Wei Na, Yong Wu, Li Xinyan, Zhou Yafan, Deng Manfei, Zhu Houze, Jin Huijuan
Institute of Brain Research, Huazhong University of Science and Technology, Wuhan, 430030, China.
J Neurol. 2015 Jan;262(1):81-90. doi: 10.1007/s00415-014-7534-1. Epub 2014 Oct 12.
Post-stroke depression (PSD) is a frequent problem in stroke rehabilitation. Several studies have evaluated association between the lesion location and the risk of depression. Different conclusions and contradictory findings have been published. The aim of the present study was to perform a systematic meta-analysis to evaluate the relationship between PSD and lesion location. We researched PubMed, ISI Web of Science, EMBASE, and systematically reviewed available publications reporting investigations on stroke location and risk of PSD. Subgroup analyses were performed according to the time since stroke onset to assessment for PSD or the source of patients. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used for pooled analyses. Heterogeneity was assessed with Cochran's Q test and I (2) test. Begg's funnel plot and Egger's test were used to examine the publication bias. A total of 43 studies involving 5,507 patients suffering from stroke were included in this meta-analysis. The pooled OR with 95 % CI for the overall association of stroke location and depression risk was 0.99 (0.88-1.11). Subgroups analyses highlighted that only studies with subacute post-stroke group (1-6 months) showed a statistical association between right hemisphere stroke and risk of depression (OR = 0.79, 95 % CI 0.66-0.93). This systematic review offered no support for the hypothesis that lesion of the left hemisphere was associated with an increased risk of depression after stroke. We only find significant association between right hemisphere stroke and incidence of depression for studies within subacute post-stroke phase.
中风后抑郁（PSD）是中风康复中常见的问题。多项研究评估了病变部位与抑郁风险之间的关联。已发表了不同的结论和相互矛盾的研究结果。本研究的目的是进行系统的荟萃分析，以评估PSD与病变部位之间的关系。我们检索了PubMed、ISI Web of Science、EMBASE，并系统回顾了报告中风部位与PSD风险调查的现有出版物。根据中风发作至PSD评估的时间或患者来源进行亚组分析。采用比值比（OR）和95%置信区间（CI）进行汇总分析。用Cochran's Q检验和I²检验评估异质性。用Begg漏斗图和Egger检验检查发表偏倚。本荟萃分析共纳入43项研究，涉及5507例中风患者。中风部位与抑郁风险总体关联的合并OR（95%CI）为0.99（0.88 - 1.11）。亚组分析强调，只有中风后亚急性期（1 - 6个月）的研究显示右半球中风与抑郁风险之间存在统计学关联（OR = 0.79，95%CI 0.66 - 0.93）。本系统评价不支持左半球病变与中风后抑郁风险增加相关的假设。我们仅发现中风后亚急性期的研究中右半球中风与抑郁发生率之间存在显著关联。
