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主观认知下降中的脑血管损伤:系统评价和荟萃分析。

Cerebrovascular damage in subjective cognitive decline: A systematic review and meta-analysis.

机构信息

Faculty of Health Sciences, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.

Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States.

出版信息

Ageing Res Rev. 2022 Dec;82:101757. doi: 10.1016/j.arr.2022.101757. Epub 2022 Oct 12.

Abstract

BACKGROUND

Subjective cognitive decline (SCD) has been postulated as an early marker of Alzheimer's Disease (AD) but it can also be associated to other non-AD pathologies such as Vascular Dementia (VaD). Nevertheless, there is scarce data about SCD as a potential harbinger of cerebrovascular pathology. Thus, we conducted a systematic review and meta-analysis on the association between SCD and cerebrovascular damage measured by neuroimaging markers.

METHOD

This study was performed following the PRISMA guidelines. The search was conducted in 3 databases (PubMed, Scopus and Web of Science) from origin to December 8th, 2021. Primary studies including cognitively unimpaired adults with SCD and neuroimaging markers of cerebrovascular damage (i.e., white matter signal abnormalities, WMSA) were selected. Qualitative synthesis and meta-analysis of studies with a case-control design was performed.

RESULTS

Of 241 articles identified, 21 research articles were selected. Eight case-control studies were included for the meta-analysis. A significant overall effect-size was observed for the mean WMSA burden in SCD relative to controls, where the WMSA burden was higher in SCD.

CONCLUSION

Our findings show the potential usefulness of SCD as a harbinger of cerebrovascular disease in cognitively healthy individuals. Further research is needed in order to elucidate the role of SCD as a preclinical marker of vascular cognitive impairment.

摘要

背景

主观认知下降(SCD)被认为是阿尔茨海默病(AD)的早期标志物,但它也可能与其他非 AD 病理学相关,如血管性痴呆(VaD)。然而,关于 SCD 作为脑血管病理学潜在先兆的数据很少。因此,我们对 SCD 与通过神经影像学标志物测量的脑血管损伤之间的关联进行了系统评价和荟萃分析。

方法

本研究遵循 PRISMA 指南进行。从起源到 2021 年 12 月 8 日,在 3 个数据库(PubMed、Scopus 和 Web of Science)中进行了搜索。选择了包括认知正常的 SCD 患者和脑血管损伤的神经影像学标志物(即,白质信号异常,WMSA)的初级研究。对病例对照设计的研究进行定性综合和荟萃分析。

结果

在确定的 241 篇文章中,选择了 21 篇研究文章。纳入了 8 项病例对照研究进行荟萃分析。在 SCD 与对照组相比,WMSA 负担的平均总体效应大小显著,SCD 中的 WMSA 负担更高。

结论

我们的研究结果表明,SCD 作为认知健康个体脑血管疾病的潜在有用标志物具有潜在的作用。需要进一步的研究来阐明 SCD 作为血管性认知障碍的临床前标志物的作用。

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