Post stroke depression and risk of stroke recurrence and mortality: A systematic review and meta-analysis

Cai, Wa; Mueller, Christoph; Li, Yijing; Shen, Wei-Dong; Stewart, Robert

doi:10.1016/j.arr.2019.01.013

Cited by 237 publications

(177 citation statements)

References 42 publications

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“…Psychiatric disorders are common complications post-stroke and are associated with worsened outcomes, including low quality of life, increase in the burden of caregiving, and unfavorable functional status[ 2 , 3 ]. Even early neuropsychiatric disorders after stroke (NDS) may increase the risk of mortality and recurrence in patients with stroke[ 4 , 5 ]. The current management and treatment of the majority of NDS is not satisfactory, except for some antidepressants that show therapeutic benefit[ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications

Zhang¹,

Xu²,

Liu³

et al. 2020

WJP

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A spectrum of neuropsychiatric disorders is a common complication from stroke. Neuropsychiatric disorders after stroke have negative effects on functional recovery, increasing the rate of mortality and disability of stroke survivors. Given the vital significance of maintaining physical and mental health in stroke patients, neuropsychiatric issues after stroke have raised concerns by clinicians and researchers. This mini-review focuses on the most common non-cognitive functional neuropsychiatric disorders seen after stroke, including depressive disorders, anxiety disorders, post-traumatic stress disorder, psychosis, and psychotic disorders. For each condition, the clinical performance, epidemiology, identification of the therapeutic implication, and strategies are reviewed and discussed; the main opinions and perspectives presented here are based on the latest controlled studies, meta-analysis, or updated systematic reviews. In the absence of data from controlled studies, consensus recommendations were provided accordingly.

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Section: Introductionmentioning

confidence: 99%

Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications

Zhang¹,

Xu²,

Liu³

et al. 2020

WJP

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“…Post-stroke depression (PSD), a disease that leads to permanent tissue damage caused by thrombotic and/or hemorrhagic events, refers to psychiatric symptoms such as sleeplessness, depressed mood, and inferiority (Bai et al, 2017). Individuals with PSD exhibit poor rehabilitation outcomes, social isolation, suicidal ideation, and suicide attempts, all of which affect recovery, prolong hospital stays and increase the economic burden compared to non-depressed stroke patients (Cai et al, 2019). With the physiological defect and social dysfunction, PSD also causes cognitive impairments such as attentional decline, impaired memory, and impaired motor function (Quaranta et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Improved Resting-State Functional Dynamics in Post-stroke Depressive Patients After Shugan Jieyu Capsule Treatment

Yao

Wang

et al. 2020

Front. Neurosci.

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Shugan Jieyu Capsule (SG), a Chinese herbal medicine mainly composed of Acanthopanax and Hypericum perforatum, has been used to ameliorate cognitive impairments and emotional problems induced by post-stroke depression (PSD), while the altered brain dynamics underlying the ameliorative effects of SG have remained unclear. Our study focused on investigating the potential neurobiological mechanisms of SG in improving the cognitive function of PSD patients via restingstate functional magnetic resonance imaging (fMRI). Fifteen PSD patients (mean ages: 64.13 ± 6.01 years) were instructed to take 0.72 g of SG twice a day for 8 weeks. PSD patients underwent fMRIs, the 24-item Hamilton Depression Scale (HAMD-24) and the Montreal Cognitive Assessment (MoCA) at baseline and the end of intervention, and these assessments were also performed on twenty-one healthy controls (HC) (mean ages: 60.67 ± 6.95 years). Additionally, the dynamic amplitude of low-frequency fluctuations (dALFF) and functional connectivity (dFC) were determined to reveal changes in dynamic functional patterns. We found that taking SG significantly reduced the depressive symptoms assessed by HAMD-24 and improved cognitive functions assessed by MoCA in PSD patients. Furthermore, at baseline, PSD patients showed decreased dALFF in the right precuneus and increased dFC between the right precuneus and left angular gyrus, compared with HC. After intervention, the dALFF and dFC variances of the abnormal patterns were reversed. Additionally, the dALFF variance in the right precuneus was positively correlated with MoCA scores in PSD patients after SG treatment. Collectively, our results indicate that SG may improve the cognitive function of PSD patients through alteration of brain dynamics. Our findings lay a foundation for the exploration of the neurobiological mechanisms of SG in ameliorating symptoms of PSD patients.

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“…A recent meta-analysis correlated depression after a stroke with a significantly greater risk of mortality in patients post-stroke; therefore, it is essential to establish lines of research for decreasing anxiety and pain in these patients. Along these lines, the use of video games may be an interesting tool for inclusion in adapted protocols for patients with stroke [58].…”

Section: Discussionmentioning

confidence: 99%

Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

Cano-Manas

Collado-Vázquez

Hernández

et al. 2020

Journal of Healthcare Engineering

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Purpose. To determine the effects of a structured protocol using commercial video games on balance, postural control, functionality, quality of life, and level of motivation in patients with subacute stroke. Methods. A randomized controlled trial was conducted. A control group (n = 25) received eight weeks of conventional rehabilitation consisting of five weekly sessions based on an approach for task-oriented motor training. The experimental group (n = 23) received conventional rehabilitation + video-game based therapy for eight weeks with commercial video games using the Xbox 360° video games console and the Kinect® device with the same total treatment time for both groups. The Modified Rankin Scale, Barthel Index, Tinetti scale, Functional Reach test, Get Up and Go test, Baropodometry, EuroQoL 5D (EQ-5D), satisfaction, adherence, and motivation were used as outcome measures. Results. In the between-group comparison, statistically significant differences were observed in the Modified Rankin scores (p<0.01), the Barthel Index (p=0.05), the Tinetti gait assessment (p=0.02), the Functional Reach test (p<0.01), the Get Up and Go test (p=0.05), the pain/discomfort dimension (p<0.01), and anxiety/depression dimension (p<0.01) of the EQ-5D and the VAS (visual analog scale) (p<0.01) on the perceived health status based on the EQ-5D questionnaire. Regarding the scale of motivation, self-esteem, and adherence, statistically significant differences were achieved in motivation (p<0.01), self-esteem (p<0.01), and adherence (p<0.01) variables. Conclusion. A protocol of semi-immersive video-game based therapy, combined with conventional therapy, may be effective for improving balance, functionality, quality of life, and motivation in patients with subacute stroke. This trial is registered with NCT03528395.

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Post stroke depression and risk of stroke recurrence and mortality: A systematic review and meta-analysis

Cited by 237 publications

References 42 publications

Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications

Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications

Improved Resting-State Functional Dynamics in Post-stroke Depressive Patients After Shugan Jieyu Capsule Treatment

Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

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