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The advances of post-stroke depression: 2021 update

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Abstract

Post-stroke depression (PSD) is one of common and serious sequelae of stroke. Approximately, one in three stroke survivors suffered from depression after stroke. It heavily affected functional rehabilitation, which leaded to poor quality of life. What is worse, it is strongly associated with high mortality. In this review, we aimed to derive a comprehensive and integrated understanding of PSD according to recently published papers and previous classic articles. Based on the considerable number of studies, we found that within 2 years incidence of PSD has a range from 11 to 41%. Many factors contribute to the occurrence of PSD, including the history of depression, stroke severity, lesion location, and so on. Currently, the diagnosis of PSD is mainly based on the DSM guidelines and combined with various depression scales. Unfortunately, we lack a unified mechanism to explain PSD which mechanisms now involve dysregulation of hypothalamic–pituitary–adrenal (HPA) axis, increased inflammatory factors, decreased levels of monoamines, glutamate-mediated excitotoxicity, and abnormal neurotrophic response. At present, both pharmacotherapy and psychological therapies are employed in treating PSD. Although great advance has been made by researchers, there are still a lot of issues need to be addressed. Especially, the mechanism of PSD is not completely clear.

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Acknowledgements

This work was supported by National Natural Science Foundation of China (Nos. U20A20357), and “The Fundamental Research Funds for the Central Universities”.

Funding

This work was supported by National Natural Science Foundation of China (Nos. U20A20357), and “The Fundamental Research Funds for the Central Universities”.

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Authors and Affiliations

  1. Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China

    Jianglong Guo, Wen Sun & Xinfeng Liu

  2. Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China

    Jinjing Wang & Xinfeng Liu

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  1. Jianglong Guo
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  2. Jinjing Wang
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  3. Wen Sun
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XL and WS designed the study. JG wrote the manuscript. JW and WS revised the manuscript. All the authors contributed to and have approved the final manuscript.

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Correspondence to Xinfeng Liu.

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Guo, J., Wang, J., Sun, W. et al. The advances of post-stroke depression: 2021 update. J Neurol 269, 1236–1249 (2022). https://doi.org/10.1007/s00415-021-10597-4

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