Zeng TF, Zhang JY, Wang XJ. Evaluation of the pathological cascade of post-subarachnoid hemorrhage anxiety and depression. World J Psychiatry 2026; 16(8): 116117 [DOI: 10.5498/wjp.v16.i8.116117]
Corresponding Author of This Article
Xue-Jian Wang, MD, PhD, Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, No. 666 Shengli Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. 6841441@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
letter
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
Zeng TF, Zhang JY, Wang XJ. Evaluation of the pathological cascade of post-subarachnoid hemorrhage anxiety and depression. World J Psychiatry 2026; 16(8): 116117 [DOI: 10.5498/wjp.v16.i8.116117]
World J Psychiatry. Aug 19, 2026; 16(8): 116117 Published online Aug 19, 2026. doi: 10.5498/wjp.v16.i8.116117
Evaluation of the pathological cascade of post-subarachnoid hemorrhage anxiety and depression
Teng-Fei Zeng, Jing-Yuan Zhang, Xue-Jian Wang
Teng-Fei Zeng, Xue-Jian Wang, Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, Nantong 226000, Jiangsu Province, China
Jing-Yuan Zhang, Department of Nursing Studies, Xinglin College, Nantong University, Nantong 226000, Jiangsu Province, China
Xue-Jian Wang, Department of Neurosurgery, Nantong First People’s Hospital Affiliated to Southeast University, Nanjing 210000, Jiangsu Province, China
Co-first authors: Teng-Fei Zeng and Jing-Yuan Zhang.
Author contributions: Zeng TF, Zhang JY, and Wang XJ contributed to reviewing and editing the manuscript; Zeng TF and Zhang JY contributed equally to this manuscript as co-first authors; Zhang JY and Wang XJ contributed to conceptualization and original manuscript draft. All authors have read and approved the final manuscript.
Supported by Science and Technology Program of Nantong City, No. Key003 and No. JCZ2022040; Science and Technology Program of Nantong Health Committee, No. MA2019003, No. MA2021017, and No. MSZ2024038; and Kangda College of Nanjing Medical University, No. KD2021JYYJYB025, No. KD2022KYJJZD022, No. KD2024KYJJ289, and No. KD2025JYYJZD009; Research Project on Teaching Reform of Nantong University, No. 2025J23; and Jiangsu Province Occupational Health Research Project, No. JSZJ20251217.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Xue-Jian Wang, MD, PhD, Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, No. 666 Shengli Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. 6841441@163.com
Received: November 2, 2025 Revised: December 14, 2025 Accepted: January 23, 2026 Published online: August 19, 2026 Processing time: 261 Days and 1.2 Hours
Abstract
Anxiety and depression disorders following subarachnoid hemorrhage (SAH) are common neuropsychological complications, which will definitely affect the long-term functional recovery and quality of life of patients. So far, the pathophysiological mechanisms of such complications have not been fully elucidated, and effective treatment strategies are lacking. This letter to the editor is a comment on a preclinical study conducted by Qin and other scholars. The research team established the SAH rat model, combined with multi-dimensional behavior detection, diffusion tensor imaging (DTI) scanning, inflammatory factor expression level detection and other methods to clarify the specific mechanism of emotional dysfunction after SAH. The study not only identified the temporal dynamic characteristics of emotional disorders, discovered a new pathological cascade of “cytotoxic edema - NOD-like receptor pyrin domain-containing 3 inflammasome activation - limbic-prefrontal circuit injury”, and verified the feasibility of diffusion tensor imaging parameters (fractional anisotropy/apparent diffusion coefficient values) and cerebrospinal fluid interleukin-1β as objective indicators for disease progression assessment. This article summarizes the core academic value of this study, and combined with the existing research progress in this field, further analyzes the reference value of this achievement for defining the intervention time window, the practical difficulties in the process of clinical transformation, and the possible breakthrough direction of follow-up research, in order to provide new ideas for the precise prevention and treatment of neuropsychiatric complications after SAH.
Core Tip: This study identified a novel pathological cascade of “cytotoxic edema - NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome activation - limbic-prefrontal circuit injury”, which is a key driver of anxiety and depression after subarachnoid hemorrhage. The contributions of this study are mainly reflected in threefold: (1) Quantified the time-dependent changes of emotional behavior, brain structure, and inflammatory response, among which diffusion tensor imaging parameters and cerebrospinal fluid interleukin-1β emerged as robust, objective biomarkers; (2) Confirmed that the NLRP3-interleukin-1β axis is a central regulatory node; and (3) Demonstrated translational potential: diffusion tensor imaging can be used for risk stratification, and NLRP3 inhibitors can be used as intervention methods.
