Humayra Syeda, Yahya Noorazrul, Ning Chai Jia, Mir Imtiyaz Ali, Mohamed Abdul Latiff, Manan Hanani Abdul
Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of Radiology, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, School of Diagnostic and Applied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Front Neurol. 2024 Oct 15;15:1425399. doi: 10.3389/fneur.2024.1425399. eCollection 2024.
Functional magnetic resonance imaging (fMRI) is a useful tool to evaluate brain inefficiencies secondary to cardiovascular diseases (CVDs); nevertheless, limited fMRI studies have been conducted to investigate the effect of CVDs on brain functional changes and cognitive function. This systematic review aims to explore, synthesise, and report fMRI outcomes (resting state and task-based) and cognitive performance in patients with CVDs.
Two reviewers independently searched published literature until April 2024 on ScienceDirect, PubMed, Web of Science, and ClinicalTrials.gov adhering to the PRISMA protocol. A total of 26 eligible studies were considered for full-text screening, of which 10 were included in this review. The methodological quality was assessed by mixed methods appraisal tool and was reported as empirically fair.
Among 336 subjects with CVDs, aged between 49.90 ± 6.10 to 72.20 ± 5.70 years, the majority had coronary artery diseases (n = 177, 52.68%) and hypertension (n = 200, 59.52%), and approximately half of them were females (n = 169, 50.30%). Based on the qualitative synthesis, subjects with CVDs demonstrated an increased cognitive decline (reduced Mini-Mental State Examination/Montreal Cognitive Assessment mean values) and attenuated task performance (lower mean 2-back task scores and slower reaction time). Results also indicated impaired brain activity at the supplementary motor area associated with poor ejection fraction; reduced default mode network suppression linked to high low-density lipoprotein cholesterol; lower regional homogeneity and amplitude of low-frequency fluctuation values; and reduced functional connectivity. In summary, alterations in brain networks connectivity may have contributed to an impaired cognitive performance in patients with cardiovascular diseases.
It can be extrapolated that CVDs tend to alter the brain network connectivity and result in cognitive impairment and poorer task performance. However, for future imaging studies, more stringent and homogenous demographic data are highly recommended.
功能磁共振成像（fMRI）是评估心血管疾病（CVD）继发脑功能低下的有用工具；然而，针对CVD对脑功能变化和认知功能影响的fMRI研究有限。本系统评价旨在探索、综合并报告CVD患者的fMRI结果（静息态和基于任务的）及认知表现。
两名研究者按照PRISMA方案，独立检索截至2024年4月在ScienceDirect、PubMed、Web of Science和ClinicalTrials.gov上发表的文献。共筛选出26项符合条件的研究进行全文筛选，其中10项纳入本综述。采用混合方法评估工具评估方法学质量，并报告为经验性公平。
在336名年龄在49.90±6.10至72.20±5.70岁之间的CVD患者中，大多数患有冠状动脉疾病（n = 177，52.68%）和高血压（n = 200，59.52%），约一半为女性（n = 169，50.30%）。基于定性综合分析，CVD患者表现出认知能力下降加剧（简易精神状态检查表/蒙特利尔认知评估平均值降低）和任务表现减弱（2-back任务平均得分较低且反应时间较慢）。结果还表明，与射血分数降低相关的辅助运动区脑活动受损；与高低密度脂蛋白胆固醇相关的默认模式网络抑制减弱；区域同质性和低频波动值幅度降低；以及功能连接性降低。总之，脑网络连接性的改变可能导致了心血管疾病患者认知表现受损。
可以推断，CVD往往会改变脑网络连接性，导致认知障碍和较差的任务表现。然而，对于未来的影像学研究，强烈建议采用更严格和统一的人口统计学数据。
