轻度脑损伤病人任务态fMRI脑区激活:元分析

Task-state fMRI activations in patients with mild traumatic brain injury: a meta-analysis

目的运用激活似然估计(activation likelihood estimation,ALE)元分析探讨轻度创伤性脑损伤(mild traumatic brain injury,mTBI)病人认知相关脑区激活特点,并试图阐明mTBI病人认知功能改变的神经机制。方法系统检索中文及外文数据库,检索时间从建库开始至2020年3月2日。运用软件Ginger-ALE 3.0.2进行坐标统一化与元分析。计算出的脑区ALE分布图通过Mango软件与Brainnet Review软件呈现。结果共纳入7项研究,其中mTBI病例174例,健康对照者140例。元分析结果显示:与健康被试者相比,mTBI病人左前叶角回、左枕叶视觉联合、左侧中脑、右颞叶角回、右侧小脑扁桃体等脑区激活增强,而右背外侧前额叶、左小脑前叶、左背外侧前额叶、右侧额中回、右侧后扣带回等脑区激活减弱。进一步联合分析发现:右侧额中回背外侧前额叶为共激活减弱脑区。结论右侧额中回背外侧前额叶激活减弱是区分mTBI病人与健康被试者的主要脑区。此外,认知障碍可能与右侧额中回背外侧前额叶激活减弱有关,这可能与控制注意力的神经网络的募集能力下降有关。

Objective To analyze the activation characteristics of cognition-related brain regions in patients with mild traumatic brain injury(mTBI) by activation likelihood estimation(ALE), and explore the neural mechanism of changes in cognitive function in patients with mTBI. Methods The Chinese databases and English databases were systematically searched from the inception dates to March 2, 2020. The software Ginger-ALE 3.0.2 for coordinate unification and meta-analysis was used. The calculated ALE distribution map of the brain area was presented by Mango software and Brainnet Review software. Results A total of 7 studies were included, with a total of 314 participants, including 174 mTBI cases and 140 healthy volunteers. The meta-analysis demonstrated that compared with healthy volunteers, the activation of left anterior lobe angle gyrus, left occipital lobe visual union,left midbrain, right temporal lobe angle gyrus and right cerebellar tonsil were increased in mTBI patients;and the activation of right lateral dorsal prefrontal lobe, left cerebellar frontal lobe, left lateral dorsal prefrontal lobe, right midfrontal gyrus and right posterior cingulate gyrus were decreased in mTBI patients. Furthermore, conjunction analysis indicated that the dorsal lateral prefrontal lobe of the right middle frontal gyrus was a zone of reduced coactivation. Conclusions The weakened dorsal lateral prefrontal activation of the right middle frontal gyrus is the main brain area that distinguishes mTBI patients from healthy volunteers. Cognitive impairment may be associated with reducing activation of the dorsal lateral prefrontal lobe of the right middle frontal gyrus, which may be related to decreased recruitment capacity of the neural network that controls attention.