阿尔茨海默病、帕金森病、路易体痴呆和多系统萎缩患者脑脊液神经元特异性烯醇化酶水平的荟萃分析。

Meta-analysis of cerebrospinal fluid neuron-specific enolase levels in Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy.

机构信息

Department of Neurology, Asahikawa City Hospital, 1-1-65 Kinseicho, Asahikawa, 070-8610, Japan.

Division of Neurology, First Department of Internal Medicine, Asahikawa Medical University Hospital, Asahikawa, Japan.

出版信息

Alzheimers Res Ther. 2021 Oct 5;13(1):163. doi: 10.1186/s13195-021-00907-3.

BACKGROUND

This study examined the usefulness of cerebrospinal fluid (CSF) neuron-specific enolase (NSE) levels as a candidate biomarker of neurodegeneration in Alzheimer's disease (AD), Parkinson's disease (PD), PD with dementia (PDD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA).

METHODS

We performed a systematic search of PubMed, the Cochrane Library, Scopus, and Google Scholar to find studies that measured CSF NSE levels in AD, PD, DLB, and/or MSA. For each disease, we pooled all available data and performed a meta-analysis, and meta-regression analyses of age and sex were conducted if the main analysis found a significant association.

RESULTS

Twenty studies were included (13 for AD, 8 for PD/PDD/DLB, and 4 for MSA). Significantly elevated CSF NSE levels were detected in AD (Hedges' g = 0.822, 95% confidence interval [95% CI] 0.332 to 1.311, p = 0.0010), but the data exhibited high heterogeneity (I = 88.43%, p < 0.001). The meta-regression analysis of AD showed that age (p < 0.001), but not sex, had a significant effect on CSF NSE levels. A meta-analysis of the pooled data for PD/PDD/DLB did not show any significant changes in the CSF NSE level, but a sub-group analysis of PDD/DLB revealed significantly elevated CSF NSE levels (Hedges' g = 0.507, 95% CI 0.020 to 0.993, p = 0.0412). No significant changes in CSF NSE levels were detected in MSA.

CONCLUSIONS

The CSF NSE level may be a useful biomarker of neurodegeneration in AD and PDD/DLB. Age was found to affect the CSF NSE levels of AD patients.

背景

本研究探讨了脑脊液（CSF）神经元特异性烯醇化酶（NSE）水平作为阿尔茨海默病（AD）、帕金森病（PD）、PD 伴痴呆（PDD）、路易体痴呆（DLB）和多系统萎缩（MSA）神经退行性变候选生物标志物的有用性。

方法

我们系统地检索了 PubMed、Cochrane 图书馆、Scopus 和 Google Scholar，以找到测量 AD、PD、DLB 和/或 MSA 患者 CSF NSE 水平的研究。对于每种疾病，我们汇总了所有可用数据并进行了荟萃分析，如果主要分析发现存在显著相关性，则进行了年龄和性别荟萃回归分析。

结果

共纳入 20 项研究（AD 研究 13 项，PD/PDD/DLB 研究 8 项，MSA 研究 4 项）。AD 患者的 CSF NSE 水平显著升高（Hedges'g=0.822，95%置信区间[95%CI]0.332 至 1.311，p=0.0010），但数据异质性较大（I=88.43%，p<0.001）。AD 的荟萃回归分析表明，年龄（p<0.001），而不是性别，对 CSF NSE 水平有显著影响。PD/PDD/DLB 的汇总数据分析未显示 CSF NSE 水平有任何显著变化，但 PDD/DLB 的亚组分析显示 CSF NSE 水平显著升高（Hedges'g=0.507，95%CI 0.020 至 0.993，p=0.0412）。MSA 患者的 CSF NSE 水平无显著变化。