Relationship Between Post-Stroke Depresssion and Lesion Location: A Meta-Analysis

中風後憂鬱與大腦損傷位置相關性之整合分析研究

余麗樺(Lifa Yu) ； 劉景寬(Ching-Kuan Liu) ； 陳九五(Jew-Wu Chen) ； 王興耀(Shing-Yaw Wang) ； 吳玉欣(Yu-Hsin Wu) ； 游勝宏(Sheng-Horng Yu)

《The Kaohsiung Journal of Medical Sciences》 20卷8期 (2004/08) Pp. 372-380

摘要

大腦損傷的解剖學定位與中風後憂鬱的發生之間的關聯性仍是未解決的問題，對於這個爭議的現象值得作進一步探索與釐清；因此，本研究的目的是從中風後憂鬱與大腦損傷位置的關聯性之研究領域中，根據現有的研究結果，做一系統性的量化回顧，並探究造成研究結果之差異性來源，以尋求一致性且更強而有力的結論。研究中所回顧的文獻範圍係取自 MEDLINE 、 PsycINFO 、 EMBAsE 資料庫，系統性地蒐集相關文獻，且檢視重要文獻中參考資料所列之文獻，從每篇研究報告中登錄重要特微變項，計算中風後憂鬱與大腦損傷位置的關連效果量，採整合分析技術進行分析。本整合分析中包含 52 篇研究文獻，參與研究之患者達 3 , 668 位，研究結果顯示中風後憂鬱與右腦損傷有輕度的關連性存在，而造成研究結果之異質性來源主要包括語言功能障礙患者的排除控制、使用不同之憂鬱評量工具與方式等因素。未來的研究應著重於訂定明確的研究報告規範，進一步地改善對於失語症患者的憂鬱評量工具和採用合宜的方法學，以清楚地探究中風後憂鬱與損傷位置之關連性。

關鍵字

中風後憂鬱 ； 損傷位置 ； 整合分析

並列摘要

Our understanding of the relationship between the neuroanatomic loci of brain damage and the incidence of post-stroke depression (PSD) is not complete. Many studies have investigated this relationship and the evidence is conflicting. With the purpose of gaining a consistent, strong, and credible conclusion on the relationship between PSD and the loci of brain damage, a meta-analysis was used in this study to systematically reanalyze the findings of related studies and to investigate the sources of heterogeneity among study results. The key words “stroke or cerebrovascular” and “depression or mood or affective” were entered into the MEDLINE, PsycINFO, and EMBASE databases to search for relevant studies. The references cited in the studies found were also used to locate additional studies. For each eligible study, the important study characteristics were recorded, and the effect sizes of the relationship between PSD and lesion location were computed. Furthermore, we conducted subgroup analyses to explore the heterogeneity among study results. A total of 3,668 patients participating in 52 studies were included in this meta-analysis. There was a weak relationship between PSD and right hemisphere lesion. The major sources of heterogeneous study results included systematic exclusion of patients with language dysfunction and use of different assessors and instruments for diagnosing depression. Future efforts should aim to enhance standards for reporting studies, improve assessment tools for assessing depression of aphasic patients, and adopt appropriate study methodologies for investigating the relationship between PSD and lesion location.

並列關鍵字

post-stroke depression ； lesion location ； meta-analysis