基因多态性与中风后上肢运动改善--系统回顾与荟萃分析。

IF 2.6 Q2 CLINICAL NEUROLOGY
Journal of Central Nervous System Disease Pub Date : 2024-07-19 eCollection Date: 2024-01-01 DOI:10.1177/11795735241266601
Sandeep K Subramanian, Riley T Morgan, Carl Rasmusson, Kayla M Shepherd, Carol L Li
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引用次数: 0

摘要

背景:中风后上肢(UL)运动的改善与适应性神经可塑性和运动学习有关。干预相关因素(包括提供强化、可变和特定任务练习)和个体特定因素(包括基因多态性的存在)都会影响运动能力的改善。在中风患者中,最常见的多态性存在于脑衍生神经营养因子(BDNF)、载脂蛋白(APOE)和儿茶酚-O-甲基转移酶(COMT)中。这些多聚酶涉及用精氨酸取代胱氨酸(APOEε4)或用 1 或 2 个蛋氨酸取代缬氨酸(BDNF:val66met, met66met; COMT:val158met; met158met)。然而,这些多态性对脑卒中后UL运动改善的具体影响尚未阐明:研究基因多态性对卒中后UL运动改善的影响:设计:系统回顾和荟萃分析:我们对英文发表的文献进行了系统检索。改良的 Downs 和 Black 检查表有助于评估研究质量。我们比较了具有和不具有多态性的个体在 UL 运动损伤和活动评分方面的变化。Meta 分析有助于评估运动障碍(Fugl Meyer 评估)评分的变化,其依据是至少 2 项研究/时间点。根据康复治疗规范系统对效应大小(ES)进行量化:小(0.08-0.18)、中(0.19-0.40)和大(≥0.41):我们检索到 10 项研究(4 项质量良好,6 项质量一般)。与 BDNF val66met 和 met66met 多态性患者相比,荟萃分析表明,无多态性的患者在干预完成时(0.5,95% CI:0.11-0.88)和保留时(0.58,95% CI:0.06-1.11)运动损伤较低(大 ES)。存在 CoMT val158met 或 met158met 多态性的结果相似,无多态性者的损伤程度较低(大 ES ≥1.5),活动评分较高(大 ES 为 0.5-0.76 不等)。APOEε4的存在并不影响UL运动能力的改善:结论:BDNF和COMT中存在1个或2个met等位基因的多态性对UL运动改善有负面影响。注册:https://osf.io/wk9cf/。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Genetic polymorphisms and post-stroke upper limb motor improvement - A systematic review and meta-analysis.

Background: Post-stroke upper limb (UL) motor improvement is associated with adaptive neuroplasticity and motor learning. Both intervention-related (including provision of intensive, variable, and task-specific practice) and individual-specific factors (including the presence of genetic polymorphisms) influence improvement. In individuals with stroke, most commonly, polymorphisms are found in Brain Derived Neurotrophic Factor (BDNF), Apolipoprotein (APOE) and Catechol-O-Methyltransferase (COMT). These involve a replacement of cystine by arginine (APOEε4) or valines by 1 or 2 methionines (BDNF:val66met, met66met; COMT:val158met; met158met). However, the implications of these polymorphisms on post-stroke UL motor improvement specifically have not yet been elucidated.

Objective: Examine the influence of genetic polymorphism on post-stroke UL motor improvement.

Design: Systematic Review and Meta-Analysis.

Methods: We conducted a systematic search of the literature published in English language. The modified Downs and Black checklist helped assess study quality. We compared change in UL motor impairment and activity scores between individuals with and without the polymorphisms. Meta-analyses helped assess change in motor impairment (Fugl Meyer Assessment) scores based upon a minimum of 2 studies/time point. Effect sizes (ES) were quantified based upon the Rehabilitation Treatment Specification System as follows: small (0.08-0.18), medium (0.19 -0.40) and large (≥0.41).

Results: We retrieved 10 (4 good and 6 fair quality) studies. Compared to those with BDNF val66met and met66met polymorphism, meta-analyses revealed lower motor impairment (large ES) in those without the polymorphism at intervention completion (0.5, 95% CI: 0.11-0.88) and at retention (0.58, 95% CI:0.06-1.11). The presence of CoMT val158met or met158met polymorphism had similar results, with lower impairment (large ES ≥1.5) and higher activity scores (large ES ranging from 0.5-0.76) in those without the polymorphism. Presence of APOEε4 form did not influence UL motor improvement.

Conclusion: Polymorphisms with the presence of 1 or 2 met alleles in BDNF and COMT negatively influence UL motor improvement.

Registration: https://osf.io/wk9cf/.

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6.90
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