Depression as the cause and consequence of cerebrovascular diseases

Autor: Tamara Rabi-Zikic, Aleksandra Nedic, Petar Slankamenac, Zeljko Zivanovic, Dragica Dobrenov, Marija Zarkov
Rok vydání: 2007
Předmět:
Zdroj: Medical review. 60:255-260
ISSN: 1820-7383
0025-8105
DOI: 10.2298/mpns0706255r
Popis: Inbtroduction: Recent epidemiological, clinical, neuroimaging and neuropathological studies have reported substantial evidence on the complex interactive relationships between depression and cerebrovascular diseases, especially in older populations, and plausible explanations of the etiopathogenetic mechanisms in both directions have been proposed. Poststroke depression Although there is no general consensus regarding its prevalence, it is widely accepted that major depression after stroke is common and that it should be recognized as a key factor in rehabilitation and outcome following stroke. Vascular depression The "vascular depression" hypothesis presupposes that late-onset depression may often result from vascular damage to frontal-subcortical circuits implicated in mood regulation. This concept has stimulated many researches and the obtained results support the proposed hypothesis. Depression as a stroke risk factor Recent large studies have emphasized the role of depression per se in the development of subsequent stroke. Mechanisms proposed to explain the increased risk of cerebrovascular diseases in depressed patients There are a number of plausible mechanisms that could explain why depression may increase the risk of subsequent cerebrovascular disease, the most important being sympathoadrenal hyperactivity, platelet activation, an increase in inflammatory cytokines and an increased risk of arrhythmias. Conclusion: Thorough clinical examinations determining the conventional stroke risk factors in the population with depression, as well as management of depression as part of the overall measures for the reduction of cerebrovascular risk factors are of utmost importance.
Databáze: OpenAIRE