Saywell Isaac, Child Brittany, Foreman Lauren, Collins-Praino Lyndsey, Baetu Irina
Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
Ann N Y Acad Sci. 2023 Apr;1522(1):15-23. doi: 10.1111/nyas.14967. Epub 2023 Feb 5.
Cognitive reserve has been used to justify neuropathologically unexplainable mismatches in Alzheimer's disease outcomes. Recent evidence has suggested this effect may be replicable across other conditions. However, it is still unclear whether cognitive reserve applies to α-synucleinopathies or to motor outcomes, or if medication confounds effects. This review protocol follows PRISMA-P guidelines and aims to investigate whether cognitive reserve can predict both cognitive and motor outcomes for α-synucleinopathy patients. MEDLINE (via PubMed), Scopus, psycINFO (via Ovid), CINAHL (via EBSCO), and Web of Science have been searched. Cross-sectional, cohort, case-control, and longitudinal studies investigating the association between cognitive reserve and cognitive and/or motor outcomes for Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy will be included. Reviewers will independently perform screening, while also extracting data, assessing the risk of bias (using a version of the Quality in Prognostic Studies tool), and rating evidence quality (using GRADE). If possible, random-effects meta-analyses will be conducted for each unique outcome variable and α-synucleinopathy; otherwise, a narrative synthesis will be performed. Depending on the number of studies, exploratory analyses may involve meta-regression to assess potential confounding effects. Understanding the broader protective effect of cognitive reserve has significant implications for preventive interventions in the wider population.
认知储备已被用来解释阿尔茨海默病结局中神经病理学上无法解释的不匹配现象。最近的证据表明，这种效应可能在其他疾病中也具有可重复性。然而，认知储备是否适用于α-突触核蛋白病或运动结局，或者药物是否会混淆效应，目前仍不清楚。本综述方案遵循PRISMA-P指南，旨在研究认知储备是否能够预测α-突触核蛋白病患者的认知和运动结局。我们检索了MEDLINE（通过PubMed）、Scopus、psycINFO（通过Ovid）、CINAHL（通过EBSCO）和Web of Science。将纳入调查认知储备与帕金森病、路易体痴呆或多系统萎缩的认知和/或运动结局之间关联的横断面研究、队列研究、病例对照研究和纵向研究。评审人员将独立进行筛选，同时提取数据、评估偏倚风险（使用预后研究质量工具的一个版本）并对证据质量进行评级（使用GRADE）。如果可能，将对每个独特的结局变量和α-突触核蛋白病进行随机效应荟萃分析；否则，将进行叙述性综合分析。根据研究数量，探索性分析可能包括元回归，以评估潜在的混杂效应。了解认知储备更广泛的保护作用对更广泛人群的预防性干预具有重要意义。
