Remote Ischemic Conditioning: A Novel Non-Invasive Approach to Prevent Post-Stroke Depression.

Wenbo Zhao,Yuchuan Ding,Fang Jiang,Jing Zhang,Xunming Ji,Zhen Zhang

doi:10.3389/fnagi.2017.00270

Wenbo Zhao, Yuchuan Ding + Show 4 more

Open Access

https://doi.org/10.3389/fnagi.2017.00270

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Abstract

Post-stroke depression (PSD) is a common neuropsychiatric complication of stroke. However, due to the high expense and side effects of pharmacotherapy and the difficult-to-achieve of psychotherapy, the prevention and treatment of PSD are still far from satisfaction. Inflammation hypothesis is now playing an essential role in the pathophysiological mechanism of PSD, and it may be a new preventive and therapeutic target. Remote ischemic conditioning (RIC) is a non-invasive and easy-to-use physical strategy, which has been used to protect brain (including ischemic and hemorrhagic stroke), heart and many other organs in clinical trials. The underlying mechanisms of RIC include anti-inflammation, anti-oxidative stress, immune system regulation and other potential pathways. Our hypothesis is that RIC is a novel approach to prevent PSD. The important implications of this hypothesis are that: (1) RIC could be widely used in clinical practice to prevent PSD if our hypothesis were verified; and (2) RIC would be thoroughly explored to test its effects on other neurobehavioral disorders (e.g., cognitive impairment).

Highlights

Post-stroke depression (PSD) is one of the most frequent and important neuropsychiatric complications of stroke
Our hypothesis could be supported by the evidences that the mechanism of Remote ischemic conditioning (RIC) includes anti-inflammation, immunoregulation, antioxidant and other underlying pathways, which are existed in the pathophysiology of PSD
Psychological, social and biological factors all play their roles in the occurrence of PSD (De Ryck et al, 2014)

Summary

Introduction

Post-stroke depression (PSD) is one of the most frequent and important neuropsychiatric complications of stroke. The underlying mechanisms involved in providing RIC induced distant organs protection include anti-inflammation, anti-oxidative stress, immune system regulation, autonomous nervous system regulation and other potential pathways (Randhawa et al, 2015). Inflammation has complex interactions with monoamine system, hypothalamic-pituitary-adrenal (HPA) axis and neuroplasticity, and all of them contribute to the pathophysiological mechanisms of PSD (Fang and Cheng, 2009; Li et al, 2014).

Results

Conclusion