Research Hotspots and Trends on Post-Stroke Depression: a Bibliometric Analysis

doi:10.21203/rs.3.rs-3915747/v1

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Research Hotspots and Trends on Post-Stroke Depression: a Bibliometric Analysis

https://doi.org/10.21203/rs.3.rs-3915747/v1

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Post-stroke depression (PSD) is a common neuropsychiatric consequence of stroke that can negatively impact cognitive function, somatic function recovery, and patient survival. This paper utilized bibliometric and visualized analysis to explore current research hotspots and trends in this field to identify future clinical practice directions. Researchers utilized the Web of Science Core Collection (WoSCC) to extract papers on PSD and employed tools such as CiteSpace, VOSviewer, and Scimago Graphica to visually analyze the knowledge network of authors, institutions, countries/regions, journals, cited authors, cited references, cited journals, and keywords. A total of 850 papers were extracted from WoSCC, with Robinson, RG being identified as the most influential author in this area. The most prolific institution was Wenzhou Medical University, and China emerged as the leading country in producing research on PSD. Journal of Affective Disorders was found to be the most productive journal, with the primary keywords including poststroke depression, stroke, depression, and symptom. Co-citation analysis identified Robinson, RG as the leading researcher in PSD. The top-cited journal was Stroke, and the paper titled “Poststroke Depression: A Review” was ranked the most cited. Finally, “Neurosciences & Neurology” emerged as the most frequent study category. This study provided valuable information on the hotspot and frontier in PSD research, including potential partners and institutions, as well as reference points for future research topics and development directions.

post-stroke depression

bibliometric analysis

hotspots

research trends

Post-stroke depression (PSD) is a common mental complication that occurs in approximately one-third of all stroke survivors. It can occur in the acute phase, mid-term, and recovery phase after stroke, with incidence rates of 33%, 33%, and 34%, respectively [1, 2]. PSD can cause depressive and somatic symptoms, such as insomnia, decreased interest, and decreased appetite, and can even lead to suicidal thoughts [3]. A cohort study of 157,243 stroke patients revealed that 25.4% of them developed depression within two years [4]. Besides, in Asian stroke survivors, PSD reportedly affects approximately 26.6 to 29.1% [5]. Patients with PSD are reported to have higher mortality, poorer recovery, and lower quality of life for patients, their families, and society [6–9]. Notably, Women are more susceptible to PSD than men [10], and identifying risk factors is important. Accumulating evidence suggests that PSD development is influenced by various factors, including biological and psychosocial factors [11, 12]. Treatments for PSD include pharmacological interventions, rehabilitation physiotherapy, psychotherapy, and electroconvulsive interventions [13]. However, more than half of the patients don't experience remission after adequate treatment [14].

Although there is an abundance of literature on PSD, there is currently a lack of comprehensive global research to outline the research frontiers in this field. Therefore, our goal is to conduct a bibliometric analysis using CiteSpace (6.1.R6), VOSviewer (1.6.19), and Scimago Graphica (1.0.35) to establish a scientific reference for scholars [15–17]. By evaluating existing data, our aim is to assist researchers in identifying specific research topics, global trends, and hotspots in the field of PSD. By providing guidance for future academic endeavors in this field, we are eager to promote research and knowledge progression in this vital field of study.

Data Source and Search Strategies

WoSCC, recognized as the largest and most comprehensive academic resource database [18], was selected as the data source for this study, covering SCI-EXPANDED, SSCI, CCR-EXPANDED, and IC. The search strategy employed in this study was TI=(“post-stroke depression” OR “post stroke depression” OR “depression after stroke” OR “poststroke depression” OR “poststroke depressive disorder” OR “post-ischaemic depressive disorder” OR “post-ischemic depressive disorder” OR “post-stroke depressive disorder”), covering the period from the inception of the databases until December 27th, 2023. To ensure a systematic and comprehensive approach, two researchers independently executed a predefined search strategy to explore the literature. During the screening process, both researchers applied inclusion and exclusion criteria to the title and abstract of each article. Only articles and review articles met the inclusion criteria, while conference abstracts, editorial materials, letters, corrections, early access articles, conference papers, retractions, book chapters, retractions of publications, and news items were excluded. Furthermore, the study was restricted to articles published in English to maintain consistency (Fig. 1).

