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Affective Prosody and Depression After Stroke: A Pilot Study. BACKGROUND AND PURPOSE: Poststroke depression (PSD) is a frequent complication of stroke with detrimental consequences in terms of quality of life and functional outcomes. In individuals with major depression, several studies have demonstrated an alteration of affective prosody. The aim of this study is to identify prosodic markers that may be predictive of PSD. METHODS: Patient voices were recorded at baseline and 3 months after stroke. We extracted prosodic parameters, including fundamental frequency, percentage of voice breaks, and shimmer. Depression and anxiety symptoms were assessed 3 months later. RESULTS: Among the 49 patients included in the study, 22.5% developed PSD 3 months after stroke. A significant decrease was observed concerning the fundamental frequency among patients who developed PSD. Discriminant analysis demonstrated that initial voice breaks coupled with shimmer are strongly predictive of subsequent PSD. CONCLUSIONS: Early alterations of affective prosody are associated with a higher risk of PSD 3 months after a stroke. This new physiological approach overcomes traditional barriers associated with clinical instruments and contributes to the prediction of this disorder.