Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review

Woranush, Warunya; Moskopp, Mats Leif; Sedghi, Annahita; Stuckart, Isabella; Noll, Thomas; Barlinn, Kristian; Siepmann, Timo

doi:10.2147/ndt.s337865

Cited by 15 publications

(5 citation statements)

References 81 publications

(156 reference statements)

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“…52-54 Patients might even be less prone to post-stroke depression, representing a severe burden to recovery after stroke. 55 The application of tDCS as an adjunctive treatment in rehabilitation regimes after stroke could thus effectively improve recovery of function. Consistently, the recent literature shows that in humans, tDCS improved long-term motor recovery when applied in addition to established rehabilitation regimes but not alone.…”

Section: Discussionmentioning

confidence: 99%

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

Walter

Pikhovych

Endepols

et al. 2022

Neurorehabil Neural Repair

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Background Transcranial direct current stimulation (tDCS) promotes recovery after stroke in humans. The underlying mechanisms, however, remain to be elucidated. Animal models suggest tDCS effects on neuroinflammation, stem cell proliferation, neurogenesis, and neural plasticity. Objective In a longitudinal study, we employed tDCS in the subacute and chronic phase after experimental focal cerebral ischemia in mice to explore the relationship between functional recovery and cellular processes. Methods Mice received photothrombosis in the right motor cortex, verified by Magnetic Resonance Imaging. A composite neuroscore quantified subsequent functional deficits. Mice received tDCS daily: either 5 sessions from day 5 to 9, or 10 sessions with days 12 to 16 in addition. TDCS with anodal or cathodal polarity was compared to sham stimulation. Further imaging to assess proliferation and neuroinflammation was performed by immunohistochemistry at different time points and Positron Emission Tomography at the end of the observation time of 3 weeks. Results Cathodal tDCS at 198 kC/m2 (220 A/m2) between days 5 and 9 accelerated functional recovery, increased neurogenesis, decreased microglial activation, and mitigated CD16/32-expression associated with M1-phenotype. Anodal tDCS exerted similar effects on neurogenesis and microglial polarization but not on recovery of function or microglial activation. TDCS on days 12 to 16 after stroke did not induce any further effects, suggesting that the therapeutic time window was closed by then. Conclusion Overall, data suggest that non-invasive neuromodulation by tDCS impacts neurogenesis and microglial activation as critical cellular processes influencing functional recovery during the early phase of regeneration from focal cerebral ischemia.

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Section: Discussionmentioning

confidence: 99%

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

Walter

Pikhovych

Endepols

et al. 2022

Neurorehabil Neural Repair

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“…Aiming to explain these positive changes, we can suggest a few directions. Depression has a long-term negative effect on functional outcomes post stroke [ 55 , 56 ], and low functional ability may lead to an impact in depression, revealing a vicious cycle between the two constructs [ 57 , 58 ]. Therefore, possibly by improving activities of daily living and achieving their occupational goals (as we previously reported) [ 27 ], participants might have improved their emotional state.…”

Section: Discussionmentioning

confidence: 99%

Functional and Cognitive Occupational Therapy (FaCoT) Improves Self-Efficacy and Behavioral–Emotional Status of Individuals with Mild Stroke; Analysis of Secondary Outcomes

Adamit

Shames

Rand

2023

IJERPH

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Background: Mild stroke is characterized by subtle impairments, such as low self-efficacy and emotional and behavioral symptoms, which restrict daily living. Functional and Cognitive Occupational Therapy (FaCoT) is a novel intervention, developed for individuals with mild stroke. Objectives: To examine the effectiveness of FaCoT compared to a control group to improve self-efficacy, behavior, and emotional status (secondary outcome measures). Material and Methods: Community-dwelling individuals with mild stroke participated in a single-blind randomized controlled trial with assessments at pre, post, and 3-month follow-up. FaCoT included 10 weekly individual sessions practicing cognitive and behavioral strategies. The control group received standard care. The New General Self-Efficacy Scale assessed self-efficacy; the Geriatric Depression Scale assessed depressive symptoms; the Dysexecutive Questionnaire assessed behavior and emotional status; and the ‘perception of self’ subscale from the Reintegration to Normal Living Index assessed participation. Results: Sixty-six participants were randomized to FaCoT (n = 33, mean (SD) age 64.6 (8.2)) and to the control (n = 33, age 64.4 (10.8)). Self-efficacy, depression, behavior, and emotional status improved significantly over time in the FaCoT group compared with the control, with small to large effect size values. Conclusion: The efficacy of FaCoT was established. FaCoT should be considered for community-dwelling individuals with mild stroke.

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“…Rehabilitation of the affected individuals takes significant time, and substantial financial resources incurred in prolonged treatment can take a toll on the finances of the family involved. Woranush et al [ 205 ] established that the efficacy of post-stroke depression increases with the duration of preventive treatment. Therefore, improved outcomes will be realized if the medications used provide rapid and robust responses.…”

Section: Future Research In Drug Therapy Of Psdmentioning

confidence: 99%

Pathophysiology and Current Drug Treatments for Post-Stroke Depression: A Review

Frank

Gruenbaum

Zlotnik

et al. 2022

IJMS

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Post-stroke depression (PSD) is a biopsychosocial disorder that affects individuals who have suffered a stroke at any point. PSD has a 20 to 60 percent reported prevalence among stroke survivors. Its effects are usually adverse, can lead to disability, and may increase mortality if not managed or treated early. PSD is linked to several other medical conditions, including anxiety, hyper-locomotor activity, and poor functional recovery. Despite significant awareness of its adverse impacts, understanding the pathogenesis of PSD has proved challenging. The exact pathophysiology of PSD is unknown, yet its complexity has been definitively shown, involving mechanisms such as dysfunction of monoamine, the glutamatergic systems, the gut-brain axis, and neuroinflammation. The current effectiveness of PSD treatment is about 30–40 percent of all cases. In this review, we examined different pathophysiological mechanisms and current pharmacological and non-pharmacological approaches for the treatment of PSD.

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Preventive Approaches for Post-Stroke Depression: Where Do We Stand? A Systematic Review

Cited by 15 publications

References 81 publications

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

Functional and Cognitive Occupational Therapy (FaCoT) Improves Self-Efficacy and Behavioral–Emotional Status of Individuals with Mild Stroke; Analysis of Secondary Outcomes

Pathophysiology and Current Drug Treatments for Post-Stroke Depression: A Review

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