-
Frontiers in Neurology 2021By reviewing the existing clinical studies about visual snow (VS) as a symptom or as part of visual snow syndrome (VSS), we aim at improving our understanding of VSS...
By reviewing the existing clinical studies about visual snow (VS) as a symptom or as part of visual snow syndrome (VSS), we aim at improving our understanding of VSS being a network disorder. Patients with VSS suffer from a continuous visual disturbance resembling the view of a badly tuned analog television (i.e., VS) and other visual, as well as non-visual symptoms. These symptoms can persist over years and often strongly impact the quality of life. The exact prevalence is still unknown, but up to 2.2% of the population could be affected. Presently, there is no established treatment, and the underlying pathophysiology is unknown. In recent years, there have been several approaches to identify the brain areas involved and their interplay to explain the complex presentation. We collected the clinical and paraclinical evidence from the currently published original studies on VS and its syndrome by searching PubMed and Google Scholar for the term visual snow. We included original studies in English or German and excluded all reviews, case reports that did not add new information to the topic of this review, and articles that were not retrievable in PubMed or Google Scholar. We grouped the studies according to the methods that were used. Fifty-three studies were found for this review. In VSS, the clinical spectrum includes additional visual disturbances such as excessive floaters, palinopsia, nyctalopia, photophobia, and entoptic phenomena. There is also an association with other perceptual and affective disorders as well as cognitive symptoms. The studies that have been included in this review demonstrate structural, functional, and metabolic alterations in the primary and/or secondary visual areas of the brain. Beyond that, results indicate a disruption in the pre-cortical visual pathways and large-scale networks including the default mode network and the salience network. The combination of the clinical picture and widespread functional and structural alterations in visual and extra-visual areas indicates that the VSS is a network disorder. The involvement of pre-cortical visual structures and attentional networks might result in an impairment of "filtering" and prioritizing stimuli as top-down process with subsequent excessive activation of the visual cortices when exposed to irrelevant external and internal stimuli. Limitations of the existing literature are that not all authors used the ICHD-3 definition of the VSS. Some were referring to the symptom VS, and in many cases, the control groups were not matched for migraine or migraine aura.
PubMed: 34671311
DOI: 10.3389/fneur.2021.724072 -
Medicina (Kaunas, Lithuania) Sep 2023Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared... (Review)
Review
Transcutaneous electrical nerve stimulation (TENS), a pain-alleviating and muscle-relaxing treatment used in physio-therapeutic clinical practice, has recently appeared to be just as effective in dysphonia. This review aimed at clarifying whether TENS can be an effective practice in dysphonia therapy and/or management on its own or combined with other types of interventions and, hence, whether its practice can be a useful, more widespread establishment to speech and language therapy intervention methods. A search was conducted on the PubMed database using specific terms based on the PICO search strategy. Eventually, four randomized controlled studies and four clinical trials were included. The methodological quality of the included studies was evaluated using the physiotherapy evidence-based database (PEDro) assessment tool, and this indicated high-quality research with an average score of 8.43. The studies utilized various TENS devices, predominantly the Dualpex 961 device (frequency of 10 Hz, phase of 200 ms). The assessment methods varied, including auditory perception, vocal therapy, electrostimulation, audio and video perceptual assessments, and laryngeal evaluations. The clinical outcomes of TENS showed a reduction in musculoskeletal pain in various areas, while the acoustic analysis results were significant in only one study. TENS was compared to manual laryngeal therapy (LMT), placebo TENS, and vocal therapy in different studies with mixed results. This review supports the idea that a multidimensional approach, incorporating various therapeutic modalities (TENS, LMT, speech therapy, and vocal training) can yield positive outcomes for patients with voice disorders. Further research is needed to explore the specific mechanisms of action and optimal treatment protocols for TENS in voice therapy.
Topics: Humans; Transcutaneous Electric Nerve Stimulation; Dysphonia; Musculoskeletal Pain; Treatment Outcome
PubMed: 37893455
DOI: 10.3390/medicina59101737 -
Medicina (Kaunas, Lithuania) Sep 2021: A growing number of studies correlated higher levels of serum uric acid (UA) with both: lower risk of Parkinson's Disease (PD) occurrence and slower progression of the... (Review)
Review
The Influence of Serum Uric Acid Level on Non-Motor Symptoms Occurrence and Severity in Patients with Idiopathic Parkinson's Disease and Atypical Parkinsonisms-A Systematic Review.
