Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India.
Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, India.
Brain Res Bull. 2021 Mar;168:74-88. doi: 10.1016/j.brainresbull.2020.12.012. Epub 2020 Dec 31.
Cerebral ischemia contributes to significant disabilities worldwide, impairing cognitive function and motor coordination in affected individuals. Stroke has severe neuropsychological outcomes, the major one being a stroke. Stroke survivors begin to show symptoms of depression within a few months of the incidence that overtime progresses to become a long-term ailment. As the pathophysiology for the progression of the disease is multifactorial and complex, it limits the understanding of the disease mechanism completely. Meta-analyses and randomized clinical trials have shown that intervening early with tricyclic antidepressants and selective serotonin receptor inhibitors can be effective. However, these pharmacotherapies possess several limitations that have given rise to newer approaches such as brain stimulation, psychotherapy and rehabilitation therapy, which in today's time are gaining attention for their beneficial results in post-stroke depression (PSD). The present review highlights numerous factors like lesion location, inflammatory mediators and genetic abnormalities that play a crucial role in the development of depression in stroke patients. Further, we have also discussed various mechanisms involved in post-stroke depression (PSD) and strategies for early detection and diagnosis using biomarkers that may revolutionize treatment for the affected population. Towards the end, along with the preclinical scenario, we have also discussed the various treatment approaches like pharmacotherapy, traditional medicines, psychotherapy, electrical stimulation and microRNAs being utilized for effectively managing PSD.
脑缺血导致全球范围内的严重残疾，损害了受影响个体的认知功能和运动协调能力。中风有严重的神经心理学后果，主要后果是中风。中风幸存者在发病后几个月内开始出现抑郁症状，随着时间的推移，这些症状逐渐发展成为长期疾病。由于疾病进展的病理生理学是多因素和复杂的，因此完全理解疾病机制受到限制。荟萃分析和随机临床试验表明，早期干预三环类抗抑郁药和选择性 5-羟色胺受体抑制剂可能有效。然而，这些药物治疗存在一些局限性，促使人们采用新的方法，如脑刺激、心理治疗和康复治疗，这些方法在当今时代因其对中风后抑郁（PSD）的有益效果而受到关注。本综述强调了许多因素，如病变部位、炎症介质和遗传异常，这些因素在中风患者中抑郁的发展中起着至关重要的作用。此外，我们还讨论了涉及中风后抑郁（PSD）的各种机制，以及使用生物标志物进行早期检测和诊断的策略，这可能会彻底改变对受影响人群的治疗方法。最后，除了临床前情况外，我们还讨论了各种治疗方法，如药物治疗、传统药物、心理治疗、电刺激和 microRNAs，这些方法被用于有效治疗 PSD。
