Christos C Liapis, Despina Perrea, Maria Ginieri-Coccossis, Foteini Christidis, Ioannis Zalonis, Christos D Liapis
{"title":"[颈动脉血管重建对颈动脉高度狭窄患者情绪症状和生活质量的影响]。","authors":"Christos C Liapis, Despina Perrea, Maria Ginieri-Coccossis, Foteini Christidis, Ioannis Zalonis, Christos D Liapis","doi":"10.22365/jpsych.2023.003","DOIUrl":null,"url":null,"abstract":"<p><p>Carotid occlusive disease has been related to ischaemic strokes and cerebral hypoperfusion, thus affecting patients' quality of life, mainly because of cognitive decline and depressive symptoms. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may, postoperatively, have a positive impact on patients' quality of life and mental condition, though there have been also presented elusive findings and controversial results. The aim of the present study is to evaluate the effect of carotid revascularization (CEA, CAS) on patients' psychological condition and quality of life through a baseline and follow-up examination. We present data of a group of 35 patients (age range:60-80 years, ΜA=70,26-SD=9,05) with severe, left or right, carotid artery stenosis (>75%), presented with or without symptoms, who underwent surgical treatment with CEA or CAS. Baseline and follow-up (6 months post-surgery) evaluation was conducted in order to assess patients' depressive symptoms and quality of life, through completion of the Beck Depression Inventory and WHOQOL-BREF Inventory, respectively. No statistically significant (p < 0,05) effect of the revascularization process on mood or quality of life assessment could be documented for our patients, regardless of the applied technique (CAS or CEA). Our study supports existing evidence that all of the traditional vascular risk factors represent active participants in the inflammatory process, which has also been implicated in the pathophysiology of depression as well as in pathogenesis of atherosclerotic processes. Thus we have to illuminate new links between the two nosological entities, in the crossroads of psychiatry, neurology and angiology, through the pathways of inflammatory reactions and endothelium dysfunctions. Even though the effects of carotid revascularization on patient's mood and quality of life, are often characterized by opposing results, pathophysiological processes of \"vascular depression\" and \"post stroke depression\" remain a promising interdisciplinary medical domain, sharing both scientific and clinical interests between the fields of neurosciences and vascular medicine. Our results, regarding the bilateral connection of depression and carotid artery disease, advocate a most probable causality link between atherosclerotic process and depressive symptoms, rather than justifying a direct association between depressive disorders and carotid stenosis and inferred cerebral blood flow reduction per se.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[The effects of carotid revascularization on mood symptoms and quality of life in patients with high - grade carotid stenosis].\",\"authors\":\"Christos C Liapis, Despina Perrea, Maria Ginieri-Coccossis, Foteini Christidis, Ioannis Zalonis, Christos D Liapis\",\"doi\":\"10.22365/jpsych.2023.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Carotid occlusive disease has been related to ischaemic strokes and cerebral hypoperfusion, thus affecting patients' quality of life, mainly because of cognitive decline and depressive symptoms. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may, postoperatively, have a positive impact on patients' quality of life and mental condition, though there have been also presented elusive findings and controversial results. The aim of the present study is to evaluate the effect of carotid revascularization (CEA, CAS) on patients' psychological condition and quality of life through a baseline and follow-up examination. We present data of a group of 35 patients (age range:60-80 years, ΜA=70,26-SD=9,05) with severe, left or right, carotid artery stenosis (>75%), presented with or without symptoms, who underwent surgical treatment with CEA or CAS. Baseline and follow-up (6 months post-surgery) evaluation was conducted in order to assess patients' depressive symptoms and quality of life, through completion of the Beck Depression Inventory and WHOQOL-BREF Inventory, respectively. No statistically significant (p < 0,05) effect of the revascularization process on mood or quality of life assessment could be documented for our patients, regardless of the applied technique (CAS or CEA). Our study supports existing evidence that all of the traditional vascular risk factors represent active participants in the inflammatory process, which has also been implicated in the pathophysiology of depression as well as in pathogenesis of atherosclerotic processes. Thus we have