轻度认知障碍磁共振扩散张量成像研究的Meta分析Measurement of diffusion tensor imaging in patients with mild cognitive impairment: a meta analysis
王东东;姜春晖;王俭;
摘要(Abstract):
目的用Meta分析法评价磁共振扩散张量成像对轻度认知障碍(mild cognitive impairment,MCI)的诊断价值。材料与方法使用计算机检索数据库Pubmed、CNKI、万方、维普等,收集有关磁共振扩散张量成像对MCI研究的文献,检索时限均为自建库至2015年1月31日。从文献中提取轻度认知障碍组与正常对照组(NC)所使用的定量指标各向异性(fractional anisotrophy,FA)值对不同脑区(额叶、顶叶、颞叶、枕叶、后扣带束、海马、海马旁回、内囊后肢、上、下纵束、穹窿、胼胝体膝部及压部、钩束)的测量数据,用Meta分析软件(Review manager 5.3)对最终符合标准的文献进行汇总分析,获得汇总加权均数差(weighted mean difference,WMD)及95%可信区间(95%CI)。结果共纳入47篇文献(30篇英文、17篇中文),MCI组的FA值低于NC组,汇总WMD及95%CI为–0.05[–0.05,0.04],上述脑区除枕叶外差异均具有统计学意义。结论 MCI患者存在脑白质微细结构的损害,弥散张量成像(diffusion tensor imaging,DTI)技术能够提供MCI的早期诊断指标。
关键词(KeyWords): 轻度认知障碍;扩散张量成像;Meta分析;帕金森病
基金项目(Foundation):
作者(Author): 王东东;姜春晖;王俭;
Email:
参考文献(References):
- [1]Ownby RL,Crocco E,Acevedo A,et al.Depression and risk for alzheimer's disease:systematic review,meta-analysis,and metaregression analysis.Arch Gen Psychiatry,2006,63(5):530-538.
- [2]Bai F,Zhang Z,Watson DR,et al.Abnormal integrity of association fiber tracts in amnestic mild cognitive impairment.J Neurol Sci,2009,278(1-2):102-106.
- [3]Cho H,Yang DW,Shon YM,et al.Abnormal integrity of corticocortical tracts in mild cognitive impairment:a diffusion tensor imaging study.J Korean Med Sci,2008,23(3):477-483.
- [4]Zhuang L,Wen W,Trollor JN,et al.Abnormalities of the fornix in mild cognitive impairment are related to episodic memory loss.J Alzheimers Dis,2012,29(3):629-639.
- [5]Pievani M,Agosta F,Pagani E,et al.Assessment of white matter tract damage in mild cognitive impairment and alzheimer's disease.Hum Brain Mapp,2010,31(12):1862-1875.
- [6]Nowrangi MA,Okonkwo O,Lyketsos C,et al.Atlas-based diffusion tensor imaging correlates of executive function.J Alzheimers Dis,2015,44(2):585-598.
- [7]Duffy SL,Paradise M,Hickie IB,et al.Cognitive impairment with and without depression history:an analysis of white matter micro structure.J Psychiatry Neurosci,2014,39(2):135-143.
- [8]Fellgiebel A,Muller MJ,Wille P,et al.Color-coded diffusiontensor-imaging of posterior cingulate fiber tracts in mild cognitive impairment.Neurobiol Aging,2005,26(8):1193-1198.
- [9]Stricker NH,Salat DH,Foley JM,et al.Decreased white matter integrity in neuropsychologically defined mild cognitive impairment is independent of cortical thinning.J Int Neuropsychol Soc,2013,19(8):925-937.
- [10]Milller MJ,Greverus D,Weibrich C,et al.Diagnostic utility of hippocampal size and mean diffusivity in amnestic MCI.Neurobiol Aging,2007,28(3):398-403.
- [11]Shim YS,Yoon B,Shon YM,et al.Difference of the hippocampal and white matter microalterations in MCI patients according to the severity of subcortical vascular changes:neuropsychological correlates of diffusion tensor imaging.Clin Neurol Neurosurg,2008,110(6):552-561.
- [12]Liu Y,Spulber G,Lehtimaki KK,et al.Diffusion tensor imaging and tract-based spatial statistics in alzheimer's disease and mild cognitive impairment.Neurobiol Aging,2011,32(9):1558-1571.
- [13]Zhang Y,Schuff N,Jahng GH,et al.Diffusion tensor imaging of cingulum fibers in mild cognitive impairment and alzheimer's disease.Neurology,2007,68(1):13-19.
