Annweiler Cedric, Annweiler Thierry, Montero-Odasso Manuel, Bartha Robert, Beauchet Olivier
Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
Department of Radiology, University Hospital of Saint-Etienne, France.
Maturitas. 2014 May;78(1):30-9. doi: 10.1016/j.maturitas.2014.02.013. Epub 2014 Mar 6.
Vitamin D has multiple functions in the nervous system. Our objective was to systematically review and quantitatively synthesize evidence on the location and nature of brain morphometric changes linked to vitamin D depletion or repletion. A Medline search was conducted in February 2014, without limit of date and language restriction, using the MeSH terms "Vitamin D" OR "Ergocalciferols" combined with "Brain Mapping" OR "Magnetic Resonance Imaging" OR "Tomography, X-ray Computed" OR "Tomography, Emission-Computed, Single-Photon" OR "Positron-Emission Tomography" OR "Nuclear Medicine" OR "Radionucleide Imaging". Of the 376 selected studies, nine observational studies - two animal and seven human studies - met the selection criteria. The number of participants ranged from 20 to 333 (40-79% female). Three studies were eligible for fixed-effects meta-analysis of bias-corrected effect size of the difference in lateral ventricle volume between cases with vitamin D depletion and controls. Results showed that vitamin D depletion was associated with lower brain volume, specifically larger lateral ventricles. The pooled effect size was 1.01 [95% CI: 0.62; 1.41], a 'large' effect size indicating that the ventricle volume was 1.01 SD higher with vitamin D depletion. Results on brain subvolumes were mixed, and indicated that brain atrophy with vitamin D depletion could be explained not by temporal lobe atrophy but rather by loss of matter at the cranial vertex, possibly in the precuneus cortex. In conclusion, despite increasing evidence arguing for an action of vitamin D in the brain, data is sparse regarding brain morphological changes related to vitamin D depletion. The retrieved association between vitamin D depletion and brain atrophy provides a scientific base for vitamin D replacement trials.
维生素D在神经系统中具有多种功能。我们的目的是系统回顾并定量综合有关与维生素D缺乏或补充相关的脑形态测量变化的位置和性质的证据。2014年2月进行了一项Medline检索，不受日期和语言限制，使用医学主题词“维生素D”或“麦角钙化醇”与“脑图谱”或“磁共振成像”或“X线计算机断层扫描”或“发射计算机断层扫描，单光子”或“正电子发射断层扫描”或“核医学”或“放射性核素成像”相结合。在所选的376项研究中，有9项观察性研究——2项动物研究和7项人类研究——符合入选标准。参与者人数从20到333不等（女性占40 - 79%）。三项研究符合对维生素D缺乏病例与对照组之间侧脑室体积差异的偏倚校正效应大小进行固定效应荟萃分析的条件。结果显示，维生素D缺乏与脑容量降低有关，特别是侧脑室更大。合并效应大小为1.01 [95%置信区间：0.62；1.41]，这是一个“大”效应大小，表明维生素D缺乏时脑室体积高出1.01个标准差。关于脑亚体积的结果不一，表明维生素D缺乏导致的脑萎缩可能不是由颞叶萎缩引起的，而是由颅顶，可能是楔前叶皮质的物质丢失所致。总之，尽管越来越多的证据支持维生素D在大脑中的作用，但关于与维生素D缺乏相关的脑形态变化的数据却很稀少。所检索到的维生素D缺乏与脑萎缩之间的关联为维生素D替代试验提供了科学依据。
