运动干预对帕金森病患者神经可塑性的影响:基于脑成像研究的ALE元分析

目的:帕金森病(Parkinson Disease,PD)是高发的运动障碍疾病,运动干预影响PD大脑活动和神经可塑性的研究结果不一致且机制未明。综合现有基于坐标点的功能性脑成像随机对照实验,可提供运动干预对PD神经可塑性影响的综合证据。方法:基于关键词在Medline,Embase,Cochrane,PsycINFO,PubMed等数据库其检索到以613篇文献,根据筛选标准最终纳入10篇,样本量共计137人。运用Ginger ALE软件,对纳入的文献进行激活似然估计(Activation Likelihood Estimation,ALE)元分析,计算每个脑区跨实验激活的可能性。结果:运动干预影响PD脑区激活的坐标点共71个,计算得出14个激活峰值点:包括左右大脑内侧额叶,左右小脑前叶、基底节;左半球颞中回、中脑;右半球扣带回、梭状回、舌状回、额下回和中央后回。结论:运动干预显著激活了与PD核心病理性损伤的脑区以及运动执行控制相关脑区。运动干预在脑激活层面有益于PD患者神经可塑性变化,这种变化可能是多个脑区协同变化的结果。

Effects of Exercise Intervention on Neuroplasticity in Patients with Parkinson’s Disease: ALE Meta-analysis Based on Brain Imaging Studies

Parkinson’s Disease (PD) is a high incidence of movement disorders.Studies on the effect of exercise intervention on PD brain activity and neuroplasticity are inconsistent and the mechanism is unclear.Comprehensive evidence of the effect of exercise intervention on PD neuroplasticity can be provided by combining existing coordinate point-based randomized controlled experiments of functional brain imaging.Based on the key words of Medline,Embase,Cochrane,PsycINFO,PubMed and other databases,613 papers were obtained.According to the screening criteria,10 papers were finally included,involving 137 people.By using Ginger ALE software,activation Likelihood Estimation (ALE) meta-analysis was performed for the included papers to calculate the possibility of cross-experimental activation for each brain region.It was found that there were 71 coordinate points that exercise intervention affected activation of PD brain area,and 14 activation peaks were calculated including left and right medial frontal lobe,left and right anterior cerebellum,basal ganglia,left hemisphere middle temporal gyrus and middle brain,right cingulate gyrus,fusiform gyrus,lingual gyrus,inferior frontal gyrus and posterior central gyrus.It could be concluded that exercise intervention significantly activated the brain regions associated with pathological injury of PD core and motor executive control.Exercise intervention was beneficial to the changes of neuroplasticity in PD patients at the level of brain activation,which might be the result of synergistic changes in multiple brain regions.