Li Xuanting, Yuan Junliang, Yang Lei, Qin Wei, Yang Shuna, Li Yue, Fan Huimin, Hu Wenli
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
PLoS One. 2017 Sep 21;12(9):e0185145. doi: 10.1371/journal.pone.0185145. eCollection 2017.
Accumulated data suggests that cerebral microbleeds (CMBs) play an important role in the decline of cognitive function, but the results remain inconsistent. In the current study, we aimed to investigate the association between CMBs and cognitive function, as well as the various effects of CMBs on different domains of cognition.
We searched through the databases of PubMed, Embase, Cochrane Library, and ScienceDirect. After a consistency test, the publication bias was evaluated and a sensitivity analysis was performed with combined odds ratios (OR) and standardized mean difference (SMD) of CMBs.
A meta-analysis of 25 studies with 9343 participants total was conducted. Patients with CMBs had higher incidence of cognitive impairment (OR:3.5410; 95% confidence interval [CI] [2.2979, 5.4567], p<0.05) and lower scores of cognitive functions (SMD: -0.2700 [-0.4267, -0.1133], p<0.05 in Mini-Mental State Examination [MMSE] group and -0.4869 [-0.8902, -0.0818], p<0.05 in Montreal Cognitive Assessment [MoCA] group). Our results also indicated that patients with CMBs had obvious decline in cognitive functions, for instance, orientation (SMD: -0.9565 [-1.7260, -0.1869], p<0.05), attention and calculation (SMD: -1.1518 [-1.9553, -0.3484], p<0.05) and delayed recall (SMD: -0.5527 [-1.1043, -0.0011], p = 0.05).
Our data suggested that CMBs might be an important risk factor for cognitive dysfunction, especially in the domains of orientation, attention and calculation and delayed recall functions. Prospective cohort studies with further investigations will be needed in larger samples.
累积数据表明,脑微出血(CMBs)在认知功能衰退中起重要作用,但结果仍不一致。在本研究中,我们旨在探讨CMBs与认知功能之间的关联,以及CMBs对不同认知领域的各种影响。
我们检索了PubMed、Embase、Cochrane图书馆和ScienceDirect数据库。经过一致性检验后,评估发表偏倚,并对CMBs的合并比值比(OR)和标准化均数差(SMD)进行敏感性分析。
对25项研究共9343名参与者进行了荟萃分析。CMBs患者认知障碍发生率更高(OR:3.5410;95%置信区间[CI][2.2979,5.4567],p<0.05),认知功能得分更低(简易精神状态检查表[MMSE]组SMD:-0.2700[-0.4267,-0.1133],p<0.05;蒙特利尔认知评估量表[MoCA]组SMD:-0.4869[-0.8902,-0.0818],p<0.05)。我们的结果还表明,CMBs患者的认知功能有明显下降,例如,定向(SMD:-0.9565[-1.7260,-0.1869],p<0.05)、注意力及计算能力(SMD:-1.1518[-1.9553,-0.3484],p<0.05)和延迟回忆(SMD:-0.5527[-1.1043,-0.0011],p = 0.05)。
我们的数据表明,CMBs可能是认知功能障碍的一个重要危险因素,尤其是在定向、注意力及计算能力和延迟回忆功能方面。需要在更大样本中进行进一步调查的前瞻性队列研究。