不同运动方案后脑源性神经营养因子(BDNF)水平的变化:帕金森病临床研究的系统评价

Changes of brain-derived neurotrophic factor (BDNF) levels after different exercise protocols: a systematic review of clinical studies in Parkinson's disease.

作者信息

Paterno Andrea, Polsinelli Giovanni, Federico Bruno

机构信息

Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Italy.

出版信息

Front Physiol. 2024 Feb 20;15:1352305. doi: 10.3389/fphys.2024.1352305. eCollection 2024.

Abstract

Brain-Derived Neurotrophic Factor (BDNF) serum levels are reduced in patients with Parkinson's Disease (PD). This study aimed to assess the effect of exercise intensity, volume and type on BDNF levels in patients with PD. We searched clinicaltrials.gov, CINAHL, Embase, PubMed, Scopus, Web of Science for both controlled and non-controlled studies in patients with PD, published between 2003 and 2022, which assessed Brain-Derived Neurotrophic Factor before and after different exercise protocols. Exercise intensity was estimated using a time-weighted average of Metabolic Equivalent of Task (MET), while exercise volume was estimated by multiplying MET for the duration of exercise. Exercise types were classified as aerobic, resistance, balance and others. We computed two distinct standardized measures of effects: Hedges' g to estimate differences between experimental and control group in pre-post intervention BDNF changes, and Cohen's d to measure pre-post intervention changes in BDNF values for each study arm. Meta-regression and linear regression were used to assess whether these effect measures were associated with intensity, volume and type. PROSPERO registration number: CRD42023418629. Sixteen studies (8 two-arm trials and 8 single-arm trials) including 370 patients with PD were eligible for the systematic review. Selected studies had a large variability in terms of population and intervention characteristics. The meta-analysis showed a significant improvement in BDNF levels in the exercise group compared to the control group, Hedges' g = 0.70 (95% CI: 0.03, 1.38), with substantial heterogeneity (I = 76.0%). Between-group differences in intensity were positively associated with change in BDNF in a subset of 5 controlled studies. In the analysis which included non-controlled studies, intensity and total exercise volume were both positively associated with BDNF change. No difference was found according to exercise type. Exercises of greater intensity may increase BDNF levels in patients with PD, while the role of volume of exercise needs to be further explored.

摘要

帕金森病(PD)患者血清中的脑源性神经营养因子(BDNF)水平会降低。本研究旨在评估运动强度、运动量和运动类型对PD患者BDNF水平的影响。我们在clinicaltrials.gov、CINAHL、Embase、PubMed、Scopus、Web of Science中检索了2003年至2022年间发表的关于PD患者的对照和非对照研究,这些研究评估了不同运动方案前后的脑源性神经营养因子。运动强度通过任务代谢当量(MET)的时间加权平均值来估计,而运动量则通过将MET与运动持续时间相乘来估计。运动类型分为有氧运动、抗阻运动、平衡运动和其他运动。我们计算了两种不同的标准化效应量:Hedges' g用于估计实验组和对照组在干预前后BDNF变化的差异,Cohen's d用于测量每个研究组中BDNF值在干预前后的变化。采用Meta回归和线性回归来评估这些效应量是否与强度、量和类型相关。PROSPERO注册号:CRD42023418629。16项研究(8项双臂试验和8项单臂试验),共370例PD患者符合系统评价的标准。所选研究在人群和干预特征方面存在很大差异。Meta分析显示,与对照组相比,运动组的BDNF水平有显著改善,Hedges' g = 0.70(95% CI:0.03,1.38),存在显著异质性(I = 76.0%)。在5项对照研究的子集中,组间强度差异与BDNF变化呈正相关。在纳入非对照研究的分析中,强度和总运动量均与BDNF变化呈正相关。未发现运动类型之间存在差异。强度更大的运动可能会提高PD患者的BDNF水平,而运动量的作用有待进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f533/10912511/85f6792d44d5/fphys-15-1352305-g001.jpg

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