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Psychiatrike = Psychiatriki 2020Prevalence of Alzheimer's Disease and other forms of dementia is increasing in accordance with the increase of life expectancy and the resulting world population aging,...
Prevalence of Alzheimer's Disease and other forms of dementia is increasing in accordance with the increase of life expectancy and the resulting world population aging, while an effective pharmaceutical treatment is pending. These facts underline the need for development of targeted interventions that could decrease the incidence of dementia. Dietary supplementation, especially sources of ω-3 fatty acids and polyphenols such as fish oil and blueberries respectively, have been reported to have a beneficial effect on cognitive functioning. The aim of this review is to summarize the most recent findings of clinical studies investigating the effect of dietary supplementation on cognitive performance and identify potential effective interventions. For this purpose, PubMed, Scopus and Google Scholar research was conducted and a total of ten studies met the selection criteria. Four of these studies investigated the effect of ω-3 fatty acid supplementation. Two of these presented significant benefits in certain domains of cognitive functions (such as working memory, space imagery efficiency perceptual speed), in full scale IQ as well as prevention of hippocampal atrophy while the remaining two did not report any improvements. Two more studies investigated the effect of polyphenol supplementation and reported minor benefits in spatial memory as well as enhanced stimulation of certain brain regions. One study compared the effect of fish oil and blueberry supplementation as well as their combination and presented cognitive benefits for both fish oil and blueberries but not for their simultaneous administration. Finally, three more studies investigated the effect of DW 2009 soybean, ashwagandha and a nutraceutical formulation and reported cognitive benefits in attention, memory and global cognition respectively for their intervention groups. In total, eight studies investigated interventions on people with Mild Cognitive Impairment or Subjective Cognitive Impairment and all of them reported significant cognitive benefits in some cognitive domains. On the contrary, the remaining two studies included individuals with diagnosed dementia reported minimal to hardly any benefits. Conclusively, the interventions of the studies reviewed seem promising for individuals at risk of dementia, but not for those who are already diagnosed with dementia. However, further research is required to validate their effect as well as determine recommended doses.
Topics: Clinical Trials as Topic; Cognition; Diet Therapy; Dietary Supplements; Humans; Neurocognitive Disorders
PubMed: 33099465
DOI: 10.22365/jpsych.2020.313.248 -
The Cochrane Database of Systematic... Dec 2020Cystic fibrosis is the most common autosomal recessive disease in white populations, and causes respiratory dysfunction in the majority of individuals. Numerous types of...
BACKGROUND
Cystic fibrosis is the most common autosomal recessive disease in white populations, and causes respiratory dysfunction in the majority of individuals. Numerous types of respiratory muscle training to improve respiratory function and health-related quality of life in people with cystic fibrosis have been reported in the literature. Hence a systematic review of the literature is needed to establish the effectiveness of respiratory muscle training (either inspiratory or expiratory muscle training) on clinical outcomes in cystic fibrosis. This is an update of a previously published review.
OBJECTIVES
To determine the effectiveness of respiratory muscle training on clinical outcomes in people with cystic fibrosis.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of most recent search: 11 June 2020. A hand search of the Journal of Cystic Fibrosis and Pediatric Pulmonology was performed, along with an electronic search of online trial databases. Date of most recent search: 05 October 2020.
SELECTION CRITERIA
Randomised controlled studies comparing respiratory muscle training with a control group in people with cystic fibrosis.
DATA COLLECTION AND ANALYSIS
Review authors independently selected articles for inclusion, evaluated the methodological quality of the studies, and extracted data. Additional information was sought from trial authors where necessary. The quality of the evidence was assessed using the GRADE system.
