Depression after stroke: a review of the evidence base to inform the development of an integrated care pathway. Part 1: Diagnosis, frequency and impact

Abstract

Further work is required to adapt and evaluate instruments to measure depression in the context of stroke. Development of an integrated care pathway may help to establish a more consistent approach to assessment and diagnosis of PSD.

La atorvastatina protege las neuronas GABAérgicas y dopaminérgicas del sistema nigroestriatal en un modelo experimental de isquemia cerebral focal transitoria en ratas

“…These regions are involved in processing sensorimotor, cognitive and affective information, which is consistent with the types of pathophysiological conditions that often occur following ischemia, such as depression (42,43), anxiety, cognitive disorders and other behavioral changes (44)(45)(46).…”

The effects of increased therapy time on cognition and mood in frail patients with a stroke who rehabilitate on rehabilitation units of nursing homes in the Netherlands: A protocol of a comparative study

“…executive functions, and mood in frail stroke patients. It is known that a decline in cognition and mood both relate to more severe functional limitations and less functional recovery [25,26]. More specifically, the prevalence of cognitive disorders in stroke patients is high and varies from 22% [27] to 63% [28].…”

Depression and apathy after stroke

“…Based on full-text evaluation of the remaining articles, 135 articles met inclusion criteria. Reasons for exclusion were: conference abstract, 34 research protocol, 35 review article, 36,37 small sample size, [38][39][40][41][42][43][44][45] other outcome than depression or apathy, 46-48 study population other than stroke or no separate results available for stroke subpopulation, [49][50][51][52][53][54][55] and no evaluation of imaging markers. 56 Fourteen additional studies found in reference lists and fulfilling eligibility criteria were included, resulting in a total of 149 studies.…”

“…In contrast with lesion-related markers, generalized markers of vascular brain pathology like white matter hyperintensities (WMH), cerebral microbleeds, (silent) old infarcts, as well as degenerative pathology like cerebral atrophy are less frequently studied in association with PSD, though there are suggestions that they play a role in the development of PSD as well. [46][47][48][49] Furthermore, there are hypotheses that PSD may be related to an increased inflammatory response 50 and also genetic polymorphisms in the serotonin system might be involved. 51 In addition to abovementioned biological factors, psychosocial mechanisms are suggested to be involved in the development of PSD.…”

“…depression and dementia), but mounting evidence suggests that it might be an independent syndrome with a different etiology. [48][49][50] Post-stroke apathy (PSA) is as frequent as PSD, with a mean prevalence rate of 34.6 % at 4 months post-stroke. 5 However, PSA gained relatively less attention in research in comparison with PSD, and most research focuses on the difference between the two.…”