Early emotional interventions for post-stroke functional prognosis: a systematic review and meta-analysis

Area of Science:

• Neuroscience
• Psychiatry
• Rehabilitation Medicine

Background:

• Post-stroke emotional disorders (PSEDs) negatively impact functional recovery after stroke.
• Optimal early intervention strategies for PSEDs remain unclear.

Purpose of the Study:

• To evaluate the efficacy of early emotional interventions on functional outcomes in stroke patients.
• To compare the benefits of different intervention types and initiation timings.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) up to November 2025.
• Included adults with acute/subacute stroke (≤ 3 months) receiving pharmacological, psychological, neuromodulation, or combined emotional interventions.
• Primary outcome: change in Barthel Index (BI) score at follow-up.

Main Results:

• Thirty-eight RCTs (n=12,020) showed interventions improved BI scores (WMD: 6.8; 95% CI: 5.2-8.4) compared to control.
• Cognitive behavioral therapy (WMD: 8.2), combined interventions (WMD: 9.1), rTMS (WMD: 6.5), and SSRIs (WMD: 4.2) demonstrated significant benefits.
• Interventions initiated within 2 weeks post-stroke showed greater improvement (WMD: 10.3) than later initiation (WMD: 5.8).

Conclusions:

• Early emotional interventions significantly enhance functional recovery post-stroke.
• Cognitive behavioral therapy and combined interventions initiated within 2 weeks offer the most substantial benefits.
• Findings support integrating targeted emotional interventions into standard early stroke care.