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Brain and Behavior Sep 2022Among the target groups in child and adolescent psychiatry, transcranial direct current stimulation (tDCS) has been more applied in neurodevelopmental disorders... (Review)
Review
A systematic review of randomized controlled trials on efficacy and safety of transcranial direct current stimulation in major neurodevelopmental disorders: ADHD, autism, and dyslexia.
OBJECTIVE
Among the target groups in child and adolescent psychiatry, transcranial direct current stimulation (tDCS) has been more applied in neurodevelopmental disorders specifically, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and dyslexia. This systematic review aims to provide the latest update on published randomized-controlled trials applying tDCS in these disorders for evaluating its efficacy and safety.
METHODS
Based on a pre-registered protocol (PROSPERO: CRD42022321430) and using the PRISMA approach, a literature search identified 35 randomized controlled trials investigating the effects of tDCS on children and adolescents with ADHD (n = 17), ASD (n = 11), and dyslexia (n = 7).
RESULTS
In ADHD, prefrontal anodal tDCS is reported more effective compared to stimulation of the right inferior frontal gyrus. Similarly in ASD, prefrontal anodal tDCS was found effective for improving behavioral problems. In dyslexia, stimulating temporoparietal regions was the most common and effective protocol. In ASD and dyslexia, all tDCS studies found an improvement in at least one of the outcome variables while 64.7% of studies (11 of 17) in ADHD found a similar effect. About 88% of all tDCS studies with a multi-session design in 3 disorders (16 of 18) reported a significant improvement in one or all outcome variables after the intervention. Randomized, double-blind, controlled trials consisted of around 70.5%, 36.3%, and 57.1% of tDCS studies in ADHD, ASD, and dyslexia, respectively. tDCS was found safe with no reported serious side effects in 6587 sessions conducted on 745 children and adolescents across 35 studies.
CONCLUSION
tDCS was found safe and partially effective. For evaluation of clinical utility, larger randomized controlled trials with a double-blind design and follow-up measurements are required. Titration studies that systematically evaluate different stimulation intensities, duration, and electrode placement are lacking.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Autistic Disorder; Child; Dyslexia; Humans; Prefrontal Cortex; Randomized Controlled Trials as Topic; Transcranial Direct Current Stimulation
PubMed: 35938945
DOI: 10.1002/brb3.2724 -
Frontiers in Public Health 2023The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the...
AIM
The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses.
METHODS
For this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September 2015 and August 2022. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study 2019.
RESULTS
Based on our inclusion criteria, 10 systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from 3,456 identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to 56 countries. Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2-0.3%) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability.
CONCLUSION
Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.
Topics: Adolescent; Child; Humans; Autism Spectrum Disorder; Cerebral Palsy; Developmental Disabilities; Dyslexia; Epilepsy; Intellectual Disability; Prevalence; Systematic Reviews as Topic
PubMed: 36891340
DOI: 10.3389/fpubh.2023.1122009 -
Frontiers in Psychiatry 2021Several studies have reported contradictory results regarding the benefits of music interventions in children and adolescents with neurodevelopmental disorders (NDDs),...
Several studies have reported contradictory results regarding the benefits of music interventions in children and adolescents with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD). We performed a systematic review according to the PRISMA guidelines. We searched the Cochrane, PubMed and Medline databases from January 1970 to September 2020 to review all empirical findings, except case reports, measuring the effect of music therapy on youths with ASD, intellectual disability (ID), communication disorder (CD), developmental coordination disorder (DCD), specific learning disorder, and attention/deficit hyperactivity disorder (ADHD). Thirty-nine studies ( = 1,774 participants) were included in this review (ASD: = 22; ID: = 7; CD and dyslexia: = 5; DCD: = 0; ADHD: = 5 studies). Two main music therapies were used: educational music therapy and improvisational music therapy. A positive effect of educational music therapy on patients with ASD was reported in most controlled studies (6/7), particularly in terms of speech production. A positive effect of improvisational music therapy was reported in most controlled studies (6/8), particularly in terms of social functioning. The subgroup of patients with both ASD and ID had a higher response rate. Data are lacking for children with other NDDs, although preliminary evidence appears encouraging for educational music therapy in children with dyslexia. Improvisational music therapy in children with NDDs appears relevant for individuals with both ASD and ID. More research should be encouraged to explore whether oral and written language skills may improve after educational music therapy, as preliminary data are encouraging.
