中风后的情绪化;诊断、病理生理学和治疗。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-10-01 Epub Date: 2024-04-11 DOI:10.1177/17474930241242952
Niall M Broomfield, Joshua Blake, Fergus Gracey, Tom Steverson
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引用次数: 0

摘要

每 5 名中风患者中就有 1 人在中风 6 个月后会出现中风后情绪低落,尽管这种情况很常见,但人们对这种中风症状的了解却很少。相关文献十分有限,尤其是与其他常见的神经系统疾病(如失语症和视力障碍)相比。本叙述性综述对这些文献进行了总结,为临床实践和未来研究提供参考。我们将讨论定义、发病率、神经生物学、诱发和促发因素以及治疗方法。越来越多的证据表明,与情绪表达或调节过程功能相关的特定区域受损、结构性通路中断以及相关血清素分泌和调节紊乱单独或共同导致了情绪化类型的表现。研究中使用了一系列情绪化测量工具,因此很难对不同研究进行比较。最近开发的 "近期卒中后情绪测试-问卷"(TEARS-Q)可以进行标准化评估。可供选择的治疗方案有限,而且很少有充分有效的治疗试验。抗抑郁药可能会减轻严重程度,但还需要更多的试验数据。目前还没有非药物干预的随机对照试验。我们需要开展更多的研究,以提高对这一常见致残症状的认识和治疗。最后,我们提出了该领域的研究重点和建议。
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Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment.

Background: Post-stroke emotionalism affects one in five stroke sufferers 6 months after their stroke, but despite its frequency remains a poorly understood stroke symptom. The literature is limited, especially compared to other frequently observed neurological conditions such as aphasia and visual neglect.

Aim and methods: This narrative review presents a summary of the post-stroke emotionalism literature, to inform clinical practice and future research. We cover discussion of definitions, prevalence, neurobiology, predisposing and precipitating factors, and treatment.

Results: Increasing evidence suggests that damage to specific areas functionally linked to emotion expression or regulation processes, disruption to structural pathways and those related to serotonin production and modulation individually or in concert give rise to emotionalism-type presentations. A range of emotionalism measurement tools have been used in research contexts making between study comparisons difficult. Testing for Emotionalism after Recent Stroke-Questionnaire (TEARS-Q) has recently been developed to allow standardized assessment. Treatment options are limited, and there have been few adequately powered treatment trials. Antidepressants may reduce severity, but more trial data are required. There have been no randomized-controlled trials of non-pharmacological interventions.

Conclusions: More research is needed to improve recognition and treatment of this common and disabling symptom. We conclude with research priorities and recommendations for the field.

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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
期刊最新文献
Plasma metabolites, systolic blood pressure, lifestyle, and stroke risk: A prospective cohort study. Detection of atrial fibrillation after stroke due to large or small vessel disease: Systematic review and meta-analysis. Unveiling connections between venous disruption and cerebral small vessel disease using diffusion tensor image analysis along perivascular space (DTI-ALPS): A 7-T MRI study. Elevated risk of end-stage kidney disease in stroke patients: A population-based observational study. Impact of time from symptom onset to puncture, and puncture to reperfusion, in endovascular therapy in the late time window (>6 hours).
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