Work

Exploring new rehabilitation pathways for stroke based on the comorbidity of post-stroke hypoesthesia with anxiety and depression

Year: 2026

Type: article

Abstract: Background: Post-stroke hypoesthesia is a common yet often overlooked sequela, involving diminished capacities in touch, temperature, and pain perception. Recent studies suggest that sensory deficits not only hinder functional recovery but also show a high rate of comorbidity with anxiety and depression. Objective: This study aims to systematically integrate the neural mechanisms, perceptual processing features, and behavioral consequences of post-stroke hypoesthesia and emotional disorders, to explore their comorbid relationship and propose more targeted rehabilitation strategies based on these mechanisms. Methods: This review conducts an interdisciplinary literature search, integrating research from neuroimaging, cognitive neuroscience, and rehabilitation medicine, including 73 relevant studies. The keywords used in the screening are "Hypesthesia," "Impaired Sensation," "Anxiety," and "Depression," covering studies on sensory impairments and mood disorders. By comparing the sensory-emotion interaction mechanisms in stroke and non-stroke populations, a bidirectional model is constructed. Results: Findings indicate that post-stroke hypoesthesia results not only from structural damage in regions such as the thalamus, insula, and prefrontal cortex, but also from functional disruptions in perceptual processing. These impairments contribute to a closed-loop mechanism involving neural dysconnectivity and predictive coding dysfunction, which facilitates the emergence of anxiety and depression. In turn, these emotional disorders further suppress sensory recovery, significantly reducing patients' motivation and rehabilitation compliance. Conclusion: Post-stroke hypoesthesia should be recognized as a critical etiological and maintaining factor in anxiety and depression. The coexistence of pathological and functional mechanisms underscores the need for rehabilitation strategies that transcend the boundaries of perception, emotion, and cognition. Developing a rehabilitation pathway centered on "sensory-emotional co-regulation" can facilitate early identification, subtype-specific intervention, and comprehensive support for emotional comorbidities following stroke.

Source: PeerJ

DOI: 10.7717/peerj.20679