Bibliometric Analysis

Citespace, VOSviewer, and Scimago Graphica were employed for the purpose of data visualization in this study. Citespace was employed to carry out category analysis, keywords analysis, and dual-map overlay analysis. The magnitude of nodes represents the frequency of the item, with each node having a centrality number. Moreover, high centrality indicates a significant and crucial role in the network [19]. VOSviewer and Scimago Graphica were utilized to generate diagrams that illustrate collaboration among authors, institutions, countries/regions, journals, cited authors, cited references, and cited journals. All findings were visualized through images constructed by nodes and links. The size of the node is influenced by the number of documents and citations, while the links between nodes indicate cooperation among items. The quantity and thickness of the links disclose the level of interconnectedness among items [20]. Additionally, the color represents the publication year in VOSviewer, but indicates the total link strength (TLS) in Scimago Graphica. Furthermore, TLS is a significant parameter to measure the importance of an item in the network, with higher TLS signifying greater global influence and importance within the entire network [21].

Overview of the Included Publications

In the field of PSD research, a total of 850 papers were retrieved, spanning from 1999 to 2023, including 176 review and 674 articles (Fig. 2A). The number of citations for these papers ranged from 64 to 2026. The study included contributions from 4041 authors from 1134 institutions in 53 different countries/regions. The papers were published in 296 journals and cited a total of 20364 references from 4866 journals, involving 14664 cited authors. Table 1 presents a comprehensive list of leading authors, institutions, countries/regions, journals, cited authors, cited journals, cited references, categories, and keywords, ranked based on publication volume, citation frequency, TLS, number of keywords, and centrality.

Figure 2B presents an overview of the prevalence of research subjects in the field of PSD, highlighting Neurosciences & Neurology and Clinical Neurology as the two predominant subjects, comprising 370 and 249 papers, respectively. The year 2022 witnessed the highest number of publications, with a total of 99 papers being published. Among the identified papers, the most frequently cited publication emerged in 2005, accumulating a significant total of 2026 citations. Additionally, the paper with the highest average number of citations was published in 2005, garnering an impressive 144 citations (Fig. 2C).

Analysis of Authors, Institutions, and Countries/Regions

Figure 3 showcases the network of collaborative relationships among authors in the PSD research dataset. Only authors with at least 2 publications were considered, resulting in a cohort of 662 authors out of 4041 researchers included in the network analysis. As shown in Fig. 3A, Robinson, RG emerged as the most prolific contributor, with 21 papers, followed by Zhao, Xin with 17 papers. Figure 3B is the overlay map ranked by documents that change annually and Fig. 3C is the density map ranked by citations. Additionally, Lan, Yan (145), Li, Guo (145), Miao, Jinfeng (145), Qiu, Xiuli (145), Sun, Wenzhe (145), and Zhu, Zhou (145) all possess the same TLS in Fig. 3D, underscoring their pivotal role and notable influence in the field of study. It is noteworthy, however, that despite Robinson, RG's larger number of publications, his TLS is low, indicating limited impact and collaboration with others.

In this analysis, only institutions with 4 or more papers engaging in scientific research collaborations were considered, resulting in 105 out of 1134 institutions being included in the network analysis. Notably, as shown in Fig. 4A, Wenzhou Medical University emerges as the most prolific with the highest number of documents (28), followed closely by Capital Medical University (26), Chongqing Medical University (23), University of Iowa (21), and Huazhong University of Science and Technology (20). Besides, Fig. 4B is the overlay map ranked by documents that change annually and Fig. 4C is the density map ranked by citations. Looking at the TLS scores, the top 5 institutions are Capital Medical University (41), Nanjing Medical University (31), University of Notre Dame Australia (28), Southeast University (27), and the University of Western Australia (21) (Fig. 4D). Capital Medical University, ranking second in the number of publications, takes the lead in TLS, highlighting its significant research influence and authority in the field.

Total of 53 countries/regions participated in the study on PSD. Through the analysis of documents and the TLS per country/region, we can identify the influential countries/regions in this field and establish a collaborative network. According to Fig. 5A, China ranked first with the highest number of documents (474), followed by the United States (134), the United Kingdom (52), and Australia (49). Figure 5B is the overlay map ranked by documents that change annually and Fig. 5C is the density map ranked by citations. Moreover, the top four countries/regions in terms of TLS were the United States (70), China (59), Australia (55), and the United Kingdom (44) (Fig. 5D). It is noteworthy that the United States, China, Australia, and the United Kingdom ranked among the top four in both the number of publications and TLS. This ranking indicates that these countries are highly respected in scientific research and hold significant authority in the field.

