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心力衰竭与抑郁症之间的神经影像学联系——一项叙述性综述

Neuroimaging Links Between Heart Failure and Depression-A Narrative Review.

作者信息

Deste Giacomo, Lombardi Carlo, Gasparotti Roberto, Vita Antonio, Corbo Daniele

机构信息

Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Department of Mental Health and Addiction Services, ASST Valcamonica, 25040 Esine, Italy.

出版信息

Brain Sci. 2024 Dec 20;14(12):1283. doi: 10.3390/brainsci14121283.

Abstract

BACKGROUND AND OBJECTIVE

It is commonly known that there is a connection between heart disease and depression symptoms. Compared to heart failure patients without concurrent depression, those with depressive symptoms are more likely to have longer hospital stays and more outpatient visits following discharge. Although the exact neurobiological mechanisms causing the correlation between heart disease and depression symptoms are unknown, it is thought that vascular abnormalities may be a major factor. The purpose of this review was to examine the connection between brain networks linked to depression and heart failure (HF).

METHODS

PRISMA guidelines were followed. We included studies that reported both heart failure as well as depression and neuroimaging.

RESULTS

We identified 159 papers, but only 12 articles were included. Our findings show that reduced cerebral blood flow (CBF) following HF, along with other contributing factors such as chronic inflammation and neurovascular dysfunction, can lead to significant brain tissue damage and disruption of neural networks. The resulting alteration in the brain increases the risk of developing depression, as the neural circuits responsible for emotional regulation become compromised.

CONCLUSIONS

Individuals with heart failure (HF) exhibit reduced regional cerebral blood flow across multiple brain areas, many of which are critical for mood regulation and are commonly implicated in depression, such as the left frontal cortex and right hippocampus.

摘要

背景与目的

众所周知,心脏病与抑郁症状之间存在关联。与没有并发抑郁症的心力衰竭患者相比,有抑郁症状的患者更有可能住院时间更长,出院后门诊就诊次数更多。尽管导致心脏病与抑郁症状之间相关性的确切神经生物学机制尚不清楚,但人们认为血管异常可能是一个主要因素。本综述的目的是研究与抑郁症相关的脑网络与心力衰竭(HF)之间的联系。

方法

遵循PRISMA指南。我们纳入了既报告心力衰竭又报告抑郁症和神经影像学的研究。

结果

我们识别出159篇论文,但仅纳入了12篇文章。我们的研究结果表明,心力衰竭后脑血流量(CBF)减少,以及慢性炎症和神经血管功能障碍等其他促成因素,可导致显著的脑组织损伤和神经网络破坏。大脑由此产生的改变增加了患抑郁症的风险,因为负责情绪调节的神经回路受到了损害。

结论

心力衰竭(HF)患者在多个脑区的局部脑血流量减少,其中许多脑区对情绪调节至关重要,并且通常与抑郁症有关,如左侧额叶皮质和右侧海马体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be23/11674504/e4486dbcd533/brainsci-14-01283-g001.jpg

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