目的:使用tau-正电子发射断层扫描(PET)成像评估进行性核上性麻痹(PSP)患者与健康对照(HC)或其他神经退行性疾病之间tau负荷的差异。
方法:在PubMed上进行系统搜索,Embase,和WebofScience数据库用于PSP患者的tau-PET研究,到2022年4月1日使用随机效应模型计算tau示踪剂摄取的标准化平均差(SMD)。基于tau示踪剂类型的亚组分析,元回归,并进行了敏感性分析。
结果:27项研究,包括553PSP,626HC,和406其他神经退行性疾病被包括在内。与HC相比,PSP患者显示基底神经节中tau结合升高,中脑,齿状核,小脑白质,和额叶,SMD减少(SMD:0.390-1.698)。与帕金森病患者相比,在中脑中发现tau结合增加,基底神经节,齿状核,PSP患者额叶和顶叶的SMD降低(SMD:0.503-1.853)。PSP患者在丘脑底核(SMD=1.351)和苍白球(SMD=1.000)中显示出较高的tau结合,与阿尔茨海默病患者相比,皮质和海马旁回的结合较低(SMD:-2.976至-1.018)。PSP患者的中脑tau结合力高于多系统萎缩患者(SMD=1.269)。
结论:TauPET成像显示PSP患者与HC或其他神经退行性疾病之间tau沉积的不同形貌。在解释结果时,应考虑示踪剂对4R-tau的亲和力和选择性以及示踪剂的脱靶结合。
OBJECTIVE: To evaluate the difference of tau burden between patients with progressive supranuclear palsy (PSP) and healthy controls (HCs) or other neurodegenerative diseases using tau-positron emission tomography (PET) imaging.
METHODS: A systematic search on PubMed, Embase, and Web of Science databases was performed for tau-PET studies in PSP patients, up to April 1, 2022. Standardized mean differences (SMDs) of tau
tracer uptake were calculated using random-effects models. Subgroup analysis based on the type of tau tracers, meta-regression, and sensitivity analysis were conducted.
RESULTS: Twenty-seven studies comprising 553 PSP, 626 HCs, and 406 other neurodegenerative diseases were included. Compared with HCs, PSP patients showed elevated tau binding in basal ganglia, midbrain, dentate nucleus, cerebellar white matter, and frontal lobe with decreasing SMD (SMD: 0.390-1.698). Compared with Parkinson\'s disease patients, increased tau binding was identified in the midbrain, basal ganglia, dentate nucleus, and frontal and parietal lobe in PSP patients with decreasing SMD (SMD: 0.503-1.853). PSP patients showed higher tau binding in the subthalamic nucleus (SMD = 1.351) and globus pallidus (SMD = 1.000), and lower binding in the cortex and parahippocampal gyrus than Alzheimer\'s disease patients (SMD: - 2.976 to - 1.018). PSP patients showed higher midbrain tau binding than multiple system atrophy patients (SMD = 1.269).
CONCLUSIONS: Tau PET imaging indicates different topography of tau deposition between PSP patients and HCs or other neurodegenerative disorders. The affinity and selectivity of tracers for 4R-tau and the off-target binding of tracers should be considered when interpreting the results.