PubMed: 33897497
DOI: 10.3389/fpsyt.2021.643234 -
Neuroscience and Biobehavioral Reviews Sep 2020This study presents a comprehensive systematic review and meta-analysis of temporal processing in autism spectrum disorder (ASD) and developmental dyslexia (DD), two... (Meta-Analysis)
Meta-Analysis Review
This study presents a comprehensive systematic review and meta-analysis of temporal processing in autism spectrum disorder (ASD) and developmental dyslexia (DD), two neurodevelopmental disorders in which temporal processing deficits have been highly researched. The results provide strong evidence for impairments in temporal processing in both ASD (g = 0.48) and DD (g = 0.82), as measured by judgments of temporal order and simultaneity. In individual analyses, multisensory temporal processing was impaired for both ASD and DD, and unisensory auditory, visual and tactile processing were all impaired in DD. In ASD, speech stimuli showed moderate impairment effect sizes, whereas nonspeech stimuli showed small effects. Greater reading and spelling skills in DD were associated with greater temporal precision. Temporal deficits did not show changes with age in either disorder. In addition to more clearly defining temporal impairments in ASD and DD, the results highlight common and distinct patterns of temporal processing between these disorders. Deficits are discussed in relation to existing theoretical models, and recommendations are made for future research.
Topics: Auditory Perception; Autism Spectrum Disorder; Autistic Disorder; Dyslexia; Humans; Time Perception; Visual Perception
PubMed: 32544540
DOI: 10.1016/j.neubiorev.2020.06.013 -
Neuroscience and Biobehavioral Reviews Jan 2022Behavioral research supports the efficacy of intervention for reading disability, but the brain mechanisms underlying improvement in reading are not well understood.... (Meta-Analysis)
Meta-Analysis Review
Behavioral research supports the efficacy of intervention for reading disability, but the brain mechanisms underlying improvement in reading are not well understood. Here, we review 39 neuroimaging studies of reading intervention to characterize links between reading improvement and changes in the brain. We report evidence of changes in activation, connectivity, and structure within the reading network, and right hemisphere, frontal and sub-cortical regions. Our meta-analysis of changes in brain activation from pre- to post- reading intervention in eight studies did not yield any significant effects. Methodological heterogeneity among studies may contribute to the lack of significant meta-analytic findings. Based on our qualitative synthesis, we propose that brain changes in response to intervention should be considered in terms of interactions among distributed cognitive, linguistic and sensory systems, rather than via a "normalized" vs. "compensatory" dichotomy. Further empirical research is needed to identify effects of moderating factors such as features of intervention programs, neuroimaging tasks, and individual differences among participants.
Topics: Brain; Brain Mapping; Dyslexia; Humans; Magnetic Resonance Imaging; Neuronal Plasticity
PubMed: 34856223
DOI: 10.1016/j.neubiorev.2021.11.011 -
Acta Psychologica Jun 2024In recent decades, the connections between academic skills, such as reading, writing, and calculation, and motor skills/capacities have received increasing attention.... (Meta-Analysis)
Meta-Analysis Review
In recent decades, the connections between academic skills, such as reading, writing, and calculation, and motor skills/capacities have received increasing attention. Many studies provided evidence for motor difficulties in children and adolescents with dyslexia, prompting the need for a meta-analysis to combine these multiple findings. Therefore, we conducted a meta-analysis using PsycINFO, Pubmed, and SportDiscus as scientific databases. A total of 572 studies were analyzed following several stringent inclusion criteria, resulting in the inclusion of 23 peer-reviewed studies in the final analysis. Our results showed that children and adolescents with dyslexia displayed significant different performances in multiple motor tasks and these differences persisted also when the type of motor task was considered as moderator in the analysis. The present findings are in accordance with the literature that supports a close connection between reading disabilities and difficulties in motor skills/capacities.
