脑卒中后的抑郁和病变位置:一个系统的审查
A J Carson1, S MacHale, K Allen
1University Department of Psychiatry, Royal Edinburgh Hospital, UK. A.Carson@ed.ac.uk
Lancet (London, England)
|August 30, 2000
概括
在中风后脑损伤的位置似乎不会影响患抑郁症的风险. 这一系统性审查没有发现支持特定脑损伤位置增加中风后抑郁风险的假设的证据.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床神经学 临床神经学
背景情况:
- 关于大脑损伤位置对中风后抑郁风险的影响存在相互矛盾的证据.
- 之前的研究尚未确定左半球或左前部病变是否与中风后的抑郁症有更强烈的关联.
研究的目的:
- 系统地审查和检查该假设,中风后抑郁风险受到损伤位置的影响.
- 为了调查左半球中风或左前脑病变是否与其他区域相比更常见地与抑郁症有关.
主要方法:
- 对多个数据库 (MEDLINE,BIDS ISI,PsychLit) 进行了全面的计算机辅助和手动搜索.
- 两位独立调查人员系统地审查了有关中风病变位置和抑郁症之间的关联的合格报告.
- 对收集的数据进行了固定效应和随机效应的元分析.
主要成果:
- 在143份确定的报告中,包括了48份;然而,并非所有报告都包含原始数据.
- 只有两个原始数据报告支持了假设,而七个显然没有.
- 分析显示,左半球和右半球中风之间的抑郁风险没有显著差异 (RR 0.95,95% CI 0.83-1.10).
- 与其他大脑区域相比,没有发现与左前部病变相关的抑郁风险有显著差异 (RR 1.17,95% CI 0.87-1.62).
- 仅限于高质量的研究,主要抑郁症或按中风后的时间分层的分析并没有改变这些发现.
结论:
- 这一系统性审查没有支持这样的假设,即大脑病变的位置会影响中风后抑郁症的风险.
- 这些发现表明,损伤位置不是中风后抑郁症的重要预测因素.
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