Ma Juming, Yang Xue, Xu Fan, Li Hongjun
Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China.
Front Neurol. 2022 Jul 7;13:898191. doi: 10.3389/fneur.2022.898191. eCollection 2022.
The patients with HIV-associated neurocognitive disorder (HAND) are often accompanied by white matter structure damage. Diffusion tensor imaging (DTI) is an important tool to detect white matter structural damage. However, the changes in DTI values reported in many studies are diverse in different white matter fiber tracts and brain regions.
Our research is dedicated to evaluating the consistency and difference of the correlation between HAND and DTI measures in different studies. Additionally, the value of DTI in HAND evaluation is used to obtain consensus and independent conclusions between studies.
We searched PubMed and Web of Science to collect relevant studies using DTI for the diagnosis of HAND. After screening and evaluating the search results, meta-analysis is used for quantitative research on data. Articles that cannot collect data but meet the research relevance will be subjected to a system review.
The meta-analysis shows that the HAND group has lower fractional anisotropy (standardized mean difference = -0.57 < 0.0001) and higher mean diffusivity (standardized mean difference = 0.04 < 0.0001) than the healthy control group in corpus callosum. In other white matter fibers, we found similar changes in fractional anisotropy (standardized mean difference = -1.18 < 0.0001) and mean diffusivity (standardized mean difference = 0.69 < 0.0001). However, the heterogeneity (represented by I) between the studies is high (in corpus callosum 94, 88%, in other matter fibers 95, 81%). After subgroup analysis, the heterogeneity is obtained as 19.5, 40.7% (FA, MD in corpus callosum) and 0, 0% (FA, MD among other white matter fibers).
The changes in white matter fibers in patients with HAND are statistically significant at the observation level of DTI compared with healthy people. The differences between the studies are mainly derived from demographics, start and maintenance time of antiretroviral therapy, differences in nadir CD4+T cells, and the use of different neurocognitive function scales. As an effective method to detect the changes in white matter fibers, DTI is of great significance for the diagnosis of HAND, but there are still some shortcomings. In the absence of neurocognitive function scales, independent diagnosis remains difficult. https://inplasy.com/inplasy-2021-10-0079/.
人类免疫缺陷病毒相关神经认知障碍（HAND）患者常伴有白质结构损伤。扩散张量成像（DTI）是检测白质结构损伤的重要工具。然而，许多研究报道的DTI值变化在不同的白质纤维束和脑区中各不相同。
我们的研究致力于评估不同研究中HAND与DTI测量值之间相关性的一致性和差异。此外，使用DTI在HAND评估中的价值来获得不同研究之间的共识和独立结论。
我们检索了PubMed和Web of Science以收集使用DTI诊断HAND的相关研究。在对检索结果进行筛选和评估后，采用荟萃分析对数据进行定量研究。无法收集数据但符合研究相关性的文章将进行系统评价。
荟萃分析表明，与健康对照组相比，HAND组胼胝体的各向异性分数较低（标准化平均差=-0.57，P<0.0001），平均扩散率较高（标准化平均差=0.04，P<0.0001）。在其他白质纤维中，我们发现各向异性分数（标准化平均差=-1.18，P<0.0001）和平均扩散率（标准化平均差=0.69，P<0.0001）有类似变化。然而，各研究之间的异质性（以I²表示）较高（胼胝体中I²为94.88%，其他白质纤维中I²为95.81%）。亚组分析后，异质性分别为19.5%、40.7%（胼胝体中的FA、MD）和0%、0%（其他白质纤维中的FA、MD）。
与健康人相比，HAND患者白质纤维的变化在DTI观察水平上具有统计学意义。各研究之间的差异主要源于人口统计学、抗逆转录病毒治疗的开始和维持时间、最低点CD4+T细胞的差异以及不同神经认知功能量表的使用。作为检测白质纤维变化的有效方法，DTI对HAND的诊断具有重要意义，但仍存在一些不足。在缺乏神经认知功能量表的情况下，独立诊断仍然困难。https://inplasy.com/inplasy-2021-10-0079/ 。
