Department of Neurology, Affiliated Liuzhou People's Hospital of Guangxi University of Science and Technology/Liuzhou People's Hospital, Liuzhou, Guangxi, China.
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Braz J Med Biol Res. 2020;53(6):e9275. doi: 10.1590/1414-431x20209275. Epub 2020 May 18.
Evidence from previous voxel-based morphometry (VBM) studies indicates that widespread brain regions are involved in Parkinson's disease with mild cognitive impairment (PD-MCI). However, the spatial localization reported for gray matter (GM) abnormalities is heterogeneous. The aim of the present study was to quantitatively integrate studies on GM abnormalities observed in PD-MCI in order to determine whether a pattern exists. Eligible whole-brain VBM studies were identified by a systematic search of articles in PubMed and EMBASE databases spanning from 1995 to January 1, 2019. A meta-analysis was performed to investigate regional GM abnormalities in PD-MCI. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of PD-MCI compared with PD patients with normal cognitive function (PD-NC). A total of 12 studies comprising 243 PD-MCI patients and 326 PD-NC were included in the meta-analysis. PD-MCI patients showed a robust GM decrease in the left insula and left superior temporal gyrus. Moreover, meta-regression analysis demonstrated that age, PD duration and stage, and Unified Parkinson's Disease Rating Scale III and Mini-Mental State Examination scores might be partly correlated with the GM abnormalities observed in PD-MCI patients. The convergent findings of this quantitative meta-analysis revealed a characteristic neuroanatomical pattern in PD-MCI. The findings provide some evidence that MCI in PD may result in the breakdown of the insula and temporal gyrus, which may serve as specific regions of interest for further investigations.
先前基于体素的形态计量学（VBM）研究的证据表明，广泛的大脑区域参与了伴有轻度认知障碍的帕金森病（PD-MCI）。然而，报告的灰质（GM）异常的空间定位是异质的。本研究的目的是定量整合 PD-MCI 中观察到的 GM 异常的研究，以确定是否存在模式。通过对 1995 年至 2019 年 1 月 1 日期间在 PubMed 和 EMBASE 数据库中发表的文章进行系统搜索，确定了符合条件的全脑 VBM 研究。进行荟萃分析以研究 PD-MCI 中的区域性 GM 异常。采用各向异性效应大小版本的种子基 d 映射（AES-SDM）荟萃分析，以探讨 PD-MCI 与认知功能正常的帕金森病患者（PD-NC）相比 GMV 的差异。共有 12 项研究纳入了 243 名 PD-MCI 患者和 326 名 PD-NC，进行了荟萃分析。PD-MCI 患者的左侧岛叶和左侧颞上回 GM 明显减少。此外，元回归分析表明，年龄、PD 病程和分期以及统一帕金森病评定量表 III 评分和简易精神状态检查评分可能与 PD-MCI 患者观察到的 GM 异常部分相关。这项定量荟萃分析的一致发现揭示了 PD-MCI 中的特征性神经解剖模式。这些发现为 PD 中的 MCI 可能导致岛叶和颞叶破裂提供了一些证据，这可能为进一步的研究提供了特定的感兴趣区域。
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