Analysis of Journal and the Dual Journal Map Overlay

By conducting a comprehensive analysis of academic journals, we can gain valuable insights into their impact and academic reputation within the research field. In this particular analysis, only journals with a minimum of 6 citations were considered, resulting in 31 journals being included in the study out of a total of 269. According to Fig. 6A, the Journal of Affective Disorders emerged as the frontrunner with the highest number of documents at 40, followed by Medicine (39), Stroke (26), and Neuropsychiatric Disease and Treatment (24). Figure 6B is the overlay map ranked by documents that change annually and Fig. 6C is the density map ranked by citations. In terms of TLS, Stroke received the highest rating of 399, followed by the Journal of Affective Disorders (236), Frontiers in Psychiatry (147), and Medicine (141) (Fig. 6D). The significant ratings obtained by Stroke, Journal of Affective Disorders, and Medicine indicate their active involvement in PSD research and their close collaborations with other leading journals in the field.

Dual-map overlay analysis is a valuable approach for examining the transfer of knowledge among academic papers and tracking evolving trends within various disciplines. As shown in Fig. 6E, 3 major reference paths can be observed. Specifically, papers published in Molecular/Biology/Immunology, Psychology/Education/Health Economics/Economic/Political, and Neurology/Sports/Ophthalmology journals cited papers published in Economics/Economic/Political, Molecular/Biology/Genetics, and Psychology/Education/Social. This finding can serve as a useful reference for new researchers embarking on the depression field.

Analysis of Keywords

Keywords serve as succinct summaries of primary research content within an article and play a pivotal role in substantiating research focal points within a specific field. The incorporation of keywords enables researchers to navigate vast amounts of information more efficiently. In the present study, the most frequently encountered keywords include poststroke depression (469), stroke (458), depression (253), and symptom (174). Poststroke depression holds the highest count, indicating a close connection to the study's theme. Moreover, centrality indicators provide an accurate understanding of a keyword's significance and impact. The top 4 keywords in centrality were neuropsychological test (1.34), impact (1.04), cognitive impairment (0.97), and cognition (0.96) (Fig. 7A). These findings offer valuable insights to researchers regarding relevant keywords, enabling them to identify emerging trends and align their research with the current literature in the field.

Keyword clustering is a useful technique for analyzing the relationships between co-occurring keywords in a specific field. In this study, we used cluster analysis to examine the network of keywords related to PSD from 1999 to 2023. Figure 7B displays the generation of 14 clusters using the LLR algorithm. The modularity Q was 0.7357, and the mean silhouette S was 0.8756, confirming the strong and convincing clustering results. The 14 clusters were labeled as follows: #0 acute ischemic stroke, #1 protocol, #2 follow up, #3 meta-analysis, #4 anxiety, #5 mortality, #6 citalopram, #7 biomarker, #8 expression, #9 affective disorder, #10 post-stroke depression, #11 resting-state functional magnetic resonance, #12 depression, and #13 bdnf. Clusters #7, #8, #9, #11, and #13 included clinical diagnosis, while clusters #0, #10, and #12 represented complications associated with the topic. Clusters #6 covered treatment methods, while clusters #1, #3, and #5 included research methods and results. Clusters #2 and #4 were associated with symptoms of PSD. In summary, keyword clustering is a valuable tool for identifying relationships and patterns in a field, helping to categorize and organize academic literature.

The timeline view provides valuable insights into the changing trends and distinct stages of keywords in the field of PSD. By displaying the chronological occurrence of keywords, it enables researchers to monitor influential themes and comprehend the historical context of research in their area of interest. Upon analyzing the timeline, it becomes clear that the period from 1999 to 2005 marked the initial phase of PSD research. During this time, keywords such as cerebral infarction, quality of life, mood disorder, cognitive impairment, brain, functional recovery, cerebrovascular disorder, and poststroke depression were prominent. Between 2005 and 2015, new research topics emerged and gained attention in the field. Themes like c reactive protein, ischemic stroke, acupuncture, mortality, antidepressant treatment, and mechanism became focal points of investigation. Since 2015, the field has witnessed steady development, with the emergence of additional research topics such as gut microbiota, vitamin d, global burden, escitalopram, insulin resistance, inflammatory cytokine, hippocampal neurogenesis, and astrocyte. This phase indicates a growing diversification and exploration of various aspects related to PSD. Overall, the timeline view assists researchers in gaining a comprehensive understanding of the chronological progression of ideas in their field. It allows for the identification of key themes and the tracking of influential trends, enabling researchers to appreciate the transformative nature of research in their area over time (Fig. 7C).

