Lan Duo, Song Siying, Jia Milan, Wang Mengqi, Jiao Baolian, Liu Yunhuan, Ding Yuchuan, Ji Xunming, Meng Ran
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100053, China.
J Clin Med. 2022 Nov 24;11(23):6927. doi: 10.3390/jcm11236927.
Background and purpose: Anxiety and depression are common in patients with Cerebral venous outflow disturbance (CVOD). Here, we aimed to explore possible mechanisms underlying this phenomenon. Methods: We enrolled patients diagnosed with imaging-confirmed CVOD, including internal jugular venous stenosis (IJVS) and cerebral venous sinus stenosis (CVSS) between 2017 and 2020. All of them had MRI/PWI scans. The Hamilton Anxiety Scale (HAMA) and 24-item Hamilton Depression Scale (HAMD) were used to evaluate the degree of anxiety and depression at the baseline and three months post-stenting. In addition, the relationships between the HAMA and HAMD scores, white matter lesions, and cerebral perfusion were analyzed using multiple logistic regressions. Results: A total of 61 CVOD patients (mean age 47.95 ± 15.26 years, 59.0% females) were enrolled in this study. Over 70% of them reported symptoms of anxiety and/or depression. Severe CVOD-related anxiety correlated with older age (p = 0.046) and comorbid hyperlipidemia (p = 0.005). Additionally, head noise, sleep disturbances, and white matter lesions (WMLs) were common risk factors for anxiety and depression (p < 0.05). WMLs were considered an independent risk factor for anxiety based on multiple regression analysis (p = 0.029). Self-contrast displayed that CVOD-related anxiety (p = 0.027) and depression (p = 0.017) scores could be corrected by stenting, as the hypoperfusion scores in the limbic lobes of patients with anxiety and depression were significantly higher than those in patients without. Conclusions: CVOD-induced hypoperfusion-mediated changes in the white matter microstructure may represent an underlying mechanism of anxiety and depression in patients with chronic CVOD.
焦虑和抑郁在脑静脉流出道障碍（CVOD）患者中很常见。在此，我们旨在探讨这一现象背后的可能机制。方法：我们纳入了2017年至2020年间经影像学确诊为CVOD的患者，包括颈内静脉狭窄（IJVS）和脑静脉窦狭窄（CVSS）。他们均进行了MRI/PWI扫描。采用汉密尔顿焦虑量表（HAMA）和24项汉密尔顿抑郁量表（HAMD）在基线和支架置入后三个月评估焦虑和抑郁程度。此外，使用多元逻辑回归分析HAMA和HAMD评分、白质病变与脑灌注之间的关系。结果：本研究共纳入61例CVOD患者（平均年龄47.95±15.26岁，59.0%为女性）。超过70%的患者报告有焦虑和/或抑郁症状。严重的CVOD相关焦虑与年龄较大（p = 0.046）和合并高脂血症（p = 0.005）相关。此外，头部杂音、睡眠障碍和白质病变（WMLs）是焦虑和抑郁的常见危险因素（p < 0.05）。基于多元回归分析，WMLs被认为是焦虑的独立危险因素（p = 0.029）。自身对照显示，CVOD相关焦虑（p = 0.027）和抑郁（p = 0.）评分可通过支架置入得到纠正，因为焦虑和抑郁患者边缘叶的灌注不足评分显著高于无焦虑和抑郁的患者。结论：CVOD引起的灌注不足介导的白质微观结构变化可能是慢性CVOD患者焦虑和抑郁的潜在机制。
