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ORIGINAL RESEARCH article

Front. Neurol.

Sec. Stroke

Low-dose statins combined with repetitive transcranial magnetic stimulation reduce post-stroke depression

Provisionally accepted
Chaohua  CuiChaohua Cui1*Chuhua  CaiChuhua Cai2Qiulian  YinQiulian Yin1Haoye  GuanHaoye Guan2Tonghua  LongTonghua Long1
  • 1Youjiang Medical University for Nationalities, Baise, China
  • 2Guangxi University of Science and Technology, Liuzhou, China

The final, formatted version of the article will be published soon.

Background: The effectiveness of statins in preventing post-stroke depression (PSD) remains controversial. Lower testosterone levels caused by statins could potentially increase the risk of PSD. Low-dose statins could offer better benefits due to their lesser impact on testosterone levels. Repetitive transcranial magnetic stimulation (rTMS) has been shown to reduce PSD in the acute stage. The combination of low-dose statins and rTMS may provide a promising therapeutic option for patients with PSD. Methods: Data were collected from ischemic stroke patients. Unsupervised machine learning methods were employed to explore the risk factor of PSD. Our prospective cohort study collected data from ischemic stroke patients over three years. The patients' conditions determined the prescription of statins. The outcomes measured included the incidence of PSD, favorable functional outcome (FFO) at 6-and 12-months post-onset. Results: A total of 545 patients were included in the study. The mean age was 60.99±12.768 years, and 31.9% of the participants were female. The combination of low-dose statins and rTMS subgroup had the lowest incidence of PSD at both 6 and 12 months (p<0.001). In multivariable logistic regression, the combination of low-dose statins and rTMS was inversely related to PSD at six months (OR=0.370, P=0.003) and 12 months (OR=0.386, P=0.004). Conclusion: The combination of statins and the rTMS group related the lower incidence of PSD in stroke patients. Combining low-dose statins and rTMS could reduce PSD and further improve the prognosis of ischemic stroke patients.

Keywords: post-stroke depression, Statins, repetitive transcranial magnetic stimulation, incidence rate and prognosis, machine learning

Received: 18 Jun 2025; Accepted: 14 Nov 2025.

Copyright: © 2025 Cui, Cai, Yin, Guan and Long. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Chaohua Cui, cchaiwp@163.com

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