Hu Xiaohui, Yang Yan, Gong Daokai
Department of Neurology, Jingzhou Central Hospital, Tongji Medical College, Huazhong University of Science Technology, Renming Road No. 1, Jingzhou City, 434020, Hubei Province, China.
Hubei College of Chinese Medicines, Jingzhou, China.
Neurol Sci. 2017 Mar;38(3):407-414. doi: 10.1007/s10072-016-2783-7. Epub 2016 Nov 28.
As a biomarker of axonal injury, neurofilament light chain (NFL) in multiple system atrophy (MSA) patients and Parkinson's disease (PD) patients has been investigated by numerous studies. However, cerebrospinal fluid (CSF) NFL changes are conflicting in MSA patients relative to PD patients to date. Therefore, the current study was carried out to find out possible heterogeneity sources. Furthermore, "Neurofilament", "Neurofilament light chain" and "Multiple system atrophy" were employed to search "PubMed", "Springer" and "Medline" databases until August 2016 with standard mean difference (Std.MD) being calculated. In addition, subgroup analysis and meta-regression were performed to assess possible heterogeneity sources. Nine studies were pooled, in which 212 MSA patients and 373 PD patients were involved. Moreover, CSF NFL in MSA patients was higher than that in PD patients [pooled Std.MD = 1.56, 95% CI (1.12, 2.00), p < 0.00001] with significant heterogeneity (I = 76%). Besides, population variations, sample size, the difference in CSF phosphorylated tau (p-tau) levels between MSA patients and PD patients, and Hoehn-Yahr staging of PD patients were the main heterogeneity sources. As shown by meta-regression, Hedges's g of CSF NFL was correlated with CSF Std.MD of α-synuclein between MSA patients and healthy controls (r = -1.34824, p = 0.00025). Therefore, CSF NFL increased in MSA patients relative to PD patients. Meta-regression showed that NFL was associated with α-synuclein in CSF of MSA patients relative to healthy controls. Due to the influence of heterogeneity sources, more prospective large sample studies are still needed to assess CSF NFL changes in MSA patients relative to PD patients.
作为轴突损伤的生物标志物，神经丝轻链（NFL）在多系统萎缩（MSA）患者和帕金森病（PD）患者中已得到大量研究。然而，迄今为止，MSA患者脑脊液（CSF）中NFL的变化与PD患者相比存在矛盾。因此，开展本研究以找出可能的异质性来源。此外，使用“神经丝”“神经丝轻链”和“多系统萎缩”检索“PubMed”“Springer”和“Medline”数据库至2016年8月，并计算标准平均差（Std.MD）。另外，进行亚组分析和元回归以评估可能的异质性来源。汇总了9项研究，涉及212例MSA患者和373例PD患者。而且，MSA患者脑脊液中的NFL高于PD患者[合并Std.MD = 1.56，95%CI（1.12，2.00），p < 0.00001]，存在显著异质性（I = 76%）。此外，人群差异、样本量、MSA患者和PD患者脑脊液磷酸化tau（p-tau）水平的差异以及PD患者的Hoehn-Yahr分期是主要的异质性来源。元回归显示，MSA患者与健康对照之间脑脊液NFL的Hedges's g与α-突触核蛋白的脑脊液Std.MD相关（r = -1.34824，p = 0.00025）。因此，与PD患者相比，MSA患者脑脊液NFL升高。元回归显示，相对于健康对照，MSA患者脑脊液中的NFL与α-突触核蛋白相关。由于异质性来源的影响，仍需要更多前瞻性大样本研究来评估MSA患者与PD患者相比脑脊液NFL的变化。
