Risk factors for the development of apathy after cerebral stroke taking into account comorbid psychopathology


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. Apathy is a common condition in many neurological pathologies and is a common complication of stroke. Objective. Evaluation of the risk factors for post-stroke apathy taking into account its comorbidity and influence on the process of restoring impaired neurological functions. Methods. The study included 207patients with new onset ischemic stroke; the mean age of the patients was 66±12 years. The assessment of neurological deficit, the severity of disability, the diagnosis of apathy in accordance with the Starkstein criteria, the diagnosis of depression and asthenia on the first day of a stroke, 14, 28 days, 3, 6 months and 1 year after a stroke were carried out. Results. The frequency of apathy was 23% (47 patients). Using a dimensional approach, clinical groups depending on the comorbidity of apathy with asthenia and depression were identified, and it was found that they are not identical in terms of demographic characteristics, anamnestic data, characteristics of the brain lesion focus, and behavioral patterns of the patient in the post-stroke period. The negative effect of apathy on the severity of neurological deficit, disability and cognitive dysfunction according to MMSE was shown. Conclusion. The data obtained on the heterogeneity of clinical groups, the revealed negative effect of apathy on the degree of neurological deficit and disability indicate the need for diagnosis and correction of this condition in the complex of rehabilitation measures.

全文:

