脑卒中后的妄想是否与下丘脑垂体轴的失调有关?
Amanda J Barugh1, Alasdair M J MacLullich2, Susan S Shenkin3
1Geriatric and Stroke Medicine, Royal Infirmary, Edinburgh, United Kingdom.
Frontiers in stroke
|January 16, 2026
概括
脑卒中后的妄想似乎与皮质醇变化没有独立的联系. 这项研究发现,在一年内,中风患者的皮质醇水平和妄之间没有显著的关联.
科学领域:
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
- 老年医学 老年医学
背景情况:
- 脑卒中后的妄想是一种与较差的长期认知结果相关的重大并发症.
- 脑卒中后妄想的潜在机制仍然不完全理解,压力反应是潜在的因素.
- 调查皮质醇失调的作用可能会为痴呆症病理生理学提供见解.
研究的目的:
- 为了研究皮质醇调节失调与中风后第一年痴呆的发生之间的关系.
- 在急性中风病房设置中进行前性队列研究.
主要方法:
- 招募的患者年龄在60岁或以上,入住急性中风病房,不包括服用类固醇的患者.
- 收集了关于中风严重程度,中风前认知和一般疾病严重程度的基线数据.
- 在多个时间点监测患者的痴呆症,直至中风后12个月,并分析唾液皮质醇水平 (早上和晚上).
主要成果:
- 在95名参与者中,26人 (27%) 在12个月内经历过妄想.
- 痴呆症与年龄较大,女性性别,中风前独立性较低,IQCODE得分较高,中风严重程度更高,以及特定的中风类型 (全额前部循环) 相关.
- 虽然单变量分析表明了一些早期的关联,但多变量分析显示,在任何随访点上,狂妄症和皮质醇水平之间没有显著的独立关联.
结论:
- 在中风后期,皮质醇失调和妄之间没有发现独立的关联.
- 皮质醇和中风后痴呆症之间的任何潜在联系,如果存在的话,很可能是最小的.
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