Wijeratne Tissa, Sales Carmela
School of Psychology and Public Health, La Trobe University, Melbourne 3000, Australia.
Department of Neurology, Western Health & University Melbourne, AIMSS, Level Three, WHCRE, Sunshine Hospital, St Albans 3021, Australia.
J Clin Med. 2021 Apr 14;10(8):1674. doi: 10.3390/jcm10081674.
Ischemic Stroke precedes depression. Post-stroke depression (PSD) is a major driver for poor recovery, negative quality of life, poor rehabilitation outcomes and poor functional ability. In this systematic review, we analysed the inflammatory basis of post-stroke depression, which involves bioenergetic failure, deranged iron homeostasis (calcium influx, Na influx, potassium efflux etc), excitotoxicity, acidotoxicity, disruption of the blood brain barrier, cytokine-mediated cytotoxicity, reactive oxygen mediated toxicity, activation of cyclooxygenase pathway and generation of toxic products. This process subsequently results in cell death, maladapted, persistent neuro-inflammation and deranged neuronal networks in mood-related brain regions. Furthermore, an in-depth review likewise reveals that anatomic structures related to post-stroke depression may be localized to complex circuitries involving the cortical and subcortical regions.
缺血性中风先于抑郁症出现。中风后抑郁症（PSD）是恢复不佳、生活质量负面、康复效果差和功能能力低下的主要驱动因素。在本系统评价中，我们分析了中风后抑郁症的炎症基础，这涉及生物能量衰竭、铁稳态紊乱（钙内流、钠内流、钾外流等）、兴奋性毒性、酸毒性、血脑屏障破坏、细胞因子介导的细胞毒性、活性氧介导的毒性、环氧合酶途径激活和有毒产物生成。这一过程随后导致细胞死亡、适应不良、持续性神经炎症以及与情绪相关脑区的神经元网络紊乱。此外，深入综述同样表明，与中风后抑郁症相关的解剖结构可能定位于涉及皮质和皮质下区域的复杂回路。
