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Ischemic Stroke precedes depression. Post-stroke depression (PSD) is a major driver for poor recovery, negative quality of life, poor rehabilitation outcomes and poor functional ability. In this systematic review, we analysed the inflammatory basis of post-stroke depression, which involves bioenergetic failure, deranged iron homeostasis (calcium influx, Na influx, potassium efflux etc), excitotoxicity, acidotoxicity, disruption of the blood brain barrier, cytokine-mediated cytotoxicity, reactive oxygen mediated toxicity, activation of cyclooxygenase pathway and generation of toxic products. This process subsequently results in cell death, maladapted, persistent neuro-inflammation and deranged neuronal networks in mood-related brain regions. Furthermore, an in-depth review likewise reveals that anatomic structures related to post-stroke depression may be localized to complex circuitries involving the cortical and subcortical regions.
Tissa Wijeratne; Carmela Sales. 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, 10, 1674 .
AMA StyleTissa Wijeratne, Carmela Sales. 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; 10 (8):1674.
Chicago/Turabian StyleTissa Wijeratne; Carmela Sales. 2021. "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 10, no. 8: 1674.
Stroke is one of the leading causes of adult disability and the second leading cause of death worldwide. The immune system actively participates in the pathobiological process of acute ischemic stroke (AIS), during the index event and the repair process. Research on neurovascular inflammation has created a renewed interest in the use of easily available biomarkers reflective of innate and adaptive immunological changes with potential diagnostic, prognostic, and therapeutic implications particularly in AIS. The current scoping review aimed to assess the significance the neutrophil to lymphocyte (NLR) in AIS and its related complications and explore their association with post-stroke recovery trajectory. The Arksey and O’Malley methodological framework was employed to review the published papers on the neutrophil–lymphocyte ratio (NLR) and AIS in late November 2020. Only studies published in English from 2000–2020 were included in this scoping review. Fifty-three published papers were reviewed. This review’s key finding is that a canonical inflammatory response occurs in the hyperacute, acute, subacute, and chronic stages of stroke. An excessive circulating innate immune cells (neutrophils) and reduced circulating adaptive immune cells (lymphocytes) are associated with poorer outcomes during the acute interventions as well as the recovery trajectory. This scoping review’s findings highlights the utility of a systems biology-based approach in stroke care.
Tissa Wijeratne; Carmela Sales; Rohit Menon; Leila Karimi; Mihajlo Jakovljevic. Highlighting the Role of Universally Available and Innate Immune Cell Counts in Acute Ischemic Stroke: A Scoping Review. Sustainability 2021, 13, 4069 .
AMA StyleTissa Wijeratne, Carmela Sales, Rohit Menon, Leila Karimi, Mihajlo Jakovljevic. Highlighting the Role of Universally Available and Innate Immune Cell Counts in Acute Ischemic Stroke: A Scoping Review. Sustainability. 2021; 13 (7):4069.
Chicago/Turabian StyleTissa Wijeratne; Carmela Sales; Rohit Menon; Leila Karimi; Mihajlo Jakovljevic. 2021. "Highlighting the Role of Universally Available and Innate Immune Cell Counts in Acute Ischemic Stroke: A Scoping Review." Sustainability 13, no. 7: 4069.
A case of a 75-year-old man with COVID-19, severe neurological symptoms (acute stroke-like symptoms and signs and full recovery after a prolonged hospital stay), and intracranial hypertension is discussed with an in-depth review of his clinical features, biochemistry, haematology, highlighting the relationship between changes in neutrophil-lymphocyte ratio, C-reactive protein level, D-dimer level, and the clinical onset of acute ischemic stroke-like symptoms in the setting of COVID-19 and major neurological manifestations. This is the first such case reported in Australia to date. This case also illustrates the recovery of a patient with COVID-19 complicated with severe neurological symptoms (acute ischemic stroke-like symptoms) during the prolonged intensive care unit stay (at day 26) followed by slow neurorehabilitation and normal recovery from both respiratory and neurological involvement. The onset of acute stroke-like symptoms appears to be closely associated with changes of neutrophil-lymphocyte ratio and in C-reactive protein, and D-dimer levels.
Tissa Wijeratne; Carmela A Sales; Sheila G Crewther; Vinh Nguyen; Leila Karimi. First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization. Cureus 2020, 12, 1 .
AMA StyleTissa Wijeratne, Carmela A Sales, Sheila G Crewther, Vinh Nguyen, Leila Karimi. First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization. Cureus. 2020; 12 (9):1.
Chicago/Turabian StyleTissa Wijeratne; Carmela A Sales; Sheila G Crewther; Vinh Nguyen; Leila Karimi. 2020. "First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization." Cureus 12, no. 9: 1.