Kronenberg G, Gertz K, Heinz A, Endres M
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany.
Br J Pharmacol. 2014 Oct;171(20):4673-89. doi: 10.1111/bph.12775. Epub 2014 Jul 2.
At least one-third of stroke survivors suffer from depression. The development of comorbid depression after stroke is clinically highly significant because post-stroke depression is associated with increased mortality, slows recovery and leads to worse functional outcomes. Here, we review the evidence that post-stroke depression can be effectively modelled in experimental rodents via a variety of approaches. This opens an exciting new window onto the neurobiology of depression and permits probing potential underlying mechanisms such as disturbed cellular plasticity, neuroendocrine dysregulation, neuroinflammation, and neurodegeneration in a novel context. From the point of view of translational stroke research, extending the scope of experimental investigations beyond the study of short-term end points and, in particular, acute lesion size, may help improve the relevance of preclinical results to human disease. Furthermore, accumulating evidence from both clinical and experimental studies offers the tantalizing prospect of 5-hydroxytryptaminergic antidepressants as the first pharmacological therapy for stroke that would be available during the subacute and chronic phases of recovery. Interdisciplinary neuropsychiatric research will be called on to dissect the mechanisms underpinning the beneficial effects of antidepressants on stroke recovery.
至少三分之一的中风幸存者患有抑郁症。中风后共病抑郁症的发生在临床上具有高度重要性，因为中风后抑郁症与死亡率增加、恢复缓慢以及导致更差的功能结局相关。在此，我们综述了通过多种方法可在实验啮齿动物中有效模拟中风后抑郁症的证据。这为抑郁症的神经生物学打开了一扇令人兴奋的新窗口，并允许在新的背景下探究潜在的潜在机制，如细胞可塑性紊乱、神经内分泌失调、神经炎症和神经退行性变。从转化性中风研究的角度来看，将实验研究的范围扩展到短期终点之外，特别是急性病变大小的研究之外，可能有助于提高临床前结果与人类疾病的相关性。此外，临床和实验研究积累的证据提供了诱人的前景，即5-羟色胺能抗抑郁药作为中风恢复亚急性期和慢性期可用的第一种药物治疗方法。跨学科神经精神病学研究将被要求剖析抗抑郁药对中风恢复有益作用的潜在机制。
