脑小血管病与情绪障碍研究进展

Research Progress on Cerebral Small Vessel Disease and Emotional Disorders

摘要: 脑小血管病(cerebral small vessel disease, CSVD)是以脑内小动脉、小静脉、毛细血管及微循环结构病变为主要特征的一组临床–影像综合征，常表现为腔隙性脑梗死、白质高信号、微出血及脑萎缩等。近年来，随着磁共振成像(MRI)技术的发展，CSVD在老龄人群中的检出率显著提高。除认知障碍外，情绪障碍，尤其是抑郁和焦虑，逐渐被认为是CSVD的重要临床表现之一。越来越多研究提示，CSVD与情绪障碍之间存在密切关联，其机制可能涉及白质纤维束损伤、额–纹状体–边缘系统环路破坏、慢性炎症反应及神经递质失衡等。本文综述CSVD与情绪障碍的流行病学特征、神经影像学证据、可能发病机制及临床干预策略，旨在为临床早期识别和综合管理提供参考。

Abstract: Cerebral small vessel disease (CSVD) is a clinical-radiological syndrome characterized by pathological changes in the small arteries, venules, capillaries, and microcirculation within the brain. It commonly manifests as lacunar infarction, white matter hyperintensities, cerebral microbleeds, and brain atrophy. In recent years, with the advancement of magnetic resonance imaging (MRI) techniques, the detection rate of CSVD in the elderly population has increased significantly. In addition to cognitive impairment, emotional disorders, particularly depression and anxiety, have gradually been recognized as important clinical manifestations of CSVD. A growing body of evidence suggests a close association between CSVD and emotional disorders. The underlying mechanisms may involve white matter tract damage, disruption of the frontal-striatal-limbic circuitry, chronic inflammatory responses, and neurotransmitter imbalance. This article reviews the epidemiological characteristics, neuroimaging evidence, potential pathophysiological mechanisms, and clinical intervention strategies related to CSVD and emotional disorders, aiming to provide a reference for early clinical identification and comprehensive management.