|
|
卒中后抑郁发病机制的研究进展
|
Abstract:
卒中后抑郁(PSD)是卒中患者中常见的神经心理障碍，其主要特征为持续的情绪和兴趣下降，并可降低患者在治疗过程中的依从性、主动性和积极性。PSD会导致康复效果差，影响日常生活，严重者甚至危及生命。尽管我们已对PSD的不利影响有了深入认识，但其确切的发病机制仍不明确，仍需进一步深入研究，以为临床PSD的预防和治疗提供参考。
Post stroke depression (PSD) is a common neurological and psychological disorder among stroke patients, characterized by sustained emotional and interest decline, and can reduce patients’ compliance, initiative, and positivity during the treatment process. PSD can lead to poor rehabilitation outcomes, affect daily life, and in severe cases, even endanger life. Although we have gained a deeper understanding of the adverse effects of PSD, its exact pathogenesis is still unclear and further in-depth research is needed to provide reference for the prevention and treatment of PSD in clinical practice.
| [1] | Lee, C., Jeon, S.H., Kim, M.J., Ra, G.D., Lee, Y., Hong, S.H., et al. (2021) Factors Affecting Post-Stroke Depression in Acute Ischemic Stroke Patients after 3 Months. Journal of Personalized Medicine, 11, Article 1178. https://doi.org/10.3390/jpm11111178 |
| [2] | Liu, L., Xu, M., Marshall, I.J., Wolfe, C.D., Wang, Y. and O’Connell, M.D. (2023) Prevalence and Natural History of Depression after Stroke: A Systematic Review and Meta-Analysis of Observational Studies. PLOS Medicine, 20, e1004200. https://doi.org/10.1371/journal.pmed.1004200 |
| [3] | Feng, C., Fang, M. and Liu, X. (2014) The Neurobiological Pathogenesis of Poststroke Depression. The Scientific World Journal, 2014, Article ID: 521349. https://doi.org/10.1155/2014/521349 |
| [4] | 李世明, 冯为, 崔凤伟, 等. 中国脑卒中后抑郁患病率meta分析[J]. 实用医学杂志, 2021, 37(16): 2058-2064. |
| [5] | Medeiros, G.C., Roy, D., Kontos, N. and Beach, S.R. (2020) Post-Stroke Depression: A 2020 Updated Review. General Hospital Psychiatry, 66, 70-80. https://doi.org/10.1016/j.genhosppsych.2020.06.011 |
| [6] | Ayerbe, L., Ayis, S., Crichton, S.L., Rudd, A.G. and Wolfe, C.D.A. (2014) Explanatory Factors for the Increased Mortality of Stroke Patients with Depression. Neurology, 83, 2007-2012. https://doi.org/10.1212/wnl.0000000000001029 |
| [7] | 潘爱琴, 张璇, 张冬林, 等. 脑卒中患者发生卒中后抑郁的危险因素研究进展[J]. 医药前沿, 2024, 14(31): 26-28. |
| [8] | 汪海潮, 毛森林, 王澎伟, 李峰. 卒中后抑郁的发病机制及危险因素的研究进展[J]. 中风与神经疾病杂志, 2023, 40(9): 785-788. |
| [9] | Gloria, M.U., Jonah, O.E., Olusanjo, A.C., Chiebuka, O.E., Nene, J.J., Nwakego, A.U., et al. (2024) Post-Stroke Depression and Suicidal Ideations: Relationship with Gender and Marital Status: A Cross Sectional Study. Journal of Primary Care & Community Health, 15, 1-7. https://doi.org/10.1177/21501319241233172 |
| [10] | Volz, M., Ladwig, S. and Werheid, K. (2019) Gender Differences in Post-Stroke Depression: A Longitudinal Analysis of Prevalence, Persistence and Predictive Value of Known Risk Factors. Neuropsychological Rehabilitation, 31, 1-17. https://doi.org/10.1080/09602011.2019.1648301 |
| [11] | De Ryck, A., Brouns, R., Geurden, M., Elseviers, M., De Deyn, P.P. and Engelborghs, S. (2014) Risk Factors for Poststroke Depression: Identification of Inconsistencies Based on a Systematic Review. Journal of Geriatric Psychiatry and Neurology, 27, 147-158. https://doi.org/10.1177/0891988714527514 |
| [12] | 李长红, 李辉. 脑卒中患者并发抑郁的危险因素分析[J]. 国际老年医学杂志, 2022, 43(5): 576-580. |
| [13] | Guo, W.Y., Zhang, Z.H., Mu, J.L., Liu, D., Zhao, L., Yao, Z.Y., et al. (2016) Relationship between 5-HTTLPR Polymorphism and Post-Stroke Depression. Genetics and Molecular Research, 15, 1-6. https://doi.org/10.4238/gmr.15017460 |
