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Epilepsia Dec 2023Limited guidance exists regarding the assessment and management of psychogenic non-epileptic seizures (PNES) in children. Our aim was to develop consensus-based... (Review)
Review
Scoping review and expert-based consensus recommendations for assessment and management of psychogenic non-epileptic (functional) seizures (PNES) in children: A report from the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy.
Limited guidance exists regarding the assessment and management of psychogenic non-epileptic seizures (PNES) in children. Our aim was to develop consensus-based recommendations to fill this gap. The members of the International League Against Epilepsy (ILAE) Task Force on Pediatric Psychiatric Issues conducted a scoping review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SR) standards. This was supplemented with a Delphi process sent to pediatric PNES experts. Consensus was defined as ≥80% agreement. The systematic search identified 77 studies, the majority (55%) of which were retrospective (only one randomized clinical trial). The primary means of PNES identification was video electroencephalography (vEEG) in 84% of studies. Better outcome was associated with access to counseling/psychological intervention. Children with PNES have more frequent psychiatric disorders than controls. The Delphi resulted in 22 recommendations: Assessment-There was consensus on the importance of (1) taking a comprehensive developmental history; (2) obtaining a description of the events; (3) asking about potential stressors; (4) the need to use vEEG if available parent, self, and school reports and video recordings can contribute to a "probable" diagnosis; and (5) that invasive provocation techniques or deceit should not be employed. Management-There was consensus about the (1) need for a professional with expertise in epilepsy to remain involved for a period after PNES diagnosis; (2) provision of appropriate educational materials to the child and caregivers; and (3) that the decision on treatment modality for PNES in children should consider the child's age, cognitive ability, and family factors. Comorbidities-There was consensus that all children with PNES should be screened for mental health and neurodevelopmental difficulties. Recommendations to facilitate the assessment and management of PNES in children were developed. Future directions to fill knowledge gaps were proposed.
Topics: Humans; Child; Retrospective Studies; Consensus; Seizures; Epilepsy; Mental Disorders; Electroencephalography; Randomized Controlled Trials as Topic
PubMed: 37804168
DOI: 10.1111/epi.17768 -
Sleep Medicine Reviews Oct 2022Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples... (Meta-Analysis)
Meta-Analysis Review
Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples evaluated memory. We first evaluated effect sizes for all tests together, before separately assessing their effects on memory, vigilance, speed of processing and executive function. We next examined whether nap effects were moderated by study features of age, nap length, nap start time, habituality and prior sleep restriction. Naps showed significant benefits for the total aggregate of cognitive tests (Cohen's d = 0.379, CI = 0.296-0.462). Significant domain specific effects were present for declarative (Cohen's d = 0.376, CI = 0.269-0.482) and procedural memory (Cohen's d = 0.494, CI = 0.301-0.686), vigilance (Cohen's d = 0.610, CI = 0.291-0.929) and speed of processing (Cohen's d = 0.211, CI = 0.052-0.369). There were no significant moderation effects of any of the study features. Nap effects were of comparable magnitude across subgroups of each of the 5 moderators (Q values = 0.009 to 8.572, p values > 0.116). Afternoon naps have a small to medium benefit over multiple cognitive tests. These effects transcend age, nap duration and tentatively, habituality and prior nocturnal sleep.
Topics: Humans; Cognition; Executive Function; Sleep; Wakefulness
PubMed: 36041284
DOI: 10.1016/j.smrv.2022.101666 -
Clinical Psychology Review Jul 2022Deficits in episodic future thinking (EFT) characteristics such as detail/vividness, specificity and the use of mental imagery are associated with psychopathology.... (Meta-Analysis)
Meta-Analysis Review
Deficits in episodic future thinking (EFT) characteristics such as detail/vividness, specificity and the use of mental imagery are associated with psychopathology. However, whether these characteristics are associated with anxiety is not well understood. This article reports a systematic review and meta-analysis of research examining associations between anxiety and these EFT characteristics. Peer-reviewed studies that are published in the English language and contain at least one measure of anxiety and one measure of EFT characteristics were screened for inclusion in APAPsychINFO, CINAHL Plus and MEDLINE. Twenty-nine studies met the inclusion criteria. Results indicated that anxiety was not significantly correlated with detail/vividness overall. However, this was qualified by a moderating effect of cue valence. This finding is consistent with the Attentional Control and Contrast Avoidance Theories of anxiety, whereby higher anxiety is related to high detail/vividness in future thinking in the context of negatively-valenced cues, and conversely lower detail/vividness for positively-valenced cues. Anxiety was not significantly associated with specificity or the use of mental imagery. While heterogeneity and the low number of studies examining particular associations limited the findings, the results provide insight into the current state of the field and have both theoretical and clinical implications.
