Department of Cardiovascular Sciences, University of Leicester, Leicester, LE1 5WW, UK,
J Neurol. 2013 Nov;260(11):2715-21. doi: 10.1007/s00415-013-6836-z. Epub 2013 Jan 12.
The aim of this study was to systematically review CBF studies, assess their methodological quality, and identify trends in the association between task-related brain activation patterns and CBF changes in ischemic stroke (IS) patients. We searched the MEDLINE, EMBASE, CINAHL, and Web of Sciences databases for studies of functional recovery with quantification of CBF responses to brain activation paradigms after IS. Titles, abstracts and full text of articles were scrutinised according to pre-defined selection criteria. Two independent reviewers (AS, VH) undertook the methodological quality screening and data extraction of the included studies. Sixteen of the 1,521 identified studies were relevant. Studies showed weaknesses in key methodological criteria (e.g. population size, discussion of limitations), and only seven studies compared responses with a control population. Overall, there was no agreement between CBF responses in either the affected or unaffected hemisphere and prediction of post-IS recovery. Some studies have shown a higher CBF increase in the unaffected hemisphere when the affected hemisphere was stimulated compared to the healthy control responses. However, CBF responses in the affected hemisphere were inconsistent. Many post-IS CBF studies are of poor methodological quality, and do not demonstrate a consistent response post-IS or a relationship with recovery. Further longitudinal studies assessing the natural history of CBF responses to brain paradigms following IS should be undertaken to determine prognostic significance, and to inform future therapeutic strategies.
本研究旨在系统回顾脑血流（CBF）研究，评估其方法学质量，并确定与缺血性卒中（IS）患者大脑激活模式相关的 CBF 变化之间关联的趋势。我们检索了 MEDLINE、EMBASE、CINAHL 和 Web of Sciences 数据库，以寻找与 IS 后通过脑激活范式量化 CBF 反应的功能恢复相关的研究。根据预先设定的选择标准，对文章的标题、摘要和全文进行了仔细审查。从 1521 项研究中确定了 16 项相关研究。研究在关键方法学标准（例如，人口规模、对局限性的讨论）方面存在缺陷，仅有 7 项研究将反应与对照人群进行了比较。总体而言，无论是在受影响的半球还是在未受影响的半球中，CBF 反应均与 IS 后的恢复预测之间没有一致性。一些研究表明，与健康对照组的反应相比，受影响的半球受到刺激时，未受影响的半球的 CBF 增加更高。但是，受影响的半球中的 CBF 反应不一致。许多 IS 后 CBF 研究的方法学质量较差，并且不能证明 IS 后存在一致的反应或与恢复的关系。应进一步开展评估 IS 后大脑范式的 CBF 反应自然史的纵向研究，以确定其预后意义，并为未来的治疗策略提供信息。
