Research Advances in Multimodal Framework-Based Identification and Therapeutic Management of Post-Stroke Depression via the Microbiota-Gut-Brain Axis

Dec 22, 2025Neuropsychiatric Disease and Treatment

New Approaches to Identifying and Treating Post-Stroke Depression Through the Gut-Brain Connection Using Multiple Methods

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Abstract

Dysregulation of the may contribute to the pathogenesis of .

Patients with post-stroke depression often experience psychosocial impairments and behavioral manifestations that hinder rehabilitation.
Recent research indicates that communication pathways between gut microbiota and the central nervous system are involved in depression.
Identifying therapeutic targets through the microbiota-gut-brain axis could lead to new treatment strategies for post-stroke depression.
A proposed multimodal framework integrates neurobiology, gut microbiota, and Traditional Chinese Medicine approaches for treating this condition.
Advancements in neuroimaging, metabolomics, and microbiomics may enhance the identification of mechanisms associated with post-stroke depression.
Future studies should focus on large-scale cohorts and artificial intelligence to explore interactions of biomarkers related to this condition.

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Patients with 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 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.

Key numbers

27.5% to 62.5%

Prevalence of

Incidence of within the first three years after a stroke.

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Research Advances in Multimodal Framework-Based Identification and Therapeutic Management of Post-Stroke Depression via the Microbiota-Gut-Brain Axis

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Recent issues from the gut-brain axis brief