Topics: Anxiety; Anxiety Disorders; Cues; Forecasting; Humans; Thinking
PubMed: 35660923
DOI: 10.1016/j.cpr.2022.102162 -
Journal of the International... Feb 2023Despite the importance of social cognitive functions to mental health and social adjustment, examination of these functions is absent in routine assessment of epilepsy... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Despite the importance of social cognitive functions to mental health and social adjustment, examination of these functions is absent in routine assessment of epilepsy patients. Thus, this review aims to provide a comprehensive overview of the literature on four major aspects of social cognition among temporal and frontal lobe epilepsy, which is a critical step toward designing new interventions.
METHOD
Papers from 1990 to 2021 were reviewed and examined for inclusion in this study. After the deduplication process, a systematic review and meta-analysis of 44 and 40 articles, respectively, involving 113 people with frontal lobe epilepsy and 1482 people with temporal lobe epilepsy were conducted.
RESULTS
Our results indicated that while patients with frontal or temporal lobe epilepsy have difficulties in all aspects of social cognition relative to nonclinical controls, the effect sizes were larger for theory of mind ( = .95), than for emotion recognition ( = .69) among temporal lobe epilepsy group. The frontal lobe epilepsy group exhibited significantly greater impairment in emotion recognition compared to temporal lobe. Additionally, people with right temporal lobe epilepsy ( = 1.10) performed more poorly than those with a left-sided ( = .90) seizure focus, specifically in the theory of mind domain.
CONCLUSIONS
These data point to a potentially important difference in the severity of deficits within the emotion recognition and theory of mind abilities depending on the laterlization of seizure side. We also suggest a guide for the assessment of impairments in social cognition that can be integrated into multidisciplinary clinical evaluation for people with epilepsy.
Topics: Humans; Epilepsy, Temporal Lobe; Epilepsy, Frontal Lobe; Social Cognition; Neuropsychological Tests; Cognition; Seizures; Frontal Lobe
PubMed: 35249578
DOI: 10.1017/S1355617722000066 -
Neuroscience and Biobehavioral Reviews Aug 2023Event-related potentials (ERPs) represent the cortical processing of sensory, motor or cognitive functions invoked by particular events or stimuli. A current theory... (Meta-Analysis)
Meta-Analysis Review
Event-related potentials (ERPs) represent the cortical processing of sensory, motor or cognitive functions invoked by particular events or stimuli. A current theory posits that the catecholaminergic neurotransmitters dopamine (DA) and norepinephrine (NE) modulate a number of endogenous ERPs during various cognitive processes. This manuscript aims to evaluate a leading neurotransmitter hypothesis with a systematic overview and meta-analysis of pharmacologic DA and NE manipulation of specific ERPs in healthy subjects during executive function. Specifically, the frontally-distributed P3a, N2, and N/ERN (or error-related negativity) are supposedly modulated primarily by DA, whereas the parietally-distributed P3b is thought to be modulated by NE. Based on preceding research, we refer to this distinction between frontally-distributed DA-sensitive and parietally-distributed NE-sensitive ERP components as the Extended Neurobiological Polich (ENP) hypothesis. Our systematic review and meta-analysis indicate that this distinction is too simplistic and many factors interact with DA and NE to influence these specific ERPs. These may include genetic factors, the specific cognitive processes engaged, or elements of study design, i.e. session or sequence effects or data-analysis strategies.
Topics: Humans; Dopamine; Evoked Potentials; Cognition; Executive Function; Electroencephalography; Event-Related Potentials, P300
PubMed: 37150485
DOI: 10.1016/j.neubiorev.2023.105221 -
Epilepsy & Behavior : E&B Sep 2021The epilepsy surgery treatment gap is well defined and secondary to a broad range of issues, including healthcare professionals' (HCPs') knowledge, attitude, and... (Review)
Review
OBJECTIVE
The epilepsy surgery treatment gap is well defined and secondary to a broad range of issues, including healthcare professionals' (HCPs') knowledge, attitude, and perception (KAP) toward epilepsy surgery. However, no previous systematic reviews investigated this important topic.