- [14]Bozoki AC,Korolev IO,Davis NC,et al.Disruption of limbic white matter pathways in mild cognitive impairment and alzheimer's disease:a DTI/FDG-PET study.Hum Brain Mapp,2012,33(8):1792-1802.
- [15]Ukmar M,Makuc E,Onor ML,et al.Evaluation of white matter damage in patients with alzheimer's disease and in patients with mild cognitive impairment by using diffusion tensor imaging.Radiol Med,2008,113(6):915-922.
- [16]Hong YJ,Yoon B,Lim SC,et al.Micro structural changes in the hippocampus and posterior cingulate in mild cognitive impairment and alzheimer's disease:a diffusion tensor imaging study.Neurol Sci,2013,34(7):1215-1221.
- [17]Choo IH,Lee DY,Oh JS,et al.Posterior cingulate cortex atrophy and regional cingulum disruption in mild cognitive impairment and alzheimer's disease.Neurobiol Aging,2010,31(5):772-779.
- [18]Delano-Wood L,Stricker NH,Sorg SF,et al.Posterior cingulum white matter disruption and its associations with verbal memory and stroke risk in mild cognitive impairment.J Alzheimers Dis,2012,29(3):589-603.
- [19]Carter SF,Embleton KV,Anton-Rodriguez JM,et al.Regional neuronal network failure and cognition in late-onset sporadic alzheimer's disease.AJNR Am J Neuroradiol,2014,35(6Suppl):18-30.
- [20]Scrascia F,Curcio G,Ursini F,et al.Relationship among diffusion tensor imaging,EEG activity,and cognitive status in mild cognitive impairment and alzheimer's disease patients.J Alzheimers Dis,2014,38(4):939-950.
- [21]Goldstein FC,Mao H,Wang L,et al.White matter Integrity and episodic memory performance in mild cognitive impairment:a diffusion tensor imaging study.Brain Imaging Behav,2009,3(2):132-141.
- [22]Kiuchi K,Morikawa M,Taoka T,et al.Abnormalities of the uncinate fasciculus and posterior cingulate fasciculus in mild cognitive impairment and early alzheimer's disease:a diffusion tensor tractography study.BrainRes,2009,1287(9):184-191.
- [23]Huang J,Auchus AP.Diffusion tensor imaging of normal appearing white matter and its correlation with cognitive functioning in mild cognitive impairment and alzheimer's disease.Ann N Y Acad Sci,2007,1097(1):259-264.
- [24]Nishioka C,Poh C,Sun SW.Diffusion tensor imaging reveals visual pathway damage in patients with mild cognitive impairment and alzheimer's disease.J Alzheimers Dis,2015,45(1):97-107.
- [25]Zimny A,Szewczyk P,Bladowska J,et al.Quantitative evaluation of changes in the selected white matter tracts using diffusion tensor imaging in patients with alzheimer's disease and mild cognitive impairment.Neuroradiol J,2012,25(3):300-310.
- [26]Fujie S,Namiki C,Nishi H,et al.The role of the uncinate fasciculus in memory and emotional recognition in amnestic mild cognitive impairment.Dement Geriatr Cogn Disord,2008,26(5):432-439.
- [27]Chen TF,Lin CC,Chen YF,et al.Diffusion tensor changes in patients with amnesic mild cognitive impairment and various dementias.Psychiatry Res,2009,173(1):15-21.
- [28]Thillainadesan S,Wen W,Zhuang L,et al.Changes in mild cognitive impairment and its subtypes as seen on diffusion tensor imaging.Int Psychogeriatr,2012,24(9):1483-1493.
- [29]Rogalski EJ,Murphy CM,deToledo-Morrell L,et al.Changes in parahippocampal white matter integrity in amnestic mild cognitive impairment:a diffusion tensor imaging study.Behav Neurol,2009,21(1):51-61.
- [30]Sali D,Verganelakis DA,Gotsis E,et al.Diffusion tensor imaging(DTI)in the detection of white matter lesions in patients with mild cognitive impairment(MCI).Acta Neurol Belg,2013,113(4):441-451.
- [31]Larroza A,Moratal D,D'Ocon AV,et al.Tractography of the uncinate fasciculus and the posterior cingulate fasciculus in patients with mild cognitive impairment and Alzheimer disease.Neurologia,2014,29(1):11-20.
- [32]Gao GF.DTI study of alzheimer's disease,mild cognitive impairment.Tianjin:Tianjin Medical University,2006.高光峰.Alzheimer病及轻度认知障碍磁共振扩散张量成像的研究.天津:天津医科大学,2006.
