卒中后抑郁脑网络的研究进展

doi:10.3969/j.issn.1673-5765.2020.05.004

摘要/Abstract

摘要：

卒中后抑郁（post-stroke depression，PSD）是卒中后最常见的精神并发症，有近三分之一的卒中幸存者会罹患PSD。目前越来越多的证据支持脑网络的异常改变是导致PSD的神经生理病理基础。卒中局部病变不仅导致特定局部脑网络（情感网络、默认网络、突显网络、记忆控制网络等）发生重构，而且还可引发全脑脑网络拓扑结构的重塑。部分卒中患者在脑网络重塑过程中，情感相关的网络发生了特征性重构，最终导致脑功能的失常出现了临床抑郁症状，导致PSD的发生。本文就PSD的脑网络研究的最新进展进行综述，以探讨PSD的发病机制。

文章导读： 与情感相关的特定脑网络及全脑网络在卒中后发生重构，这是导致卒中后抑郁的关键发病机制。

关键词: 卒中; 卒中后抑郁; 连接体; 脑网络

Abstract:

Post-stroke depression (PSD) is the most common psychiatric complication after stroke, affecting nearly a third of stroke survivors. Emerging evidence supported that abnormal changes in brain networks are the neurophysiological basis of PSD. The focal brain lesions can not only result in the remodeling of some specific brain networks (such as affective network, default mood network, salience network, cognitive control network), but also the topological reorganization of the whole brain networks. During the remodeling of brain networks in some stroke patients, the abnormal changes of affective network can lead to partial brain dysfunction, and depression symptoms occurr, that’s PSD. In order to explore the pathogenesis of PSD, this article reviewed the latest research on brain networks in PSD.

Key words: Stroke; Post-stroke depression; Connectome; Brain network

李在望，党鸽，韩晶，王倩，郭毅. 卒中后抑郁脑网络的研究进展[J]. 中国卒中杂志, 2020, 15(05): 477-483.

LI Zai-wang, DANG Ge, HAN Jing, WANG Qian, GUO Yi. Emergency Thrombectomy for Acute Ischemic Stroke under the COVID-19 Epidemic[J]. Chinese Journal of Stroke, 2020, 15(05): 477-483.

参考文献

[1] LI L J，YAO X M，GUAN B Y，et al. Persistent

depression is a predictor of quality of life in stroke

survivors：results from a 5-year follow-up study of

a Chinese cohort[J]. Chin Med J（Engl），2019，132

（18）：2206-2212.

[2] BARTOLI F，LILLIA N，LAX A，et al. Depression

after stroke and risk of mortality：a systematic

review and meta-analysis[J]. Stroke Res Treat，2013，

2013（1）：862978.

[3] DWYER HOLLENDER K. Screening，diagnosis，

and treatment of post-stroke depression[J]. J

Neurosci Nurs，2014，46（3）：135-141.

[4] CARSON A J，MACHALE S，ALLEN K，et

al. Depression after stroke and lesion location：a systematic review[J]. Lancet，2000，356（9224）：

122-126.

[5] AYERBE L，AYIS S，WOLFE C D，et al. Natural

history，predictors and outcomes of depression after

stroke：systematic review and meta-analysis[J]. Br J

Psychiatry，2013，202（1）：14-21.

[6] YU L，LIU C K，CHEN J W，et al. Relationship

between post-stroke depression and lesion location：

a meta-analysis[J]. Kaohsiung J Med Sci，2004，20

（8）：372-380.

[7] PADMANABHAN J L，COOKE D，JOUTSA J，et

al. A human depression circuit derived from focal

brain lesions[J]. Biol Psychiatry，2019，86（10）：749-

758.

[8] SHI Y，ZENG Y，WU L，et al. A study of the brain

functional network of post-stroke depression in three

different lesion locations[J]. Sci Rep，2017，7（1）：

14795.

[9] ROBINSON R G. Neuropsychiatric consequences of

stroke[J]. Annu Rev Med，1997，48（1）：217-229.

[10] YANG S，HUA P，SHANG X，et al. A significant

risk factor for poststroke depression：the depressionrelated

subnetwork[J]. J Psychiatry Neurosci，2015，

40（4）：259-268.

[11] VATAJA R，LEPPAVUORI A，POHJASVAARA

T，et al. Poststroke depression and lesion location

revisited[J]. J Neuropsychiatry Clin Neurosci，2004，

16（2）：156-162.

[12] ANGELERI F，ANGELERI V A，FOSCHI N，et

al. Depression after stroke：an investigation through

catamnesis[J]. J Clin Psychiatry，1997，58（6）：261-

265.

[13] WANG Z，SHI Y，LIU F，et al. Diversiform

etiologies for post-stroke depression[J]. Front

Psychiatry，2018，9（1）：761.

[14] BOES A D，PRASAD S，LIU H，et al. Network

localization of neurological symptoms from focal

brain lesions[J]. Brain，2015，138（Pt 10）：3061-

3075.

[15] LEERGAARD T B，HILGETAG C C，SPORNS O.