METHODS
The systematic review was conducted according to Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified a total of 652 articles from multiple databases using database-specific queries and included 65 articles for full-text review after screening the titles and abstracts of the articles. Finally, we selected 11 papers for qualitative analysis. We critically appraised the quality of the studies using the Joanna Briggs critical appraisal tool.
RESULTS
The qualitative analysis of the content identified several key reasons causing healthcare professional-related barriers to epilepsy surgery: inadequate knowledge and awareness about the role of epilepsy surgery in drug-resistant epilepsy (DRE), poor identification and referral of patients with DRE, insufficient selection of candidates for presurgical workup, negative or ambivalent attitudes and perceptions regarding epilepsy surgery, deficient communication practices with patients regarding risk-benefit analysis of epilepsy surgery, and challenging coordination issues with the surgical referral. Neurologists with formal instruction in epilepsy, surgical exposure during training, participation in high volume epilepsy practice, or prior experience in surgical referral may refer more patients for surgical evaluation.
CONCLUSIONS
While significant work has been conducted in a limited number of studies to explore HCPs' knowledge gap and educational need regarding epilepsy surgery, further research is needed in defining the learning goals, assessing and validating specific learning gaps among providers, defining the learning outcomes, optimizing the educational format, content, and outcome measures, and appraising the achieved results following the educational intervention.
Topics: Epilepsy; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Learning; Perception
PubMed: 34273740
DOI: 10.1016/j.yebeh.2021.108199 -
Neuropsychology Review Mar 2021This review synthesized current literature of behavioral and cognitive studies targeting reward processing in autism spectrum disorder (ASD). The National Institute of... (Review)
Review
This review synthesized current literature of behavioral and cognitive studies targeting reward processing in autism spectrum disorder (ASD). The National Institute of Mental Health's Research Domain Criteria (RDoC) Positive Valence System (PVS) domain was used as an overarching framework. The objectives were to determine which component operations of reward processing may be atypical in ASD and consequently postulate a heuristic model of reward processing in ASD that could be evaluated with future research. 34 studies were identified from the Embase, PubMed, PsycINFO, and Web of Science databases and included in the review using guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (also known as PRISMA guidelines). The extant literature suggested potential relationships between social symptoms of ASD and PVS sub-constructs of reward anticipation, probabilistic and reinforcement learning, reward prediction error, reward (probability), delay, and effort as well as between restricted and repetitive behaviors and interests (RRBIs) and PVS-sub constructs of initial response to reward, reward anticipation, reward (probability), delay, and effort. However, these findings are limited by a sparse and mixed literature for some sub-constructs. We put forward a developmentally informed heuristic model that posits how these component reward processes may be implicated in early ASD behaviors as well as later emerging and more intransigent symptoms. Future research is needed to comprehensively evaluate the proposed model.
Topics: Autism Spectrum Disorder; Cognition; Humans; Reward
PubMed: 33174110
DOI: 10.1007/s11065-020-09459-z -
The British Journal of Social Psychology Oct 2023The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we... (Meta-Analysis)
Meta-Analysis
The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.
Topics: Humans; Empathy; Decision Making; Judgment; Morals; Ethical Theory
PubMed: 37314211
DOI: 10.1111/bjso.12654 -
Neuroscience and Biobehavioral Reviews Sep 2022Anxiety is often conceptualised as the prototypical disorder of interoception (one's perception of bodily states). Whilst theoretical models predict an association... (Meta-Analysis)
Meta-Analysis Review
Anxiety is often conceptualised as the prototypical disorder of interoception (one's perception of bodily states). Whilst theoretical models predict an association between interoceptive accuracy and anxiety, empirical work has produced mixed results. This manuscript presents a pre-registered systematic review (https://osf.io/2h5xz) and meta-analysis of 55 studies, obtained via a Pubmed search on 9th November 2020, examining the relationship between state and trait anxiety and objectively measured cardiac interoceptive accuracy as assessed by heartbeat counting and discrimination tasks. Potential moderators of this relationship - the age, gender and clinical diagnoses of participants, the anxiety measures used and the study design - were also explored. Overall, we found no evidence for an association between cardiac interoceptive accuracy and anxiety, with none of the factors examined moderating this finding. We discuss the implications these findings have for future research, with a particular focus on the need for further investigation of the relationship between anxiety and other facets of interoception.
Topics: Anxiety; Anxiety Disorders; Awareness; Heart; Heart Rate; Humans; Interoception
PubMed: 35798125
DOI: 10.1016/j.neubiorev.2022.104754 -
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