| [14] | Tang, W.K., Tang, N., Liao, C.D., Liang, H.J., Mok, V.C.T., Ungvari, G.S., et al. (2013) Serotonin Receptor 2C Gene Polymorphism Associated with Post-Stroke Depression in Chinese Patients. Genetics and Molecular Research, 12, 1546-1553. https://doi.org/10.4238/2013.may.13.8 |
| [15] | Fuying, Z., Yingying, Y., Shining, Z., Kezhong, Z., Yanyan, S., Xuemei, Z., et al. (2019) Novel Susceptibility Genes Were Found in a Targeted Sequencing of Stroke Patients with or without Depression in the Chinese Han Population. Journal of Affective Disorders, 255, 1-9. https://doi.org/10.1016/j.jad.2019.05.023 |
| [16] | 黄俊芳, 黄建敏, 蒙兰青, 李雪斌. 载脂蛋白E基因多态性、同型半胱氨酸对老年卒中后抑郁的预测价值[J]. 河北医科大学学报, 2018, 39(11): 1257-1261. |
| [17] | Zhao, F., Yue, Y., Jiang, H. and Yuan, Y. (2019) Shared Genetic Risk Factors for Depression and Stroke. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 93, 55-70. https://doi.org/10.1016/j.pnpbp.2019.03.003 |
| [18] | 韩瑾, 宋研博, 徐方飚, 等. 中医药调控BDNF/TrkB信号通路治疗卒中后抑郁的研究进展[J/OL]. 海南医学院学报: 1-28. https://doi.org/10.13210/j.cnki.jhmu.20241105.001, 2024-12-23. |
| [19] | 罗冬, 李国梁, 温慧军, 王军文. 系统性免疫炎症指数对急性缺血性卒中后抑郁的预测价值[J]. 中国卒中杂志, 2024, 19(2): 190-196. |
| [20] | Rosales, C. (2018) Neutrophil: A Cell with Many Roles in Inflammation or Several Cell Types? Frontiers in Physiology, 9, Article 113. https://doi.org/10.3389/fphys.2018.00113 |
| [21] | Su, M., Ouyang, X. and Song, Y. (2022) Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Monocyte to Lymphocyte Ratio in Depression: A Meta-Analysis. Journal of Affective Disorders, 308, 375-383. https://doi.org/10.1016/j.jad.2022.04.038 |
| [22] | Prinz, M., Jung, S. and Priller, J. (2019) Microglia Biology: One Century of Evolving Concepts. Cell, 179, 292-311. https://doi.org/10.1016/j.cell.2019.08.053 |
| [23] | Sullivan, G.M., Ogden, R.T., Huang, Y., Oquendo, M.A., Mann, J.J. and Parsey, R.V. (2013) Higher in vivo Serotonin-1A Binding in Posttraumatic Stress Disorder: A Pet Study with [11C]Way-100635. Depression and Anxiety, 30, 197-206. https://doi.org/10.1002/da.22019 |
| [24] | Zhang, X., Wang, C.-B., Duan, L.-H., Long, J.-J., Xiao, P., Wang, Y.-L., et al. (2023) Correlation Research of Serum Substance P, CCK-8, and 5-HT Values with Depression Levels in Stroke Survivors. European Review for Medical and Pharmacological Sciences, 27, 1248-1254. https://doi.org/10.26355/eurrev_202302_31357 |
| [25] | Zahrai, A., Vahid-Ansari, F., Daigle, M. and Albert, P.R. (2020) Fluoxetine-Induced Recovery of Serotonin and Norepinephrine Projections in a Mouse Model of Post-Stroke Depression. Translational Psychiatry, 10, Article No. 334. https://doi.org/10.1038/s41398-020-01008-9 |
| [26] | Wang, S., Zhang, Z., Guo, Y., Sui, Y. and Sun, Y. (2010) Involvement of Serotonin Neurotransmission in Hippocampal Neurogenesis and Behavioral Responses in a Rat Model of Post-Stroke Depression. Pharmacology Biochemistry and Behavior, 95, 129-137. https://doi.org/10.1016/j.pbb.2009.12.017 |
| [27] | Lin, C., Hashimoto, K. and Lane, H. (2019) Editorial: Glutamate-Related Biomarkers for Neuropsychiatric Disorders. Frontiers in Psychiatry, 10, Article 904. https://doi.org/10.3389/fpsyt.2019.00904 |
| [28] | Nicolo, J., O’Brien, T.J. and Kwan, P. (2019) Role of Cerebral Glutamate in Post-Stroke Epileptogenesis. NeuroImage: Clinical, 24, Article 102069. https://doi.org/10.1016/j.nicl.2019.102069 |
| [29] | Gruenbaum, B.F., Kutz, R., Zlotnik, A. and Boyko, M. (2020) Blood Glutamate Scavenging as a Novel Glutamate-Based Therapeutic Approach for Post-Stroke Depression. Therapeutic Advances in Psychopharmacology, vol. 10. https://doi.org/10.1177/2045125320903951 |