Topics: Humans; Dyslexia; Motor Skills; Child; Adolescent; Reading
PubMed: 38642452
DOI: 10.1016/j.actpsy.2024.104269 -
International Journal of Language &... Jan 2021People with aphasia (PWA) frequently present impairments in reading comprehension. Such impairments can be particularly debilitating due to the limitations and... (Review)
Review
BACKGROUND
People with aphasia (PWA) frequently present impairments in reading comprehension. Such impairments can be particularly debilitating due to the limitations and constraints they impose on everyday life. Recent technological advancements in the field of information and communication technologies offer many compensative tools for PWA. However, most technological tools are designed for patients with speech production impairments. Instruments addressing reading impairments associated with aphasia remain scarce and underrepresented in the scientific literature.
AIMS
To conduct a state-of-the-art review of the technologies currently available to PWA and acquired reading impairments. In particular, this review covers (1) research on technologies explicitly developed to compensate for reading difficulties associated with aphasia; and (2) research into which accessibility features included in mainstream high-tech systems are helpful for PWA when trying to access written material.
METHODS & PROCEDURES
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) international standard, the authors conducted a systematic review from 2009 to 2019. The databases inspected were Scopus, Web of Science, PubMed, the Cochrane collection, IEEE Xplore, ScienceDirect and SpringerLink. Other research papers were included after checking the references of the selected papers.
MAIN CONTRIBUTION
The review reveals that research on compensative devices for reading impairments largely neglects tools for individuals with aphasia and acquired reading difficulties. Most of the studies in this field are qualitative investigations of how patients with literacy difficulties tackle everyday tasks with the help of mainstream technology (e.g., smartphone applications). Therefore, this paper highlights the scarce high-tech alternatives that support text comprehension in PWA and acquired reading impairments, and suggests further work on the development of customized software for smartphones and personal computers.
CONCLUSIONS
High-tech reading tools may help PWA to regain reading autonomy. PWA and acquired reading impairments employ a wide array of devices to overcome reading difficulties, which underlines the importance of reading in everyday life. However, the supports currently available are not yet flexible and accurate enough to answer their day-to-day needs. Thus, further work is necessary to enhance the compensative devices available to them. For instance, existing new technologies in the area of natural language processing (such as automatic text simplification) could potentially be used in compensative devices. What this paper adds What is already known on the subject Most research on high-tech compensative reading tools is focused on investigating how patients with aphasia and acquired reading impairments cope with their reading difficulties in everyday life by resorting to different types of technology. Yet, we still lack specific research on compensative reading technology for PWA. What this paper adds to existing knowledge This review shows that PWA with acquired reading impairments are offered limited options for accessing written content easily and autonomously-and those few resources that are available are not specifically designed for PWA. What are the potential or actual clinical implications of this work? Both aphasia and acquired reading impairments can vary in terms of both their severity and the associated typology of cognitive impairments. Therefore, it might be interesting to investigate flexible and highly adaptable reading support designed for them-and innovations in the field of information and communication technology might prove particularly fruitful.
Topics: Aphasia; Comprehension; Dyslexia; Humans; Reading; Writing
PubMed: 32918536
DOI: 10.1111/1460-6984.12569 -
Neuroscience and Biobehavioral Reviews Jun 2023Differences in sensory function have been documented for a number of neurodevelopmental conditions, including reading and language impairments. Prior studies have... (Meta-Analysis)
Meta-Analysis Review
Differences in sensory function have been documented for a number of neurodevelopmental conditions, including reading and language impairments. Prior studies have measured audiovisual multisensory integration (i.e., the ability to combine inputs from the auditory and visual modalities) in these populations. The present study sought to systematically review and quantitatively synthesize the extant literature on audiovisual multisensory integration in individuals with reading and language impairments. A comprehensive search strategy yielded 56 reports, of which 38 were used to extract 109 group difference and 68 correlational effect sizes. There was an overall difference between individuals with reading and language impairments and comparisons on audiovisual integration. There was a nonsignificant trend towards moderation according to sample type (i.e., reading versus language) and publication/small study bias for this model. Overall, there was a small but non-significant correlation between metrics of audiovisual integration and reading or language ability; this model was not moderated by sample or study characteristics, nor was there evidence of publication/small study bias. Limitations and future directions for primary and meta-analytic research are discussed.
