中国精神分裂症患者失匹配负波特征的Meta分析

背景:国外对精神分裂症患者失匹配负波(mismatch negaitvity,MMN)波幅进行Meta分析发现其明显低于健康对照组,区分效应值(Cohen's d,)d在1.00左右,使之可能成为精神分裂症早期诊断的生物标志物.但检索文献未发现纳入中国精神分裂症人群MMN研究的Meta分析报道,因此有必要对中国精神分裂症患者的MMN进行Meta分析.目的:通过Meta分析计算中国精神分裂症患者MMN的平均效应值,探讨其是否可作为中国精神分裂症患者的生物标志物.方法:计算机检索中国知网(China Naitonal Knowledge Infrastructure,CKNI)、万方数据库(WanFang Data)、维普数据库(Vip Citaiton Databases,VIP)、PubMed数据库,收集2017年5月8日前公开发表的关于中国汉族精神分裂症患者MMN研究的相关文献.MMN受损的影响通过计算精神分裂症患者组和健康对照组之间的标准平均差(SMDs)来评估MMN波幅.结果:共有11篇文献纳入分析.Newcastle-Ottawa Scale(NOS)评估所有研究的总体质量超过6.这些研究的meta分析数据包括精神分裂症患者432例,健康对照人群392例.Meta分析结果显示,精神分裂症组与健康对照组相比MMN受损显著(Cohen's d=1.004).剔除异质性大的文献2个,患者组和健康对照组之间MMN差异的效应值降为0.79(Cohen's d=0.79).亚组分析显示精神分裂症病程大于3年的患者MMN波幅缺失的效应值为0.95,而病程小于3年的效应值为0.77.通过Egger回归分析得出的发表偏移(t=1.83;p=0.101)提示没有发表偏移.结论:中国精神分裂症患者和健康对照者之间的MMN波幅效应值与其他关于该研究的meta分析结果是一致的,提示中国汉族精神分裂症患者也表现有MMN受损.

Mismatch Negaitvity in Han Chinese Paitents with Schizophrenia: A Meta-Analysis

Background: Previous meta-analysis revealed that mismatch negativity(MMN) amplitude decreased in patients with schizophrenia compared with healthy controls (Cohen's d, d about 1), leading to the possibility of mismatch negativity being used as a biomarker for schizophrenia. However, it is unknown whether MMN is reliably changed in Chinese patients. It is necessary to carry out a meta-analysis on MMN of Han Chinese patients with schizophrenia.Aim: To investigate whether MMN could be used as a biomarker for Han Chinese patients with schizophrenia Methods: A literature search was conducted to identify clinical trials on MMN in Han Chinese schizophrenia patients published before May 8, 2017, by searching the Chinese language databases CNKI, WanFang Data, VIP Data and PubMed. The effects of MMN deficits were evaluated for MMN amplitude by calculating standard mean diffierence (SMDs) between schizophrenia patient groups and healthy control groups. Results: A total of 11 studies were included in the analysis. The total quality of all the studies were more than 6 as evaluated by Newcastle-Ottawa Scale (NOS). Meta-analysis of data from these studies had a pooled sample of 432 patients with schizophrenia and 392 healthy controls. There exists significant MMN deficit in schizophrenia patients compared to healthy controls (Cohen's d=1.004). When studies were excluded due to heterogeneity, the pooled effect size of the MMN differences between the patient group and healthy controls dropped to 0.79 (Cohen's d=0.79). Subgroup analysis showed that MMN amplitude deficits of schizophrenia over three years had the pooled effect size of 0.95, and less than three years had the pooled effect size of 0.77. Publication bias conducted via Egger regression test (t = 1.83; p = 0.101), suggested that there was no publication bias.Conclusion: The effect size of MMN amplitude between Chinese patients with schizophrenia and healthy controls is consistent with other meta-analyses published on this topic, suggesting that Han Chinese patients with schizophrenia also exhibited MMN deficits.