The Relationship Between 5-Hydroxytryptamine and Its Metabolite Changes With Post-stroke Depression

Abstract

Post-stroke depression (PSD) is the most common and serious sequelae of stroke. Approximately 33% of stroke survivors were affected by PSD. However, many issues (e.g., incidence, diagnostic marker, and risk factor) related to PSD remained unclear. The "monoamine hypothesis" is a significant hypothesis for depression, which suggests that three monoamines play a key role in depression. Therefore, most current antidepressants are developed to modulate the monoamines on PSD treatment, and these antidepressants have good effects on patients with PSD. However, the potential mechanisms of three monoamines in PSD are still unclear. Previously, we proposed "three primary emotions," which suggested a new model of basic emotions based on the three monoamines. It may provide a new way for PSD treatment. In addition, recent studies have found that monoamine-related emotional intervention also showed potential effects in the treatment and prevention of PSD. This study discusses these issues and attempts to provide a prospect for future research on PSD.

Keywords: 5-Hydroxytryptamine; emotional intervention; monoamine hypothesis; post-stroke depression; three primary emotions.

Figure 1

A neural mechanism model of PSD. IL-6, interleukin-6; IL-1β, interleukin-1β; CRP, C-reactive protein; CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropic hormone; 5-HT, 5-hydroxytryptamine; BDNF, brain-derived neurotrophic factor.

Figure 2

A new model for basic emotions, which might be the neural mechanisms of PSD. The monoamine (NE, DA, and 5-HT) might be the substrate for basic emotions, which include joy, sadness (disgust), and fear (anger). [A figure from our previous paper, (61)]. NE, norepinephrine; DA, dopamine; 5-HT, 5-hydroxytryptamine.