J Neurol Neurosurg Psychiatry 81:1312-1315 doi:10.1136/jnnp.2009.203141
  • Research paper

White matter hyperintensities in post-stroke depression: a case control study

  1. K S Wong2
  1. 1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
  2. 2Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China
  3. 3Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Hong Kong SAR, China
  1. Correspondence to W K Tang, Department of Psychiatry, 11/F Prince of Wales Hospital, Shatin Hospital, Shatin, NT, Hong Kong SAR, China; tangwk{at}
  • Received 13 December 2009
  • Revised 16 February 2010
  • Accepted 26 February 2010
  • Published Online First 20 June 2010


Objective Despite extensive research on post-stroke depression (PSD), the role of white matter hyperintensities (WMHs) in its pathogenesis remains uncertain. The aim of this study was to evaluate the relationship between WMHs and PSD in Chinese patients with first or recurrent stroke.

Methods A cohort of 994 patients with acute ischaemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. A psychiatrist administered the Structural Clinical Interview for DSM-IV to all patients and made a diagnosis of PSD 3 months after the index stroke. 78 (7.8%) patients had PSD; 78 stroke patients matched according to age and sex but without PSD served as a control group. The severity and location of WMHs were evaluated with MRI.

Results In comparison with the non-PSD group, patients in the PSD group were more likely to have severe deep WMHs (12.8% vs 1.3%; p=0.009). Severe deep WMHs remained an independent predictor of PSD in the multivariate analysis with an OR of 13.8 (p=0.016).

Conclusion The results suggest that WMHs may play a role in the development of PSD. The importance of WMHs in the treatment and outcome of PSD warrants further investigation.


  • Funding Research Grants Council of the Hong Kong Special Administrative Region.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Clinical Research Ethics Committee of the Chinese University of Hong Kong.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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