: A growing number of studies correlated higher levels of serum uric acid (UA) with both: lower risk of Parkinson's Disease (PD) occurrence and slower progression of the disease. Similar conclusions were made where studies correlated UA with atypical Parkinsonisms (AP) progression. A few researchers have studied the issue of the influence of serum UA on the occurrence of non-motor symptoms (NMS) in PD and AP. Our systematic review is the first review completely dedicated to this matter. : A comprehensive evaluation of the literature was performed to review the relationship between UA and NMS in PD and AP. The systematic review was conducted according to PRISMA Statement guidelines. The following databases were searched starting in April 2021: MEDLINE via PubMed, Embase, and Scopus. During the research, the following filters were used: >2010, articles in English, concerning humans. The study was not registered and received no external funding. : Seven articles meeting all inclusion criteria were included in this study. Collectively, data on 1104 patients were analyzed. A correlation between serum UA concentration and a few NMS types has been provided by the analyzed studies. In four papers, sleep disorders and fatigue were related to UA for both advanced and early PD. Other commonly appearing NMS domains were Attention/memory (4 studies), Depression/anxiety (3 studies), Cardiovascular (3 studies), Gastrointestinal (1 study), Perceptual (1 study), and Miscellaneous (1 study). For AP, no significant correlation between UA and worsening of NMS has been found. Based on the analyzed studies, a correlation between serum UA level and the occurrence and worsening of NMS in PD and APs cannot be definitively determined. Large-scale studies with a more diverse patient population and with more accurate methods of NMS assessment in Parkinsonism are needed.
Topics: Fatigue; Humans; Parkinson Disease; Parkinsonian Disorders; Sleep Wake Disorders; Uric Acid
PubMed: 34577895
DOI: 10.3390/medicina57090972 -
Journal of the International... Nov 2022The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional... (Review)
Review
OBJECTIVES
The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke.
METHODS
One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches.
RESULTS
Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments.
CONCLUSIONS
This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.
Topics: Humans; Speech Disorders; Emotions; Linguistics; Stroke; Perceptual Disorders
PubMed: 34989666
DOI: 10.1017/S1355617721001302 -
Brain and Behavior May 2017To provide a systematic overview of interventions for stroke related visual impairments. (Review)
Review
AIM
To provide a systematic overview of interventions for stroke related visual impairments.
METHOD
A systematic review of the literature was conducted including randomized controlled trials, controlled trials, cohort studies, observational studies, systematic reviews, and retrospective medical note reviews. All languages were included and translation obtained. This review covers adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke and were discussed separately. We searched scholarly online resources and hand searched articles and registers of published, unpublished, and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. Article selection was performed by two authors independently. Data were extracted by one author and verified by a second. The quality of the evidence and risk of bias was assessed using appropriate tools dependant on the type of article.
RESULTS
Forty-nine articles (4142 subjects) were included in the review, including an overview of four Cochrane systematic reviews. Interventions appraised included those for visual field loss, ocular motility deficits, reduced central vision, and visual perceptual deficits.
CONCLUSION
Further high quality randomized controlled trials are required to determine the effectiveness of interventions for treating post-stroke visual impairments. For interventions which are used in practice but do not yet have an evidence base in the literature, it is imperative that these treatments be addressed and evaluated in future studies.
Topics: Adult; Humans; Stroke; Stroke Rehabilitation; Vision Disorders
PubMed: 28523224
DOI: 10.1002/brb3.682 -
Schizophrenia Bulletin Mar 2016Although timing deficits are a robust finding in schizophrenia (SZ), the notion of a genuine time perception disorder in SZ is still being debated because distortions in... (Meta-Analysis)
Meta-Analysis Review
Although timing deficits are a robust finding in schizophrenia (SZ), the notion of a genuine time perception disorder in SZ is still being debated because distortions in timing might depend on neuropsychological deficits that are characteristics of the illness. Here we used meta-analytic methods to summarize the evidence of timing deficits in SZ and moderator analyses to determine whether defective timing in SZ arises from nontemporal sources or from defective time perception. PubMed Services, PsycNET, and Scopus were searched through March 2015, and all references in articles were investigated to find other relevant studies. Studies were selected if they included subjects with a primary diagnosis of SZ compared to a healthy control (HC) group and if they reported behavioral measures of duration estimation (perceptual and motor explicit timing). Data from 24 studies published from 1956 to 2015, which comprised 747 SZ individuals and 808 HC, were included. Results indicate that SZ individuals are less accurate than HC in estimating time duration across a wide range of tasks. Subgroup analyses showed that the fundamental timing deficit in SZ is independent from the length of the to-be-timed duration (automatic and cognitively controlled timing) and from methods of stimuli estimation (perceptual and motor timing). Thus, time perception per se is disturbed in SZ (not just task-specific timing processes) and this perturbation is independent from more generalized cognitive impairments. Behavioral evidence of disturbed automatic timing should be more thoroughly investigated with the aim of defining it as a cognitive phenotype for more homogeneous diagnostic subgrouping.