Keyword bursts provides valuable insights into emerging trends and cutting-edge topics in specific fields, and offers important information for understanding the latest developments and guiding future research work. In Fig. 7D, the red line represents the start and end dates of the burst word, while the strength of the line indicates its degree of influence. The figure displays the top 20 keywords with the strongest citation bursts. Among the top 4 keywords with the highest strength, we find mood disorder (13,73), follow up (8.65), stroke patient (8.42), and nortriptyline (8.3). These keywords have witnessed significant interest bursts, indicating the focus of the field. Analyzing the duration of burst words, we discovered that mood disorder had a burst from 1999 to 2009, followed by follow up (1999 to 2010) and lesion location (1999 to 2006). T These persistent outbreaks highlight the enduring relevance and impact of these keywords on research in this field. Furthermore, the most recent burst words are impact, social support, mechanism, and post-stroke depression. The figure implies that the persistence of these outbreaks will continue, indicating ongoing interest and research focus in these fields.

Analysis of Co-Cited Author, Co-Cited Reference, and Co-Cited Journal

Co-citation analysis of authors highlights their outstanding stature and impact within the field. Only cited authors with 56 or more citations were included in this analysis, resulting in 61 authors out of a total of 14664. Notably, Robinson, RG (903) emerged as the most highly co-cited author, followed by Hackett, Ml (615), and Ayerbe, L (316). Furthermore, in terms of TLS, Robinson, RG (14142), Hackett, Ml (6757), and Morris, Plp (5324) ranked at the top. The top two authors with the highest co-citation counts also ranked at the top in terms of TLS, thereby demonstrating that their contributions have not only garnered extensive recognition but have also exerted a profound influence on the research landscape in this particular area (Fig. 8A).

Co-citation analysis of journals offers valuable insights into the significance of different journals and disciplines within the field. For this specific analysis, we focused on cited journals that had a minimum of 139 citations. Out of the total 4866 cited journals, 52 were selected for inclusion in the analysis. Among the top three co-cited journals, Stroke emerged as the leader with 3464 citations, followed by the American Journal of Psychiatry with 862 citations, and Journal of Affective Disorders with 822 citations. Furthermore, when assessing the TLS, which indicates the overall influence of journals based on co-citations, Stroke achieved the highest rank with a link strength of 93586. The American Journal of Psychiatry closely followed with a link strength of 27314, and The British Journal of Psychiatry secured the third position with a link strength of 23315. It is notable that the top two co-cited journals also ranked highest in terms of TLS, emphasizing their prestigious academic standing within the field (Fig. 8B).

Co-citation analysis of references provides valuable insights into the degree of interconnectedness among cited references in a given field. In this analysis, we focused on cited references that appeared 46 times or more out of a total of 20,364 cited references. A selection of 50 cited references was included in this analysis. The most-cited reference is “Poststroke Depression: A Review” published by Robinson, RG in American Journal of Psychiatry. The second most-cited paper is “Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies” published by Hackett ML in International Journal of Stroke. The third most-cited publication is “Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis” published by Ayerbe, L in British Journal of Psychiatry. The fourth most-cited publication is “Predictors of Depression after Stroke” published by Hackett, ML in Stroke. The fifth most-cited publication is “A rating scale for depression” published by Hamilton, MA in Journal of Neurology, Neurosurgery, and Psychiatry. These top five co-cited references also achieved the highest rankings in terms of TLS, emphasizing their esteemed academic status and significant contribution to the field of PSD (Fig. 8C).

In this study, we conducted a bibliometric analysis and utilized network visualization techniques to identify the most influential authors, institutions, countries/regions, journals, cited authors, cited journals, cited references, and keywords related to PSD. This is believed to be the first bibliometric analysis that provides both a historical perspective on scientific advancements in the field of PSD and sheds light on current research hotspots and clinical practice trends. These findings have significant implications for students, researchers, and practitioners in this field.

