卒中后抑郁与脑小血管病关系的研究进展

摘要/Abstract

摘要：

卒中后抑郁为卒中常见并发症之一，不仅影响患者的精神及神经功能恢复，甚至增加患者的病死率、致残率，对患者的预后产生消极影响。卒中后抑郁与病变部位、病变程度等存在一定程度的相关性，但近年来研究证实脑小血管病变同样与卒中后抑郁的发生密切相关，随着人口老龄化的加剧，脑小血管病的发病率随之增加，它不仅是卒中后抑郁发生的危险因素，并且会加重卒中后抑郁的严重程度。本文对脑小血管病与卒中后抑郁的关系做一综述。

文章导读： CVSD与PSD关系密切，关注CSVD及其在PSD发病中发挥的作用,可以为PSD的早期诊断、预防及治疗奠定重要的基础。

关键词: 卒中后抑郁; 脑小血管病; 脑白质疏松

Abstract:

The post-stroke depression (PSD) is one of the common complications after stroke. It not only affects the recovery of the psychiatric and neurological function in patients, but also increases mortality and morbidity, resulting in a negative influence for the prognosis in patients with stroke. There is a certain degree of correlation between the PSD and the lesion site, degree of pathological changes. But recent studies demonstrated that the cerebral small vessel diseases (CSVD) are also closely related to the occurrence of PSD. With the increasing of the aging population, the occurrence of the CSVD is raising. The CSVD is not only an important risk factor of PSD, but also increases the severity of PSD. In this article, we made a review of the relationship between CSVD and PSD.

Key words: Post-stroke depression; Cerebral small vessel diseases; Leukoaraiosis

明宝红1，郭阳2. 卒中后抑郁与脑小血管病关系的研究进展[J]. 中国卒中杂志, 2015, 10(04): 359-363.

MING Bao-Hong, GUO Yang.. Research Progress of Post-stroke Depression and Cerebral Small Vessel Diseases [J]. Chinese Journal of Stroke, 2015, 10(04): 359-363.

参考文献

参考文献

1 Köhler S, Hackett ML, O'Brien JT, et al. Neuropsychiatric outcomes of stroke--author's reply[J]. Lancet Neurol, 2014, 13:1168-1169.

2 Robinson RG. Poststroke depression:prevalence, diagnosis, treatment and disease progression[J]. Biol Psychiatry, 2003, 54:376-387.

3 脑小血管病诊治专家共识组. 脑小血管病的诊治专家共识[J]. 中华内科杂志, 2013, 52:893-896.

4 Camões Barbosa A, Sequeira Medeiros L, Duarte N, et al. Predictors of poststroke depression:a retrospective study in a rehabilitation unit[J]. Acta Med Port, 2011, 24:175-180.

5 Haq SU, Symeon C, Agius M, et al. Screening for depression in post stroke patients[J]. Psychiatr Danub, 2010, 22:s33-s35.

6 Zhang N, Wang CX, Wang AX, et al. Time course of depression and one-year prognosis of patiens with stroke in mainland China[J]. CNS Neurosci Ther, 2012, 18:475-481.

7 Bour A, Rasquin S, Aben I, et al. A one-year follow-up study into the course of depression after stroke[J]. J Nutr Health Aging, 2010, 14:488-493.

8 Loubinouxl, Kronenberg G, Endres M, et al. Poststroke depression:mechanisms, translation and therapy[J]. J Cell Mol Med, 2012, 16:1961-1969.

9 Berg A, Palomäki H, Lehtihalmes M, et al. Post-stoke depression:an 18-month follow-up[J]. Stroke, 2003, 34:138-143.

10 邵蓓丽, 林岩, 李焰生, 等. 卒中后抑郁障碍与血管性危险因素的相关性[J]. 神经病学与神经康复学杂志, 2010, 7:17-20.

11 Robinson RG, Spalletta G. Poststroke depression:a review[J]. Can J Psychiatry, 2010, 55:341-349.

12 Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease:insights from neuroimaging[J]. Lancet Neurol, 2013, 12:483-497.

13 Wiszniewska M, Devuyst G, Bogousslavsky J, et al. What is the significance of leukoaraiosis in patients with acute ischemic stroke[J]. Arch Neurol, 2000, 57:967-973.

14 Tang WK, Chen YK, Lu JY, et al. White matter hyperintensities in poststroke depression:a case control study[J]. J Neurol Neurosurg Psychiatry, 2010, 81:1312-1315.

15 钱俊枫, 张志, 钱方媛, 等. 缺血性卒中后抑郁与脑白质疏松关系的初步研究[J]. 中华神经医学杂志, 2013, 12:1043-1049.

16 祁晓媛. 腔隙性脑梗死与脑小血管病的关系[J]. 医学综述, 2013, 19:1613-1616.

17 Winblad B, Palmer K, Kivipelto M. Mild cognitive impairment:beyond controversies, towards a consensus:report for the International Working Group on Mild Cognitive Impairment[J]. J Intern Med, 2004, 256:240-246.

18 张君, 张春雷, 王维, 等, 腔隙性脑梗死患者卒中后抑郁的临床分析[J]. 临床神经病学杂志, 2012, 25:449-451.

19 Santos M, Gold G, Kövari E, et al. Differential impact of lacunes and microvascular lesions on poststroke depression[J]. Stroke, 2009, 40:3557-3562.

20 董春霞. 脑微出血的研究进展[J]. 中风与神经疾病杂志, 2013, 30:83-86.

21 柴超, 夏爽, 沈文. 脑微出血的空间与时间分布及对临床治疗的影响[J]. 国际医学放射学杂志, 2013, 36:324-327.

