音乐干预对阿尔茨海默病患者激活模式区域差异的功能磁共振成像Meta分析

doi:10.3969/j.issn.1006-9771.2025.10.006

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (10): 1156-1163.doi: 10.3969/j.issn.1006-9771.2025.10.006

音乐干预对阿尔茨海默病患者激活模式区域差异的功能磁共振成像Meta分析

杨三峡¹(), 刘清栾², 万嘉敏¹

1.武汉体育学院艺术学院，湖北武汉市 430079
2.武汉体育学院新闻传播学院，湖北武汉市 430079

收稿日期:2025-06-13 修回日期:2025-09-07 出版日期:2025-10-25 发布日期:2025-11-10
通讯作者: 杨三峡，E-mail： 258278010@qq.com
作者简介:杨三峡(1977-)，女，汉族，湖北荆门市人，硕士，副教授，硕士研究生导师，主要研究方向：音乐与脑科学、音乐康复治疗、音乐理论与实践研究。
基金资助:
湖北省教育厅哲学社会科学研究重点项目(23D039)

Regional differences in brain activation after music intervention for Alzheimer's disease: a meta-analysis of functional magnetic resonance imaging

YANG Sanxia¹(), LIU Qingluan², WAN Jiamin¹

1. College of Arts, Wuhan Sports University, Wuhan, Hubei 430079, China
2. College of Journalism and Communication, Wuhan Sports University, Wuhan, Hubei 430079, China

Received:2025-06-13 Revised:2025-09-07 Published:2025-10-25 Online:2025-11-10
Contact: YANG Sanxia, E-mail: 258278010@qq.com
Supported by:
Key Project of Philosophy and Social Sciences Research of Hubei Provincial Department of Education(23D039)

摘要/Abstract

摘要：

目的探讨音乐干预对阿尔茨海默病(AD)患者神经可塑性的影响。
方法检索PubMed、EBSCOhost、Web of Science、Embase、中国知网、万方数据库和维普建库至2025年2月间发表的音乐干预对AD患者神经可塑性影响的文献。采用激活似然性估计(ALE)对功能磁共振成像数据进行Meta分析。
结果共纳入5项fMRI研究，涉及134例被试，包含99例AD患者，共提取49个激活坐标。健康组的主要激活区域为左侧楔前叶、右侧额下回和右侧颞上回，AD组的主要激活区域则转移至右下叶屏状核及相邻右岛叶、左侧额上回、右内侧额回和左颞上回。AD患者在进行音乐处理时，神经激活模式从高级联合皮质向皮质下结构转移，并伴随额叶激活模式的代偿性改变和顶叶激活的缺失。
结论音乐干预能够有效激活AD患者相对保留的皮质下-边缘系统，并促进额叶代偿性重组。

关键词: 阿尔茨海默病, 音乐疗法, 神经元可塑性, 功能磁共振成像, Meta分析

Abstract:

Objective To systematically investigate the impact of music intervention on neuroplasticity in patients with Alzheimer's disease (AD).
Methods PubMed, EBSCOhost, Web of Science, Embase, CNKI, Wanfang data and VIP were searched for studies published up to February, 2025. They were analysed using GingerALE 3.0.2 for meta-analysis.
Results Five fMRI studies were included, involving 134 participants (99 with AD). A total of 49 activation coordinates were extracted. The main activation regions in the healthy group were concentrated in the left precuneus, the right inferior frontal gyrus and the right superior temporal gyrus, while the primary activated regions in AD group shifted to the right operculum and adjacent right insula, left superior frontal gyrus, right medial frontal gyrus, and left superior temporal gyrus, indicating that during music processing, neural activation patterns in AD patients shifted from higher-order associative cortices to subcortical structures, accompanied by compensatory changes in frontal lobe activation and a loss of activation in the parietal lobe, particularly in the precuneus.
Conclusion Music intervention can activate the relatively preserved subcortical-limbic system in patients with AD and promote compensatory reorganization of the frontal lobes.

