基于静息态磁共振功能成像对阿尔茨海默病轻度认知障碍期默认网络与内侧颞叶区脑功能连接研究的Meta分析OA

Objective To explore the diagnostic value of resting-state functional magnetic resonance imaging(rs-fMRI)for mild cognitive impairment(MCI)stage of Alzheimer's disease(AD),and to investigate the changes in brain functional connectivity in default mode network(DMN)and medial temporal lobe(MTL)regions. Methods Literatures were retrieved from multiple databases including CNKI,PubMed,Medline,and Embase,etc.from January,2020 to October,2025,investigating the changes in functional connectivity of DMN and MTL in pa-tients with MCI compared to health control(HC)using rs-fMRI.Two researchers independently screened and ex-tracted the literatures and methodological quality was assessed using QUADAS-2.Review Manager 5.4 was used to perform a meta-analysis of neuroimaging indicators in MCI patients and HC subjects.Stata and SDM were uti-lized to summarize diagnostic efficacy and brain functional connectivity,calculating the over all sensitivity,speci-ficity and summary receiver operating characteristic-area under the curve(SROC-AUC).Deeks funnel plots were drawn,literature weights were analyzed,and subgroup analyses were conducted. Results A total of ten literatures were ultimately included,involving 1 010 patients with MCI and 1 714 HC subjects.MCI patients showed decreased or abnormal blood oxygen level dependence signals in DMN,focusing on bilater-al medial prefrontal cortex(mPFC)and posterior cingulate cortex.The SROC-AUC was 0.91.In MTL,there was a characteristic decrease of spontaneous neural functional connectivities between the hippocampus and other re-gions,reflecting the obstruction of information transmission from episodic memory to the central nodes.Abnor-mal functional connectivity in DMN and MTL resulted in compensatory resting-state functional connectivity en-hancement in other subnetworks or local functional connections,such as frontoparietal network and the hippo-campal-parietal network.Abnormal activation of mPFC suggested atrophy of the hippocampus or abnormal brain function.The decline in functional connectivity between DMN and MTL indicated impairment of memory and in-formation processing in the early stage. Conclusion The early functional decoupling between DMN and MTL is a crucial neural mechanism at the MCI stage of AD,providing important neuroimaging evidence for the early diagnosis of AD.