Co-authorship analysis is a valuable method for researchers to identify potential partnerships for future collaborations [22]. In the field of PSD, Robinson, RG and his collaborators (such as Jorge, RE., Kimura, M., Narushima, K., Moser, DJ., Arndt, S., and Spalletta, G) have played a leading role [23–27]. T Their research has made significant contributions to the field, including the discovery that antidepressants can significantly decrease the incidence of PSD compared to placebo. Early treatment with antidepressants for PSD also appears to enhance physical and cognitive recovery from stroke and may increase survival up to 10 years following stroke. Jorge has emphasized that future research should focus on identifying additional aspects of the mechanism of PSD to develop more specific therapeutic interventions [28]. Spalletta, G discovered that depression following acute stroke is also linked to higher levels of cognitive impairment and increased mortality. Furthermore, six double-blind controlled studies have demonstrated the effective treatment of PSD with antidepressants. They stated that in the future, the use of antidepressant treatment is expected to play a more significant role in managing patients with acute stroke. Additional research is required to uncover the mechanisms underlying depression and how antidepressants contribute to enhanced physical and cognitive recovery, as well as reduced mortality rates [29]. Starkstein, S conducted a randomized double-blind treatment trial, and the results suggest that nefiracetam could potentially serve as an effective treatment for stroke patients [30]. Additionally, Veselin indicated that individuals with a familial history of psychiatric disorder were one and a half times more likely to develop a poststroke depression compared to those without such a family history [31]. In summary, these studies hold significant importance in comprehending the pathogenesis of PSD, evaluating the effectiveness of antidepressant medications, and examining the influence of associated factors.

Among the 1134 institutions studying PSD, Wenzhou Medical University emerged as the leading contributor in China. The majority of papers were published in Asia and North America, followed by Europe, Oceania, and South America. China holds a prominent position in this field, with 474 papers, which is 3.5 times the number published in the United States. Among the top 9 research institutions, 7 are based in China, including Wenzhou Medical University, Capital Medical University, Chongqing Medical University, Huazhong University of Science and Technology, Nanjing Medical University, Southeast University, and Chinese University of Hong Kong. The United States ranked first in terms of published papers, demonstrating its significant influence and international collaboration in relevant research. Additionally, a country's academic capabilities can be influenced by factors such as economic status, government funding, publishing traditions, and renowned authors. The journal Journal of Affective Disorders published the greatest number of papers, underscoring its influence in this particular field.

Keywords are of paramount importance in scientific research as they convey the main content of relevant papers. The analysis of keyword co-occurrence offers insights into the proximity and prevalence of research topics in scientific domains. Based on our examination of co-occurring keywords, our findings indicate the research endeavors primarily concern treatment modalities and the underlying mechanisms of the disease.

Fluoxetine, electroacupuncture, nortriptyline, and citalopram are commonly used therapeutic drugs for treating depression. For instance, treatment with fluoxetine for 5 weeks has been shown to improve chronic unpredictable mild stress (CUMS) induced depressive-like behaviors in mice. Fluoxetine has been demonstrated to inhibit depression-induced necroptotic kinase activation, reverse the reduction in astrocytes and astrocytic necroptosis and dysfunction, decrease inflammatory cytokines, and upregulate brain-derived neurotropic factors and 5-HT1A levels [32]. Electroacupuncture is an effective and safe therapy used to treat multiple diseases such as Parkinson’s disease [33, 34], insomnia [35, 36], anxiety [37, 38], and depression [39, 40], chronic fatigue syndrome[41]. In a study by Lin, electroacupuncture was found to prevent astrocyte atrophy in the prefrontal cortex and alleviate depressive-like behavior in mice subjected to CUMS [42]. Moreover, Doxycycline combined with escitalopram has been shown to reverse depressive-like behavior and neuroinflammatory hippocampal alterations in the lipopolysaccharide model of depression [43].

For mechanism, the most studied is brain derived neurotrophic factor (BDNF). Chen's study indicated that overexpression of brain-derived neurotrophic factor in the hippocampus of rats with PSD alleviated depression-like behaviors [44]. Li also demonstrated a significant correlation between serum BDNF levels upon admission and the development of PSD within three months [45]. Inflammation is another mechanism involved in PSD. Wen provided insights into the pathogenesis of PSD by analyzing the dynamics of cytokines over time, revealing different patterns of inflammatory responses in patients with PSD at multiple time points. Furthermore, IFN-γ was suggested as a potential predictive biomarker for early-onset PSD [46]. Wang proposed that suppressing the expression of inflammatory cytokines could lead to a reduction in the severity of PSD [47]. Lastly, has been found to play a crucial role in PSD. Seyed FN supported the idea that increased oxidative stress in cerebral tissues during ischemia contributes to the development of PSD. Polyphenols were suggested to have a protective effect on neurons against oxidative stress, mitigating ischemic damage by inhibiting lipid peroxidation, interacting with nitric oxide generated by the vascular endothelium, and reducing inflammation [48]. The research findings above have identified treatment methods and mechanisms for PSD, which may improve patients' mood and brain function through modulation of neurotrophic factors, anti-inflammatory effects, and antioxidative mechanisms. Further investigation is needed to the explore treatment methods and various factors influencing the mechanisms and of PSD.

