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帕金森病的影像执行功能:一项激活似然估计荟萃分析。

Imaging executive functions in Parkinson's disease: An activation likelihood estimation meta-analysis.

机构信息

Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany.

Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran.

出版信息

Parkinsonism Relat Disord. 2019 Jun;63:137-142. doi: 10.1016/j.parkreldis.2019.02.015. Epub 2019 Feb 20.

DOI:10.1016/j.parkreldis.2019.02.015
PMID:30833230
Abstract

INTRODUCTION

Executive dysfunction is a common and early cognitive symptom in Parkinson's disease (PD) with a detrimental effect on quality of life of patients and their care givers. Thus, a number of neuroimaging studies investigated the underlying neural correlates of such an impairment. Results of individual studies, however, are not univocal in terms of location and directionality of associated functional brain changes.

OBJECTIVE

To assess convergence of abnormal brain activation in patients with PD during the performance of tasks probing executive functions (EF).

METHODS

We screened the functional imaging literature on EF in PD using the PubMed database, extracted reported stereotactic data and tested for convergence of deviant neural activation in patients with PD when compared to healthy controls (HC) using a coordinate-based activation likelihood estimation approach.

RESULTS

We identified 22 eligible papers from which the main proportion was targeted at the investigation of working memory encompassing 354 patients and 306 HC. Surprisingly, no significant converging aberrant activation between HC and patients (ON, OFF or ON + OFF medication, respectively) could be observed when controlling for multiple comparisons using family-wise error correction on cluster-level.

CONCLUSION

We conclude that there is currently not enough available evidence to pinpoint a specific neural correlate associated with executive dysfunction in PD. This might be due to the small number of studies performed and their methodical inconsistency. Therefore, it is important to conduct more research regarding functional brain changes associated with EF in these patients using more consistent frameworks and bigger samples.

摘要

简介

执行功能障碍是帕金森病(PD)中常见且早期的认知症状,对患者及其照顾者的生活质量有不利影响。因此,许多神经影像学研究调查了这种损伤的潜在神经相关性。然而,个别研究的结果在相关功能脑变化的位置和方向性方面并不一致。

目的

评估在执行功能(EF)任务中执行时,PD 患者异常大脑激活的收敛性。

方法

我们使用 PubMed 数据库筛选了关于 PD 中 EF 的功能成像文献,提取了报告的立体定向数据,并使用基于坐标的激活似然估计方法,测试了与健康对照组(HC)相比,PD 患者异常神经激活的收敛性。

结果

我们从 22 篇合格的论文中确定了主要针对工作记忆调查的论文,其中包括 354 名患者和 306 名 HC。令人惊讶的是,当使用簇级别的全方差错误校正对多重比较进行控制时,我们无法观察到 HC 和患者之间(分别为 ON、OFF 或 ON+OFF 药物治疗)异常激活的显著收敛。

结论

我们得出的结论是,目前没有足够的证据来确定与 PD 中执行功能障碍相关的特定神经相关性。这可能是由于进行的研究数量较少且方法不一致。因此,使用更一致的框架和更大的样本量来研究这些患者与 EF 相关的功能脑变化非常重要。

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