Maria Blöchl1, Sophie Meissner2, Steffen Nestler2. 1. Department for Psychology, University of Leipzig, Germany; International Max Plank Research School: Neuroscience of Communication: Structure, Function, and Plasticity, Leipzig, Germany. Electronic address: maria.bloechl@uni-leipzig.de. 2. Department for Psychology, University of Leipzig, Germany.
Abstract
BACKGROUND: Depression after stroke is common and has been proposed to negatively affect disability by preventing optimal physical rehabilitation and recovery. However, the nature of this influence remains poorly understood. Here, we synthesise longitudinal studies to examine the hypotheses that depression after stroke (i) hampers physical rehabilitation, (ii) prevents functional improvement during recovery, and (iii) is associated with poor functional outcomes. METHODS: A systematic literature search was conducted using the databases PubMed and Web of Science. A total of 5672 studies were screened; 28 met criteria for inclusion. The quality of included studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Individual studies showed no consistent effects of depression post-stroke on (i) the effectiveness of physical rehabilitation and (ii) functional improvements during recovery. In contrast, random-effects models revealed that (iii) depression after stroke was associated with an increased risk for poor long-term disability (OR: 2.16, 95% CI 1.70-2.77). Overall, the quality of studies was moderate and there was evidence for publication bias. LIMITATIONS: The number of included studies was small. There was considerable methodological heterogeneity between studies, prohibiting meta-analyses for all effects of interest. Few studies examined the influence of antidepressants. CONCLUSIONS: Depressed stroke patients are generally more disabled. However, depressed mood might not restrict improvements in physical disability during rehabilitation and recovery, although it seems to be linked to a delayed increase in the risk of poor functional outcome. High-quality evidence from longitudinal studies is needed to clarify the precise mechanisms and temporal dynamics underlying these associations.
BACKGROUND:Depression after stroke is common and has been proposed to negatively affect disability by preventing optimal physical rehabilitation and recovery. However, the nature of this influence remains poorly understood. Here, we synthesise longitudinal studies to examine the hypotheses that depression after stroke (i) hampers physical rehabilitation, (ii) prevents functional improvement during recovery, and (iii) is associated with poor functional outcomes. METHODS: A systematic literature search was conducted using the databases PubMed and Web of Science. A total of 5672 studies were screened; 28 met criteria for inclusion. The quality of included studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Individual studies showed no consistent effects of depression post-stroke on (i) the effectiveness of physical rehabilitation and (ii) functional improvements during recovery. In contrast, random-effects models revealed that (iii) depression after stroke was associated with an increased risk for poor long-term disability (OR: 2.16, 95% CI 1.70-2.77). Overall, the quality of studies was moderate and there was evidence for publication bias. LIMITATIONS: The number of included studies was small. There was considerable methodological heterogeneity between studies, prohibiting meta-analyses for all effects of interest. Few studies examined the influence of antidepressants. CONCLUSIONS:Depressed strokepatients are generally more disabled. However, depressed mood might not restrict improvements in physical disability during rehabilitation and recovery, although it seems to be linked to a delayed increase in the risk of poor functional outcome. High-quality evidence from longitudinal studies is needed to clarify the precise mechanisms and temporal dynamics underlying these associations.
Authors: Daniela Pinter; Simon Fandler-Höfler; Viktoria Fruhwirth; Lisa Berger; Gerhard Bachmaier; Susanna Horner; Sebastian Eppinger; Markus Kneihsl; Christian Enzinger; Thomas Gattringer Journal: Front Neurol Date: 2022-04-25 Impact factor: 4.086
Authors: Fidel López-Espuela; Raúl Roncero-Martín; Maria de la Luz Canal-Macías; Jose M Moran; Vicente Vera; Adela Gomez-Luque; Alejandro Lendinez-Mesa; Juan Diego Pedrera-Zamorano; Ignacio Casado-Naranjo; Jesus Lavado-García Journal: Int J Environ Res Public Health Date: 2020-12-20 Impact factor: 3.390