22 Koennecke HC. Cerebral microbleeds on MRI:prevalence, associations, and potential clinicial implications[J]. Neurology, 2006, 66:165-171.

23 Tang WK, Chen YK, Lu JY, et al. Cerebral microbleeds and depression in lacunar stroke[J]. Stoke, 2011, 42:2443-2446.

24 Tang WK, Chen YK, Lu JY, et al. Cerebral microbleeds and symptom severity of post-stroke depression:a magnetic resonance imaging study[J]. J Affect Disord, 2011, 129:354-358.

25 Rouhl RP, van Oostenbrugge RJ, Knottnerus IL, et al. Virchow-Robin spaces relate to cerebral small vessel disease severity[J]. J Neurol, 2008, 255:692-696.

26 Kwee RM, Kwee TC. Virchow-Robin spaces at MR imaging[J]. Radiographics, 2007, 27:1071-1086.

27 汤剑萍, 李焰生, 林岩, 等. 缺血性脑卒中患者抑郁状态与影像学改变的关系[J]. 中国卒中杂志, 2006, 1:466-469.

28 Vataja R, Pohjasvaara T, Leppävuori A, et al. Magnetic resonance imaging correlates of depression after ischemic stroke[J]. Arch Gen Psychiatry, 2001, 58:925-931.

29 Wu RH, Li Q, Tan Y, et al. Depresssion in silent lacunar infarction:a cross-sectional study of its association with location of silent lacunar infaction and vascular risk factors[J]. Neurol Sci, 2014, 35:1553-1559.

30 Tang WK, Chen Y, Liang H, et al. Cerebral microbleeds as a predictor of 1-year outcome of poststroke depression[J]. Stroke, 2014, 45:77-81.

31 Chatterjee K, Fall S, Barer D. Mood after stroke:a case control study of biochemical, neuro-imaging and socio-economic risk factors for major depression in stroke survivors[J]. BMC Neurol, 2010, 10:125.

[1]	郑占军, 赵性泉. 脑小血管病影像学标志物与自发性高血压脑出血的相关性研究进展[J]. 中国卒中杂志, 2022, 17(12): 1396-1402.
[2]	陈超, 万慧娟, 董文玉, 王圣松, 余苹, 邵晓秋. 脑小血管病总负荷与中老年癫痫患者认知功能的相关性[J]. 中国卒中杂志, 2022, 17(06): 622-627.
[3]	沈蓉, 周华, 赵中. 盐酸舍曲林预防性治疗卒中后抑郁的多中心研究[J]. 中国卒中杂志, 2022, 17(05): 510-515.
[4]	马佳丽, 王玉青, 王恺闻, 东晶晶, 李永秋. 脑小血管病总负荷的影响因素探索及临床预测模型建立[J]. 中国卒中杂志, 2022, 17(05): 523-528.
[5]	叶益超, 玉石, 佘亚军, 方正, 王毅. 血管性帕金森综合征的研究进展[J]. 中国卒中杂志, 2022, 17(04): 346-350.
[6]	朱翠婷, 胡文立. 头晕/眩晕患者脑小血管病总负荷的危险因素分析[J]. 中国卒中杂志, 2022, 17(04): 354-359.
[7]	陈政宇, 陈国芳, 陈彤, 马冬娇. 急性缺血性卒中静脉溶栓患者不同部位脑白质疏松的影响因素分析[J]. 中国卒中杂志, 2021, 16(12): 1248-1252.
[8]	薛晶, 张广, 孙宏巍, 翟蕴, 孙艳艳, 汤颖. 以细菌性脑膜炎为病因的合并脑小血管病影像表现的颅内深静脉血栓形成1例[J]. 中国卒中杂志, 2021, 16(12): 1273-1277.
[9]	任大为, 赵子珺, 果海姣, 杨保林, 陈旭, 付景娜, 赵亚争, 刘文丽, 刘佩云, 卫景沛. 卒中急性期NIHSS评分与卒中后抑郁相关性的meta分析[J]. 中国卒中杂志, 2021, 16(09): 930-939.
[10]	刘慧琳, 刘东涛, 卜乔, 李坤, 潘振宇, 范小伟, 周立春. 脑小血管病相关轻度认知功能障碍患者边缘系统微结构改变研究[J]. 中国卒中杂志, 2021, 16(08): 793-798.
[11]	中国研究型医院学会脑小血管病专业委员会《中国脑小血管病诊治专家共识》编写组. 中国脑小血管病诊治专家共识2021[J]. 中国卒中杂志, 2021, 16(07): 716-726.
[12]	秦伟，胡红梅，李譞婷，王韵，杨淑娜，胡文立. 青年缺血性卒中患者脑小血管病总负荷的危险因素分析[J]. 中国卒中杂志, 2021, 16(05): 470-474.
[13]	李丽君，张宁，陈琦，王春雪. 正念干预卒中后抑郁症状的meta分析[J]. 中国卒中杂志, 2021, 16(05): 502-507.
[14]	陆皓璇，马笑笑，娄昕. 高尿酸血症相关脑血管病的研究进展[J]. 中国卒中杂志, 2021, 16(05): 524-528.
[15]	孟利芳，彭雪，刘昊，王瑾，刘俊丽，贾祥磊，赵盼盼，王凡，王超伟，张黎军，李青，吉四辈，袁彬，蔡瑞艳，杨如，李少敏，赵建华（*第一作者）. 脑小血管病所致认知功能障碍与血清脑源性神经营养因子水平的相关性[J]. 中国卒中杂志, 2021, 16(04): 371-375.