帕金森病患者的超声迷走神经萎缩:是神话还是事实?最近的证据进行了系统回顾和荟萃分析来解答。
Sonographic vagus nerve atrophy in Parkinson's disease: Myth or fact? A systematic review and meta-analysis of recent evidence answers.
机构信息
Department of Neurology, RWTH Aachen University, Aachen, Germany.
Faculty of Pharmacy, Alexandria University, Alexandria, Egypt; Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
出版信息
Parkinsonism Relat Disord. 2023 Jul;112:105451. doi: 10.1016/j.parkreldis.2023.105451. Epub 2023 May 22.
BACKGROUND
Parkinson's disease (PD) is a major cause of disability. We aimed to assess the benefit of ultrasonography of the vagus nerve (VN) to compare between PD and healthy controls as well as to deliver reference values of nerve cross sectional area (CSA).
MATERIALS AND METHODS
We performed a systematic search on Medline (PubMed), Scopus, Embase, and Web of Science, up till July 25, 2022. After article selection and screening, we performed a quality assessment using the Newcastle-Ottawa Scale. Furthermore, a statistical analysis and subgroup analysis was performed.
RESULTS
Eleven studies were included with a total of 809 participants (409 PD patients and 400 controls). A statistically significant difference in the CSA of the right and left VN between PD patients and healthy controls was observed, indicating the atrophy of VN in PD patients (p < 0.00001). The subgroup meta-analysis for average measurements of VN CSA showed insignificant heterogeneity for age (I = 48.67%, p = 0.058), level of measurements (I = 57.91%, p = 0.05), and disease duration (I = 27.1%, p = 0.241).
CONCLUSION
Our meta-analysis showed a sonographically detectable degree of neuronal damage in PD, which correlates with VN atrophy with high confidence. Therefore, we believe this is a potential marker for vagus neuronal lesions. Future studies are required to assess the potential clinical correlation.
背景
帕金森病(PD)是导致残疾的主要原因之一。我们旨在评估迷走神经(VN)超声检查的益处,以比较 PD 患者和健康对照组,并提供神经横截面积(CSA)的参考值。
材料和方法
我们在 2022 年 7 月 25 日之前对 Medline(PubMed)、Scopus、Embase 和 Web of Science 进行了系统搜索。在文章选择和筛选后,我们使用纽卡斯尔-渥太华量表进行了质量评估。此外,还进行了统计分析和亚组分析。
结果
共纳入 11 项研究,总计 809 名参与者(409 名 PD 患者和 400 名对照者)。观察到 PD 患者和健康对照组右侧和左侧 VN CSA 存在统计学显著差异,表明 PD 患者 VN 萎缩(p<0.00001)。VN CSA 平均测量的亚组荟萃分析显示,年龄(I=48.67%,p=0.058)、测量水平(I=57.91%,p=0.05)和疾病持续时间(I=27.1%,p=0.241)的异质性无统计学意义。
结论
我们的荟萃分析显示 PD 存在可通过超声检测到的神经元损伤程度,这与 VN 萎缩高度相关。因此,我们认为这是迷走神经神经元病变的潜在标志物。需要进一步的研究来评估其潜在的临床相关性。