| [30] | 贾曼, 陈喆思, 李晓丹, 郭太品. 基于谷氨酸能系统障碍探讨针刺治疗卒中后抑郁的可能机制[J]. 中医学报, 2019, 34(7): 1405-1409. |
| [31] | Li, J., Sha, L. and Xu, Q. (2020) An Early Increase in Glutamate Is Critical for the Development of Depression-Like Behavior in a Chronic Restraint Stress (CRS) Model. Brain Research Bulletin, 162, 59-66. https://doi.org/10.1016/j.brainresbull.2020.05.013 |
| [32] | Frank, D., Kuts, R., Tsenter, P., Gruenbaum, B.F., Grinshpun, Y., Zvenigorodsky, V., et al. (2019) The Effect of Pyruvate on the Development and Progression of Post-Stroke Depression: A New Therapeutic Approach. Neuropharmacology, 155, 173-184. https://doi.org/10.1016/j.neuropharm.2019.05.035 |
| [33] | Guo, J., Wang, J., Sun, W. and Liu, X. (2021) The Advances of Post-Stroke Depression: 2021 Update. Journal of Neurology, 269, 1236-1249. https://doi.org/10.1007/s00415-021-10597-4 |
| [34] | 余蕾, 武文志, 张云桥, 等. HPA轴在抑郁症中的研究概述[J]. 昆明医科大学学报, 2023, 44(2): 166-171. |
| [35] | Villa, R.F., Ferrari, F. and Moretti, A. (2018) Post-Stroke Depression: Mechanisms and Pharmacological Treatment. Pharmacology & Therapeutics, 184, 131-144. https://doi.org/10.1016/j.pharmthera.2017.11.005 |
| [36] | Luo, L., Li, C., Du, X., Shi, Q., Huang, Q., Xu, X., et al. (2019) Effect of Aerobic Exercise on BDNF/proBDNF Expression in the Ischemic Hippocampus and Depression Recovery of Rats after Stroke. Behavioural Brain Research, 362, 323-331. https://doi.org/10.1016/j.bbr.2018.11.037 |
| [37] | Berretta, A., Tzeng, Y. and Clarkson, A.N. (2014) Post-Stroke Recovery: The Role of Activity-Dependent Release of Brain-Derived Neurotrophic Factor. Expert Review of Neurotherapeutics, 14, 1335-1344. https://doi.org/10.1586/14737175.2014.969242 |
| [38] | Zhang, E. and Liao, P. (2019) Brain‐Derived Neurotrophic Factor and Post‐Stroke Depression. Journal of Neuroscience Research, 98, 537-548. https://doi.org/10.1002/jnr.24510 |
| [39] | Youssef, M.M., Underwood, M.D., Huang, Y., Hsiung, S., Liu, Y., Simpson, N.R., et al. (2018) Association of BDNF Val66Met Polymorphism and Brain BDNF Levels with Major Depression and Suicide. International Journal of Neuropsychopharmacology, 21, 528-538. https://doi.org/10.1093/ijnp/pyy008 |
| [40] | Zhao, A., Ma, B., Xu, L., Yao, M., Zhang, Y., Xue, B., et al. (2021) Jiedu Tongluo Granules Ameliorates Post-Stroke Depression Rat Model via Regulating NMDAR/BDNF Signaling Pathway. Frontiers in Pharmacology, 12, Article 662003. https://doi.org/10.3389/fphar.2021.662003 |
| [41] | Jiang, W., Chen, J., Gong, L., Liu, F., Zhao, H., Yan, Z., et al. (2023) Microbiota-Derived Short-Chain Fatty Acids May Participate in Post-Stroke Depression by Regulating Host’s Lipid Metabolism. Journal of Psychiatric Research, 161, 426-434. https://doi.org/10.1016/j.jpsychires.2023.03.032 |
| [42] | 肖艾妮, 王翔宇, 刘聪杰, 等. 炎性标志物与卒中后抑郁的研究进展[J]. 临床医学研究与实践, 2024, 9(2): 195-198. |
| [43] | Guo, J., Wang, J., Xia, Y., Jiang, S., Xu, P., Tao, C., et al. (2022) Thyroid Function Affects the Risk of Post-Stroke Depression in Patients with Acute Lacunar Stroke. Frontiers in Neurology, 13, Article 792843. https://doi.org/10.3389/fneur.2022.792843 |
| [44] | Zhang, Y., Cheng, L., Chen, Y., Yang, G., Liu, J. and Zeng, L. (2016) Clinical Predictor and Circulating MicroRNA Profile Expression in Patients with Early Onset Post-Stroke Depression. Journal of Affective Disorders, 193, 51-58. https://doi.org/10.1016/j.jad.2015.12.061 |
| [45] | 王莉丽, 杨九州, 蔡效红, 崔向波. 血清GFAP、Hcy、NLR、炎症因子与脑卒中后抑郁的相关性分析[J]. 河南医学研究, 2023, 32(20): 3700-3704. |
