摘要
A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertensionand diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.
A number of studies have assessed the influence ofdepression on the risk of cardiovascular disease. Agrowing literature indicates a link between depressionand cerebrovascular events, although the direction ofthis association remains unclear. Numerous data haveemerged suggesting an association between depressivesymptoms and subsequent risk of stroke, thusleading to the hypothesis that a direct causality betweendepression and stroke exists. Notwithstanding,how depression may act as a risk factor for stroke isstill unclear. Depression might be linked to stroke vianeuroendocrine and inflammation effects, through correlationwith major comorbidities such as hypertensionand diabetes or by intervention of lifestyle behavioralmediators. Finally, antidepressant medications haverecently drawn attention for a possible association withincreased risk of stroke, although such findings remainuncertain. Depression has been also established as animportant consequence after stroke, exerting a significantadverse impact on the course of motor recovery,social functioning and, overall, on quality of life. Poststroke depression occurs in nearly one third of strokecases, but the exact mechanism leading to depressionafter stroke is still incompletely understood. In this article,we will review contemporary epidemiologic studies,discuss potential mechanisms and specific aspectsof the complex relation between depression and stroke.
