# Research advances on the pathogenesis and clinical interventions of post-stroke depression

## TL;DR

This paper reviews the causes and treatments for post-stroke depression, a common condition affecting stroke survivors, and highlights promising approaches for better care.

## Contribution

The paper provides a comprehensive synthesis of recent advances in understanding and managing post-stroke depression.

## Key findings

- Post-stroke depression affects 30–50% of stroke survivors and impacts rehabilitation and quality of life.
- Multidisciplinary integrated care and precision medicine show promise for improving outcomes in post-stroke depression.
- Pharmacotherapy, psychotherapy, and neuromodulation are among the effective clinical interventions for post-stroke depression.

## Abstract

Post-stroke depression (PSD) is a common neuropsychiatric complication affecting 30–50% of stroke survivors, impairing rehabilitation, quality of life, and prognosis.

This narrative review synthesizes recent evidence on PSD pathogenesis (neurotransmitter dysregulation, neuroinflammation, impaired neuroplasticity; psychosocial factors such as stress and social support deficits; gene–environment interactions including 5-HTT and BDNF polymorphisms), clinical interventions (pharmacotherapy with SSRIs/SNRIs, psychotherapy including CBT, neuromodulation via rTMS/tDCS/ECT, novel agents such as ketamine, and multidisciplinary models), and prevention (risk stratification, early screening with PHQ-9/HAMD, personalized biological/psychosocial strategies, and digital monitoring).

Despite gaps in long-term data and validated biomarkers, multidisciplinary integrated care and precision medicine approaches offer promising avenues to optimize screening, early intervention, prevention, and long-term outcomes for stroke survivors.