Department of Neurology, Shanghai Electric Power Hospital, Shanghai, China.
Eur Rev Med Pharmacol Sci. 2024 Feb;28(3):899-906. doi: 10.26355/eurrev_202402_35327.
The pathogenesis of Parkinson's disease (PD) is associated with abnormal iron accumulation. Magnetic resonance imaging (MRI) studies have shown that patients with Parkinson's disease have an increased amount of iron in their substantia nigra (SN). We have undertaken a meta-analysis of studies using MRI in PD, to explore the potential role of MRI in diagnosing PD using abnormal iron deposition in SN as a candidate biomarker.
Searches of PubMed, Embase, and Medline databases revealed 16 studies that compared PD patients and healthy controls (HC). A sensitivity analysis and subgroup analysis were performed to evaluate the reliability of our results. Estimates were pooled by the fixed-effects model. As an expression of I2, we computed the proportion of variation due to heterogeneity.
We included 16 studies with sample sizes of 435 PD and 355 HC in our meta-analysis. Results showed that SN iron deposition was significantly elevated (p<0.00001) in patients with PD compared to HC ones (SMD=0.72, 95% confidence interval 0.57 to 0.87, p<0.00001).
Our findings, based on a homogeneous group-level analysis, suggest that MRI-based SN iron deposition could be used to distinguish PD from HC. For a more rigorous investigation of SN iron deposition in PD, larger cohort studies are needed.
帕金森病（PD）的发病机制与异常铁积累有关。磁共振成像（MRI）研究表明，帕金森病患者的黑质（SN）中铁含量增加。我们对使用 MRI 诊断 PD 的研究进行了荟萃分析，以探索 MRI 作为 SN 中异常铁沉积的候选生物标志物在诊断 PD 中的潜在作用。
在 PubMed、Embase 和 Medline 数据库中进行检索，共发现 16 项比较 PD 患者和健康对照者（HC）的研究。进行敏感性分析和亚组分析，以评估我们结果的可靠性。采用固定效应模型对估计值进行汇总。作为 I2 的表示，我们计算了由于异质性引起的变异比例。
我们将 16 项研究纳入荟萃分析，这些研究的样本量分别为 435 名 PD 患者和 355 名 HC。结果表明，与 HC 相比，PD 患者的 SN 铁沉积明显升高（p<0.00001）（SMD=0.72，95%置信区间 0.57 至 0.87，p<0.00001）。
基于同质组水平分析的结果表明，基于 MRI 的 SN 铁沉积可用于区分 PD 和 HC。为了更严格地研究 PD 中的 SN 铁沉积，需要更大的队列研究。
