Bossù Paola, Salani Francesca, Cacciari Claudia, Picchetto Livio, Cao Marina, Bizzoni Federica, Rasura Maurizia, Caltagirone Carlo, Robinson Robert G, Orzi Francesco, Spalletta Gianfranco
Department of Clinical and Behavioral Neurology, Santa Lucia Foundation, Rome, Italy.
Curr Neurovasc Res. 2009 Aug;6(3):163-70. doi: 10.2174/156720209788970036. Epub 2009 Aug 1.
Stroke has been shown to lead to depressive disorders, anxiety disorders and other emotional consequences. Although the cause of these disorders is a subject of debate, stroke has clearly been shown to lead to the production of pro-inflammatory cytokines, which we hypothesized to play a role in the production of post-stroke emotional disorders. Thus we investigated here whether acute stroke might be associated with changes in the normal serum levels of IL-18 and if these changes were related to stroke severity, as well as to the presence and severity of alexithymia and depression. Thirty patients with a first-ever symptomatic ischemic stroke were included. Alexithymia (Toronto Alexithymia Scale; TAS-20), depression (Hamilton Depression Rating Scale; HDRS-17) and serum IL-18 were assessed. Stroke patients showed serum levels of IL-18 significantly related to stroke severity. Furthermore, a strong positive correlation was observed between IL-18 levels and severity of alexithymia, particularly among patients with right-hemisphere lesions. Specifically, circulating concentrations of IL-18 were significantly increased in patients with categorical alexithymia (TAS-20 score 61), as compared with both non alexithymic patients and control subjects. In addition, stroke was more severe in alexithymic patients, as compared to non alexithymic patients. Following multivariate regression, serum IL-18 levels appeared to be specifically associated with alexithymia rather than with stroke severity in patients with right-hemisphere lesions only. These results suggest that IL-18 might be specifically implicated in the pathogenesis of post-stroke alexithymia, ultimately contributing to impaired recovery from stroke.
中风已被证明会导致抑郁症、焦虑症和其他情绪后果。尽管这些疾病的病因存在争议，但中风已明确被证明会导致促炎细胞因子的产生，我们假设这些因子在中风后情绪障碍的产生中起作用。因此，我们在此研究急性中风是否可能与正常血清白细胞介素-18（IL-18）水平的变化有关，以及这些变化是否与中风严重程度、述情障碍和抑郁症的存在及严重程度相关。纳入了30例首次出现症状性缺血性中风的患者。评估了述情障碍（多伦多述情障碍量表；TAS-20）、抑郁（汉密尔顿抑郁评定量表；HDRS-17）和血清IL-18。中风患者的血清IL-18水平与中风严重程度显著相关。此外，观察到IL-18水平与述情障碍严重程度之间存在强正相关，特别是在右半球病变患者中。具体而言，与非述情障碍患者和对照组相比，在分类述情障碍患者（TAS-20评分≥61）中，循环中的IL-18浓度显著升高。此外，与非述情障碍患者相比，述情障碍患者的中风更严重。经过多变量回归分析，血清IL-18水平似乎仅在右半球病变患者中与述情障碍而非中风严重程度有特定关联。这些结果表明，IL-18可能特别参与中风后述情障碍的发病机制，最终导致中风恢复受损。
