Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Neurol. 2022 Jun;269(6):2862-2873. doi: 10.1007/s00415-022-10961-y. Epub 2022 Jan 11.
Neuroimaging studies have reported gray matter changes in patients with idiopathic dystonia but with considerable variations. Here, we aimed to investigate the convergence of dystonia-related gray matter changes across studies.
The whole brain voxel-based morphometry studies comparing idiopathic dystonia and healthy controls were systematically searched in the PubMed, Web of Science and Embase. Meta-analysis of gray matter changes was performed using the anisotropic effect size-based signed differential mapping.
Twenty-eight studies comparing 701 idiopathic dystonia patients and 712 healthy controls were included in the meta-analysis. Compared to healthy controls, idiopathic dystonia patients showed increased gray matter in bilateral precentral and postcentral gyri, bilateral putamen and pallidum, right insula, and left supramarginal gyrus, while decreased gray matter in bilateral temporal poles, bilateral supplementary motor areas, right angular gyrus, inferior parietal gyrus and precuneus, left insula and inferior frontal gyrus. These findings remained robust in the jackknife sensitivity analysis, and no significant heterogeneity was detected. Subgroup analyses of different phenotypes of dystonia were performed to further confirm the above findings.
The meta-analysis showed that consistent widespread gray matter abnormalities were shared in different subtypes of idiopathic dystonia and were not restricted to the corticostriatal circuits.
神经影像学研究报告特发性肌张力障碍患者存在灰质变化,但存在较大差异。在此,我们旨在研究跨研究的与肌张力障碍相关的灰质变化的收敛性。
系统地在 PubMed、Web of Science 和 Embase 中搜索比较特发性肌张力障碍和健康对照的全脑基于体素的形态测量学研究。使用各向异性效应大小的有符号差异映射对灰质变化进行荟萃分析。
荟萃分析纳入了 28 项比较 701 例特发性肌张力障碍患者和 712 例健康对照的研究。与健康对照组相比,特发性肌张力障碍患者双侧中央前回和中央后回、双侧壳核和苍白球、右侧岛叶和左侧缘上回灰质增加,双侧颞极、双侧辅助运动区、右侧角回、下顶叶和楔前叶、左侧岛叶和下额回灰质减少。在 Jackknife 敏感性分析中,这些发现仍然稳健,且未检测到显著的异质性。对不同类型的肌张力障碍进行亚组分析,以进一步证实上述发现。
荟萃分析表明,不同亚型的特发性肌张力障碍存在一致的广泛灰质异常,且不限于皮质纹状体回路。