Cited references play a crucial role in identifying influential literature within a specific field. Highly cited references are often considered as seminal works with significant impact. The most frequently cited reference in this context is an article published by Robinson, RG in the American Journal of Psychiatry in 2016. Robinson, RG underscores that the primary focus in future research should be on elucidating additional aspects of the PSD mechanism, as this may pave the way for more targeted therapeutic interventions and potentially address or stave off other neuropsychiatric disorders stemming from stroke [28]. The paper with the second highest number of citations, authored by Hackett ML and published in the International Journal of Stroke in 2014, proposed that training in the use of validated depression screening tools should be provided to all clinical staff involved in stroke care. Furthermore, they emphasized the importance of creating a comfortable environment for discussing mood symptoms with stroke survivors. Additionally, Hackett ML noted the necessity for further large-scale clinical trials to identify simple and cost-effective strategies for managing depression following a stroke [49]. The third most cited paper, written by Ayerbe L and published in the British Journal of Psychiatry in 2013, focused on estimating the natural progression, predictors, and outcomes of depression after a stroke. Ayerbe and colleagues stressed the significance of identifying predictors of PSD to help clinicians identify patients at higher risk of experiencing this problem. The need for such identification was emphasized as it would enable clinical trials to focus on preventive interventions for PSD [50]. Overall, these highly cited papers highlight the importance of addressing PSD through further research, improved training for clinical staff, and identification of predictors of depression. By doing so, we can develop more effective preventive and therapeutic interventions, ultimately improving the overall outcomes and quality of life for stroke survivors.

As a bibliometric analysis, this study possesses two limitations. Firstly, although WoSCC is extensively employed as a search database, there is a potential for overlooking papers that are not indexed in this database. Moreover, as our study specifically concentrated on English literature, there is a possibility that we inadvertently excluded other relevant studies published in languages other than English.

This study unveils the escalating global reach of research on PSD. The number of publications has witnessed substantial growth, increasing from 9 in 2004 to 99 in 2022, implying a well-established and promising research domain. China and the United States have emerged as the leading forces in this area, and noteworthy collaborations among countries/regions have made significant contributions to the advancement of research. Research keywords such as “social support”, “mechanism”, “c-reactive protein” “interleukin 6” and “astrocyte” have emerged as hotspots, have garnered increasing attention, suggesting potential future research directions. Overall, this study offers a historical perspective on PSD, providing insights into prominent research authors, institutions, countries/regions, journals, focal points, and frontiers for further exploration in this field.

Acknowledgments

The authors would like to express their appreciation to WOS database for providing a platforms for researchers to upload their valuable datasets. Thanks for the Citespace, VOSviewer, and Scimago Graphica, which is very helpful for the analysis of our study results.

Conflict of Interest Statement

The authors have no conflicts of interest to declare

Funding Sources

This study was supported by the National Key Research and Development Project (Grant No. 2022YFC3500403); Key Project of Traditional Chinese Medicine Science and Technology Plan of Shandong Province (Grant No. Z-2023019).

Author contributions

Yuanxiang Liu and Jiguo Yang designed and supervised the study. Zhixia Jia wrote and revised the draft manuscript. Xuhao Li and Xingxin Wang developed the search strategy and searched the databases. Wenyan Yu and Jinling Li performed the literature search and data acquisition. All authors contributed to the article and approved the submitted version

Data Availability Statement

All data generated or analyzed during this study are included in this article. Further enquiries can bedirected to the corresponding author.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

