Neuropsychiatric sequelae of stroke

The solution for this is to address the causes of depression, anxiety and apathy. Probably by stopping the neuronal cascade of death and having stroke protocols that lead to 100% recovery.  Attack the correct problem not the sequelae.
http://www.nature.com/articles/nrneurol.2016.46.epdf?

José M.Ferro

1

, Lara Caeiro

2

and Maria Luísa Figueira

1

Abstract

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Stroke survivors are often affected by psychological distress and neuropsychiatric

disturbances. About one-third of stroke survivors experience depression, anxiety or apathy,

whichare the most common neuropsychiatric sequelae of stroke. Neuropsychiatric sequelae

aredisabling, and can have a negative influence on recovery, reduce quality of life and lead to

exhaustion of the caregiver. Despite the availability of screening instruments and effective

treatments, neuropsychiatric disturbances attributed to stroke are currently underdiagnosed and

undertreated. Stroke severity, stroke-related disabilities, cerebral small vessel disease, previous

psychiatric disease, poor coping strategies and unfavourable psychosocial environment influence

the presence and severity of the psychiatric sequelae of stroke. Although consistent associations

between psychiatric disturbances and specific stroke locations have yet to be confirmed, functional

MRI studies are beginning to unveil the anatomical networks that are disrupted in stroke-associated

psychiatric disorders. Evidence regarding biochemical and genetic biomarkers for

stroke-associated psychiatric disorders is still limited, and better understanding of the biological

determinants and pathophysiology of these disorders is needed. Investigation into the

management of these conditions must be continued, and should include pilot studies to assess the

benefits of innovative behavioural interventions and large-scale cooperative randomized controlled

pharmacological trials of drugs that are safe to use in patients with stroke.