■患有HIV相关神经认知障碍(HAND)的患者通常伴有白质结构损害。扩散张量成像(DTI)是检测白质结构损伤的重要工具。然而,在许多研究中报告的DTI值的变化在不同的白质纤维束和大脑区域是不同的.
■我们的研究致力于评估不同研究中HAND和DTI度量之间相关性的一致性和差异。此外,DTI在HAND评估中的价值用于获得研究之间的共识和独立结论。
■我们搜索了PubMed和WebofScience,收集使用DTI诊断HAND的相关研究。在筛选和评估搜索结果后,荟萃分析用于数据的定量研究。无法收集数据但符合研究相关性的文章将接受系统审查。
■荟萃分析表明,与健康对照组相比,HAND组具有较低的分数各向异性(标准化平均差=-0.57p<0.0001)和较高的平均扩散率(标准化平均差=0.04p<0.0001)。在其他白质纤维中,我们发现分数各向异性(标准化平均差=-1.18p<0.0001)和平均扩散率(标准化平均差=0.69p<0.0001)的变化相似。然而,研究之间的异质性(由I2表示)很高(在call体94,88%,在其他物质纤维中95,81%)。亚组分析后,异质性为19.5%,40.7%(FA,call体的MD)和0,0%(FA,在其他白质纤维中的MD)。
■与健康人相比,HAND患者的白质纤维变化在DTI的观察水平上具有统计学意义。这些研究之间的差异主要来自人口统计学,抗逆转录病毒治疗的开始和维持时间,在最低点CD4+T细胞的差异,并使用不同的神经认知功能量表。作为检测白质纤维变化的有效方法,DTI对HAND的诊断具有重要意义。但是仍然存在一些缺点。在没有神经认知功能量表的情况下,独立诊断仍然困难。系统审查注册:https://inplasy.com/inplasy-2021-10-0079/。
UNASSIGNED: The patients with HIV-associated neurocognitive disorder (HAND) are often accompanied by white matter structure damage. Diffusion tensor imaging (DTI) is an important tool to detect white matter structural damage. However, the changes in DTI values reported in many studies are diverse in different white matter fiber tracts and brain regions.
UNASSIGNED: Our research is dedicated to evaluating the consistency and difference of the correlation between HAND and DTI measures in different studies. Additionally, the value of DTI in HAND evaluation is used to obtain consensus and independent conclusions between studies.
UNASSIGNED: We searched PubMed and Web of Science to collect relevant studies using DTI for the diagnosis of HAND. After screening and evaluating the search results, meta-analysis is used for quantitative research on data. Articles that cannot collect data but meet the research relevance will be subjected to a system review.
UNASSIGNED: The meta-analysis shows that the HAND group has lower fractional anisotropy (standardized mean difference = -0.57 p < 0.0001) and higher mean diffusivity (standardized mean difference = 0.04 p < 0.0001) than the healthy control group in corpus callosum. In other white matter fibers, we found similar changes in fractional anisotropy (standardized mean difference = -1.18 p < 0.0001) and mean diffusivity (standardized mean difference = 0.69 p < 0.0001). However, the heterogeneity (represented by I2) between the studies is high (in corpus callosum 94, 88%, in other matter fibers 95, 81%). After subgroup analysis, the heterogeneity is obtained as 19.5, 40.7% (FA, MD in corpus callosum) and 0, 0% (FA, MD among other white matter fibers).
UNASSIGNED: The changes in white matter fibers in patients with HAND are statistically significant at the observation level of DTI compared with healthy people. The differences between the studies are mainly derived from demographics, start and maintenance time of antiretroviral therapy, differences in nadir CD4+T cells, and the use of different neurocognitive function scales. As an effective method to detect the changes in white matter fibers, DTI is of great significance for the diagnosis of HAND, but there are still some shortcomings. In the absence of neurocognitive function scales, independent diagnosis remains difficult.Systematic Review Registration: https://inplasy.com/inplasy-2021-10-0079/.