Hegarty Shane V, Lee David J, O'Keeffe Gerard W, Sullivan Aideen M
Department of Anatomy and Neuroscience, Biosciences Institute, University College Cork, Cork, Ireland.
Department of Anatomy and Neuroscience, Biosciences Institute, University College Cork, Cork, Ireland.
Parkinsonism Relat Disord. 2017 May;38:19-25. doi: 10.1016/j.parkreldis.2017.02.011. Epub 2017 Feb 10.
Neurotrophic factors (NTFs) have been evaluated for neuroprotective effects in Parkinson's disease (PD). However, clinical trials examining the efficacy of intracerebral administration of NTFs on motor symptoms in PD have produced mixed results, and are thus inconclusive. The objective of this systematic review and meta-analysis was to determine the effects of intracerebral NTF application on motor symptoms in people with PD.
We searched PubMed, MEDLINE, EMBASE, and Cochrane from inception through to March 31 2016 for open-label trials and randomized controlled trials (RCTs) which intracerebrally administered NTFs to PD patients, and which performed motor examination using the Unified Parkinson's Disease Rating Scale.
Eight studies with a total of 223 participants were included. Fixed effects analysis revealed that NTF treatment did not significantly reduce motor symptoms in PD patients compared to placebo controls (P = 0.98). Combining open-label and RCT data, both treatment with NTFs (P < 0.001) and treatment with placebo (P < 0.05) significantly improved motor function in PD patients when compared to predicted symptoms in untreated PD controls. Finally, random effects analysis revealed that NTF-treated PD patients were not significantly likely to improve following intracerebral NTF administration (P = 0.25).
In conclusion, intracerebral NTF administration does not improve motor symptoms in PD patients, when compared to placebo-treated controls. These findings may guide therapeutic decisions and inform future research on NTFs and their application in PD.
神经营养因子（NTFs）已被评估在帕金森病（PD）中的神经保护作用。然而，关于脑内给予神经营养因子对帕金森病运动症状疗效的临床试验结果不一，因此尚无定论。本系统评价和荟萃分析的目的是确定脑内应用神经营养因子对帕金森病患者运动症状的影响。
我们检索了从数据库建立至2016年3月31日的PubMed、MEDLINE、EMBASE和Cochrane数据库，以查找向帕金森病患者脑内给予神经营养因子并使用统一帕金森病评定量表进行运动检查的开放标签试验和随机对照试验（RCTs）。
纳入了8项研究，共223名参与者。固定效应分析显示，与安慰剂对照组相比，神经营养因子治疗并未显著减轻帕金森病患者的运动症状（P = 0.98）。将开放标签和随机对照试验数据合并后，与未治疗的帕金森病对照的预测症状相比，神经营养因子治疗（P < 0.001）和安慰剂治疗（P < 0.05）均显著改善了帕金森病患者的运动功能。最后，随机效应分析显示，脑内给予神经营养因子后，接受神经营养因子治疗的帕金森病患者改善的可能性并不显著（P = 0.25）。
总之，与安慰剂治疗的对照组相比，脑内给予神经营养因子并不能改善帕金森病患者的运动症状。这些发现可能指导治疗决策，并为未来关于神经营养因子及其在帕金森病中的应用的研究提供参考。