受限制的访问

作者简介

E. Ponevezhskaya

Pirogov Russian National Research Medical University

Moscow, Russia

Elizaveta Petrova

Pirogov Russian National Research Medical University

Email: 6332011@mail.ru
Moscow, Russia

M. Savina

Mental Health Research Center

Moscow, Russia

E. Koltsova

Pirogov Russian National Research Medical University

Moscow, Russia

参考

  1. Mayo N.E., Fellows L.K., Scott S.C., et al. A longitudinal view of apathy and its impact after stroke. Stroke. 2009;40(10):3299-307. doi: 10.1161/STROKEAHA.109.554410.
  2. Hama S., Yamashita H., Shigenobu M., et al. Poststroke affective or apathetic depression and lesion location: left frontal lobe and bilateral basal ganglia. Eur Arch Psych Clin Neuros. 2007;257(3):149-52. doi: 10.1007/s00406-006-0698-7.
  3. Аведисова А.С., Гехт А.Б., Захарова К.В. и др. Апатия в структуре психических и неврологических расстройств позднего возраста. Журнал неврологии и психиатрии им. С.С. Корсакова. 2014;114(6):77-85.
  4. Husain M., Roiser J.P Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nat Rev Neurosci. 2018;19(8):470-84. doi: 10.1038/s41583-018-0029-9.
  5. Савина М.А. Депрессии в постинсультном периоде: факторы риска и подходы к терапии. Ремедиум Приволжье. 2019;8(176).
  6. van Dalen J.W., Moll van Charante E.P., Nederkoorn P.J., et al. Poststroke apathy. Stroke. 2013;44(3):851-60. doi: 10.1161/STROKEAHA.112.674614.
  7. Caeiro L., Ferro J.M., Costa J. Apathy secondary to stroke: a systematic review and meta-analysis. Cerebrovasc Dis. 2013;35(1):23-39. doi: 10.1159/000346076.
  8. Marin R.S., Wilkosz PA. Disorders of diminished motivation. J Head Trauma Rehabil. 2005;20(4):377-88. doi: 10.1097/00001199200507000-00009.
  9. Marin R.S. Differential diagnosis and classification of apathy. Am J Psych. 1990;147:22-30. doi: 10.1176/ajp.147.1.22.
  10. van Reekum R., Stuss D.T., Ostrander L. Apathy: why care? J Neuropsych Clin. Neurosci. 2005;17(1):7-19. 19. doi: 10.1176/jnp.17.1.7.
  11. Петрова Е.А, Поневежская Е.В., Савина М.А., Кольцова Е.А. Постинсультная апатия. Consilium Medicum. 2020;22(9):33-7.
  12. Савина М.А. Постинсультные психические нарушения: клинико-статистические, клинические, клинико-патогенетические, прогностические аспекты. Дисс. докт. мед. наук. М., 2016.
  13. Кутлубаев М.А., Ахмадеева Л.Р Постинсультная апатия. Журнал неврологии и психиатрии им. С.С. Корсакова. 2012;112:99-102.
  14. Douven E., Staals J., Freeze W.M., et al. Imaging markers associated with the development of poststroke depression and apathy: Results of the Cognition and Affect after Stroke - a Prospective Evaluation of Risks study. Eur Stroke J. 2020;5(1):78-84. doi: 10.1177/2396987319883445.
  15. Петрова Е.А., Поневежская Е.В., Савина М.А. Структура и факторы риска постинсультной апатии. Фарматека. 2021;28(3):101-5. doi: 10.18565/pharmateca.2021.3.101-105.
  16. Douven E., Köhler S., Rodriguez M.M.F. et al. Imaging Markers of Post-Stroke Depression and Apathy: a Systematic Review and Meta-Analysis. Neuropsychol Rev. 2017;27(3):202-19. doi: 10.1007/s11065-017-9356-2.
  17. Chen L., Xiong S., Liu Y, et al. C-Reactive Protein Can Be an Early Predictor of Poststroke Apathy in Acute Ischemic Stroke Patients. J Stroke Cerebrovasc Dis. 2018;27(7):1861-69. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.021.
  18. Carnes-Vendrell A., Deus J., Molina-Seguin J., et al. Depression and Apathy After Transient Ischemic Attack or Minor Stroke: Prevalence, Evolution and Predictors. Sci Rep. 2019;9(1):16248. doi: 10.1038/s41598-019-52721-5.
  19. Yang S.R., Shang X.Y., Tao J., et al. Voxel-based analysis of fractional anisotropy in post-stroke apathy. PLoS One. 2015;10(1):e116168. doi: 10.1371/journal.pone.0116168.
  20. Starkstein S.E., Fedoroff J.P, Price T.R., et al. Apathy following cerebrovascular lesions. Stroke. 1993;24(11):1625-30. doi: 10.1161/01.str.24.11.1625.
  21. Brodaty H., Sachdev P.S., Withall A., et al. Frequency and clinical, neuropsychological and neuroimaging correlates of apathy following stroke - the Sydney Stroke Study. Psychol Med. 2005;35(12):1707-16. doi: 10.1017/S0033291705006173.
  22. Santa N., Sugimori H., Kusuda K., et al. Apathy and functional recovery following first-ever stroke.Int J Rehabil Res. 2008;31(4):321-26. doi: 10.1097/MRR.0b013e3282fc0f0e.
  23. Sagen U., Vik T.G., Moum T. et al. Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. J Psychosom Res. 2009;67(4):325-32. doi: 10.1016/j.jpsychores.2009.03.007.
  24. Петрова Е.А. Поневежская Е.В., Савина М.А., Скворцова В.И. Клинические особенности постинсультной апатии. Журнал неврологии и психиатрии им. С.С. Корсакова (Спец. выпуск). 2012;112(12):15-1920.
  25. Tang W.K., Wong L.K., Mok V.C., et al. Apathy after stroke: potential risk factors and magnetic resonance imaging markers. Hong Kong Med J. 2018;24(Suppl. 3):18-20.
  26. Савина М.А. Постинсультные депрессии. Дисс. канд. мед. наук. М., 2006.
  27. Петрова Е.А. Аффективные расстройства у больных церебральным инсультом. Дисс. докт. мед. наук. М., 2013.
  28. Onoda K., Kuroda Y., Yamamoto Y., et al. Post-stroke apathy and hypoperfusion in basal ganglia: SPECT study. Cerebrovasc Dis. 2011;31(1):6-11. doi: 10.1159/000319771.
  29. Tang W.K., Chen Y.K., Liang H.J., et al. Location of infarcts and apathy in ischemic stroke. Cerebrovasc Dis. 2013;35(6):566-71. doi: 10.1159/000351152.

补充文件

附件文件
动作
1. JATS XML
下载
##common.cookie##