Yan FL, Chen JX, Gong YW. Neuropsychiatric risk stratification in post-stroke anxiety and depression. World J Psychiatry 2026; 16(11): 117870 [DOI: 10.5498/wjp.117870]
Corresponding Author of This Article
You-Wen Gong, MD, Professor, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), No. 818 Renmin Road, Changde 415000, Hunan Province, China. 1755144149@qq.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Yan FL, Chen JX, Gong YW. Neuropsychiatric risk stratification in post-stroke anxiety and depression. World J Psychiatry 2026; 16(11): 117870 [DOI: 10.5498/wjp.117870]
World J Psychiatry. Nov 19, 2026; 16(11): 117870 Published online Nov 19, 2026. doi: 10.5498/wjp.117870
Neuropsychiatric risk stratification in post-stroke anxiety and depression
Fang-Ling Yan, Jia-Xin Chen, You-Wen Gong
Fang-Ling Yan, Jia-Xin Chen, You-Wen Gong, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Co-first authors: Fang-Ling Yan and Jia-Xin Chen.
Author contributions: Yan FL and Chen JX contributed equally and are designated as co-first authors; Gong YW designed the study and provided overall supervision; Gong YW critically revised the manuscript and completed the final version; all authors drafted, read and approved the final manuscript.
AI contribution statement: Only limited use was made of AI-based language tools (such as ChatGPT and similar language editing tools) for language polishing, including grammar correction, sentence reorganization, and improvement of academic expression. These tools did not have any impact on scientific content, explanations, or conclusions. All data analysis (if applicable) was conducted using standard statistical software and established analysis methods. No AI tools were used for data analysis. All charts/images (if any) were drawn by the author using conventional tools or derived from the original data. No images generated by AI were included.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: You-Wen Gong, MD, Professor, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), No. 818 Renmin Road, Changde 415000, Hunan Province, China. 1755144149@qq.com
Received: December 18, 2025 Revised: January 8, 2026 Accepted: January 22, 2026 Published online: November 19, 2026 Processing time: 315 Days and 18.1 Hours
Abstract
Ischemic stroke is increasingly recognized not only as a cerebrovascular event but also as a neuropsychiatric condition, with up to one-third of survivors developing significant anxiety or depression. The recent study by Zhao et al published in World Journal of Psychiatry provides important mechanistic insight into how structural, inflammatory, and neuroendocrine disturbances converge to shape post-stroke emotional outcomes. By integrating neuroimaging, clinical phenotyping, and biomarker profiling in patients, the authors identify a multidimensional vulnerability architecture connecting frontal-limbic infarcts, hemispheric lateralization, and white matter disruption with elevated interleukin-6, tumor necrosis factor-alpha, and cortisol, alongside reduced IGF-1. These interacting pathways highlight neuroinflammation- and HPA-axis-driven circuit dysfunction as central processes underlying early post-stroke affective disturbances. The study advances the field by demonstrating that neural circuit injury and cross-system biological dysregulation can be quantified to form clinically meaningful risk indicators, positioning inflammatory markers, cortisol rhythms, and lesion topology as potential early screening tools. Clinically, it underscores the need for integrated neuropsychiatric assessment and timely interventions targeting both biological and psychosocial pathways in the acute recovery window. Future translational work combining longitudinal imaging with biomarker panels may enable precision risk stratification and personalized prevention strategies for post-stroke anxiety and depression.
Core Tip: Anxiety and depression following stroke remain under-recognized contributors to long-term disability. Emerging evidence suggests these symptoms reflect quantifiable neurobiological disruptions rather than secondary reactions to impairment. This editorial argues that neuropsychiatric risk stratification—integrating lesion characteristics, neuroinflammatory biomarkers, autonomic indices, and early behavioral markers—should become a routine component of post-stroke management.
