Research hotspots and trends of post-stroke depression rehabilitation: a bibliometric analysis from 2003 to 2024

 

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Research hotspots and trends of post-stroke depression rehabilitation: a bibliometric analysis from 2003 to 2024

Hongwei Cai^1,2Shini Cai^1,2Aihong Li³Aisong Guo^1*

• ¹Department of Rehabilitation Medicine Center, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
• ²School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
• ³Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China

Background: Post-stroke depression (PSD) is a common complication of stroke and is associated with stroke prognosis. Rehabilitation plays an essential role in the comprehensive treatment of PSD. However, there are few bibliometric analyses of studies on PSD rehabilitation. This study aimed to comprehensively sort out the network of PSD rehabilitation through bibliometric analyses, analyze the research trends, focus on the hotspots related to PSD rehabilitation, and provide new research perspectives and guidance for future studies.

Methods: The Web of Science Core Collection (WoSCC) database was searched for studies about depression rehabilitation after a stroke. The search covered the period from January 1, 2003, to October 31, 2024. We analyzed countries, institutions, journals, authors and keywords using CiteSpace and VOSviewer software to create visualizations and perform a bibliometric analysis.

Results: A total of 2,227 papers were analyzed, with an increasing trend in the number of papers published each year. The United States had the highest number of published articles (458 publications), and Maastricht University and Utrecht University were the most published institutions (56 articles). Archives of Physical Medicine and Rehabilitation is the journal with the most cited publications (5,913 citations). Johanna M. A. is the most prolific author (24 publications).

Conclusion: Using bibliometric methods, relevant studies on PSD rehabilitation were reviewed. The hotspots of future research on PSD rehabilitation will center on the brain plasticity mechanism of PSD rehabilitation, PSD assessment, and new techniques of PSD rehabilitation. This article provides systematic information to support and guide future research in this area.

1 Introduction

Stroke is a severe cerebrovascular disease with high morbidity, mortality and disability rates (1). It not only leads to impairment of motor, speech and cognitive functions but also adversely affects the psychological condition of patients (2). Post-stroke depression (PSD) is a prevalent complication that significantly impacts recovery and quality of life (3). In addition to stroke symptoms, it mainly manifests as a series of depressive symptoms with low mood and loss of interest, often accompanied by corresponding somatic symptoms (4). PSD is a clinical syndrome with a high incidence, with studies reporting a 38.1% prevalence among stroke patients 1 month after onset (5). Stroke survivors frequently experience emotional challenges, as highlighted in the multicenter DESTRO study by Paolucci et al., which involved 53 centers and 1,064 consecutive stroke patients. In this study, PSD was found in 36% of patients, with depression occurring within 3 months of stroke in about 80% of cases. Most cases were mild rather than major depression and identified risk factors included a history of depression, severe disability, prior stroke, and female gender. Patient autonomy and quality of life were severely affected (6). The prevention, early diagnosis, and early treatment of PSD is urgent, as it affects patient recovery and life expectancy and increases the risk of disability and death (7).

Patients with a confirmed clinical diagnosis of PSD are typically treated clinically with standardized antidepressant medication, but the evidence base lacks large randomized controlled trials in PSD populations, and the potential bleeding risks of the medication may be detrimental to stroke rehabilitation (8). Research indicates that patients with PSD are at a higher risk of mortality and disability problems than non-depressed stroke patients (9). Nonetheless, it is surprising that PSD is frequently neglected within the community, as deficiencies in treatment and diagnosis hinder patients from obtaining the necessary rehabilitation assistance (10). Moreover, many PSD patients experience social isolation due to persistent communication difficulties, often withdrawing from social interactions as a form of self-protection. Depression in post-stroke patients is particularly significant, as it profoundly affects various aspects of daily life (11). Depression reduces quality of life and impedes stroke recovery (12). One cause of PSD is damage to stroke-induced damage to specific brain regions. For example, patients who have had a lesion in the left frontal lobe or left basal ganglia often experience more depression than those with damage in other areas of the brain (13). Another potential cause of PSD is medication. Patients who experience hypertension after a stroke may be prescribed beta-blockers to reduce their blood pressure; however, they could face an increased risk of depression as a side effect (14). Although antidepressants are effective in treating PSD, their use is often limited by adverse drug reactions and poor patient compliance (15). With advancements of rehabilitation medicine, more and more medical practitioners are focusing on the rehabilitation of PSD.

Despite increasing scholars focusing on PSD rehabilitation, the research directions and hotspots in this field remain unclear. A comprehensive bibliometric analysis has yet to be conducted to systematically examine PSD rehabilitation. Bibliometric analysis quantitatively examines knowledge carriers using mathematical and statistical methods. This field merges mathematics, statistics, and bibliography, focusing on quantification (16). Bibliometrics, on the other hand, takes literature or literature-related media as the object of study and adopts mathematical, statistical, and different measurement methods to analyze quantitative relationship within the literature and explore the dynamic evolution of science and technology (17). VOSviewer and CiteSpace are the most commonly used tools for bibliometric analyses (18). In order to understand the overall landscape and development trends of PSD rehabilitation, this study statistically analyzes the published literature in this field. It aims to provide a comprehensive review of rehabilitation studies on PSD published from 2003 to the present, to explore the current status, research hotspots, and development trends in this field, and to identify emerging research directions. Additionally, this study provides scholars with intuitive information and guidance for future research.