基于神经递质图谱的卒中后抑郁患者个体化诊疗探索——2例病例报道OA

Post-stroke depression(PSD)patients often exhibit significantly reduced 5-hydroxytryptamine(5-HT)levels.This alteration is closely associated with stroke-induced disruption of neural pathways and metabolic abnormalities.Serotonin-selective reuptake inhibitors(SSRIs),such as sertraline,the first-line antidepressant drugs,selectively inhibit presynaptic 5-HT reuptake,thereby increasing synaptic 5-HT concentrations.This case report describes two cases of ischemic PSD.Using molecular imaging techniques,the stroke lesions and affected nuclei were mapped onto 5-HT receptor/transporter density atlases,and accordingly identified presynaptic and postsynaptic injury subtypes.The results showed that the two patients presented with presynaptic injury and postsynaptic injury,respectively,suggesting that different PSD subtypes may exhibit differential response to sertraline in antidepressant treatment.This case report provides novel insights for developing precise diagnostic subtypes and individualized treatment strategies for PSD.