The Clinical Neuroscience of Post Stroke Depression

Post stroke depression or PSD is believed to occur in ten to forty percent of all patients who survive stroke. These mood disturbances overlap with primary major depressive disorder in terms of symptom profile, natural history and response to antidepressant medications. Cognitive changes, especially impairments in executive functions, are commonly encountered in PSD. This may be the result of disruption to fronto-thalamo-cortical circuits in PSD. Both functional limitations following stroke and biological mechanisms may play important roles in the pathophysiology of PSD. Antidepressants are clinically effective in managing these mood disturbances and may have an important role in the prophylaxis of depression following stroke. PSD provides a naturalistic model that facilitates the study of the clinical correlates and neurobiological mechanisms that may be relevant in the pathophysiology of vascular depression.