脑卒中后抑郁与部位的相关性研究

Relationship between Poststroke Depression and Lesion Location

目的:探讨急性期脑卒中患者影像学改变在脑卒中后抑郁(PSD)患者中的相关性和临床意义,期望早期发现PSD患者并为及时干预提供帮助。方法:对329例急性脑卒中后1个月内患者采用系统的神经心理评估和MRI检查。所有患者均常规行汉密尔顿抑郁量表(HAMD)评分,根据头颅MRI结果分析病变部位。结果:PSD的发病率以左侧半球脑卒中患者明显高于双侧和右侧半球脑卒中患者,且左侧额叶和基底节尤为突出。不同病灶数目组间比较,PSD的发生率以多灶患者明显高于单灶患者(P<0.01)。结论:急性脑卒中后PSD与病变部位在左侧半球尤其是左侧额叶、颞叶和基底节区具有显著相关性。完全前循环梗死也是易患PSD的危险因素。

Aim： To investigate the correlation and clinical significance of magnetic resonance imaging and depression among acute stroke onset. It is expected to provide some help for early diagnosis and treatment of post-stroke depression. Methods： 329 patients underwent both extensive psychiatric evaluation and comprehensive MR/ratings in one month after acute stroke. The patients had been regularly tested by the Hamilton Depression Rating Scale for Depression（HAMD）, the lesion location was analyzed by MRI. Results： The lesion location in the left hemisphere of the brain has a higher morbidity than that in both sides or the right hemisphere, especially left frontal lobe and basal ganglia. There was a significant difference in the incidence of the PSD between the several lesion location and the single lesion location（P〈0.01）. Conclusion： Lesions affecting the left side, especially left frontal lobe and basal ganglia correlate with depression after acute stroke. Total anterior circulation infarct is a risk factor of PSD.