Sachdev Perminder S, Chen Xiaohua, Joscelyne Amy, Wen Wei, Brodaty Henry
School of Psychiatry, University of New South Wales, Academic Department for Old Age Psychiatry the Prince of Wales Hospital, Randwick, NSW, Australia.
Am J Geriatr Psychiatry. 2007 Jun;15(6):487-96. doi: 10.1097/JGP.0b013e3180581fe6.
To examine the structural abnormalities in the amygdala in stroke patients and see what contribution the amygdala may make to psychopathology and cognitive dysfunction related to stroke, because the amygdala has important roles in the processing of emotions, cognitive function, and psychiatric disorders.
The authors assessed 47 stroke/transient ischemic attack (TIA) patients 3-6 months after the event and 54 comparison healthy subjects, using neuropsychological tests, medical and psychiatric examination and magnetic resonance imaging (MRI) brain scans. Volumetric T1-weighted MRI was used to obtain amygdala volumes by manual tracing.
Stroke/TIA patients had smaller right amygdalar volume, more white matter hyperintensities (WMHs), and larger lateral ventricles. The amygdala was smaller in stroke/TIA patients with cognitive impairment compared to those without impairment. The right amygdala volume was negatively correlated with visual new learning and not related to depression, anxiety, irritability, agitation or apathy at baseline or 12-month follow-up. However, baseline amygdala volume was negatively correlated with Hamilton depression scores at 12 months in healthy comparison subjects. Hypertension and atrial fibrillation, and to a lesser extent WMHs, were predictors of amygdala volume.
The amygdala is smaller in stroke/TIA patients, especially in those with cognitive impairment. This may partly be accounted for by hypertension, white matter lesions, and atrial fibrillation. It is not related to psychopathology except that small amygdalae may increase vulnerability to depression.
研究中风患者杏仁核的结构异常，探讨杏仁核在与中风相关的精神病理学和认知功能障碍中可能起的作用，因为杏仁核在情绪处理、认知功能和精神疾病中具有重要作用。
作者对47例中风/短暂性脑缺血发作（TIA）患者在发病后3至6个月进行评估，并与54名健康对照者进行比较，采用神经心理学测试、医学和精神检查以及磁共振成像（MRI）脑部扫描。通过手动追踪，利用容积性T1加权MRI获取杏仁核体积。
中风/TIA患者右侧杏仁核体积较小，白质高信号（WMH）较多，侧脑室较大。与无认知障碍的中风/TIA患者相比，有认知障碍的患者杏仁核较小。右侧杏仁核体积与视觉新学习呈负相关，在基线或12个月随访时与抑郁、焦虑、易怒、激动或冷漠无关。然而，在健康对照者中，基线杏仁核体积与12个月时的汉密尔顿抑郁评分呈负相关。高血压和心房颤动，以及程度较轻的WMH，是杏仁核体积的预测因素。
中风/TIA患者的杏仁核较小，尤其是有认知障碍的患者。这可能部分归因于高血压、白质病变和心房颤动。除了较小的杏仁核可能增加患抑郁症的易感性外，它与精神病理学无关。
