帕金森病抑郁患者的大脑活动改变：一项荟萃分析与验证研究。
Altered Brain Activity in Depression of Parkinson's Disease: A Meta-Analysis and Validation Study.
作者信息
Su Dongning, Cui Yusha, Liu Zhu, Chen Huimin, Fang Jinping, Ma Huizi, Zhou Junhong, Feng Tao
机构信息
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
出版信息
Front Aging Neurosci. 2022 Mar 23;14:806054. doi: 10.3389/fnagi.2022.806054. eCollection 2022.
BACKGROUND
The pathophysiology of depression in Parkinson's disease (PD) is not fully understood. Studies based upon functional MRI (fMRI) showed the alterations in the blood-oxygen-level-dependent (BOLD) fluctuations in multiple brain regions pertaining to depression in PD. However, large variance was observed across previous studies. Therefore, we conducted a meta-analysis to quantitatively evaluate the results in previous publications and completed an independent regions-of-interests (ROIs)-based analysis using our own data to validate the results of the meta-analysis.
METHODS
We searched PubMed, Embase, and Web of Science to identify fMRI studies in PD patients with depression. Using signed differential mapping (SDM) method, we performed a voxel-based meta-analysis. Then, a validation study by using multiscale entropy (MSE) in 28 PD patients with depression and 25 PD patients without depression was conducted. The fMRI scan was completed in anti-depression-medication-off state. The ROIs of the MSE analysis were the regions identified by the meta-analysis.
RESULTS
A total of 126 PD patients with depression and 153 PD patients without depression were included in meta-analysis. It was observed that the resting-state activities within the posterior cingulate gyrus, supplementary motor area (SMA), and cerebellum were altered in depressed patients. Then, in the validation study, these regions were used as ROIs. PD patients with depression had significantly lower MSE of the BOLD fluctuations in these regions (posterior cingulate gyrus: = 0.856, = 0.049; SMA: = 0.914, = 0.039; cerebellum: = 0.227, = 0.043).
CONCLUSION
Our study revealed that the altered BOLD activity in cingulate, SMA, and cerebellum of the brain were pertaining to depression in PD.
背景
帕金森病（PD）中抑郁症的病理生理学尚未完全明确。基于功能磁共振成像（fMRI）的研究显示，与PD抑郁症相关的多个脑区的血氧水平依赖（BOLD）波动存在改变。然而，以往研究中观察到较大差异。因此，我们进行了一项荟萃分析，以定量评估以往出版物中的结果，并使用我们自己的数据完成了基于独立兴趣区（ROI）的分析，以验证荟萃分析的结果。
方法
我们检索了PubMed、Embase和Web of Science，以识别PD抑郁症患者的fMRI研究。使用符号差异映射（SDM）方法，我们进行了基于体素的荟萃分析。然后，对28例PD抑郁症患者和25例无抑郁症的PD患者进行了多尺度熵（MSE）验证研究。fMRI扫描在停用抗抑郁药物状态下完成。MSE分析的ROI是荟萃分析确定的区域。
结果
荟萃分析共纳入126例PD抑郁症患者和153例无抑郁症的PD患者。观察到抑郁症患者后扣带回、辅助运动区（SMA）和小脑的静息态活动发生改变。然后，在验证研究中，将这些区域用作ROI。PD抑郁症患者在这些区域（后扣带回： = 0.856， = 0.049；SMA： = 0.914， = 0.039；小脑： = 0.227， = 0.043）的BOLD波动MSE显著较低。
结论
我们的研究表明，大脑扣带回、SMA和小脑的BOLD活动改变与PD抑郁症有关。
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