Reliability of White Matter Microstructural Changes in HIV Infection: Meta-Analysis and Confirmation.
Reliability of White Matter Microstructural Changes in HIV Infection: Meta-Analysis and Confirmation.
复制标题
DOI：
10.3174/ajnr.a5229
复制
发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Zeffiro TA
中科院分区：
文献类型：
--
作者：
O'Connor EE;Jaillard A;Renard F;Zeffiro TA
扩散张量成像（DTI）已被广泛用于测量HIV对白色物质（WM）微结构的影响。虽然许多人报告减少分数各向异性（FA）和增加的平均扩散率（MD）在艾滋病毒，定量不一致的研究是很大的。评价HIV对DTI测量影响的研究的一致性，然后在纵向血清阳性队列中检查DTI的可靠性。荟萃分析包括16项报告FA的横断面研究和12项报告胼胝体MD的研究。随机效应荟萃分析被用来估计研究标准化平均差异（smd）和异质性。DTI纵向可靠性估计血清阳性研究前，三个月和六个月后，开始治疗。荟萃分析显示，血清阳性者FA较低（smd-0.43; p<0.0001），MD较高（smd 0.44; p<0.003）。然而，研究间异质性占观察到的方差的58%和66%（p<0.01）。相比之下，血清阳性者的纵向队列FA较高，MD较低（均p<.0001），FA和MD测量值在6个月内高度稳定，组内相关系数均>0.96。许多研究汇集了不同治疗、年龄和疾病持续时间的参与者。HIV对WM微观结构的影响表现出很大的变化，可能是由于收购，加工或队列选择的差异。当采集参数和处理仔细控制，得到的DTI措施没有表现出高的时间变化。HIV对WM微结构的影响可能是年龄依赖性的。DTI WM微观结构测量的高度纵向可靠性使其成为有前途的疾病活动性标记物。
Diffusion tensor imaging (DTI) has been widely used to measure HIV effects on white matter (WM) microarchitecture. While many have reported reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in HIV, quantitative inconsistencies across studies are large. To evaluate the consistency across studies of HIV effects on DTI measures and then examine DTI reliability in a longitudinal seropositive cohort. The meta-analysis included 16 cross-sectional studies reporting FA and 12 studies reporting MD in the corpus callosum. Random effects meta-analysis was used to estimate study standardized mean differences (smd) and heterogeneity. DTI longitudinal reliability was estimated in seropositives studied before, and three and six months after, beginning treatment. Meta-analysis revealed lower FA (smd −0.43; p<0.0001) and higher MD (smd 0.44; p<0.003) in seropositives. Nevertheless, between study heterogeneity accounted for 58% and 66% of the observed variance (p<0.01). In contrast, the longitudinal cohort FA was higher and MD lower in seropositives (both p<.0001) and FA and MD measures were highly stable over six months, with intra-class correlation coefficients all >0.96. Many studies pooled participants with varying treatments, ages and disease durations. HIV effects on WM microstructure exhibited substantial variations that could result from acquisition, processing or cohort selection differences. When acquisition parameters and processing were carefully controlled, the resulting DTI measures did not show high temporal variation. HIV effects on WM microstructure may be age dependent. The high longitudinal reliability of DTI WM microstructure measures make them promising disease activity markers.