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静息态功能磁共振成像指导下非侵入性脑刺激对轻度认知障碍和阿尔茨海默病患者认知功能的影响:系统评价和荟萃分析。

The effects of noninvasive brain stimulation on cognitive function in patients with mild cognitive impairment and Alzheimer's disease using resting-state functional magnetic resonance imaging: A systematic review and meta-analysis.

机构信息

Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.

Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.

出版信息

CNS Neurosci Ther. 2023 Nov;29(11):3160-3172. doi: 10.1111/cns.14314. Epub 2023 Jun 22.

Abstract

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the efficacy of noninvasive brain stimulation (NIBS) on cognition using functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), thus providing the neuroimaging mechanism of cognitive intervention.

METHODS

English articles published up to April 30, 2023 were searched in the PubMed, Web of Science, Embase, and Cochrane Library databases. We included randomized controlled trials where resting-state fMRI was used to observe the effect of NIBS in patients with MCI or AD. RevMan software was used to analyze the continuous variables, and SDM-PSI software was used to perform an fMRI data analysis.

RESULTS

A total of 17 studies comprising 258 patients in the treatment group and 256 in the control group were included. After NIBS, MCI patients in the treatment group showed hyperactivation in the right precuneus and decreased activity in the left cuneus and right supplementary motor area. In contrast, patients in the control group showed decreased activity in the right middle frontal gyrus and no hyperactivation. The clinical cognitive scores in MCI patients were significantly improved by NIBS, while not in AD. Some evidence regarding the modulation of NIBS in resting-state brain activity and functional brain networks in patients with AD was found.

CONCLUSIONS

NIBS could improve cognitive function in patients with MCI and AD. fMRI evaluations could be added to evaluate the contribution of specific NIBS treatment therapeutic effectiveness.

摘要

目的

本系统评价和荟萃分析旨在评估非侵入性脑刺激(NIBS)对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者认知功能的疗效,从而提供认知干预的神经影像学机制。

方法

检索 PubMed、Web of Science、Embase 和 Cochrane Library 数据库中截至 2023 年 4 月 30 日发表的英文文章。我们纳入了使用静息态 fMRI 观察 NIBS 对 MCI 或 AD 患者影响的随机对照试验。使用 RevMan 软件分析连续变量,使用 SDM-PSI 软件进行 fMRI 数据分析。

结果

共纳入 17 项研究,治疗组 258 例,对照组 256 例。NIBS 后,治疗组 MCI 患者右侧顶下小叶活动增强,左侧楔前叶和右侧辅助运动区活动减少。而对照组患者右侧额中回活动减少,无活动增强。NIBS 可显著改善 MCI 患者的临床认知评分,但对 AD 患者无效。还发现了一些关于 AD 患者静息态脑活动和功能脑网络中 NIBS 调节的证据。

结论

NIBS 可改善 MCI 和 AD 患者的认知功能。可以进行 fMRI 评估以评估特定 NIBS 治疗疗效的贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d544/10580344/4478cabcea4d/CNS-29-3160-g001.jpg

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