Depression in Major Neurodegenerative Diseases and Strokes: A Critical Review of Similarities and Differences among Neurological Disorders

Abstract

Depression and anxiety are highly prevalent in most neurological disorders and can have a major impact on the patient’s disability and quality of life. However, mostly due to the heterogeneity of symptoms and the complexity of the underlying comorbidities, depression can be difficult to diagnose, resulting in limited recognition and in undertreatment. The early detection and treatment of depression simultaneously with the neurological disorder is key to avoiding deterioration and further disability. Although the neurologist should be able to identify and treat depression initially, a neuropsychiatry team should be available for severe cases and those who are unresponsive to treatment. Neurologists should be also aware that in neurodegenerative diseases, such as Alzheimer’s or Parkinson’s, different depression symptoms could develop at different stages of the disease. The treatment options for depression in neurological diseases include drugs, cognitive-behavioral therapy, and somatic interventions, among others, but often, the evidence-based efficacy is limited and the results are highly variable. Here, we review recent research on the diagnosis and treatment of depression in the context of Alzheimer’s disease, Parkinson’s disease, and strokes, with the aim of identifying common approaches and solutions for its initial management by the neurologist.

Neuron Foundry Mach 8: A Concept of Multi-modal Neuro-supportive Energy Therapy Device for Treating Neurodegenerative Disorders

“…The consistent enhancements in emotional well-being across multiple interventions underscore the potential relevance of multi-modal neuro-supportive energy therapy for a range of neurodegenerative and neurological disorders. In the context of AD, these interventions can aid in mitigating social withdrawal, depression, and anxiety, improving the overall quality of life for affected individuals [158]. In PD, where both motor and non-motor symptoms play a role, addressing depression, anxiety, and sociability could significantly contribute to holistic patient care [159].…”

Progress in Pharmacologic Management of Neuropsychiatric Syndromes in Neurodegenerative Disorders

“…61 OtherNDDsmayhaveevenhigherratesofmoodsymptoms, and depression occurs in up to 80% of patients with Lewy body disorders (PD, DLB, and multiple system atrophy). 62 The diagnosis of depression in NDDs is often challenging since signs and symptoms may bemaskedbymedicalcomorbidities,andsymptomsofdepressionmay overlap with those of dementia, apathy, and cognition-related reduction of activity. In the dementias, patients may not be able to describe mood symptoms due to cognitive impairment and diminished selfawareness.…”

“…61 Other NDDs may have even higher rates of mood symptoms, and depression occurs in up to 80% of patients with Lewy body disorders (PD, DLB, and multiple system atrophy). 62 The diagnosis of depression in NDDs is often challenging since signs and symptoms may be masked by medical comorbidities, and symptoms of depression may overlap with those of dementia, apathy, and cognition-related reduction of activity. In the dementias, patients may not be able to describe mood symptoms due to cognitive impairment and diminished self-awareness.…”

Evaluation of electroacupuncture as a non-pharmacological therapy for astrocytic structural aberrations and behavioral deficits in a post-ischemic depression model in mice

“…Therefore, from a morphological perspective, the changes in the process are more likely to be a “visual mirror” reflecting astrocytes’ state and structural plasticity which can affect neuron functions, particularly in pathological conditions. Of note, although studies on major depressive disorder (MDD) may provide insights into the mechanisms and therapeutic strategies for PID as they may share similarities in some aspects ( Singer et al, 2021 ; Pagonabarraga et al, 2023 ), unfortunately, the structural pathology of astrocytes during PID has been poorly studied previously, and it remains unclear whether astrocytic processes are altered in this illness.…”