- [33]Wang JH,Lv PY,Wang H,et al.Study of micro structural white matter lesions in patients with mild cognitive impairment and mild and moderate alzheimer's disease.Chinese Journal of Neuroimmunology and Neurology,2010,17(3):211-214.王建华,吕佩源,王贺波,等.DTI评价轻度认知障碍及轻中度阿尔茨海默病脑白质微细结构损害的研究.中国神经免疫学和神经病学杂志,2010,17(3):211-214.
- [34]Wu T,Liu W,Xiao CY,et al.Study of diffusion tensor imaging in patients with alzheimer's disease and mild cognitive impairment.Journal of Clinical Psychiatry,2009,19(4):224-226.吴婷,刘文,肖朝勇,等.阿尔茨海默病与轻度认知障碍弥散张量成像研究.临床精神医学杂志,2009,19(4):224-226.
- [35]Chen H,Hong N,Yu X,et al.Diffusion tentor imaging evaluation of white matter alternations in patients with mild cognitive impairment.Chin J Med Imaging Technol,2009,25(8):1358-1360.陈皓,洪楠,于欣,等.磁共振扩散张量成像评价轻度认知障碍患者的脑白质变化.中国医学影像技术,2009,25(8):1358-1360.
- [36]Chang C,Li WB,Xie WH,et al.Diffusion tensor imaging of association fiber tracts in amnestic mild cognitive.Chin J Med Imaging Technol,2010,26(1):56-59.常城,李文彬,谢文晖,等.扩散张量成像观察遗忘型轻度认知障碍患者联合纤维束.中国医学影像技术,2010,26(1):56-59.
- [37]Ji M,Ye CT,Miao HD,et al.Quantitive evaluation of senile mild cognitive impairment using MR DTI.Shanghai Medical Imaging,2011,20(3):200-204.嵇鸣,叶春涛,苗华栋,等.老年轻度认知功能障碍的高场MR脑DTI定量研究.上海医学影像,2011,20(3):200-204.
- [38]Ren QY,He L,Liu Z,et al.Diffusion tensor imaging study of cingulum fibers in mild cognitive impairment.Journal of clinical rational druguse,2014,7(2):23-24.任庆云,何丽,刘斋,等.轻度认知功能障碍患者后扣带回的磁共振扩散张量成像研究.临床合理用药杂志,2014,7(2):23-24.
- [39]Ren QY,He L,Liu Z,et al.FA value alteration in white in patients with mild cognitive impairment measured by MR diffusion tensor imaging.Journal of difficult diseases,2014,13(1):34-36,39.任庆云,何丽,刘斋,等.轻度认知功能障碍患者在MR扩散张量成像中脑白质各向异性分数值的变化.疑难病杂志,2014,13(1):34-36,39.
- [40]Liao J,Yuan HS,Zhu Y,et al.MR diffusion tensor imagingbased white matter studies in mild cognitive impairment and Alzheimer disease.Zhonghua Fang She Xue Za Zhi,2009,43(5):490-494.廖晶,袁慧书,朱玥,等.轻度认知功能障碍及阿尔茨海默病脑白质的MR扩散张量成像研究.中华放射学杂志,2009,43(5):490-494.
- [41]He L,Liu Z,Ren QY,et al.The study of diffusion tensor imaging in patients with mild cognitive impairment.J Pract Radiol,2014,30(8):1255-1258.何丽,刘斋,任庆云,等.轻度认知障碍的MR扩散张量成像研究.实用放射学杂志,2014,30(8):1255-1258.
- [42]Huang TT,Liu F,Liu ZL,et al.The application tensor imaging on 3.0 T MR in amnestic mild cognitive impairment.J Chin Clin Med Imaging,2012,23(2):77-80.黄婷婷,刘鹏飞,刘志兰,等.遗忘型轻度认知障碍的弥散张量成像研究.中国临床医学影像杂志,2012,23(2):77-80.
- [43]Hou MD,Fan GG,Li SB,et al.Diffusion tensor imaging for evaluating white matter fiber tracts in patients with amnestic mild cognitive impairment.Radiology Practice,2014,29(12):1392-1395.侯美丹,范国光,李松柏,等.遗忘型轻度认知障碍脑白质纤维束扩散张量成像研究.放射学实践,2014,29(12):1392-1395.
- [44]Wu J,Gu HM,Cao L,et al.Study of white matter tractography in patients with amnestic mild cognitive impairment.J Pract Radiol,2014,30(11):1787-1790,1801.吴娟,顾红梅,曹亮,等.遗忘型轻度认知障碍的脑白质纤维束成像研究.实用放射学杂志,2014,30(11):1787-1790,1801.
