通过扩散张量成像预测亚急性脑出血后上肢运动恢复:一项系统评价和荟萃分析。

Prediction of upper extremity motor recovery after subacute intracerebral hemorrhage through diffusion tensor imaging: a systematic review and meta-analysis.

作者信息

Kumar Pradeep, Yadav Arun Kumar, Misra Shubham, Kumar Amit, Chakravarty Kamalesh, Prasad Kameshwar

机构信息

Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, Room No. 702, 7th Floor, Ansari Nagar, New Delhi, India.

出版信息

Neuroradiology. 2016 Oct;58(10):1043-1050. doi: 10.1007/s00234-016-1718-6. Epub 2016 Jul 20.

Abstract

INTRODUCTION

Early assessment of the pyramidal tracts is important for intracerebral hemorrhage (ICH) patients in order to decide the optimal treatment or to assess appropriate rehabilitation strategies, and management of patient expectations and goals. The purpose of this study was to systematically review and summarize the current available literature on the value of Fractional Anisotropy (FA) parameter of the diffusion tensor imaging (DTI) in predicting upper extremity (UE) motor recovery after subacute ICH.

METHODS

PubMed, EMBASE, MEDLINE, Google Scholar, and Cochrane CENTRAL searches were conducted from 1 January 1950 to 31 March 2016 which were supplemented with relevant articles identified in the references. Pooled estimate using correlation between DTI parameter FA and UE motor recovery was done using comprehensive meta-analysis software.

RESULTS

Out of 97 citations, only eight studies met the criteria for inclusion in the systematic review and six studies were included in the meta-analysis. A random effects model revealed that DTI parameter FA is a significant predictor for UE motor recovery after subacute ICH (correlation coefficient = 0.56; 95 % confidence interval 0.44 to 0.65, P value <0.001). However, moderate heterogeneity was observed between the studies (Tau-squared = 0.28, I-squared = 70.3).

CONCLUSION

The studies reported so far on correlation between FA parameter of DTI and UE motor recovery in ICH patients are few with small sample sizes. This meta-analysis suggests a strong correlation between DTI parameter FA and UE motor recovery in ICH patients. Further well-designed prospective studies embedded with larger sample size are needed to confirm these findings.

摘要

引言

对于脑出血(ICH)患者,早期评估锥体束对于决定最佳治疗方案、评估合适的康复策略以及管理患者的期望和目标非常重要。本研究的目的是系统回顾和总结当前关于扩散张量成像(DTI)的分数各向异性(FA)参数在预测亚急性脑出血后上肢(UE)运动恢复价值的现有文献。

方法

从1950年1月1日至2016年3月31日进行了PubMed、EMBASE、MEDLINE、谷歌学术和Cochrane CENTRAL检索,并补充了参考文献中确定的相关文章。使用综合荟萃分析软件对DTI参数FA与UE运动恢复之间的相关性进行汇总估计。

结果

在97篇文献中,只有8项研究符合纳入系统评价的标准,6项研究纳入荟萃分析。随机效应模型显示,DTI参数FA是亚急性脑出血后UE运动恢复的显著预测指标(相关系数=0.56;95%置信区间0.44至0.65,P值<0.001)。然而,研究之间观察到中度异质性(Tau平方=0.28,I平方=70.3)。

结论

目前关于DTI的FA参数与ICH患者UE运动恢复之间相关性的研究较少,样本量较小。这项荟萃分析表明DTI参数FA与ICH患者UE运动恢复之间存在很强的相关性。需要进一步设计良好、样本量更大的前瞻性研究来证实这些发现。

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