Post-stroke depression and the aging brain
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JMP
REVIEW
Open Access
Post-stroke depression and the aging brain Gabriel R Cojocaru1, Aurel Popa-Wagner3, Elena C Stanciulescu2, Loredana Babadan1 and Ana-Maria Buga1*
Abstract Ageing is associated with changes in the function of various organ systems. Changes in the cardiovascular system affect both directly and indirectly the function in a variety of organs, including the brain, with consequent neurological (motor and sensory performance) and cognitive impairments, as well as leading to the development of various psychiatric diseases. Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of cerebral ischemia. This review discusses several animal models used for the study of PSD and summarizes recent findings in the genomic profile of the ageing brain, which are associated with age-related disorders in the elderly. Since stroke and depression are diseases with increased incidence in the elderly, great clinical benefit may especially accrue from deciphering and targeting basic mechanisms underlying PSD. Finally, we discuss the relationship between ageing, circadian rhythmicity and PSD. Keywords: Aging, Stroke, Post stroke depression, Gene profiling
Review Background
Depression in stroke survivors is of utmost clinical relevance. It often takes a chronic course and is associated with increased morbidity, mortality and a poorer functional outcome. Despite the fact that a high proportion of stroke patients develop mood symptoms, the pathomechanisms underlying the development of poststroke depression (PSD) have so far received little attention from the field of neurobiology. Relevant animal models have only sparsely been investigated. This research gap becomes even more regrettable if one considers the growing body of clinical evidence indicating a beneficial effect of antidepressants and especially of selective serotonin reuptake inhibitors (SSRIs), on postischemic outcome. Since old age as such is also associated with an enhanced susceptibility to stroke along with a poorer recovery from brain injury, it deserves to be investigated as a key modulatory factor. If we cannot prevent stroke, we shall try to alleviate its long-term consequences. In particular, great clinical benefit may accrue from deciphering and targeting basic mechanisms underlying chronic PSD in aged animals. So far, the majority of experimental stroke studies have concentrated * Correspondence: [email protected] 1 Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares str., no 2, Craiova 200349, Romania Full list of author information is available at the end of the article
heavily on acute stroke outcome, which, after all, represents only a snapshot of a complex sequence of events. This limitation may have majorly contributed to the conspicuous discrepancy between laboratory and clinical findings that has been a recurrent theme in stroke research in recent years (‘translational road block’).
Post-stroke depressio
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