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脑卒中后情绪和情感障碍的管理。

Management of post-stroke mood and emotional disturbances.

机构信息

a Department of Neurology , University of Ulsan, Asan Medical Center , Seoul , Republic of Korea.

出版信息

Expert Rev Neurother. 2017 Dec;17(12):1179-1188. doi: 10.1080/14737175.2017.1395281. Epub 2017 Oct 26.

Abstract

Mood and emotional disturbances are common in stroke patients. Out of diverse post-stroke emotional disturbances, depression, anxiety, emotional incontinence, anger proneness, and fatigue are frequent and important symptoms. These symptoms are distressing for both the patients and their caregivers, and negatively influence the patient's quality of life. The emotional symptoms are not apparent and are therefore often neglected by neurologists. Their phenomenology, predicting factors, and pathophysiology have been under-studied, and are under-recognized. In addition, well-designed clinical trials targeting on these symptoms are rare. Areas covered: This review will describe some of the most common or relevant post-stroke mood and emotional disturbances. The phenomenology, factors or predictors, and presumed etio-pathogenesis will be described. Current pharmacological and non-pharmacological management strategies of these diverse emotional disturbances will be discussed based on different pathophysiological mechanisms. Expert commentary: It is fortunate that these mood and emotional disturbances can be treated by various methods, including pharmacological and non-pharmacological therapy. To administer the appropriate therapy, we must understand the similarities and differences in the pathophysiological mechanisms associated with these emotional symptoms.

摘要

情绪和情感障碍在脑卒中患者中很常见。在各种脑卒中后情感障碍中,抑郁、焦虑、情感失禁、易激惹和疲劳是常见且重要的症状。这些症状给患者及其照护者带来困扰,并且会对患者的生活质量产生负面影响。这些情感症状并不明显,因此经常被神经科医生忽视。其表现、预测因素和病理生理学尚未得到充分研究,也未得到充分认识。此外,针对这些症状的精心设计的临床试验也很少。涵盖领域:本文将描述一些最常见或相关的脑卒中后情绪和情感障碍。将描述其表现、相关因素或预测因素以及推测的病因发病机制。根据不同的病理生理学机制,将讨论这些不同情感障碍的当前药物和非药物治疗策略。专家评论:幸运的是,这些情绪和情感障碍可以通过多种方法治疗,包括药物和非药物治疗。为了实施适当的治疗,我们必须了解与这些情感症状相关的病理生理学机制的异同。

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