脑小血管病伴发抑郁的神经影像学研究进展

Advances in neuroimaging studies of cerebral small vessel disease combined with depression

抑郁是脑小血管病(cerebral small vessel disease,CSVD)常伴发的情绪症状,与认知功能的损害有一定关系,可显著增加CSVD患者的病死率和致残率。CVSD伴发抑郁的发生与心理应激关系不大,与大脑情感环路的受损有关。本文就近年CVSD影像学特征与抑郁发生、发展的相关性及CVSD伴发抑郁神经影像学机制研究展开综述。较多文献显示深部白质病变、基底节区无症状腔隙性脑梗死是CSVD伴发抑郁发生的独立危险因素,局部脑容积减小与抑郁有关;CSVD伴发抑郁的神经影像机制研究提示抑郁症状的发生与脑叶皮层-皮质下边缘区域的神经环路相关。这些研究结果为探索CVSD伴发抑郁的神经病理学机制及特定的治疗方法提供了线索。

Depression is a common psychiatric symptom in cerebral small vessel disease(CSVD),which has a certain relationship with impairment of cognitive function and can significantly increase the mortality and morbidity of CSVD patients.The occurrence of CVSD-associated depression is less related to psychological stress,but is associated with the impairment of the brain's emotional circuit.This article reviewed the correlation between the imaging features of CVSD and the occurrence and development of depression in recent years,and the neuroimaging mechanism of depression associated with CVSD.Many literatures have shown that deep white matter hyperintensities and asymptomatic lacunar infarction in the basal ganglia are independent risk factors for depression in CSVD,and the reduction of local brain volume is associated with depression.The neuroimaging mechanism of depression associated with CSVD suggests that the occurrence of depressive symptoms is related to the neural circuits in the lobar cortex-subcortical limbic area.These findings provide clues for exploring the neuropathological mechanisms and specific treatment methods of depression associated with CVSD.