- [45]Ling RJ,Ni XS,Zhang L,et al.The correlation between diffusion tensor imaging and cognitive function in elders.Chinese Clinical Neuroscience,2010,18(6):622-630.凌茹晶,倪秀石,张琳,等.弥散张量成像与老年人认知功能的相关性.中国临床神经科学,2010,18(6):622-630.
- [46]Yang YH,Liang PP,Qin W,et al.DTI study of the white matter of dorsa lateral prefrontal cortex in patients with mild cognitive impairment.J Clin Radiol,2010,29(4):432-435.杨延辉,梁佩鹏,秦文,等,轻度认知障碍患者背外侧前额叶白质的DTI研究.临床放射学杂志,2010,29(4):432-435.
- [47]Zheng HX.The applying value of diffusion kurtosis imaging in mild cognitive impairment and alzheimer's disease.Taiyuan:Shanxi Medical University,2013.郑慧鑫.扩散峰度成像在轻度认知障碍及阿尔茨海默病中的应用价值.太原:山西医科大学,2013.
- [48]Zhao Q.The value of magnetic resonance diffusion tensor imaging in patients with mild cognitive impairment.Jinan:Shandong University,2013.赵强.磁共振弥散张量成像在轻度认知功能障碍中的应用价值研究.济南:山东大学,2012.
- [49]Sexton CE,Kalu UG,Filippini N,et al.A meta-analysis of diffusion tensor imaging in mild cognitive impairment and alzheimer's disease.Neurobiol Aging,2011,32(12):5-18.
- [50]Li SJ,Wu XB,Zhang SW,et al.Meta analysis on apparent diffusion coefficient used to differentiate benign from malignant soft tissue tumors.Chin J Magn Reson Imaging,2012,3(4):255-259.李树金,吴晓冰,张绍伟,等.表观扩散系数鉴别良恶性软组织肿瘤价值的Meta分析.磁共振成像,2012,3(4):255-259.
- [51]Yoshiura T,Wu O,Zaheer A,et al.Highly diffusion-sensitized MRI of brain:dissociation of gray and white matter.Magn Reson Med,2001,45(5):734-740.
- [52]Zimny A,Szewczyk P,Trypka E,et al.Multimodal imaging in diagnosis of alzheimer's disease and amnestic mild cognitive impairment:value of magnetic resonance spectroscopy,perfusion,and diffusion tensor imaging of the posterior cingulate region.J Alzheimers Dis,2011,27(3):591-601.
- [53]Zhang Y,Schuff N,Jahng GH,et al.Diffusion tensor imaging of cingulum fibers in mild cognitive impairment and alzheimer's disease.Neurology,2007,68(1):13-19.
- [54]Mielke MM,Kozauer NA,Chan KC,et al.Regionally-specific diffusion tensor imaging in mild cognitive impairment and alzheimer's disease.Neuroimage,2009,46(1):47-55.
- [55]Nowrangi MA,Lyketsos CG,Leoutsakos JM,et al.Longitudinal,region-specific course of diffusion tensor imaging measures in mild cognitive impairment and alzheimer's disease.Alzheimers Dement,2013,9(5):519-528.
- [56]Clerx L,Visser PJ,Verhey F,et al.New MRI markers for alzheimer's disease:a meta-analysis of diffusion tensor imaging and a comparison with medial temporal lobe measurements.J Alzheimers Dis,2012,29(2):405-429.
- [57]Tang SX,Dai JP.DTI and SWI application progress on hipppcampus in patients with alzheimer's disease.Chin J Magn Reson Imaging,2015,6(9):699-703.唐守现,戴建平.扩散张量成像和磁敏感加权成像在阿尔茨海默病海马的研究进展.磁共振成像,2015,6(9):699-703.
- [58]Elderkin-Thompson V,Ballmaier M,Hellemann G,et al.Executive function and MRI prefrontal volumes among healthy older adults.Neuropsychology,2008,22(5):626-37.
- [59]Hamidi M,Tononi G,Postle BR.Evaluating frontal and parietal contributions to spatial working memory with repetitive transcranial magnetic stimulation.Brain Res,2008,1230(9):202-210.
- [60]Pantel J,Schroder J,Jauss M,et al.Topography of callosal atrophy reflects distribution of regional cerebral volume reduction in alzheimer's disease.Psychiatry Res,1999,90(3):181-192.