Cerebrovascular reactivity in depressed patients without vascular risk factors
Cerebrovascular reactivity in depressed patients without vascular risk factors
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DOI：
10.1016/j.jpsychires.2006.10.001
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发表时间：
2008-01-01
影响因子：
4.8
通讯作者：
Neu, P.
中科院分区：
文献类型：
--
作者：
de Castro, A. Gomez-Carrillo;Bajbouj, M.;Neu, P.
脑血管反应性（CVR）作为卒中风险的预后因素似乎越来越重要。CVR反映脑小动脉对扩张性刺激的代偿性扩张性能力；这种机制在维持恒定的脑血流中起着重要作用。评价影响CVR的因素有助于预防或早期发现脑血管病（CVD）。在本研究中，我们旨在测量无血管风险抑郁症个体的CVR，以评估抑郁症对CVR的影响，从而评估其作为卒中危险因素的作用。方法：采用乙酰唑胺（ACZ）刺激25例非吸烟抑郁症患者（平均年龄48.48 +/- 14.40岁）和25例健康非吸烟对照（平均年龄46.76 +/- 13.69岁）经颅多普勒超声评估CVR，计算ACZ刺激后基线最大平均血流速度与ACZ刺激后最大平均血流速度之差。结果：患者脑底血流速度为50.6 cm/s (SD: 11.6)，对照组为52.80 cm/s (SD: 12.70)；刺激后，患者脑底血流速度为72.64 cm/s (SD: 15.75)，对照组为80.20 cm/s （SD: 18.43）。在协方差分析中，我们发现脑血管反应性在无血管风险的抑郁样本中显著降低。年龄有显著影响，而性别没有。讨论：重度抑郁症似乎降低了脑血管反应性，这支持了抑郁症患者中风风险增加的观点。导致这种现象的机制及其微妙的亚组差异有待进一步研究。(c) 2006 Elsevier Ltd.版权所有。
Introduction: Cerebrovascular reactivity (CVR) seems to be gaining importance as a prognostic factor for stroke risk. CVR reflects the compensatory dilatory capacity of cerebral arterioles to a dilatory stimulus; this mechanism plays an important role in maintaining a constant cerebral blood flow. Evaluating factors that influence CVR will help prevention or early detection of cerebrovascular disease (CVD). In this study we aimed to measure the CVR in vascular-risk free depressed individuals so as to evaluate the effect depression has on CVR and hence its role as a stroke risk factor.Methods: Using acetazolamid (ACZ) stimulation, CVR was assessed with a transcranial Doppler ultrasound in 25 non-smoking depressed patients (average age: 48.48 +/- 14.40) and in 25 healthy non-smoking controls (average age: 46.76 +/- 13.69) by calculating the difference between the maximal mean blood flow velocity at baseline and the maximal mean blood flow velocity after ACZ stimulation.Results: Basal Cerebral Blood flow in Patients was 50.6 cm/s (SD: 11.6) versus controls 52.80 cm/s (SD: 12.70) whereas after stimulation maximal blood flow velocity was 72.64 cm/s (SD: 15.75) in patients versus 80.20 cm/s (SD: 18.43) in controls. In an analysis of covariance we found that cerebrovascular reactivity was significantly reduced in the vascular-risk free depressed sample. Age had a significant influence whereas gender did not.Discussion: Major Depression appears to decrease cerebrovascular reactivity supporting the idea of increased risk for stroke in depressed patients. The mechanisms leading to this phenomenon and its subtle subgroup differences should be further investigated. (c) 2006 Elsevier Ltd. All rights reserved.