SynthesisFrontiers in neurology2025
Treatment of apathy in stroke patients: a systematic review.
Synthesis in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction: Post-stroke apathy is a prevalent yet frequently underdiagnosed neuropsychiatric syndrome, reported in up to one-third of stroke survivors, and is consistently associated with poorer functional recovery and cognitive decline. We aimed to review the current evidence on available pharmacological and non-pharmacological treatments for post-stroke apathy, and to evaluate their efficacy and safety. Methods: A systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42022332559). We searched PubMed, Web of Science, and Scopus for randomized and non-randomized clinical trials published until November 2024. Eligible studies included adults with ischemic or hemorrhagic stroke and a defined diagnosis of apathy. Interventions included pharmacological treatments and non-pharmacological strategies, such as neuromodulation techniques. Data extraction and risk of bias assessment were independently performed by two reviewers using the RoB-2 tool. Results: Ten clinical trials involving 2,359 patients were included. Pharmacological interventions with escitalopram and donepezil (alone or combined with intensive language action therapy) showed potential benefits. Nefiracetam yielded mixed results depending on dose and coexisting depression. Non-pharmacological approaches such as problem-solving therapy, motor relearning programs, strategy training, and complex rehabilitation programs demonstrated significant improvement in apathy scores. High-frequency repetitive transcranial magnetic stimulation also showed efficacy. However, heterogeneity in study design and apathy assessment scales limited direct comparisons. Conclusion: Several interventions, including escitalopram, donepezil, motor relearning programs, strategy training, and rTMS, have demonstrated potential effectiveness in treating post-stroke apathy. Nevertheless, evidence remains scarce and heterogeneous, underscoring the need for larger, high-quality randomized controlled trials to establish definitive treatment guidelines. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022332559.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.