Department of Neurology and Alzheimer Center, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands.
Department of Neurology and Alzheimer Center, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Department of Epidemiology, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
Ageing Res Rev. 2022 Aug;79:101661. doi: 10.1016/j.arr.2022.101661. Epub 2022 Jun 4.
Cerebral perfusion dysfunctions are seen in the early stages of Alzheimer's disease (AD). We systematically reviewed the literature to investigate the effect of pharmacological and non-pharmacological interventions on cerebral hemodynamics in randomized controlled trials involving AD patients or Mild Cognitive Impairment (MCI) due to AD. Studies involving other dementia types were excluded. Data was searched in April 2021 on MEDLINE, Embase, and Web of Science. Risk of bias was assessed using Cochrane Risk of Bias Tool. A meta-synthesis was performed separating results from MCI and AD studies. 31 studies were included and involved 310 MCI and 792 CE patients. The MCI studies (n = 8) included physical, cognitive, dietary, and pharmacological interventions. The AD studies (n = 23) included pharmacological, physical interventions, and phytotherapy. Cerebral perfusion was assessed with PET, ASL, Doppler, fNIRS, DSC-MRI, Xe-CT, and SPECT. Randomization and allocation concealment methods and subject characteristics such as AD-onset, education, and ethnicity were missing in several papers. Positive effects on hemodynamics were seen in 75 % of the MCI studies, and 52 % of the AD studies. Inserting cerebral perfusion outcome measures, together with established AD biomarkers, is fundamental to target all disease mechanisms and understand the role of cerebral perfusion in AD.
脑灌注功能障碍可见于阿尔茨海默病（AD）的早期阶段。我们系统地回顾了文献，以研究涉及 AD 患者或 AD 引起的轻度认知障碍（MCI）的随机对照试验中，药物和非药物干预对脑血液动力学的影响。排除了涉及其他痴呆类型的研究。于 2021 年 4 月在 MEDLINE、Embase 和 Web of Science 上搜索数据。使用 Cochrane 偏倚风险工具评估偏倚风险。对来自 MCI 和 AD 研究的结果进行了综合分析。共纳入 31 项研究，涉及 310 例 MCI 和 792 例 CE 患者。MCI 研究（n=8）包括身体、认知、饮食和药物干预。AD 研究（n=23）包括药物、物理干预和植物疗法。脑灌注采用 PET、ASL、多普勒、fNIRS、DSC-MRI、Xe-CT 和 SPECT 评估。几篇论文中均缺少随机分组和分配隐藏方法以及 AD 发病、教育和种族等受试者特征。75%的 MCI 研究和 52%的 AD 研究观察到对血液动力学有积极影响。将脑灌注结果测量与既定的 AD 生物标志物结合起来，对于靶向所有疾病机制和理解脑灌注在 AD 中的作用至关重要。
