effectiveness and safety of RIC in preventing PSD.Keywords: ischemic stroke, post stroke depression, remote ischemic conditioning, prevention