中风后抑郁症:最新进展。

IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY
Robert G Robinson, Ricardo E Jorge, Sergio E Starkstein
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引用次数: 0

摘要

人们认识到脑卒中后存在神经精神障碍已有 100 多年的历史,但直到 20 世纪 70 年代才开始进行系统的对照研究。然而,临床上最重要的进展是卒中后抑郁(PSD)的治疗和预防。最近对治疗 PSD 的随机对照试验(RCT)进行的荟萃分析表明了抗抑郁药物的疗效。同样,预防 PSD 的随机对照试验也表明,与安慰剂相比,抗抑郁药能显著降低 PSD 的发病率。早期使用抗抑郁药治疗 PSD 似乎还能促进中风后身体和认知能力的恢复,并可提高存活率达 10 年之久。遗传和表观遗传变异、白质疾病、脑血管失调、神经可塑性改变以及谷氨酸神经递质的改变可能是相关的致病因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Poststroke Depression: An Update.

The presence of neuropsychiatric disorders after stroke has been recognized for more than 100 years, but controlled systematic studies did not begin until the 1970s. The most clinically important advances, however, have been in the treatment and prevention of poststroke depression (PSD). Recent meta-analyses of randomized controlled trials (RCTs) for the treatment of PSD have demonstrated the efficacy of antidepressants. Similarly, RCTs for the prevention of PSD have shown that antidepressants significantly decrease the incidence of PSD compared with placebo. Early treatment of PSD with antidepressants also appears to enhance both physical and cognitive recovery from stroke and may increase survival up to 10 years. Genetic and epigenetic variations, white matter disease, cerebrovascular deregulation, altered neuroplasticity, and changes in glutamate neurotransmission may be relevant etiological factors.

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来源期刊
CiteScore
5.30
自引率
3.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.
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