Association between neuroinflammatory biomarker levels and antidepressant treatment response in patients diagnosed with post-stroke depression — a systematic review using multicenter published clinician-authored evidence from Massachusetts General Hospital (Harvard Medical School), Michigan Medicine, UVA Health, and all the Teaching Hospitals in Ghana (KBTH, KATH, TTH, HTH, 37MH, CCTH).

Background. Post-stroke depression (PSD) is common and associated with worse functional outcomes; neuroinflammation (e.g., elevated cytokines) has been implicated in PSD pathogenesis and may influence antidepressant response. This systematic review examines the association between neuroinflammatory biomarker levels and antidepressant treatment response in PSD, synthesizing peer-reviewed literature and clinician-authored institutional evidence relevant to the hospitals named in the title.Methods. We searched PubMed/PMC, ClinicalTrials.gov, Google Scholar and institutional pages (MGH, Michigan Medicine, UVA Health, KBTH, KATH, TTH, HTH, 37MH, CCTH) through December 2025 for studies reporting (1) neuroinflammatory biomarkers in PSD and (2) biomarker correlations with antidepressant treatment response. We included observational cohorts, RCTs, and mechanistic studies. Data were extracted and narratively synthesized because heterogeneity precluded meta-analysis. Results. Multiple studies report elevated inflammatory markers (CRP, IL-6, TNF-α, IL-18) in PSD compared with nondepressed stroke survivors (Levada, 2018; Lu et al., 2024; Sørensen, 2025). A smaller subset of longitudinal studies found that higher baseline cytokine levels (notably IL-6, CRP) predict poorer antidepressant response, whereas reductions in cytokines during treatment correlate with clinical improvement in some cohorts (Qiu et al., 2022; Chen et al., 2018). No published, clinician-authored multicenter PSD biomarker studies specifically reporting antidepressant response outcomes were identified that were authored by teams at all the named hospitals jointly; however, clinician-authored Ghanaian PSD epidemiology and stroke cohort studies (Sarfo et al., 2017) and institutional resources at MGH/UVA/Michigan provide relevant clinical context for implementing biomarker-informed research.Conclusions. Evidence supports an association between neuroinflammatory activation and PSD and suggests that greater inflammatory burden may predict reduced antidepressant responsiveness in some patients, but findings are heterogeneous. There is an urgent need for prospective, multicenter studies — ideally linking biomarker measures with standardized antidepressant treatment protocols — including sites in the hospitals named in the title.