Post-Stroke Psychiatric and Cognitive Symptoms in West Asia, South Asia and Africa: A Systematic Review and Meta-Analysis

Mahadevan, Sangeetha; Chan, Moon Fai; Moghadas, Marzieh; Shetty, Maithili; Burke, David T.; Al-Rasadi, Khalid; Al-Adawi, Samir

doi:10.3390/jcm10163655

Cited by 11 publications

(8 citation statements)

References 86 publications

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“…While there is an abundance of research on cognitive symptoms secondary to stroke from many industrialized countries, 10 little has been forthcoming from developing countries, despite having a high prevalence of stroke. In this study, we aimed to conduct an epidemiological investigation from 563 stroke centers in China to describe the cognitive status of first-ever stroke patients and risk factors related to PSCI.…”

Section: Introductionmentioning

confidence: 99%

Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China

Wang

et al. 2023

The Lancet Regional Health - Western Pacific

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Section: Introductionmentioning

confidence: 99%

Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China

Wang

et al. 2023

The Lancet Regional Health - Western Pacific

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“…It is also possible that disruption of connections in the cognitive and limbic systems [71] caused by the vascular accident could explain the relationship between post-stroke depression and cognitive impairment. Specifically, poststroke depression and executive dysfunction could result from functional overconnectivity between the default mode and salience/cognitive control networks and reduced crosshemispheric frontoparietal functional connectivity [16]. Lastly, it is theoretically possible that post-stroke depression and cognitive impairment are independent phenomena for some patients.…”

Section: Discussionmentioning

confidence: 99%

“…Depression occurs in around 30% of stroke survivors [16][17][18]. Although not consistent across all studies [18,19], depression negatively impacts post-stroke patients.…”

Section: Introductionmentioning

confidence: 94%

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Sobreiro

Terroni

Mattos

et al. 2023

Life

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Background: Depressive symptoms have been associated with cognitive impairment after stroke, and women may be specifically affected. Objective: The aim of this study was to investigate gender-specific characteristics in the relationship between changes in depression severity and changes in cognitive performance after stroke. Methods: We prospectively evaluated 73 patients without a previous history of depression in the first and fourth months after a first ischemic stroke. The severity of depressive symptoms was assessed using the 31-item version of the Hamilton Rating Scale for Depression, and executive function, attention, working memory, and verbal fluency were assessed using a neuropsychological battery. Results: We included 46 (63.0%) men and 27 (36.9%) women, with mean ages of 55.2 (SD ± 15.1) and 46.8 (SD ± 14.7) years, respectively. We found significant improvement in the digit span forward and Stroop dots from month 1 to month 4 post stroke for both men and women. Women, but not men, presented a correlation between changes in phonemic verbal fluency and changes in the 31-item version of the Hamilton Rating Scale for Depression scores. Improvement in depression was correlated with improvement in verbal fluency, and worsening in depression was correlated with worsening in verbal fluency. Conclusions: Our results suggest that women might be more vulnerable to the relationship between depressive symptoms and cognitive performance, and improvement of depression may be necessary for women’s improvement in phonemic verbal fluency from the first to the fourth month after a stroke. We did not adjust the results for multiple comparisons. Thus, our findings might be considered preliminary, and confirmatory studies, also focusing on specific characteristics of women that could explain these differences, are warranted.

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“…The search strategy is shown in the S1 Search Strategy. Eleven systematic reviews identified were hand-searched for relevant studies [3][4][5][6][7][8][17][18][19][20][21].…”

Section: Search Strategy and Data Extractionmentioning

confidence: 99%

Prevalence and natural history of depression after stroke: A systematic review and meta-analysis of observational studies

Liu

Marshall

et al. 2023

PLoS Med

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Background Depression is the most frequent psychiatric condition after stroke and is associated with negative health outcomes. We aim to undertake a systematic review and meta-analysis of the prevalence and natural history of depression after stroke. Methods and findings Studies published up to 4 November 2022 on Medline, Embase, PsycINFO, and Web of Science Core Collection were searched. We included studies of adults with stroke, where depression was assessed at a prespecified time point. Studies excluding people with aphasia and history of depression are excluded. Critical Appraisal Skills Programme(CASP) cohort study tool was used to assess risk of bias. A total of 77 studies were included in the pooled estimates of the prevalence of poststroke depression (PSD). The overall prevalence of depression was 27% (95% CI 25 to 30). Prevalence of depression was 24% (95% CI 21 to 28) by clinical interview and 29% (95% CI 25 to 32) by rating scales. Twenty-four studies with more than one assessment time point reported the natural history of PSD. Among people who were depressed within 3 months of stroke, 53% (95% CI 47 to 59) experienced persistent depression, while 44% (95% CI 38 to 50) recovered. The incidence of later depression (3 to 12 months after stroke) was 9% (95% CI 7 to 12). The cumulative incidence during 1 year after stroke was 38% (95% CI 33 to 43), and the majority (71% (95% CI 65 to 76)) of depression had onset within 3 months after stroke. The main limitation of the present study is that excluding people in source studies with severe impairments may produce imprecise estimates of the prevalence of PSD. Conclusions In this study, we observed that stroke survivors with early-onset depression (within 3 months after stroke) are at high risks for remaining depressed and make up two-thirds of the incident cases during 1 year after stroke. This highlights the need for ongoing clinical monitoring of patients depressed shortly after stroke. Trial Registration PROSPERO CRD42022314146.

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Post-Stroke Psychiatric and Cognitive Symptoms in West Asia, South Asia and Africa: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 86 publications

Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China

Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China

The Impact of Post-Stroke Depressive Symptoms on Cognitive Performance in Women and in Men: A 4 Month Prospective Study

Prevalence and natural history of depression after stroke: A systematic review and meta-analysis of observational studies

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