MAIN RESULTS
Authors identified 20 studies, of which 10 studies with 238 participants met the review's inclusion criteria. There was wide variation in the methodological and written quality of the included studies. Four of the 10 included studies were published as abstracts only and lacked concise details, thus limiting the information available. Eight studies were parallel studies and two of a cross-over design. Respiratory muscle training interventions varied dramatically, with frequency, intensity and duration ranging from thrice weekly to twice daily, 20% to 80% of maximal effort, and 10 to 30 minutes, respectively. Participant numbers ranged from 11 to 39 participants in the included studies; five studies were in adults only, one in children only and four in a combination of children and adults. No differences between treatment and control were reported in the primary outcome of pulmonary function (forced expiratory volume in one second and forced vital capacity) or postural stability (very low-quality evidence). Although no change was reported in exercise capacity as assessed by the maximum rate of oxygen use and distance completed in a six minute walk test, a 10% improvement in exercise duration was found when working at 60% of maximal effort in one study (n = 20) (very low-quality evidence). In a further study (n = 18), when working at 80% of maximal effort, health-related quality of life improved in the mastery and emotion domains (very low-quality evidence). With regards to the review's secondary outcomes, one study (n = 11) found a change in intramural pressure, functional residual capacity and maximal inspiratory pressure following training (very low-quality evidence). Another study (n=36) reported improvements in maximal inspiratory pressure following training (P < 0.001) (very low-quality evidence). A further study (n = 22) reported that respiratory muscle endurance was longer in the training group (P < 0.01). No studies reported significant differences on any other secondary outcomes. Meta-analyses could not be performed due to a lack of consistency and insufficient detail in reported outcome measures.
AUTHORS' CONCLUSIONS
There is insufficient evidence to suggest whether this intervention is beneficial or not. Healthcare practitioners should consider the use of respiratory muscle training on a case-by-case basis. Further research of reputable methodological quality is needed to determine the effectiveness of respiratory muscle training in people with cystic fibrosis. Researchers should consider the following clinical outcomes in future studies; respiratory muscle function, pulmonary function, exercise capacity, hospital admissions, and health-related quality of life. Sensory-perceptual changes, such as respiratory effort sensation (e.g. rating of perceived breathlessness) and peripheral effort sensation (e.g. rating of perceived exertion) may also help to elucidate mechanisms underpinning the effectiveness of respiratory muscle training.
Topics: Adult; Breathing Exercises; Child; Cystic Fibrosis; Forced Expiratory Flow Rates; Humans; Inhalation; Quality of Life; Randomized Controlled Trials as Topic; Respiratory Muscles; Vital Capacity
PubMed: 33331663
DOI: 10.1002/14651858.CD006112.pub5 -
NeuroImage. Clinical 2022Hallucinations are a complex and multidimensional phenomenon which can differ based on the involved pathology, typology and sensory modality. Hallucinations are common... (Review)
Review
Hallucinations are a complex and multidimensional phenomenon which can differ based on the involved pathology, typology and sensory modality. Hallucinations are common in patients with neurodegenerative diseases. Recent sparse evidence from resting state functional magnetic resonance imaging (rs-fMRI) studies has identified altered functional connectivity in those patients within several brain networks, such as the default mode, attentional and sensory ones, without, however, providing an organized picture of the mechanisms involved. This systematic review, following PRISMA guidelines, aims at critically analyzing the current literature on the brain networks associated with the phenomenon of hallucinations in patients with neurodegenerative diseases. Ten rs-fMRI studies fulfilled our selection criteria. All these studies focused on synucleinopathies, and most of them focused on visual hallucinations and were characterized by a heterogeneous methodology. Thus, instead of offering a definite picture of the mechanisms underlying hallucinations in neurodegeneration, this systematic review encourages further research especially concerning tauopathies. Notwithstanding, the findings overall suggest a disruption in the top-down (associated with memory intrusion and difficulty of inhibition) and in the bottom-up processes (associated with the sensory areas involved in the hallucinations). Further investigations are needed in order to disentangle the brain mechanisms involved in hallucinations and to overcome possible limitations characterizing the current literature.
Topics: Brain; Brain Mapping; Hallucinations; Humans; Magnetic Resonance Imaging; Neurodegenerative Diseases
PubMed: 35853345
DOI: 10.1016/j.nicl.2022.103112 -
Clinical Psychology Review Dec 2015Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as... (Review)
Review
BACKGROUND
Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as delusions and hallucinations.
OBJECTIVES
The review aims to evaluate the evidence for a relationship between sleep dysfunction and individual psychotic experiences, make links between the theoretical understanding of each, and highlight areas for future research.
METHOD
A systematic search was conducted to identify studies investigating sleep and psychotic experiences across clinical and non-clinical populations.
RESULTS
66 papers were identified. This literature robustly supports the co-occurrence of sleep dysfunction and psychotic experiences, particularly insomnia with paranoia. Sleep dysfunction predicting subsequent psychotic experiences receives support from epidemiological surveys, research on the transition to psychosis, and relapse studies. There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences. Anxiety and depression consistently arise as (partial) mediators of the sleep and psychosis relationship.
