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Роль нейротрофических факторов в развитии постинсультной депрессии
Боголепова А.Н. Роль нейротрофических факторов в развитии постинсультной депрессии. Consilium Medicum. 2019; 21 (2): 18–23. DOI: 10.26442/20751753.2019.2.190304
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Bogolepova A.N. The role of neurotrophic factors in development of post-stroke depression. Consilium Medicum. 2019; 21 (2): 18–23. DOI: 10.26442/20751753.2019.2.190304
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Аннотация
Цереброваскулярная патология является одной из важнейших причин инвалидизации. Депрессия, как сообщается, является наиболее распространенным психическим расстройством среди осложнений инсульта. Постинсультная депрессия отмечается примерно у 1/3 выживших пациентов с совокупной заболеваемостью 55%. Депрессия, возникшая после перенесенного инсульта, оказывает крайне негативное влияние на течение основного заболевания, ухудшая функциональное восстановление и качество жизни, увеличивая уровень смертности. Наличие у больного депрессивных расстройств является фактором риска развития дополнительных когнитивных нарушений, вплоть до деменции. В последние годы получено множество доказательств вовлечения нейротрофических ростовых факторов в патогенезе развития аффективных нарушений. У больных с депрессивным расстройством отмечено снижение уровня мозгового нейротрофического фактора (BDNF). Более того нейротрофические факторы могут рассматриваться как возможные биомаркеры не только самого постинсультного депрессивного расстройства, но и ответа на терапию антидепрессантами. Накопленные данные свидетельствуют о том, что BDNF играет ключевую роль в патофизиологии постинсультной депрессии. Очень важным аспектом лечения постинсультной депрессии является применения, средств нейротрофического действия, одним из которых является церебролизин. Доклинические работы наглядно демонстрируют, что Церебролизин способен модулировать уровни нейротрофических факторов, демонстрируя функциональную эквивалентность нейропептидов Церебролизина и естественных нейротрофических факторов. Клинические исследования продемонстрировали эффективность Церебролизина в отношении постинсультной депрессии. Получены положительные данные о комбинированном применении Церебролизина и антидепрессантов.
Ключевые слова: цереброваскулярная патология, ишемический инсульт, постинсультная депрессия, нейтротрофические факторы, BDNF, нейропластичность, церебролизин.
Ключевые слова: цереброваскулярная патология, ишемический инсульт, постинсультная депрессия, нейтротрофические факторы, BDNF, нейропластичность, церебролизин.
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Cerebrovascular disease is one of the most important causes of disability. Depression is reported to be the most widespread psychological disorder among stroke complications. Post-stroke depression is observed in about 1/3 of stroke survivors, the overall incidence rate is 55%. Depression that develops after stroke has a strong negative influence on the primary disease course, deteriorates functional improvement and quality of life and increases mortality rate. Depressive disorder in patients is a risk factor of additional cognitive disorders development, as much as to dementia. In recent years a lot of evidence on nerve growth factors involvement in pathogenesis of affective disorders development has been acquired. A decrease in brain-derived nerve factor (BDNF) levels was observed in patients with depressive disorders. Moreover, neurotrophic factors can be regarded as possible biomarkers not only of post-stroke depressive disorder itself but also of response to treatment with antidepressants. Acquired data show that BDNF has a key role in post-stroke depression pathophysiology. Use of medications with neurotrophic action such as cerebrolysin is an important aspect of post-stroke depression treatment. Preclinical studies showed that cerebrolysin influences levels of neurotrophic factor and demonstrated functional equivalence of cerebrolysin neuropeptides and neurotrophic factors. In clinical studies cerebrolysin effectiveness in post-stroke depression treatment was demonstrated. Positive results of cerebrolysin and antidepressants combined use were acquired.
Key words: cerebrovascular pathology, ischemic stroke, post-stroke depression, neurotrophic factors, BDNF, neuroplasticity, Cerebrolysin.
Key words: cerebrovascular pathology, ischemic stroke, post-stroke depression, neurotrophic factors, BDNF, neuroplasticity, Cerebrolysin.
Полный текст
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Авторы
А.Н.Боголепова
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России, Москва, Россия
annabogolepova@yandex.ru
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России, Москва, Россия
annabogolepova@yandex.ru
________________________________________________
Anna N. Bogolepova
Pirogov Russian National Research Medical University, Moscow, Russia
annabogolepova@yandex.ru
Pirogov Russian National Research Medical University, Moscow, Russia
annabogolepova@yandex.ru
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