背景:阿尔茨海默病(AD)是一种神经退行性疾病,发病隐匿。在疾病发作前确定预测AD痴呆风险的候选预测因子对于早期诊断和治疗至关重要。
目的:我们旨在评估血液神经丝光(NfL)链在预测AD连续体中认知能力下降方面的预测能力。
方法:我们系统地搜索了PubMed,WebofScience,和Embase从成立到2023年4月7日。根据纳入/排除标准,纳入了基线血液NfL与认知下降或临床疾病转化之间关联的纵向观察性研究。最终效应大小由调整后的风险比(HR)或标准化β(s.β)系数,置信区间为95%(CI)。
结果:共确定了2,862篇文章,26项研究纳入本荟萃分析.结果表明,基线血液NfL可以预测认知能力下降,与MMSE[s。β=-0.17,95%CI(-0.26,-0.07)];PACC[s。β=-0.09,95%CI(-0.16,-0.03)];ADAS-cog[s.β=0.21,95%CI(0.13,0.29)];CDR-SOB[s。β=0.27,95%CI(0.03,0.50)];全球认知综合[s。β=-0.05,95%CI(-0.08,-0.01)];记忆子域[s。β=-0.06,95%CI(-0.09,-0.03)];语言子域[s。β=-0.07,95%CI(-0.10,-0.05)];执行功能子域[s。β=-0.02,95%CI(-0.03,-0.01)];视觉空间子域[s。β=-0.06,95%CI(-0.08,-0.04)]。此外,基线血液NfL可以预测AD连续体中的疾病进展(从CU/SCD/MCI转变为MCI/AD)[调整HR=1.32,95%CI(1.12,1.56)]。
结论:基线血液NfL显示了对整体认知及其记忆的预测能力,语言,执行功能,视觉空间子域在AD连续体中下降。此外,它显示出预测非AD痴呆参与者疾病进展的潜力.
Alzheimer\'s disease (AD) is a neurodegenerative disease with insidious onset. Identifying candidate predictors to forecast AD dementia risk before disease onset is crucial for early diagnosis and treatment.
We aimed to assess the predictive ability of blood neurofilament light (NfL) chain in anticipating cognitive decline in the AD continuum.
We systematically searched PubMed, Web of Science, and Embase from inception until April 7, 2023. Longitudinal observational studies examining the association between baseline blood NfL and cognitive decline or clinical disease conversion were included based on inclusion/exclusion criteria. The final effect size was represented by adjusted hazard ratios (HR) or standardized beta (s.β) coefficients with a 95% confidence interval (CI).
A total of 2,862 articles were identified, and 26 studies were included in this meta-analysis. The results indicated that baseline blood NfL could predict cognitive decline, with MMSE [s.β= -0.17, 95% CI (-0.26, -0.07)]; PACC [s.β= -0.09, 95% CI (-0.16, -0.03)]; ADAS-cog [s.β= 0.21, 95% CI (0.13, 0.29)]; CDR-SOB [s.β= 0.27, 95% CI (0.03, 0.50)]; Global cognitive composite [s.β= -0.05, 95% CI (-0.08, -0.01)]; Memory subdomain [s.β= -0.06, 95% CI (-0.09, -0.03)]; Language subdomain [s.β= -0.07, 95% CI (-0.10, -0.05)]; Executive function subdomain [s.β= -0.02, 95% CI (-0.03, -0.01)]; Visuospatial subdomain [s.β= -0.06, 95% CI (-0.08, -0.04)]. Additionally, baseline blood NfL could predict disease progression (conversion from CU/SCD/MCI to MCI/AD) in the AD continuum [Adjust HR = 1.32, 95% CI (1.12, 1.56)].
Baseline blood NfL demonstrated predictive capabilities for global cognition and its memory, language, executive function, visuospatial subdomains decline in the AD continuum. Moreover, it exhibited the potential to predict disease progression in non-AD dementia participants.