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Robinson RG, Jorge RE, Clarence-Smith K (2008) Double-blind randomized treatment of poststroke depression using nefiracetam. Journal of Neuropsychiatry and Clinical Neurosciences 20 (2):178-184
JG F, K T, RG R (2007) Risk factors for and correlates of poststroke depression following discontinuation of antidepressants. Journal of Neuropsychiatry and Clinical Neurosciences 19 (4):399-405
Mikami K, Jorge RE, Moser DJ, Arndt S, Jang M, Solodkin A, Small SL, Fonzetti P, Hegel MT, Robinson RG (2011) Increased frequency of first-episode poststroke depression after discontinuation of escitalopram. Stroke 42 (11):3281-3283. doi:10.1161/strokeaha.111.626507
Robinson RG, Jorge RE (2016) Post-stroke depression: A review. American Journal of Psychiatry 173 (3):221-231. doi:10.1176/appi.ajp.2015.15030363
Robinson RG, Spalletta G (2010) Poststroke depression: A review. The Canadian Journal of Psychiatry 55 (6):341–349
Robinson RG, Jorge RE, Clarence-Smith K, Starkstein S (2009) Double-blind treatment of apathy in patients with poststroke depression using nefiracetam. Journal of Neuropsychiatry and Clinical Neurosciences 21 (2):144-151
Tenev VT, Robinson RG, Jorge RE (2008) Is family history of depression a risk factor for poststroke depression. The American Journal of Geriatric Psychiatry 17 (4):276-280
Zeb S, Ye H, Liu Y, Du H-P, Guo Y, Zhu Y-M, Ni Y, Zhang H-L, Xu Y (2023) Necroptotic kinases are involved in the reduction of depression-induced astrocytes and fluoxetine’s inhibitory effects on necroptotic kinases. Frontiers in Pharmacology 13. doi:10.3389/fphar.2022.1060954
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Table 1 The top author, institution, country/region, journal, cited author, cited journal, cited reference, category, and keyword, in terms of documents, citations, total link strength, count, and centrality

