Sako Wataru, Murakami Nagahisa, Izumi Yuishin, Kaji Ryuji
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
J Neurol Sci. 2017 Jul 15;378:153-157. doi: 10.1016/j.jns.2017.05.005. Epub 2017 May 3.
Previous studies have reported the usefulness of superior cerebellar peduncle (SCP) abnormalities in diagnosing progressive supranuclear palsy. However, the results of these studies were heterogeneous. In the present meta-analysis, we aimed to establish more robust evidence of SCP abnormalities in progressive supranuclear palsy, and to determine the cause of the previously reported heterogeneity. We identified six studies on SCP size and three studies on apparent diffusion coefficient. Key features of each study were extracted and standardized differences in size and apparent diffusion coefficient values were calculated. There was some heterogeneity in terms of the reduction in SCP size in patients with progressive supranuclear palsy compared to those with Parkinson's disease. Moreover, age and Hoehn-Yahr stage negatively correlated with standardized mean difference in SCP size between patients with progressive supranuclear palsy and Parkinson's disease. There was homogenous agreement that the SCP was smaller in patients with progressive supranuclear palsy compared to those with multiple system atrophy. Finally, in terms of apparent diffusion coefficient, there was no significant difference between patients with progressive supranuclear palsy, Parkinson's disease, or multiple system atrophy. Together, these findings suggest that SCP size, when corrected for age and disease severity, could be a diagnostic tool for progressive supranuclear palsy.
以往的研究报道了小脑上脚（SCP）异常在诊断进行性核上性麻痹中的作用。然而，这些研究的结果并不一致。在本荟萃分析中，我们旨在确立关于进行性核上性麻痹中SCP异常更有力的证据，并确定先前报道的异质性的原因。我们检索到6项关于SCP大小的研究和3项关于表观扩散系数的研究。提取了每项研究的关键特征，并计算了大小和表观扩散系数值的标准化差异。与帕金森病患者相比，进行性核上性麻痹患者的SCP大小减小方面存在一些异质性。此外，年龄和Hoehn-Yahr分期与进行性核上性麻痹患者和帕金森病患者之间SCP大小的标准化平均差异呈负相关。与多系统萎缩患者相比，进行性核上性麻痹患者的SCP较小，这一点存在一致共识。最后，就表观扩散系数而言，进行性核上性麻痹患者、帕金森病患者或多系统萎缩患者之间没有显著差异。总之，这些发现表明，校正年龄和疾病严重程度后，SCP大小可能是进行性核上性麻痹的一种诊断工具。
