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已发表论文
基于微生物群 - 肠 - 脑轴的多模态框架在卒中后抑郁的识别与治疗管理方面的研究进展
Authors Shen M , Yu P, Xiong Q, Sun Z, Zhang Y, Yang M
Received 30 August 2025
Accepted for publication 9 December 2025
Published 16 December 2025 Volume 2025:21 Pages 2835—2853
DOI https://doi.org/10.2147/NDT.S564175
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rakesh Kumar
Mengyue Shen, Penglong Yu, Qian Xiong, Zhongli Sun, Yunhui Zhang, Menglin Yang
Department of Traditional Chinese Medicine, Chongqing Three Gorges Medical College, Chongqing, People’s Republic of China
Correspondence: Mengyue Shen, Chongqing Three Gorges Medical College, 366 Tianxing Road, Wanzhou District, Chongqing, 404120, People’s Republic of China, Email mengyueshen401@163.com
Abstract: Patients with post-stroke depression typically present with psychosocial impairments, including depressed mood and pessimism, accompanied by behavioral manifestations such as social withdrawal. These symptoms significantly impede rehabilitation compliance while elevating risks of self-harm and suicidal ideation. Recent advances in microbiota-gut-brain axis research have elucidated bidirectional communication pathways between the gut microbiota-mediated neuroendocrine-immune network and the central nervous system. Dysregulation of microbiota-gut-brain axis homeostasis may precipitate neuroinflammatory cascades and NE metabolic disturbances, potentially driving post-stroke depression pathogenesis. This paper attempts to propose a multimodal precision diagnosis and treatment framework for post-stroke depression based on the microbiota-gut-brain axis mechanism, representing the first effort to integrate perspectives from neurobiology, gut microbiota, and Traditional Chinese Medicine with modern scientific interpretation to construct such a framework. The paper encompasses four levels: mechanism, integration, evidence, and application. At the mechanism level, it explores the bidirectional regulatory mechanisms of the microbiota-gut-brain axis in post-stroke depression to identify potential therapeutic targets. At the integration level, it refines core principles for constructing a multimodal system applicable to post-stroke depression and builds an microbiota-gut-brain axis based multimodal research framework for post-stroke depression. At the evidence level, by integrating neuroimaging, metabolomics, and microbiomics technologies, it discusses the potential of a multimodal identification system, which is expected to aid in identifying molecular-cellular-circuit mechanisms associated with post-stroke depression. At the application level, it reviews research progress in treating post-stroke depression using the central nervous system interventions, gut microbiota modulation, pharmaceuticals, complementary medicine, and lifestyle interventions, summarizing them into multimodal interventional strategies to inform clinical practice for comprehensive treatment. By incorporating the roles of gut microbiota and oxidative stress in stroke-related complications and neuroimmune pathologies, this review offers a more comprehensive theoretical basis for the precise treatment of post-stroke depression. Future research should rely on large-scale cohorts and artificial intelligence to clarify the dynamic interactive networks of multiple biomarkers within critical time windows, ultimately facilitating the translation of this multimodal framework from theory to clinical practice.
Keywords: post-stroke depression, microbiota-gut-brain axis, multimodal system, identification, intervention
Department of Traditional Chinese Medicine, Chongqing Three Gorges Medical College, Chongqing, People’s Republic of China
Correspondence: Mengyue Shen, Chongqing Three Gorges Medical College, 366 Tianxing Road, Wanzhou District, Chongqing, 404120, People’s Republic of China, Email mengyueshen401@163.com
Abstract: Patients with post-stroke depression typically present with psychosocial impairments, including depressed mood and pessimism, accompanied by behavioral manifestations such as social withdrawal. These symptoms significantly impede rehabilitation compliance while elevating risks of self-harm and suicidal ideation. Recent advances in microbiota-gut-brain axis research have elucidated bidirectional communication pathways between the gut microbiota-mediated neuroendocrine-immune network and the central nervous system. Dysregulation of microbiota-gut-brain axis homeostasis may precipitate neuroinflammatory cascades and NE metabolic disturbances, potentially driving post-stroke depression pathogenesis. This paper attempts to propose a multimodal precision diagnosis and treatment framework for post-stroke depression based on the microbiota-gut-brain axis mechanism, representing the first effort to integrate perspectives from neurobiology, gut microbiota, and Traditional Chinese Medicine with modern scientific interpretation to construct such a framework. The paper encompasses four levels: mechanism, integration, evidence, and application. At the mechanism level, it explores the bidirectional regulatory mechanisms of the microbiota-gut-brain axis in post-stroke depression to identify potential therapeutic targets. At the integration level, it refines core principles for constructing a multimodal system applicable to post-stroke depression and builds an microbiota-gut-brain axis based multimodal research framework for post-stroke depression. At the evidence level, by integrating neuroimaging, metabolomics, and microbiomics technologies, it discusses the potential of a multimodal identification system, which is expected to aid in identifying molecular-cellular-circuit mechanisms associated with post-stroke depression. At the application level, it reviews research progress in treating post-stroke depression using the central nervous system interventions, gut microbiota modulation, pharmaceuticals, complementary medicine, and lifestyle interventions, summarizing them into multimodal interventional strategies to inform clinical practice for comprehensive treatment. By incorporating the roles of gut microbiota and oxidative stress in stroke-related complications and neuroimmune pathologies, this review offers a more comprehensive theoretical basis for the precise treatment of post-stroke depression. Future research should rely on large-scale cohorts and artificial intelligence to clarify the dynamic interactive networks of multiple biomarkers within critical time windows, ultimately facilitating the translation of this multimodal framework from theory to clinical practice.
Keywords: post-stroke depression, microbiota-gut-brain axis, multimodal system, identification, intervention