Key words: Alzheimer's disease, music therapy, neuroplasticity, functional magnetic resonance imaging, meta-analysis

中图分类号:

R742.5

杨三峡, 刘清栾, 万嘉敏. 音乐干预对阿尔茨海默病患者激活模式区域差异的功能磁共振成像Meta分析[J]. 《中国康复理论与实践》, 2025, 31(10): 1156-1163.

YANG Sanxia, LIU Qingluan, WAN Jiamin. Regional differences in brain activation after music intervention for Alzheimer's disease: a meta-analysis of functional magnetic resonance imaging[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(10): 1156-1163.

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参考文献 32

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研究	被试数量/n		平均年龄/岁		诊断标准	MMSE评分	备注
研究	对照组	试验组	对照组	试验组	诊断标准	MMSE评分	备注
Fischer等^[15](2021)	—	14	—	73.1	NIA-AA	27.3
Golden等^[16](2016)	16	14	70.1	69.8	典型遗忘型AD标准	对照组：29 AD组：20	对照组为健康人群
King等^[17](2019)	—	17	—	71.8	fMRI临床诊断	—
Slattery等^[18](2019)	19	34	60.5	60.9	AD共识标准一般神经心理学评估脑容积MRI诊断	对照组：29.5 AD组：19.7	对照组为健康人群
Satoh等^[19](2015)	10	10	77	78.1	NINCDS-ADRDA	对照组：20.9 AD组：19.1	对照和实验组均为AD患者

研究	干预方式	干预方案	研究设计	成像方法	计算软件	坐标空间	提取坐标数
Fischer等^[15](2021)	个性化音乐集 (熟悉、不熟悉和固定3种音乐)	每天同一时段1 h，持续3周	前后测	fMRI	FSL	MNI	12
Golden等^[16](2016)	合成的数字音频刺激	-	前后测	fMRI	SPM	MNI	14
King等^[17](2019)	被动听音乐任务，包括24个区块，每个区块持续20 s，正向音乐、反向音乐、静音随机呈现	持续8 min	随时对照	fMRI	SPM	MNI	9
Slattery等^[18](2019)	熟悉和不熟悉两种音乐干预	-	前后测	fMRI	SPM	MNI	12
Satoh等^[19](2015)	YUBA歌唱训练	每周1次，持续6周	前后测	fMRI	SPM	MNI	2

组别	序号	脑区	坐标			体积/mm³	ALE值(×10^-2)
组别	序号	脑区	x	y	z	体积/mm³	ALE值(×10^-2)
健康组	1	左楔前叶	-2	-50	30	872	1.793
	2	右额下回	54	20	22	576	1.684
	3	右颞上回	60	-26	8	296	0.922
		右下叶屏状核及相邻右岛叶	54	-28	12		0.920
AD组	1	右下叶屏状核	32	-18	10	752	1.763
		右岛叶	42	-18	8		0.872
	2	左额上回	-8	-2	60	584	1.423
	3	右内侧额回	6	-2	62	576	1.157
		左额上回	0	6	62		0.772
	4	左颞上回	-52	-10	0	408	1.022

组别	脑区	脑叶	脑回
健康组	左脑(64%)/右脑(36%)	顶叶(72%)/边缘叶(28%)	楔前叶(72%)/扣带回(28%)
	右脑	额叶	额下回(64.5%)/额中回(35.5%)
	右脑	颞叶(80%)/顶叶(20%)	颞上回(70%)/中央后回(20%)/颞横回(10%)
AD组	右脑	下叶区	豆状核(47.1%)/屏状核(41.2%)/岛叶(11.8%)
	左脑	额叶	内侧额回(75%)/额上回(25%)
	右脑	额叶	内侧额回(64.5%)/额上回(35.5%)
	左脑	颞叶	颞上回

音乐干预对阿尔茨海默病患者激活模式区域差异的功能磁共振成像Meta分析

Regional differences in brain activation after music intervention for Alzheimer's disease: a meta-analysis of functional magnetic resonance imaging

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