Liu Huanhuan, Zhang Dandan, Lin Huawei, Zhang Qi, Zheng Ling, Zheng Yuxin, Yin Xiaolong, Li Zuanfang, Liang Shengxiang, Huang Saie
National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Rehabilitation Industry Institute, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Aging Neurosci. 2021 Oct 22;13:738971. doi: 10.3389/fnagi.2021.738971. eCollection 2021.
The changes of neurochemicals in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients has been observed via magnetic resonance spectroscopy in several studies. However, whether it exists the consistent pattern of changes of neurochemicals in the encephalic region during the progression of MCI to AD were still not clear. The study performed meta-analysis to investigate the patterns of neurochemical changes in the encephalic region in the progress of AD. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases, and finally included 63 studies comprising 1,086 MCI patients, 1,256 AD patients, and 1,907 healthy controls. It showed that during the progression from MCI to AD, N-acetyl aspartate (NAA) decreased continuously in the posterior cingulate (PC) (SMD: -0.42 [95% CI: -0.62 to -0.21], = -3.89, < 0.05), NAA/Cr (creatine) was consistently reduced in PC (SMD: -0.58 [95% CI: -0.86 to -0.30], = -4.06, < 0.05) and hippocampus (SMD: -0.65 [95% CI: -1.11 to -0.12], = -2.44, < 0.05), while myo-inositol (mI) (SMD: 0.44 [95% CI: 0.26-0.61], = 4.97, < 0.05) and mI/Cr (SMD: 0.43 [95% CI: 0.17-0.68], = 3.30, < 0.05) were raised in PC. Furthermore, these results were further verified by a sustained decrease in the NAA/mI of PC (SMD: -0.94 [95% CI: -1.24 to -0.65], = -6.26, < 0.05). Therefore, the levels of NAA and mI were associated with the cognitive decline and might be used as potentially biomarkers to predict the possible progression from MCI to AD. https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200308.
在多项研究中，已通过磁共振波谱观察到轻度认知障碍（MCI）和阿尔茨海默病（AD）患者神经化学物质的变化。然而，在MCI进展至AD过程中，脑区神经化学物质变化的一致模式是否存在仍不清楚。本研究进行荟萃分析，以调查AD进展过程中脑区神经化学变化的模式。我们检索了PubMed、Embase、Cochrane图书馆和Web of Science数据库，最终纳入了63项研究，包括1086例MCI患者、1256例AD患者和1907例健康对照。结果显示，在从MCI进展至AD的过程中，后扣带回（PC）中的N-乙酰天门冬氨酸（NAA）持续下降（标准化均值差：-0.42 [95%置信区间：-0.62至-0.21]，Z = -3.89，P < 0.05），PC中NAA/肌酸（Cr）持续降低（标准化均值差：-0.58 [95%置信区间：-0.86至-0.30]，Z = -4.06，P < 0.05），海马体中也如此（标准化均值差：-0.65 [95%置信区间：-1.11至-0.12]，Z = -2.44，P < 0.05），而PC中的肌醇（mI）（标准化均值差：0.44 [95%置信区间：0.26 - 0.61]，Z = 4.97，P < 0.05）和mI/Cr（标准化均值差：0.43 [95%置信区间：0.17 - 0.68]，Z = 3.30，P < 0.05）升高。此外，PC中NAA/mI的持续下降进一步验证了这些结果（标准化均值差：-0.94 [95%置信区间：-1.24至-0.65]，Z = -6.26，P < 0.05）。因此，NAA和mI的水平与认知衰退相关，可能用作预测MCI进展至AD可能性的潜在生物标志物。https://www.crd.york.ac.uk/PROSPERO/，标识符：CRD42020200308 。
