• " آیا از بین بردن پلاک شریان های مغزی ، افسردگی را بهبود می بخشد؟ "

منبع :Healthday  

 25July  2007              

    در یک مطالعه جدید انجام گرفته دراتریش پیشنهاد شد که قرار دادن یک استنت برای باز کردن شریان اصلی مغز می تواند به کاهش افسردگی همراه با بیماری به نام تنگی کاروتید کمک کند . ولی محققین در مورد این مسأله اختلاف نظر دارند که آثار مفید این روش فقط دلیل فیزیکی صرف دارند ( جریان بهتر خون به مغز) یا اینکه عامل روانی نیز در این مسأله دخیل است . پزشکان اتریشی هدایت کننده این مطالعه با عامل فیزیکی موافق ترند. دکتر Wolfgang  Mlekusch متخصص آنژیوگرافی بالینی و پزشکی داخلی در بیمارستان عمومی وین می گوید :" یافته های ما پیشنهاد می کنند که باز کردن شریان کاروتید و بهبود جریان خون رسیده به مغز از طریق یک روش با حداقل تهاجم و تحت بی حسی موضعی با کاهش مشخص علایم افسردگی همراه است ."
   به گزارش سایت جامع علوم پزشکی پرتو ایران (

آدرس ایمیل جهت جلوگیری از رباتهای هرزنامه محافظت شده اند، جهت مشاهده آنها شما نیاز به فعال ساختن جاوا اسکریپت دارید

    ? Does Clearing Plaque From Brain Artery Ease Depression

By Ed Edelson
HealthDay Reporter

 
TUESDAY, July 25 (HealthDay News) -- Inserting a stent to open the main artery to the brain may help to reduce depression associated with a condition called carotid stenosis, a new Austrian study suggests.

But experts differ about whether the beneficial effect had a purely physical cause -- better blood flow to the brain -- or whether there was a strong psychological factor involved.

The Austrian physician who led the study leans toward a physical explanation. "Our findings suggest that opening the carotid artery and restoring blood flow to the brain via a minimally invasive technique under local anesthesia is associated with significant reduction in depressive symptoms," Dr. Wolfgang Mlekusch, a specialist in clinical angiography and internal medicine at Vienna General Hospital and Medical School, said in a statement.

Mlekusch was lead author of the report that was published in the August issue of the journal Radiology.

But Dr. Michael M. Dake, chairman of the department of radiology at the University of Virginia, said the psychological element can't be ruled out.

Someone who has been told that his or her carotid artery -- the main vessel delivering blood to the brain -- is narrowed is likely to be more depressed than average because they're facing an increased risk of stroke, Dake said. "Many people in our society feel that a stroke is worse than death. It's not surprising for a person who has a disease that significantly narrows the arteries is depressed, as opposed to having something that affects the legs," he explained.

The Austrian researchers compared 143 patients with carotid stenosis -- severely narrowed carotid arteries -- with 102 patients who had peripheral arterial disease (PAD), which is narrowed vessels in the leg. All took a standard test for symptoms of depression, and one-third of those with narrowed carotid arteries had symptoms of depression, compared to 16.7 percent of those with PAD.

Four weeks after both groups underwent the artery-opening procedures, 13 percent of those treated for PAD were depressed, compared to 9.8 percent of those who had stents implanted to improve carotid blood flow.

It's possible that improved blood flow relieved the carotid-stenosis patients' depression, Dake said. But there's also the "halo effect" that some patients experience that must be considered, he said: "I went though the operation and didn't have a stroke."

But the physical effect can't be ruled out, Dake said. "This is intriguing work that needs to be followed up," he said.

Recent studies have described a condition called "vascular depression," a set of depressive disorders that may be caused by conditions that restrict blood flow to the brain. There are debates about the psychological components of those conditions.

One fact that bolsters the physical explanation was that the Austrian researchers tested a small group of carotid stenting patients several months later and found that the improvement in depressive symptoms persisted, Dake said. But the evidence falls short of convincing, he said.

"The fact is that these people had more depression than those in the control group, for whatever reasons," Dake said. "After treatment, they had significant improvement. I'm not sure it is an either-or explanation. One challenge of the future is to tease out what is the major contributor to this state."

Benjamin Mast, associate professor of psychological and brain sciences at the University of Louisville, said that challenge might be met with a trial that had a different comparison group.

"An appropriate group would be people who are waiting for stenting," Mast said. "As it is, it is difficult to say that stenting leads to relief of depression."

Mast added that one slight flaw in the study was that the measurement of depression was made just three days before stenting was done. "It would be helpful to know how stable that depression was," he said.