Mapping the connectome：multi-level analysis of

brain connectivity[J]. Front Neuroinform，2012，6

（1）：14.

[16] LINDQUIST K A，WAGER T D，KOBER H，et

al. The brain basis of emotion：a meta-analytic

review[J]. Behav Brain Sci，2012，35（3）：121-143.

[17] ZHANG P，XU Q，DAI J，et al. Dysfunction of

affective network in post ischemic stroke depression：

a resting-state functional magnetic resonance

imaging study[J]. Biomed Res Int，2014，2014（1）：

846830.

[18] WANG Y L，YANG S Z，SUN W L，et al. Altered

functional interaction hub between affective network

and cognitive control network in patients with major

depressive disorder[J]. Behav Brain Res，2016，298

（Pt B）：301-309.

[19] ZHANG X F，HE X，WU L，et al. Altered functional

connectivity of amygdala with the fronto-limbicstriatal

circuit in temporal lobe lesion as a proposed

mechanism for poststroke depression[J]. Am J Phys

Med Rehabil，2019，98（4）：303-310.

[20] ZHANG P Y，WANG J，XU Q，et al. Altered

functional connectivity in post-ischemic stroke

depression：a resting-state functional magnetic

resonance imaging study[J]. Eur J Radiol，2018，100

（1）：156-165.

[21] RAICHLE M E，SNYDER A Z. A default mode of

brain function：a brief history of an evolving idea[J].

Neuroimage，2007，37（4）：1083-1090，discussion

1097-1089.

[22] RAICHLE M E. The brain's default mode network[J].

Annu Rev Neurosci，2015，38（1）：433-447.

[23] LIANG Y，YAO Y C，ZHAO L，et al. Topological

reorganization of the default mode network in

patients with poststroke depressive symptoms：a

resting-state fMRI study[J]. J Affect Disord，2020，

260（1）：557-568.

[24] SHI Y，ZENG Y，WU L，et al. A study of the brain

abnormalities of post-stroke depression in frontal

lobe lesion[J]. Sci Rep，2017，7（1）：13203.

[25] SEELEY W W. The salience network：a neural

system for perceiving and responding to homeostatic

demands[J]. J Neurosci，2019，39（50）：9878-9882.

[26] CHAND G B，DHAMALA M. The salience

network dynamics in perceptual decision-making[J].

Neuroimage，2016，134（1）：85-93.

[27] TOUROUTOGLOU A，BLISS-MOREAU E，

ZHANG J，et al. A ventral salience network in the

macaque brain[J]. Neuroimage，2016，132（1）：190-

197.

[28] BALAEV V，ORLOV I，PETRUSHEVSKY A，et

al. Functional connectivity between salience，default

mode and frontoparietal networks in post-stroke

depression[J]. J Affect Disord，2018，227（1）：554-

562.

[29] EGOROVA N，CUMMING T，SHIRBIN C，et al. Lower cognitive control network connectivity

in stroke participants with depressive features[J].

Transl Psychiatry，2018，7（11）：4.

[30] SCHULTZ D H，ITO T，SOLOMYAK L I，et al.

Global connectivity of the fronto-parietal cognitive

control network is related to depression symptoms

in the general population[J]. Netw Neurosci，2019，3

（1）：107-123.

[31] TOZZI L，GOLDSTEIN-PIEKARSKI A N，

KORGAONKAR M S，et al. Connectivity of the

cognitive control network during response inhibition

as a predictive and response biomarker in major

depression：evidence from a randomized clinical

trial[J]. Biol Psychiatry，2020，87（5）：462-472.

[32] XU X P，TANG R，ZHANG L P，et al. Altered

topology of the structural brain network in patients

with post-stroke depression[J]. Front Neurosci，2019，

13（1）：776.

[33] WATTS D J，STROGATZ S H. Collective dynamics

of 'small-world' networks[J]. Nature，1998，393

（6684）：440-442.

[34] CAO M，HUANG H，PENG Y，et al. Toward

developmental connectomics of the human brain[J].

Front Neuroanat，2016，10（1）：25.

[35] LIAO X，VASILAKOS A V，HE Y. Smallworld

human brain networks：perspectives and

challenges[J]. Neurosci Biobehav Rev，2017，77（1）：

286-300.

[36] IMMS P，CLEMENTE A，COOK M，et al. The

structural connectome in traumatic brain injury：a

meta-analysis of graph metrics[J]. Neurosci Biobehav

Rev，2019，99（1）：128-137.

[37] SUN C C，YANG F，WANG C F，et al. Mutual

information-based brain network analysis in poststroke

patients with different levels of depression[J].

Front Hum Neurosci，2018，12：285.

[38] LIU S，GUO J，MENG J Y，et al. Abnormal EEG

complexity and functional connectivity of brain

in patients with acute thalamic ischemic stroke[J].

Comput Math Methods Med，2016，2016（14）：

2582478.

[39] SPORNS O. Network attributes for segregation

and integration in the human brain[J]. Curr Opin

Neurobiol，2013，23（2）：162-171.