Treatments to post-stroke depression, which is more effective to HAMD improvement? A network meta-analysis

Zhang, Jie; Song, Zhaoming; Chen, Gui; Jiang, Guannan; Cheng, Wei; You, Wanchun; Wang, Zhong; Chen, Gang

doi:10.3389/fphar.2022.1035895

Cited by 8 publications

(7 citation statements)

References 71 publications

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“…Early use of SSRIs such as escitalopram may be a treatment for PSD (98,99). Zhang et al (100) retrieved Meta-analyzes up to December 2021. They found that antidepressant co-adjuvant therapy may enhance the efficacy of antidepressant medications, with acupuncture combined with fluoxetine being more efficacious in treating PSD at week 4.…”

Section: Ssrismentioning

confidence: 99%

Mechanisms associated with post-stroke depression and pharmacologic therapy

Zhan,

Kong

2023

Front. Neurol.

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Stroke is one of the most common cerebrovascular diseases, which is the cause of long-term mental illness and physical disability, Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, and its mechanisms are characterized by complexity, plurality, and diversity, which seriously affects the quality of survival and prognosis of patients. Studies have focused on and recognized neurotransmitter-based mechanisms and selective serotonin-reuptake inhibitors (SSRIs) can be used to treat PSD. Neuroinflammation, neuroendocrinology, neurotrophic factors, and the site of the stroke lesion may affect neurotransmitters. Thus the mechanisms of PSD have been increasingly studied. Pharmacological treatment mainly includes SSRIs, noradrenergic and specific serotonergic antidepressant (NaSSA), anti-inflammatory drugs, vitamin D, ect, which have been confirmed to have better efficacy by clinical studies. Currently, there is an increasing number of studies related to the mechanisms of PSD. However, the mechanisms and pharmacologic treatment of PSD is still unclear. In the future, in-depth research on the mechanisms and treatment of PSD is needed to provide a reference for the prevention and treatment of clinical PSD.

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Section: Ssrismentioning

confidence: 99%

Mechanisms associated with post-stroke depression and pharmacologic therapy

Zhan,

Kong

2023

Front. Neurol.

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“…Liang and colleagues provided a further conclusion that rTMS (≤10 Hz) combined with antidepressants tends to be more effective than antidepressants alone in patients with PSD 16 . Bayesian network meta‐analyses (NMA) suggested that rTMS combined with paroxetine may be more effective than other treatments for PSD at the end of the eighth week 10 . Additionally, several studies have found that rTMS over the left dorsolateral prefrontal cortex (DLPFC) can improve cognition in patients with dementia or vascular cognitive impairment, with or without depression 17,18 .…”

Section: Introductionmentioning

confidence: 99%

“…These nonpharmacological approaches may offer an alternative avenue for PSD treatment. [8][9][10][11][12][13] NIBS therapy is a promising measure for PSD treatment that has attracted increasing attention in recent years. The two most commonly used NIBS techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is essential to explore other alternatives such as non‐invasive brain stimulation (NIBS), acupuncture, psychotherapy and even coffee consumption. These non‐pharmacological approaches may offer an alternative avenue for PSD treatment 8–13 …”

Section: Introductionmentioning

confidence: 99%

“…16 Bayesian network metaanalyses (NMA) suggested that rTMS combined with paroxetine may be more effective than other treatments for PSD at the end of the eighth week. 10 Additionally, several studies have found that rTMS over the left dorsolateral prefrontal cortex (DLPFC) can improve cognition in patients with dementia or vascular cognitive impairment, with or without depression. 17,18 In comparison, research on tDCS for PSD is limited.…”

Section: Introductionmentioning

confidence: 99%

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Non‐invasive brain stimulation for treating post‐stroke depression: A network meta‐analysis

Sun

Liu

et al. 2023

Int J Geriat Psychiatry

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Objective: To compare the antidepressant effects and tolerability of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) treatments in patients with post-stroke depression (PSD). Methods:We included randomized controlled trials comparing active stimulation with sham stimulation. Primary outcomes were the depression score after treatment, presented as standardized mean differences with 95% confidence intervals.Response/remission and long-term antidepressant efficacy were also examined. We estimated effect-size using pairwise and Bayesian network meta-analysis (NMA) with random-effects model. Results:We identified 33 studies (total n = 1793). In NMA, 5 of 6 treatment strategies were associated with higher effect compared with sham therapy: dual rTMS (standardized mean differences = −1.5; 95% confidence interval = −2.5 to −0.57), dual LFrTMS (−1.5, −2.4 to −0.61), dual tDCS (−1.1, −1.5 to −0.62), HFrTMS (−1.1, −1.3 to −0.85) and LFrTMS (−0.90, −1.2 to −0.6). And dual rTMS, dual LFrTMS or HFrTMS may be more effective than other interventions for achieving antidepressant effects. Regarding secondary outcomes, rTMS can promote depression remission and response, and alleviate depression for at least 1 month. rTMS and tDCS were well tolerated. Conclusions: Bilateral rTMS and HFrTMS are considered top-priority non-invasive brain stimulation (NIBS) interventions for improving PSD. Dual tDCS and LFrTMS are also efficient.

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Efficacy of the use of video games on mood, anxiety and depression in stroke patients: preliminary findings of a randomised controlled trial

Blázquez-González,

Mirón-González,

Lendínez-Mesa

et al. 2024

J Neurol

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Background In the different published studies, there is no consensus on the efficacy of virtual reality as an adjuvant treatment of mood states. Aim The aim of this study is to evaluate the impact of no immersive virtual reality with the Nintendo Switch device in rehabilitation treatment on mood, anxiety and depression in stroke patients admitted to neurorehabilitation units. Methods Fifty-eight patients admitted to neurorehabilitation units underwent a 1:3 multicentre randomised clinical trial. The intervention group consisted of 17 patients and the control group of 41 patients. The intervention group performed 6 virtual reality sessions together with the conventional treatment, and the control group performed only the conventional rehabilitation sessions. Primary and secondary clinical outcomes were measured before and six weeks after the intervention. Results Comparing the intervention group and control group, the anxiety levels of the intervention group decreased compared to the results observed in the control group (p = 0.01), as did the dependence of the intervention group (0.015). On the other hand, the results obtained after the intervention by the control group for anxiety (0.479) and depression (0.292) were not statistically significant. Conclusion Rehabilitation VR used as an adjuvant treatment to conventional treatment has a beneficial impact on the neurological status and state of anxiety of stroke patients admitted to neurorehabilitation units. Trial registration Registered in the https://clinicaltrials.gov/ repository (NTC NCT05143385). Protocol registration date 7 October 2021, retrospectively registered.

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Treatments to post-stroke depression, which is more effective to HAMD improvement? A network meta-analysis

Cited by 8 publications

References 71 publications

Mechanisms associated with post-stroke depression and pharmacologic therapy

Mechanisms associated with post-stroke depression and pharmacologic therapy

Non‐invasive brain stimulation for treating post‐stroke depression: A network meta‐analysis

Efficacy of the use of video games on mood, anxiety and depression in stroke patients: preliminary findings of a randomised controlled trial

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