CONCLUSION
Studies are needed that: determine the types of sleep dysfunction linked to individual psychotic experiences; establish a causal connection between sleep and psychotic experiences; and assess treatments for sleep dysfunction in patients with non-affective psychotic disorders such as schizophrenia.
Topics: Delusions; Hallucinations; Humans; Psychotic Disorders; Schizophrenia; Sleep Wake Disorders
PubMed: 26407540
DOI: 10.1016/j.cpr.2015.09.001 -
American Journal of Alzheimer's Disease... Aug 2016Clinicians often have difficulty distinguishing between various forms of dementia to achieve a correct diagnosis. Little research has been done to examine whether... (Review)
Review
Clinicians often have difficulty distinguishing between various forms of dementia to achieve a correct diagnosis. Little research has been done to examine whether awareness of one's cognitive deficits, or metacognitive monitoring, might differ between dementia diagnoses, thereby providing an additional means of differentiating between dementia subtypes. We review articles examining metacognitive comparisons between two of the most common dementia subtypes: Alzheimer's disease and frontotemporal dementia. Greater monitoring deficits were apparent in frontotemporal dementia than in Alzheimer's disease, and participants with frontotemporal dementia were less likely to utilize task experience to update and improve the accuracy of subsequent monitoring judgments. Results provide evidence for the utility of metacognitive measures as a means of distinguishing between Alzheimer's disease and frontotemporal dementia.
Topics: Agnosia; Alzheimer Disease; Awareness; Cognition Disorders; Frontotemporal Dementia; Humans
PubMed: 26705377
DOI: 10.1177/1533317515618899 -
NeuroImage. Clinical 2015Mechanisms underlying the development of phantom limb pain and neuropathic pain after limb amputation and spinal cord injury, respectively, are poorly understood. The... (Review)
Review
BACKGROUND
Mechanisms underlying the development of phantom limb pain and neuropathic pain after limb amputation and spinal cord injury, respectively, are poorly understood. The goal of this systematic review was to assess the robustness of evidence in support of "maladaptive plasticity" emerging from applications of advanced functional magnetic resonance imaging (MRI).
METHODS
Using MeSH heading search terms in PubMed and SCOPUS, a systematic review was performed querying published manuscripts.
RESULTS
From 146 candidate publications, 10 were identified as meeting the inclusion criteria. Results from fMRI investigations provided some level of support for maladaptive cortical plasticity, including longitudinal studies that demonstrated a change in functional organization related to decreases in pain. However, a number of studies have reported no relationship between reorganization, pain and deafferentation, and emerging evidence has also suggested the opposite - that is, chronic pain is associated with preserved cortical function.
CONCLUSION
Based solely on advanced functional neuroimaging results, there is only limited evidence for a relationship between chronic pain intensity and reorganization after deafferentation. The review demonstrates the need for additional neuroimaging studies to clarify the relationship between chronic pain and reorganization.
Topics: Amputation, Surgical; Brain; Brain Mapping; Chronic Pain; Extremities; Female; Humans; Magnetic Resonance Imaging; Male; Neuralgia; Neuronal Plasticity; Pain Measurement; Phantom Limb; Spinal Cord Injuries
PubMed: 26740913
DOI: 10.1016/j.nicl.2015.09.018 -
Psychological Medicine Aug 2022Auditory hallucinations in patients with psychotic disorders may be very distressing. Unfortunately, a large proportion of individuals are resistant to pharmacological... (Review)
Review
BACKGROUND
Auditory hallucinations in patients with psychotic disorders may be very distressing. Unfortunately, a large proportion of individuals are resistant to pharmacological interventions and the gold-standard cognitive-behavioral therapy for psychosis offers at best modest effects. To improve therapeutic outcomes, several therapies have been created to establish a relationship between voice-hearers and their voices. With increasing literature, we conducted a systematic review of dialogical therapies and examined the evidence behind their efficacy.
METHODS
A systematic search was performed in PubMed, PsycINFO, Web of Science, and Google Scholar. Articles were included if they discussed the effects of dialogical interventions for patients with psychotic disorders.
RESULTS
A total of 17 studies were included within this systematic review. Cumulative evidence from various therapies has shown that entering in a dialog with voices is beneficial to patients, even those who are resistant to current pharmacological treatments. Heightened benefits have been mainly observed with Relating Therapy and Avatar Therapy/Virtual Reality assisted Therapy, with evidence generally of moderate quality. Both these interventions have shown large to very large effects on voices and voice-related distress as well as moderate to large magnitude improvements on affective symptoms. Though, cognitive-behavioral therapy for command hallucinations and making sense of voices noted no improvements on voices.
