基于ALE的面肌痉挛功能和结构异常脑区的Meta分析

Meta-analysis of Brain Regions with Functional and Structural Abnormalities in Hemifacial Spasm Based on ALE

目的 通过荟萃分析探讨原发性面肌痉挛(hemifacial spasm,HFS)患者脑功能和结构的改变特点,进一步了解HFS的病理生理机制。方法收集2023年4月之前发表在相关数据库中关于HFS患者静息态功能磁共振成像(rest-state functional Magnetic resonance imaging,Rs-fMRI)和基于体素的形态学分析方法(voxel-based morphometry,VBM)的所有文章。根据纳入和排除标准筛选后,采用激活似然估计(activation likelihood estimation,ALE)方法进行meta分析。结果共纳入7篇文献、10项研究(原发性面肌痉挛患者315例,健康受试者315名),对低频振荡幅度(amplitude of low frequency fluctuation,ALFF)、低频振荡分数(Fractional amplitude of low-frequency fluctuation,fALFF)及局部一致性(regional homogeneity,ReHo)等RsfMRI指标进行功能分析。ALE-meta结果显示,相对于健康受试者,HFS患者的自发性脑功能活动在中央前回、后扣带回、脑桥及小脑显著升高,而在额中回及颞上回降低。将所有基于VBM的HFS患者灰质改变的文献进行结构分析,结果显示,相对于健康受试者,HFS患者的海马旁回、丘脑体积显著减小。结论HFS患者存在脑功能和结构的改变,主要表现为中央前回、脑桥、小脑和后扣带回脑区自发性脑功能活动的异常,以及突显网络结构的异常,初步阐明了HFS患者静息态脑功能活动及结构改变的规律及特征。

Objecttive To investigate the characteristics of brain function and structure in patients with primary hemifacial spasm by meta-analysis,and to further understand the pathophysiological mechanism of HFS.Methods All a rticles published before April 2023 in releva nt databases on resting-state functional magnetic resonance imaging and voxel-based morphological analysis methods in patients with HFS were collected.Studies were included according to the inclusion and exclusion criteria,and Metaanalysis was performed using activation likelihood estimation(ALE).Results A total of 7 articles and10 studies(315 patients with primary hemifacial spasm and 315 healthy subjects) were included.Multiple indicators of spontaneous brain activity,including ALFF,fALFF and ReH o,were com bined for functional analysis.ALE Meta-analysis results showed that the spontaneous brain activity of patients with HFS was significantly increased in the precentral gyrus,posterior cingulate gyrus,pons and cerebellu m,and significantly decreased in the middle frontal gyrus and superior temporal gyrus.The VBM was subjected to structural analysis,and the results showed that the parahippocampal gyrus and thalamus volumes were significa ntly reduced relative to healthy subjects.Conclusion Patients with HFS have changes in brain function and structure,mainly manifested as abnormal spontaneous brain activity in the precentral gyrus,pons,cerebellum and posterior cingulate gyrus,as well as abnormal salience network structure.The rules and characteristics of resting-state brain functional activity and structural changes in patients with HFS have been prelimina ries elucidated.