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中国脑卒中后抑郁与病变部位的关联:一项系统评价与荟萃分析

Association of lesion location with post-stroke depression in China: a systematic review and meta-analysis.

作者信息

Luo Xinqun, Fang Wenhua, Ji Jiawu, Zhang Yong, Garcia-Milian Rolando, Wang Zhiren, Tan Yunlong, Wang Shibin, Wang Xiaoping, Guo Xiaoyun, Luo Xingguang

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China.

Department of Psychiatry, Fujian Medical University Affiliated Fuzhou Neuropsychiatric Hospital, Fuzhou, Fujian 350001, China.

出版信息

EC Psychol Psychiatr. 2023 Mar;12(3):34-45. Epub 2023 Feb 22.

Abstract

BACKGROUND

Post-stroke depression (PSD) is a mental health condition that can develop after a stroke, with a higher risk of death and negative outcomes. However, limited research has explored how PSD incidence relates to brain locations in Chinese patients. This study aims to fill this gap by examining the link between PSD occurrence and brain lesion location, as well as the type of stroke experienced by the patient.

METHODS

We conducted a systematic search in databases to gather post-stroke depression literature published between January 1, 2015 and May 31, 2021. Following this, we performed a meta-analysis using RevMan to analyze the incidence of PSD associated with different brain regions and types of stroke separately.

RESULTS

We analyzed seven studies, with a total of 1604 participants. Our findings indicated that the incidence of PSD was higher when the stroke occurred in the left hemisphere compared to the right hemisphere (RevMan: Z = 8.93, P <0.001, OR = 2.69, 95% CI: 2.16-3.34, fixed model); PSD was more common when the stroke affected the cerebral cortex rather than the subcerebral cortex (RevMan: Z = 3.96, P <0.001, OR = 2.00, 95% CI: 1.42-2.81) and when it affected the anterior cortex compared to the posterior cortex (RevMan: Z = 3.85, P <0.001, OR = 1.89, 95% CI: 1.37-2.62). However, we did not find a significant difference in the occurrence of PSD between ischemic and hemorrhagic strokes (RevMan: Z = 0.62, P = 0.53, OR = 0.02, 95% CI: -0.05-0.09).

CONCLUSIONS

Our findings revealed a higher likelihood of PSD in the left hemisphere, specifically in the cerebral cortex and anterior region.

摘要

背景

中风后抑郁症(PSD)是一种中风后可能出现的心理健康状况,具有较高的死亡风险和不良后果。然而,针对中国患者,关于PSD发病率与脑区关系的研究有限。本研究旨在通过考察PSD的发生与脑损伤部位以及患者所经历的中风类型之间的联系来填补这一空白。

方法

我们在数据库中进行了系统检索,以收集2015年1月1日至2021年5月31日期间发表的中风后抑郁症文献。在此之后,我们使用RevMan进行荟萃分析,分别分析与不同脑区和中风类型相关的PSD发病率。

结果

我们分析了7项研究,共有1604名参与者。我们的研究结果表明,与右侧半球相比,中风发生在左侧半球时PSD的发病率更高(RevMan:Z = 8.93,P <0.001,OR = 2.69,95% CI:2.16 - 3.34,固定模型);当中风影响大脑皮层而非大脑皮层下区域时(RevMan:Z = 3.96,P <0.001,OR = 2.00,95% CI:1.42 - 2.81)以及与后皮层相比影响前皮层时(RevMan:Z = 3.85,P <0.001,OR = 1.89,95% CI:1.37 - 2.62),PSD更为常见。然而,我们未发现缺血性中风和出血性中风在PSD发生方面存在显著差异(RevMan:Z = 0.62,P = 0.53,OR = 0.02,95% CI: - 0.05 - 0.09)。

结论

我们的研究结果显示,PSD在左侧半球,特别是在大脑皮层和前部区域发生的可能性更高。

相似文献

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Post-stroke depression and lesion location: a systematic review.中风后抑郁与病灶位置:一项系统综述
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Risk Factors for Post-stroke Depression: A Meta-analysis.中风后抑郁的危险因素:一项荟萃分析。
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本文引用的文献

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Cortical Plasticity in Depression.抑郁症中的皮质可塑性
ASN Neuro. 2017 May-Jun;9(3):1759091417711512. doi: 10.1177/1759091417711512.

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