Topics: Humans; Reading; Auditory Perception; Visual Perception; Language; Language Development Disorders; Acoustic Stimulation; Photic Stimulation
PubMed: 36933815
DOI: 10.1016/j.neubiorev.2023.105130 -
International Journal of... Feb 2024This systematic review and meta-analysis aimed to assess whether (i) significant differences exist in the N400 response to lexico-semantic tasks between typically... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to assess whether (i) significant differences exist in the N400 response to lexico-semantic tasks between typically developing (TD) readers and readers with dyslexia, and (ii) whether these differences are moderated by the modality of task presentation (visual vs. auditory), the type of task, age, or opaque orthography (shallow and transparent alphabets vs Chinese morpho-syllabary). Twenty studies were included in the meta-analysis, and the analysis did not demonstrate strong evidence of publication bias. An overall effect size of Hedge's g = 0.66, p < .001, was found between typically developing readers and readers with dyslexia. All moderators were found to be significant; larger effects were associated with visual modality (g = 0.692, p < .001), semantically incongruent sentence tasks (g = 0.948, p < .001), pseudowords/characters tasks (g = 0.971, p < .001), and orthography [Chinese (g = 1.015, p < .001) vs. alphabets (g = 0.539, p < .001)]. Analysis of reaction time showed Hedge's g = 1.613, p < .001. Results suggest that the N400 reliably differentiated between typically developing readers and readers with dyslexia. Implications for future research and practice are discussed.
Topics: Humans; Male; Female; Electroencephalography; Evoked Potentials; Dyslexia; Semantics; Language; Reading
PubMed: 38128616
DOI: 10.1016/j.ijpsycho.2023.112283 -
The Cochrane Database of Systematic... Jan 2023This is an update of the Cochrane Review last published in 2017. Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of major adverse cardiovascular... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is an update of the Cochrane Review last published in 2017. Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of major adverse cardiovascular events (MACE). Antithrombotic (antiplatelet or anticoagulant) treatments may lower the risk of ischaemic MACE after ICH, but they may increase the risk of bleeding.
OBJECTIVES
To determine the overall effectiveness and safety of antithrombotic drugs on MACE and its components for people with ICH.
SEARCH METHODS
We searched the Cochrane Stroke Group Trials Register (5 October 2021). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL: the Cochrane Library 2021, Issue 10), MEDLINE Ovid (from 1948 to October 2021) and Embase Ovid (from 1980 to October 2021). The online registries of clinical trials searched were the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (5 October 2021). We screened the reference lists of included randomised controlled trials (RCTs) for additional, potentially relevant RCTs.
SELECTION CRITERIA
We selected RCTs in which participants with ICH of any age were allocated to a class of antithrombotic treatment as intervention or comparator.
DATA COLLECTION AND ANALYSIS
In accordance with standard methodological procedures recommended by Cochrane, two review authors assessed each selected RCT for its risk of bias and extracted data independently. The primary outcome was a composite of MACE, and secondary outcomes included death, individual components of the MACE composite, ICH growth, functional status and cognitive status. We estimated effects using the frequency of outcomes that occurred during the entire duration of follow-up and calculated a risk ratio (RR) for each RCT. We grouped RCTs separately for analysis according to 1) the class(es) of antithrombotic treatment used for the intervention and comparator, and 2) the duration of antithrombotic treatment use (short term versus long term). We pooled the intention-to-treat populations of RCTs using a fixed-effect model for meta-analysis, but used a random-effects model if RCTs differed substantially in their design or there was considerable heterogeneity (I ≥ 75%) in their results. We applied GRADE to assess the certainty of the evidence.