Items	R	L	D	R	L				C	R	L		TLS
Author	1	robinson, robert g.	21	1	hackett, maree l.				2951	1	lan, yan		145
	2	zhao, xin	17	2	robinson, robert g.				2501	2	li, guo		145
	3	lan, yan	15	3	jorge, ricardo e.				1643	3	miao, jinfeng		145
	4	li, guo	15	4	anderson, cs				1257	4	qiu, xiuli		145
	5	miao, jinfeng	15	5	williams, linda s.				912	5	sun, wenzhe		145
	6	qiu, xiuli	15	6	kaste, m				713	6	zhu, zhou		145
	7	sun, wenzhe	15	7	ayerbe, luis				623	7	zhao, xin		139
	8	ungvari, gabor sandor	15	8	wolfe, charles d. a.				582	8	zhu, suiqiang		136
	9	zhu, zhou	15	9	kosier, jt				531	9	pan, chensheng		121
Institution	1	wenzhou med univ	28	1	univ iowa				2501	1	capital med univ		41
	2	capital med univ	26	2	univ sydney				2319	2	nanjing med univ		31
	3	chongqing med univ	23	3	kings coll london				1039	3	univ notre dame australia		28
	4	univ iowa	21	4	univ cent lancashire				1009	4	southeast univ		27
	5	huazhong univ sci & technol	20	5	univ leeds				1000	5	univ western australia		21
	6	nanjing med univ	19	6	univ helsinki				866	6	univ macau		20
	7	southeast univ	15	7	irccs				699	7	chinese univ hong kong		19
	8	chinese univ hong kong	15	8	baylor coll med				633	8	china natl clin res ctr neurol dis		19
	9	soochow univ	15	9	indiana univ				549	9	suzhou univ		19
Country	1	china	474	1	china				6319	1	united states		70
	2	united states	134	2	united states				5730	2	china		59
	3	united kingdom	52	3	united kingdom				4080	3	australia		55
	4	australia	49	4	australia				3695	4	united kingdom		44
	5	italy	33	5	italy				2214	5	spain		24
	6	germany	29	6	canada				1279	6	italy		22
	7	south korea	28	7	finland				1171	7	germany		21
	8	canada	27	8	netherlands				989	8	iran		19
	9	japan	23	9	germany				975	9	canada		16
Journal	1	journal of affective disorders	40	1	stroke				3873	1	stroke		399
	2	medicine	39	2	journal of affective disorders				1016	2	journal of affective disorders		236
	3	stroke	26	3	journal of neurology neurosurgery and psychiatry				498	3	frontiers in psychiatry		147
	4	neuropsychiatric disease and treatment	24	4	neurology				458	4	medicine		141
	5	journal of stroke & cerebrovascular diseases	23	5	clinical rehabilitation				437	5	frontiers in neurology		123
	6	frontiers in psychiatry	22	6	journal of stroke & cerebrovascular diseases				351	6	topics in stroke rehabilitation		109
	7	frontiers in neurology	17	7	archives of physical medicine and rehabilitation				320	7	journal of stroke & cerebrovascular diseases		104
	8	international journal of geriatric psychiatry	16	8	cerebrovascular diseases				311	8	neuropsychiatric disease and treatment		95
Items	R	L				C	R	L				TLS
Cited-author	1	robinson, rg				903	1	robinson, rg				14142
	2	hackett, ml				615	2	hackett, ml				6757
	3	ayerbe, l				316	3	morris, plp				5324
	4	morris, plp				254	4	house, a				4201
	5	paolucci, s				207	5	andersen, g				4011
	6	house, a				193	6	starkstein, se				3818
	7	andersen, g				182	7	ayerbe, l				3500
	8	starkstein, se				178	8	paolucci, s				3450
	9	gainotti, g				162	9	gainotti, g				3167
Cited-journal	1	stroke				3464	1	stroke				93586
	2	am j psychiat				862	2	am j psychiat				27314
	3	j affect disorders				822	3	brit j psychiat				23315
	4	biol psychiat				692	4	j affect disorders				22627
	5	brit j psychiat				662	5	biol psychiat				20503
	6	j neurol neurosur ps				591	6	j neurol neurosur ps				20061
	7	neurology				433	7	neurology				14654
	8	int j stroke				432	8	arch gen psychiat				14653
	9	arch gen psychiat				416	9	arch phys med rehab				13999
Cited-reference	1	robinson rg, 2016, am j psychiat, v173, p221				191	1	hackett ml, 2005, stroke, v36, p2296				903
	2	hackett ml, 2014, int j stroke, v9, p1017				181	2	ayerbe l, 2013, brit j psychiat, v202, p14				896
	3	ayerbe l, 2013, brit j psychiat, v202, p14				169	3	hackett ml, 2014, int j stroke, v9, p1017				870
	4	hackett ml, 2005, stroke, v36, p2296				154	4	robinson rg, 2016, am j psychiat, v173, p221				816
	5	hamilton m, 1960, j neurol neurosur ps, v23, p56				129	5	hamilton m, 1960, j neurol neurosur ps, v23, p56				750
	6	villa rf, 2018, pharmacol therapeut, v184, p131				114	6	carson aj, 2000, lancet, v356, p122				729
	7	carson aj, 2000, lancet, v356, p122				107	7	astrom m, 1993, stroke, v24, p976				689
	8	astrom m, 1993, stroke, v24, p976				103	8	herrmann n, 1998, stroke, v29, p618				600
	9	loubinoux i, 2012, j cell mol med, v16, p1961				96	9	morris plp, 1993, am j psychiat, v150, p124				547
Items	R	Label				Co	R	L				Ce
Keywords	1	poststroke depression				469	1	neuropsychological test				1.34
	2	stroke				458	2	impact				1.04
	3	depression				253	3	cognitive impairment				0.97
	4	symptom				174	4	cognition				0.96
	5	predictor				102	5	disease				0.95
	6	major depression				101	6	gender difference				0.95
	7	lesion location				95	7	frequency				0.9
	8	disorder				93	8	caregiver				0.89
	9	risk factor				93	9	cerebral infarction				0.8
Categories	1	Neurosciences & Neurology				370	1	Neurosciences				0.46
	2	Clinical Neurology				249	2	Pharmacology & Pharmacy				0.39
	3	Psychiatry				246	3	Clinical Neurology				0.24
	4	Neurosciences				178	4	Cell Biology				0.17
	5	Medicine, General & Internal				80	5	Rehabilitation				0.16
	6	General & Internal Medicine				80	6	Health Care Sciences & Services				0.15
	7	Cardiovascular System & Cardiology				64	7	Psychiatry				0.14
	8	Peripheral Vascular Disease				62	8	Biochemistry & Molecular Biology				0.14
	9	Geriatrics & Gerontology				59	9	Public, Environmental & Occupational Health				0.13

Note:

R: Rank; L: Lable; D: Documents; C: Citations; TLS: Total link strength; Co: Count; Ce: centrality.

No competing interests reported.

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Research Hotspots and Trends on Post-Stroke Depression: a Bibliometric Analysis

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Introduction

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Data Source and Search Strategies

Bibliometric Analysis

Results

Overview of the Included Publications

Analysis of Authors, Institutions, and Countries/Regions

Analysis of Journal and the Dual Journal Map Overlay

Analysis of Keywords

Analysis of Co-Cited Author, Co-Cited Reference, and Co-Cited Journal

Discussion

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