to illuminate new links between the two nosological entities, in the crossroads of psychiatry, neurology and angiology, through the pathways of inflammatory reactions and endothelium dysfunctions. Even though the effects of carotid revascularization on patient's mood and quality of life, are often characterized by opposing results, pathophysiological processes of \\\"vascular depression\\\" and \\\"post stroke depression\\\" remain a promising interdisciplinary medical domain, sharing both scientific and clinical interests between the fields of neurosciences and vascular medicine. Our results, regarding the bilateral connection of depression and carotid artery disease, advocate a most probable causality link between atherosclerotic process and depressive symptoms, rather than justifying a direct association between depressive disorders and carotid stenosis and inferred cerebral blood flow reduction per se.</p>\",\"PeriodicalId\":20741,\"journal\":{\"name\":\"Psychiatrike = Psychiatriki\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychiatrike = Psychiatriki\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22365/jpsych.2023.003\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/2/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychiatrike = Psychiatriki","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22365/jpsych.2023.003","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/2/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
颈动脉闭塞性疾病与缺血性中风和脑灌注不足有关,从而影响患者的生活质量,主要原因是认知能力下降和抑郁症状。颈动脉血运重建技术(颈动脉内膜剥脱术(CEA)和颈动脉支架植入术(CAS))术后可能会对患者的生活质量和精神状况产生积极影响,但也有一些难以捉摸的发现和有争议的结果。本研究旨在通过基线和随访检查评估颈动脉血运重建术(CEA、CAS)对患者心理状况和生活质量的影响。我们提供了一组 35 位患者(年龄范围:60-80 岁,ΜA=70,26-SD=9,05)的数据,他们患有严重的左侧或右侧颈动脉狭窄(>75%),伴有或不伴有症状,接受了 CEA 或 CAS 手术治疗。对患者进行了基线和随访(术后 6 个月)评估,通过填写贝克抑郁量表和 WHOQOL-BREF 量表,分别评估患者的抑郁症状和生活质量。无论采用哪种技术(CAS 或 CEA),血管再通过程对患者情绪或生活质量评估的影响均无统计学意义(P < 0,05)。我们的研究支持现有的证据,即所有传统的血管风险因素都是炎症过程的积极参与者,而炎症过程也与抑郁症的病理生理学以及动脉粥样硬化过程的发病机制有关。因此,我们必须在精神病学、神经病学和血管病理学的交叉领域,通过炎症反应和内皮功能障碍的途径,阐明这两种病理实体之间的新联系。尽管颈动脉再通术对患者情绪和生活质量的影响往往是相反的,但 "血管性抑郁症 "和 "中风后抑郁症 "的病理生理过程仍然是一个很有前景的跨学科医学领域,神经科学和血管医学领域在科学和临床方面都有共同的兴趣。我们的研究结果表明,抑郁症与颈动脉疾病之间存在双向联系,因此动脉粥样硬化过程与抑郁症状之间很可能存在因果关系,而不是抑郁症与颈动脉狭窄和推断的脑血流量减少之间存在直接联系。
[The effects of carotid revascularization on mood symptoms and quality of life in patients with high - grade carotid stenosis].
Carotid occlusive disease has been related to ischaemic strokes and cerebral hypoperfusion, thus affecting patients' quality of life, mainly because of cognitive decline and depressive symptoms. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may, postoperatively, have a positive impact on patients' quality of life and mental condition, though there have been also presented elusive findings and controversial results. The aim of the present study is to evaluate the effect of carotid revascularization (CEA, CAS) on patients' psychological condition and quality of life through a baseline and follow-up examination. We present data of a group of 35 patients (age range:60-80 years, ΜA=70,26-SD=9,05) with severe, left or right, carotid artery stenosis (>75%), presented with or without symptoms, who underwent surgical treatment with CEA or CAS. Baseline and follow-up (6 months post-surgery) evaluation was conducted in order to assess patients' depressive symptoms and quality of life, through completion of the Beck Depression Inventory and WHOQOL-BREF Inventory, respectively. No statistically significant (p < 0,05) effect of the revascularization process on mood or quality of life assessment could be documented for our patients, regardless of the applied technique (CAS or CEA). Our study supports existing evidence that all of the traditional vascular risk factors represent active participants in the inflammatory process, which has also been implicated in the pathophysiology of depression as well as in pathogenesis of atherosclerotic processes. Thus we have to illuminate new links between the two nosological entities, in the crossroads of psychiatry, neurology and angiology, through the pathways of inflammatory reactions and endothelium dysfunctions. Even though the effects of carotid revascularization on patient's mood and quality of life, are often characterized by opposing results, pathophysiological processes of "vascular depression" and "post stroke depression" remain a promising interdisciplinary medical domain, sharing both scientific and clinical interests between the fields of neurosciences and vascular medicine. Our results, regarding the bilateral connection of depression and carotid artery disease, advocate a most probable causality link between atherosclerotic process and depressive symptoms, rather than justifying a direct association between depressive disorders and carotid stenosis and inferred cerebral blood flow reduction per se.