MAIN RESULTS
We identified seven new completed RCTs for this update, resulting in the inclusion of a total of nine RCTs based in secondary care, comprising 1491 participants (average age ranged from 61 to 79 years and the proportion of men ranged from 44% to 67%). The proportion of included RCTs at low risk of bias, by category was: random sequence generation (67%), allocation concealment (67%), performance (22%), detection (78%), attrition (89%), and reporting (78%). For starting versus avoiding short-term prophylactic dose anticoagulation after ICH, no RCT reported MACE. The evidence is very uncertain about the effect of starting short-term prophylactic dose anticoagulation on death (RR 1.00, 95% CI 0.59 to 1.70, P = 1.00; 3 RCTs; very low-certainty evidence), venous thromboembolism (RR 0.84, 95% CI 0.51 to 1.37, P = 0.49; 4 RCTs; very low-certainty evidence), ICH (RR 0.24, 95% CI 0.04 to 1.38, P = 0.11; 2 RCTs; very low-certainty evidence), and independent functional status (RR 2.03, 95% CI 0.78 to 5.25, P = 0.15; 1 RCT; very low-certainty evidence) over 90 days. For starting versus avoiding long-term therapeutic dose oral anticoagulation for atrial fibrillation after ICH, starting long-term therapeutic dose oral anticoagulation probably reduces MACE (RR 0.61, 95% CI 0.40 to 0.94, P = 0.02; 3 RCTs; moderate-certainty evidence) and probably reduces all major occlusive vascular events (RR 0.27, 95% CI 0.14 to 0.53, P = 0.0002; 3 RCTs; moderate-certainty evidence), but probably results in little to no difference in death (RR 1.05, 95% CI 0.62 to 1.78, P = 0.86; 3 RCTs; moderate-certainty evidence), probably increases intracranial haemorrhage (RR 2.43, 95% CI 0.88 to 6.73, P = 0.09; 3 RCTs; moderate-certainty evidence), and may result in little to no difference in independent functional status (RR 0.98, 95% CI 0.78 to 1.24, P = 0.87; 2 RCTs; low-certainty evidence) over one to three years. For starting versus avoiding long-term antiplatelet therapy after ICH, the evidence is uncertain about the effects of starting long-term antiplatelet therapy on MACE (RR 0.89, 95% CI 0.64 to 1.22, P = 0.46; 1 RCT; moderate-certainty evidence), death (RR 1.08, 95% CI 0.76 to 1.53, P = 0.66; 1 RCT; moderate-certainty evidence), all major occlusive vascular events (RR 1.03, 95% CI 0.68 to 1.55, P = 0.90; 1 RCT; moderate-certainty evidence), ICH (RR 0.52, 95% CI 0.27 to 1.03, P = 0.06; 1 RCT; moderate-certainty evidence) and independent functional status (RR 0.95, 95% CI 0.77 to 1.18, P = 0.67; 1 RCT; moderate-certainty evidence) over a median follow-up of two years. For adults within 180 days of non-cardioembolic ischaemic stroke or transient ischaemic attack and a clinical history of prior ICH, there was no evidence of an effect of long-term cilostazol compared to aspirin on MACE (RR 1.33, 95% CI 0.74 to 2.40, P = 0.34; subgroup of 1 RCT; low-certainty evidence), death (RR 1.65, 95% CI 0.55 to 4.91, P = 0.37; subgroup of 1 RCT; low-certainty evidence), or ICH (RR 1.29, 95% CI 0.35 to 4.69, P = 0.70; subgroup of 1 RCT; low-certainty evidence) over a median follow-up of 1.8 years; all major occlusive vascular events and functional status were not reported.
AUTHORS' CONCLUSIONS
We did not identify beneficial or hazardous effects of short-term prophylactic dose parenteral anticoagulation and long-term oral antiplatelet therapy after ICH on important outcomes. Although there was a significant reduction in MACE and all major occlusive vascular events after long-term treatment with therapeutic dose oral anticoagulation for atrial fibrillation after ICH, the pooled estimates were imprecise, the certainty of evidence was only moderate, and effects on other important outcomes were uncertain. Large RCTs with a low risk of bias are required to resolve the ongoing dilemmas about antithrombotic treatment after ICH.
Topics: Male; Adult; Humans; Middle Aged; Aged; Fibrinolytic Agents; Platelet Aggregation Inhibitors; Atrial Fibrillation; Cerebral Hemorrhage; Stroke; Anticoagulants
PubMed: 36700520
DOI: 10.1002/14651858.CD012144.pub3