在精神分裂症中隐藏的脑血管变化的流行:系统性审查和元分析
Shuxiang Shi1, Jiaxi Wang1, Huiqi Li1
1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
大脑小血管疾病 (CSVD) 和静音脑梗塞 (SBI) 在精神分裂症中很常见,脑缩 (BA) 显著升高. 需要更多的研究来澄清与白质超强度 (WMH) 和SBI的关联.
科学领域:
- 神经成像是一种神经成像.
- 精神病学是一个精神病学.
- 血管神经学 血管神经学
背景情况:
- 隐藏的脑血管变化,包括大脑小血管疾病 (CSVD) 和静音脑梗塞 (SBI),与精神分裂症的神经生物学有关,但往往被忽视.
- 本次元分析重点关注精神分裂症患者中这些变化的患病率和相关因素.
研究的目的:
- 估计精神分裂症中隐藏的大脑血管变化的综合流行率.
- 确定与这些变化相关的人口和临床因素.
- 为了比较精神分裂症患者和对照组之间这些变化的患病率.
主要方法:
- 系统地搜索国际和中国数据库的文献,直到2024年12月.
- 包括124项研究,包括11611名精神分裂症患者.
- 综合流行率估计,敏感性分析,子组分析和元回归的应用.
主要成果:
- 聚合的患病率估计:白质超强度 (WMH) 26.3%,周血管空间 45.7%,大脑缩 (BA) 34.8%,SBI 12.8%.
- 亚组分析显示,年龄,成像模式,中风/糖尿病排除和地区影响了患病率.
- 超回归将BA患病率与年龄较大,家族病史和最近的出版年份联系起来. 在患者中,BA显著更高 (PR=6.5),而WMH (PR=1.3) 和SBI (PR=2.0) 的差异并不显著.
结论:
- 神经成像显示在精神分裂症中经常出现WMH,SBI和BA,尽管异质性很高.
- 与对照组相比,在精神分裂症患者中观察到BA的强烈升高.
- 在精神分裂症中增加WMH或SBI的证据仍然没有确定性,需要标准化定义和风险评估.
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