Decreased Volumes of Selected Cortical and Limbic Structures of the Brain Are Associated with Post-Stroke Cognitive and Affective Disorders: Multiple Hit Scenarios?

IF 0.5 4区医学 Q4 NEUROSCIENCES Neurochemical Journal Pub Date : 2024-05-27 DOI:10.1134/s1819712424020193

M. Yu. Zhanina, T. A. Druzhkova, N. V. Ierusalimsky, E. E. Vladimirova, N. N. Eremina, A. B. Guekht, N. V. Gulyaeva

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Abstract

Post-stroke depressive disorders (PSD) and post-stroke cognitive impairments (PCI) are frequent consequences of ischemic stroke (IS). The study was focused on exploring possible associations between relative volumes of cortical and limbic brain structures during the acute period of IS, and changes in biochemical indices of hypothalamic-pituitary-adrenal, sympathoadrenal medullary and inflammatory systems, with the development of PSD or PCI after mild or moderate IS. Patients developing PSD later on had significantly smaller relative volumes of the hippocampus, entorhinal cortex, and temporal pole versus patients without depressive symptoms. PCI development was associated with significantly smaller volumes of temporal pole and supramarginal gyrus versus patients without cognitive changes. Multiple logistic regression analysis showed higher likelihood of developing PSD in patients with smaller temporal pole volume (β0 = 10.9; β = –4.27; p = 0.04) and in-creased salivary α-amylase activity (β0 = –3.55; β = 2.68e-05; p = 0.02). PCI likelihood was higher in patients with smaller supramarginal gyrus volume (β0 = 3.41; β = –0.99; p = 0.047), smaller temporal pole volume (β0 = 3.41; β = –3.12; p = 0. 06), and increased hair cortisol concentration at admission (index of accumulated stress load within a month before IS; β0 = 3.41; β = –0.05; p = 0.08). The data support the hypothesis suggesting predisposition to PSD and PCI and multi hit scenarios of their pathogenesis with IS providing a final hit.

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选定的大脑皮层和边缘结构体积的减少与脑卒中后的认知和情感障碍有关：多重打击情景？

摘要卒中后抑郁障碍（PSD）和卒中后认知障碍（PCI）是缺血性卒中（IS）的常见后果。本研究旨在探讨轻度或中度 IS 后，大脑皮层和边缘系统结构在 IS 急性期的相对体积，以及下丘脑-垂体-肾上腺、交感肾上腺髓质和炎症系统生化指标的变化与 PSD 或 PCI 的发生之间可能存在的联系。后来出现 PSD 的患者与无抑郁症状的患者相比，其海马、内侧皮层和颞极的相对体积明显较小。与无认知改变的患者相比，出现 PCI 的患者颞极和边际上回的体积明显较小。多元逻辑回归分析显示，颞极体积较小的患者发生 PSD 的可能性较高（β0 = 10.9；β = -4.27；p = 0.04），唾液α-淀粉酶活性增加的患者发生 PSD 的可能性较高（β0 = -3.55；β = 2.68e-05；p = 0.02）。边缘上回体积较小 (β0 = 3.41; β = -0.99; p = 0.047)、颞极体积较小 (β0 = 3.41; β = -3.12; p = 0. 06)、入院时毛发皮质醇浓度增加（IS 前一个月内累积压力负荷指数；β0 = 3.41; β = -0.05; p = 0.08）的患者 PCI 可能性较高。这些数据支持这一假设，即 PSD 和 PCI 的易感性及其发病机制的多重打击情景，而 IS 则是最后的打击。

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来源期刊

Neurochemical Journal 医学-神经科学

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： Neurochemical Journal (Neirokhimiya) provides a source for the communication of the latest findings in all areas of contemporary neurochemistry and other fields of relevance (including molecular biology, biochemistry, physiology, neuroimmunology, pharmacology) in an afford to expand our understanding of the functions of the nervous system. The journal presents papers on functional neurochemistry, nervous system receptors, neurotransmitters, myelin, chromaffin granules and other components of the nervous system, as well as neurophysiological and clinical aspects, behavioral reactions, etc. Relevant topics include structure and function of the nervous system proteins, neuropeptides, nucleic acids, nucleotides, lipids, and other biologically active components. The journal is devoted to the rapid publication of regular papers containing the results of original research, reviews highlighting major developments in neurochemistry, short communications, new experimental studies that use neurochemical methodology, descriptions of new methods of value for neurochemistry, theoretical material suggesting novel principles and approaches to neurochemical problems, presentations of new hypotheses and significant findings, discussions, chronicles of congresses, meetings, and conferences with short presentations of the most sensational and timely reports, information on the activity of the Russian and International Neurochemical Societies, as well as advertisements of reagents and equipment.