{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:27:17Z","timestamp":1791836837254,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Post\u2010stroke depressive symptoms are heterogeneous and variably associated with other psycho\u2010cognitive features. We employed cluster analysis to identify distinct profiles of post\u2010stroke depressive symptomatology and their association with cognitive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included consecutive patients undergoing neuropsychiatric evaluation 6 months after stroke. Cluster analysis incorporated the Center for Epidemiologic Studies Depression Scale, along with the apathy and anxiety items from the Neuropsychiatric Inventory questionnaire. Baseline clinical\/neuroimaging variables and 6\u2010months cognitive outcomes were compared across profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 189 patients with acute cerebrovascular events (median age 75.4 years, 62% male, 80% ischemic strokes). Three profiles emerged: (A) low\u2010depressive symptoms (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0108), (B) moderate\u2010depressive symptoms plus anxiety (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a041), (C) high\u2010depressive symptoms plus apathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a040). Regarding baseline predictors of 6\u2010month depressive symptoms profiles, patients with high\u2010depressive symptoms plus apathy exhibited lower Montreal Cognitive Assessment scores at baseline (16.0\u00a0vs. 21.5; adjusted odds ratio [adj.OR] per 1\u2010point increase 0.91, 95% confidence interval [95% CI] 0.83\u20130.99) compared to patients with low\u2010depressive symptoms; moderate\u2010depressive symptoms plus anxiety patients had less cortical atrophy compared to both low\u2010depressive symptoms (adj.OR 0.92, 95% CI 0.86\u20130.99) and high\u2010depressive symptoms plus apathy (adj.OR 0.89, 95% CI 0.81\u20130.97) profiles. Regarding 6\u2010month cognitive performance, high\u2010depressive symptoms plus apathy patients showed higher rates of post\u2010stroke dementia and attention\/executive function impairment compared with the two other groups (both\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), and higher rates of language impairment compared with low\u2010depressive symptoms profile (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By integrating apathy and anxiety in our model, depressive symptoms after stroke emerged as heterogeneous neuropsychiatric syndromes, showing different baseline predictors and distinctive cognitive patterns.<\/jats:p>\n                  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