CONCLUSIONS
Literature on relational-based interventions with a strong emphasis on the relational aspects of voice hearing has shown positive effects. Results suggest that these dialogical therapies might surpass the efficacy of current gold-standard approaches.
Topics: Humans; Hallucinations; Psychotic Disorders; Cognitive Behavioral Therapy; Voice
PubMed: 35855651
DOI: 10.1017/S003329172200143X -
PloS One 2020Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective...
BACKGROUND
Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses.
METHODS
We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained.
RESULTS
There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features.
CONCLUSIONS
The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
Topics: Anxiety; Anxiety Disorders; Attitude to Health; Chronic Disease; Fear; Humans; Models, Psychological; Prevalence; Severity of Illness Index
PubMed: 32716932
DOI: 10.1371/journal.pone.0234124 -
CoDAS Oct 2018Investigate the association between levodopa therapy and vocal characteristics in Parkinson's disease patients. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Investigate the association between levodopa therapy and vocal characteristics in Parkinson's disease patients.
SEARCH STRATEGY
Studies published at MEDLINE, LILACS, and SciELO, from 1960 to December 2016. A systematic review and meta-analysis was performed using the following keywords: Parkinson's disease; levodopa; L-dopa; voice; speech disorders; dysphonia; dysarthria. After analyzing titles and abstracts, two independent reviewers selected all clinical trials that met the eligibility criteria and selected the articles and the data recorded in a previously standardized table.
SELECTION CRITERIA
Trials published in English between 1960 and December 2016 individuals with clinical diagnosis of Parkinson's disease; use of levodopa therapy in stable doses; acoustic analysis combined or not with auditory-perceptual analysis to evaluate the vocal parameters under investigation.
DATA ANALYSIS
The following vocal parameters were analyzed: fundamental frequency (F 0), jitter, and vocal intensity. Standardized mean differences (SMD) were calculated using the Comprehensive Meta-analysis V2 software.
RESULTS
Nine articles met the eligibility criteria and were selected, with a total of 119 individuals. From these, six articles with 83 individuals were included in the meta-analysis. During the levodopa therapy "on" state, modifications in F 0 (SMD=0.39; 95% CI - 0.21-0.57) and jitter (SMD=0.23; 95% CI - 0.02-0.45) were observed. Vocal intensity was not affected (SMD=0.09; 95% CI - 0.22-0.39) by levodopa ingestion. Data of the included studies were controversial in the auditory-perceptual analysis of voice.
CONCLUSION
Levodopa therapy modifies F0 and jitter. No changes in vocal intensity were observed in either the "on" or "off" states of levodopa therapy.
Topics: Antiparkinson Agents; Dysarthria; Dysphonia; Female; Humans; Levodopa; Male; Parkinson Disease; Speech Production Measurement; Voice; Voice Quality
PubMed: 30304100
DOI: 10.1590/2317-1782/20182017200 -
Translational Psychiatry Nov 2021Although the pathophysiology of auditory verbal hallucinations remains uncertain, the inner speech model remains a prominent theory. A systematic review and... (Review)
Review
Although the pathophysiology of auditory verbal hallucinations remains uncertain, the inner speech model remains a prominent theory. A systematic review and meta-analyses of both functional and structural neuroimaging studies were performed to investigate the inner speech model. Of the 417 papers retrieved, 26 met the inclusion criteria. Meta-analyses found the left insula to be significantly active during auditory verbal hallucinations and to have a significantly reduced grey matter volume in hallucinators. Dysfunction of the left insula may contribute to the misattribution of inner speech due to its suggested roles in both inner speech production and the salience network. No significant activity was found at Broca's area or Heschl's gyrus during auditory verbal hallucinations. Furthermore, no structural abnormalities were found at these sites or in the arcuate fasciculi. Overall, evidence was found to both support and oppose the inner speech model. Further research should particularly include a systematic review of task-based trait studies with a focus on inner speech production and self-referential processing, and analyses of additional language-related white matter tracts.
Topics: Auditory Cortex; Hallucinations; Humans; Magnetic Resonance Imaging; Neuroimaging; Schizophrenia; Speech
PubMed: 34764242
DOI: 10.1038/s41398-021-01670-7