Neurogenic Inflammation: Difference between revisions

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Post Stroke Depression (PSD) is one of the most common mood disorders with depressive consequences in stroke patients<ref>(Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Scholar). </ref>. PSD affects approximately one-third of stroke patients<ref>Hackett, M.L.; Pickles, K. Part I: Frequency of depression after stroke: An updated systematic review and meta-analysis of
Post Stroke Depression (PSD) is one of the most common mood disorders with depressive consequences in stroke patients<ref>(Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Scholar). </ref>. PSD affects approximately one-third of stroke patients<ref>Hackett, M.L.; Pickles, K. Part I: Frequency of depression after stroke: An updated systematic review and meta-analysis of


observational studies. Int. J. Stroke 2014, 9, 1017–1025</ref>, and thus may cause a reduction in quality of life and life expectancy through multiple factors such as: cognitive decline, increased risk of falls, high suicidal rate, functional impairment, stagnated recovery process and poor response to rehabilitation <ref name=":1">Paolucci S, Iosa M, Coiro P, Venturiero V, Savo A, De Angelis D and Morone G: Post-stroke depression increases disability more than 15% in ischemic stroke survivors: A case-control study. Front Neurol. 10(926)2019.PubMed/NCBI View Article : Google Scholar</ref><ref>Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Schola</ref>. Contrarily, a reduction of depressive symptoms has been associated with better functional recovery; also, patients treated for depression show a better functional prognosis compared to untreated, depressed patients<ref name=":1" />.
observational studies. Int. J. Stroke 2014, 9, 1017–1025</ref> and is a significant factor in poor recovery<ref name=":2">Wijeratne T, Sales C. [https://pubmed.ncbi.nlm.nih.gov/33919670/ Understanding why post-stroke depression may be the norm rather than the exception: The anatomical and neuroinflammatory correlates of post-stroke depression]. Journal of Clinical Medicine. 2021 Apr 14;10(8):1674.</ref>. PSD negatively affects the quality of life, functional ability and prognostic outcomes<ref name=":2" />. Studies suggests that it is also linked to an increased likelihood of stroke recurrence and death<ref>Wu QE, Zhou AM, Han YP, Liu YM, Yang Y, Wang XM, Shi X. [https://journals.lww.com/md-journal/fulltext/2019/10180/poststroke_depression_and_risk_of_recurrent.6.aspx Poststroke depression and risk of recurrent stroke: A meta-analysis of prospective studies.] Medicine. 2019 Oct;98(42).</ref><ref>Sibolt G, Curtze S, Melkas S, Pohjasvaara T, Kaste M, Karhunen PJ, Oksala NK, Vataja R, Erkinjuntti T. Post-stroke depression and depression-executive dysfunction syndrome are associated with recurrence of ischaemic stroke. Cerebrovascular Diseases. 2013 Dec 1;36(5-6):336-43.</ref>.  PSD may reduce life expectancy through multiple factors such as: cognitive decline, increased risk of falls, high suicidal rate, functional impairment, stagnated recovery process and poor response to rehabilitation <ref name=":1">Paolucci S, Iosa M, Coiro P, Venturiero V, Savo A, De Angelis D and Morone G: Post-stroke depression increases disability more than 15% in ischemic stroke survivors: A case-control study. Front Neurol. 10(926)2019.PubMed/NCBI View Article : Google Scholar</ref><ref>Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Schola</ref>.  
 
Contrarily, a reduction of depressive symptoms has been associated with better functional recovery; also, patients treated for depression show a better functional prognosis compared to untreated, depressed patients<ref name=":1" />.
 
=== Mechanisms ===
Several mechanisms correlate PSD to neurologic dysfunction<ref name=":2" />.
 
* Inflammation: Inflammation resulting from stroke and depression impacts neuroplasticity, as seen by the decreased availability of brain-derived neurotrophic factor (BDNF) in synapses.
* Increased stress: A disproportionate increase in stress also causes physiological changes predisposing patients to hypertension and cardiac dysrhythmias
* Immune and inflammatory pathways: individual’s emotional and social experiences triggers the activation of various components of the immune and inflammatory pathways  .
* Cytokines: act a mediator in chronic inflammatory processes linked to stroke-related complications
 
=== Risk Factors ===
 
=== Clinical Features ===
 
=== Diagnosis ===


== Management / Interventions ==
== Management / Interventions ==
add text here relating to management approaches to the condition
== Resources ==
== Resources ==
add appropriate resources here
add appropriate resources here

Revision as of 08:00, 25 September 2023

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Introduction[edit | edit source]

Neurogenic inflammation (NI) is a physiological process in which mediators are released directly from the cutaneous nerves to initiate an inflammatory reaction in response to tissue damage or a painful stimuli. This results in the production of local inflammatory responses including erythema, swelling, temperature increase, tenderness, and pain.