Topics: Cognitive Dysfunction; Humans; Schizophrenia; Time Perception
PubMed: 26253596
DOI: 10.1093/schbul/sbv104 -
Journal of Neurology Jul 2015Our current clinical approach to visual hallucinations is largely derived from work carried out by Georges de Morsier in the 1930s. Now, almost a century after his... (Review)
Review
Our current clinical approach to visual hallucinations is largely derived from work carried out by Georges de Morsier in the 1930s. Now, almost a century after his influential papers, we have the research tools to further explore the ideas he put forward. In this review, we address de Morsier's proposal that visual hallucinations in all clinical conditions have a similar neurological mechanism by comparing structural imaging studies of susceptibility to visual hallucinations in Parkinson's disease, Alzheimer's disease, Dementia with Lewy bodies and schizophrenia. Systematic review of the literature was undertaken using PubMed searches. A total of 18 studies across conditions were identified reporting grey matter differences between patients with and without visual hallucinations. Grey matter changes were categorised into brain regions relevant to current theories of visual hallucinations. The distribution of cortical atrophy supports de Morsier's premise that visual hallucinations are invariably linked to aberrant activity within visual thalamo-cortical networks. Further work is required to determine by what mechanism these networks become predisposed to spontaneous activation, and whether the frontal lobe and hippocampal changes identified are present in all conditions. The findings have implications for the development of effective treatments for visual hallucinations.
Topics: Cerebral Cortex; Cognition Disorders; Hallucinations; Humans; Lewy Body Disease; Magnetic Resonance Imaging; Parkinson Disease
PubMed: 25761375
DOI: 10.1007/s00415-015-7687-6 -
Psychiatry and Clinical Neurosciences Apr 2020Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however...
AIM
Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'.
METHODS
EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded.
RESULTS
A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization.
DISCUSSION
A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
Topics: Delusions; Hallucinations; Humans; Prodromal Symptoms; Projective Techniques; Psychotic Disorders; Risk Factors; Terminology as Topic
PubMed: 31846133
DOI: 10.1111/pcn.12966 -
Epilepsy & Behavior Reports 2021Symptoms and functioning can be measured subjectively using self-report measures or objectively, based on physiological changes. This raises the question whether... (Review)
Review
Subjective versus objective measures of distress, arousal and symptom burden in patients with functional seizures and other functional neurological symptom disorder presentations: A systematic review.
Symptoms and functioning can be measured subjectively using self-report measures or objectively, based on physiological changes. This raises the question whether subjective and objective measures are closely correlated and - if not - whether one is more accurate or meaningful than the other, especially in patients with Functional Seizures (FS) or other Functional Neurological Symptom Disorders (FND), where subjective and objective observations may be thought particularly likely to deviate. This systematic review explores these questions focussing on measures of distress, arousal and symptom burden. Eighteen studies (12 FS, 6 other FND) capturing 396 FND patients were included. Eleven reported no correlation between subjective and objective measures. Only four studies reported significant correlations (r's = -0.74-0.59, p's < 0.05). The small number of studies and diverse methodologies do not provide conclusive answers to the questions posed. Given that subjective and objective measures capture different aspects of current state or function, a combination of measurement approaches is likely to provide optimal information about patients' health state. In view of the attentional and perceptual alterations implicated in FND, the difference between objective and subjective measures may represent an interesting observation in its own right.
PubMed: 34917921
DOI: 10.1016/j.ebr.2021.100502 -
Journal of Pediatric Rehabilitation... 2021Unilateral spatial neglect (USN), an inability to attend to one side of space or one's body, is commonly reported in adult stroke survivors and is associated with poor...
PURPOSE
Unilateral spatial neglect (USN), an inability to attend to one side of space or one's body, is commonly reported in adult stroke survivors and is associated with poor outcomes. USN has been reported in pediatric survivors of stroke, but its impact is unclear. The purpose of this systematic review was to summarize and evaluate the literature regarding USN in pediatric stroke survivors.
METHODS
PRISMA guidelines, Scopus, CINAHL, PubMed, and other relevant databases were searched with terms including "children", "stroke", and "unilateral neglect", with the ages of participants limited from to birth to 18 years. Data were extracted from studies on the clinical presentation of pediatric USN, the assessment of this condition, treatment options, or USN recovery.
RESULTS
A total of 18 articles met inclusion criteria. There were no current prevalence data available. USN presents similarly in children compared to adults. Several different USN assessments were used, however, there were little data regarding treatment options. Furthermore, the data suggest that not all children fully recover.
CONCLUSION
This systematic review reveals a lack of quality research to inform the assessment and treatment of children with USN. Although the literature spans decades, there remain no guidelines for standardized assessment or treatment. Similar to adults, paper-and-pencil testing may be less able to identify USN than functional assessments. It is likely that there are children who struggle with undetected USN-related deficits years after their injuries. With a rise of pediatric stroke survivors, there is a pressing need for clinicians to be educated about USN in children, clinical presentations, assessments, and treatments.
Topics: Adult; Child; Humans; Perceptual Disorders; Stroke; Stroke Rehabilitation
PubMed: 34459422
DOI: 10.3233/PRM-200779