Neurogenic inflammation has also been implicated in the pathophysiology of numerous diseases, including complex regional pain syndrome, migraine, and irritable bowel, arthritis, bladder inflammation, asthma and bladder syndromes. However, in the setting of wound healing, neurogenic inflammation helps maintain tissue integrity and facilitate tissue repair.[1]

Mechanism of Injury[edit | edit source]

Neurogenic inflammation is initiated by activation of peripheral nervous system C-fibre neurons causing a release of neuropeptides, such as substance P and calcitonin gene-related peptide (CGRP), which triggers inflammation at the site that is different from the original stimuli. Many different chemicals, including formaldehyde, ether, and cigarette smoke, can exert an irritant effect by stimulating these c-fibers in humans[1].

Post Stroke Depression[edit | edit source]

Post Stroke Depression (PSD) is one of the most common mood disorders with depressive consequences in stroke patients[2]. PSD affects approximately one-third of stroke patients[3] and is a significant factor in poor recovery[4]. PSD negatively affects the quality of life, functional ability and prognostic outcomes[4]. Studies suggests that it is also linked to an increased likelihood of stroke recurrence and death[5][6]. PSD may reduce life expectancy through multiple factors such as: cognitive decline, increased risk of falls, high suicidal rate, functional impairment, stagnated recovery process and poor response to rehabilitation [7][8].

Contrarily, a reduction of depressive symptoms has been associated with better functional recovery; also, patients treated for depression show a better functional prognosis compared to untreated, depressed patients[7].

Mechanisms[edit | edit source]

Several mechanisms correlate PSD to neurologic dysfunction[4].

  • Inflammation: Inflammation resulting from stroke and depression impacts neuroplasticity, as seen by the decreased availability of brain-derived neurotrophic factor (BDNF) in synapses.
  • Increased stress: A disproportionate increase in stress also causes physiological changes predisposing patients to hypertension and cardiac dysrhythmias
  • Immune and inflammatory pathways: individual’s emotional and social experiences triggers the activation of various components of the immune and inflammatory pathways .
  • Cytokines: act a mediator in chronic inflammatory processes linked to stroke-related complications

Risk Factors[edit | edit source]

Clinical Features[edit | edit source]

Diagnosis[edit | edit source]

Management / Interventions[edit | edit source]

Resources[edit | edit source]

add appropriate resources here

References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ 1.0 1.1 Chiu IM, von Hehn CA, Woolf CJ. Neurogenic inflammation – the peripheral nervous system’s role in host defense and immunopathology. Nat Neurosci. 2012;15:1063-1067.
  2. ↑ (Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Scholar).
  3. ↑ Hackett, M.L.; Pickles, K. Part I: Frequency of depression after stroke: An updated systematic review and meta-analysis of observational studies. Int. J. Stroke 2014, 9, 1017–1025
  4. ↑ 4.0 4.1 4.2 Wijeratne T, Sales C. Understanding why post-stroke depression may be the norm rather than the exception: The anatomical and neuroinflammatory correlates of post-stroke depression. Journal of Clinical Medicine. 2021 Apr 14;10(8):1674.
  5. ↑ Wu QE, Zhou AM, Han YP, Liu YM, Yang Y, Wang XM, Shi X. Poststroke depression and risk of recurrent stroke: A meta-analysis of prospective studies. Medicine. 2019 Oct;98(42).
  6. ↑ Sibolt G, Curtze S, Melkas S, Pohjasvaara T, Kaste M, Karhunen PJ, Oksala NK, Vataja R, Erkinjuntti T. Post-stroke depression and depression-executive dysfunction syndrome are associated with recurrence of ischaemic stroke. Cerebrovascular Diseases. 2013 Dec 1;36(5-6):336-43.
  7. ↑ 7.0 7.1 Paolucci S, Iosa M, Coiro P, Venturiero V, Savo A, De Angelis D and Morone G: Post-stroke depression increases disability more than 15% in ischemic stroke survivors: A case-control study. Front Neurol. 10(926)2019.PubMed/NCBI View Article : Google Scholar
  8. ↑ Robinson RG and Jorge RE: Post-stroke depression: A review. Am J Psychiatry. 173:221–231. 2016.PubMed/NCBI View Article : Google Schola

 

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