-
Psychological Medicine Apr 2020People with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have abnormalities in frontal, temporal, parietal and striato-thalamic... (Comparative Study)
Comparative Study Meta-Analysis
Comparative meta-analyses of brain structural and functional abnormalities during cognitive control in attention-deficit/hyperactivity disorder and autism spectrum disorder.
BACKGROUND
People with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have abnormalities in frontal, temporal, parietal and striato-thalamic networks. It is unclear to what extent these abnormalities are distinctive or shared. This comparative meta-analysis aimed to identify the most consistent disorder-differentiating and shared structural and functional abnormalities.
METHODS
Systematic literature search was conducted for whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies of cognitive control comparing people with ASD or ADHD with typically developing controls. Regional gray matter volume (GMV) and fMRI abnormalities during cognitive control were compared in the overall sample and in age-, sex- and IQ-matched subgroups with seed-based d mapping meta-analytic methods.
RESULTS
Eighty-six independent VBM (1533 ADHD and 1295 controls; 1445 ASD and 1477 controls) and 60 fMRI datasets (1001 ADHD and 1004 controls; 335 ASD and 353 controls) were identified. The VBM meta-analyses revealed ADHD-differentiating decreased ventromedial orbitofrontal (z = 2.22, p < 0.0001) but ASD-differentiating increased bilateral temporal and right dorsolateral prefrontal GMV (zs ⩾ 1.64, ps ⩽ 0.002). The fMRI meta-analyses of cognitive control revealed ASD-differentiating medial prefrontal underactivation but overactivation in bilateral ventrolateral prefrontal cortices and precuneus (zs ⩾ 1.04, ps ⩽ 0.003). During motor response inhibition specifically, ADHD relative to ASD showed right inferior fronto-striatal underactivation (zs ⩾ 1.14, ps ⩽ 0.003) but shared right anterior insula underactivation.
CONCLUSIONS
People with ADHD and ASD have mostly distinct structural abnormalities, with enlarged fronto-temporal GMV in ASD and reduced orbitofrontal GMV in ADHD; and mostly distinct functional abnormalities, which were more pronounced in ASD.
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Brain; Cerebral Cortex; Child; Cognition; Female; Gray Matter; Humans; Magnetic Resonance Imaging; Male; Parietal Lobe; Thalamus; Young Adult
PubMed: 32216846
DOI: 10.1017/S0033291720000574 -
Schizophrenia Bulletin Oct 2017Individuals with schizophrenia are burdened with impairments in functional outcome, despite existing interventions. The lack of understanding of the neurobiological... (Meta-Analysis)
Meta-Analysis Review
Individuals with schizophrenia are burdened with impairments in functional outcome, despite existing interventions. The lack of understanding of the neurobiological correlates supporting adaptive function in the disorder is a significant barrier to developing more effective treatments. This research conducted a systematic and meta-analytic review of all peer-reviewed studies examining brain-functional outcome relationships in schizophrenia. A total of 53 (37 structural and 16 functional) brain imaging studies examining the neural correlates of functional outcome across 1631 individuals with schizophrenia were identified from literature searches in relevant databases occurring between January, 1968 and December, 2016. Study characteristics and results representing brain-functional outcome relationships were systematically extracted, reviewed, and meta-analyzed. Results indicated that better functional outcome was associated with greater fronto-limbic and whole brain volumes, smaller ventricles, and greater activation, especially during social cognitive processing. Thematic observations revealed that the dorsolateral prefrontal cortex, anterior cingulate, posterior cingulate, parahippocampal gyrus, superior temporal sulcus, and cerebellum may have role in functioning. The neural basis of functional outcome and disability is infrequently studied in schizophrenia. While existing evidence is limited and heterogeneous, these findings suggest that the structural and functional integrity of fronto-limbic brain regions is consistently related to functional outcome in individuals with schizophrenia. Further research is needed to understand the mechanisms and directionality of these relationships, and the potential for identifying neural targets to support functional improvement.
Topics: Adult; Brain; Employment; Humans; Independent Living; Interpersonal Relations; Middle Aged; Schizophrenia; Young Adult
PubMed: 28204755
DOI: 10.1093/schbul/sbx008 -
Neurologia 2023Fibromyalgia syndrome (FM) is a chronic pathology characterised by widespread pain commonly associated with psychological distress affecting quality of life. In recent... (Review)
Review
BACKGROUND
Fibromyalgia syndrome (FM) is a chronic pathology characterised by widespread pain commonly associated with psychological distress affecting quality of life. In recent years, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have been investigated to treat chronic pain. The aim of the current review is to determine the effects of tDCS and TMS on the main symptoms of patients with FM.
DEVELOPMENT
A systematic review based on PRISMA guidelines was carried out. The search strategy was performed in MEDLINE, SCOPUS, PEDro and Cochrane Library. Randomised controlled trials based on the effects of tDCS and TMS on pain, pressure pain threshold (PPT), fatigue, anxiety and depression, catastrophising and quality of life in patients with FM were analysed. Fourteen studies were included.
CONCLUSIONS
The application of tDCS to the motor cortex is the only intervention shown to decrease pain in the short and medium-term in patients with FM. The application of both interventions showed improvements in PPT, catastrophising and quality of life when applied to the motor cortex, and in fatigue when applied to the dorsolateral prefrontal cortex. The effects of these interventions on anxiety and depression are unclear.
Topics: Humans; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation; Fibromyalgia; Quality of Life; Chronic Pain; Fatigue
PubMed: 37031798
DOI: 10.1016/j.nrleng.2020.07.025 -
Frontiers in Neurology 2023Transcranial magnetic stimulation (TMS) is a non-invasive intervention that holds promise for improving cognitive function in individuals with Alzheimer's disease (AD)....
INTRODUCTION
Transcranial magnetic stimulation (TMS) is a non-invasive intervention that holds promise for improving cognitive function in individuals with Alzheimer's disease (AD). However, the effectiveness of this therapy and the optimal TMS parameters has not reached a consensus. The purpose of the meta-analysis was to systematically discern the effectiveness of different components of TMS protocols on cognitive improvement in patients with mild cognitive impairment (MCI) and AD.
METHODS
The meta-analysis was preregistered on Prospero (registration number: CRD42022345482). PubMed, Web of Science, Science Direct, and Cochrane Library databases were used to search, screen and identify eligible studies with the following keywords: Transcranial Magnetic Stimulation OR TMS OR theta burst stimulation AND Alzheimer OR Alzheimers OR Alzheimer's OR mild cognitive impairment OR MCI. Randomized controlled trials (RCTs) of participants with accepted standardized diagnostic criteria were searched by two authors independently. The risk of bias was assessed using an adapted Cochrane Risk of Bias tool. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using the random-effects models. Subgroup analyses were performed to investigate the influential factors.
RESULTS
A total of 21 studies and 25 trials were included in this meta-analysis. The findings revealed a significant overall cognition improvement of real stimulation compared with sham stimulation (short-term effects: SMD, 0.91; 95% CI 0.44-1.38; < 0.01; long-lasting effects: SMD, 0.91; 95% CI 0.27-1.55; < 0.01). Subgroup analysis demonstrated that stimulation of the left dorsolateral prefrontal cortex and bilateral cerebellums, as well as moderate frequency stimulation (5 Hz and 10 Hz) on mild and moderate cognitive impairment patients, were more effective than other TMS protocols. However, the additional application of cognitive training showed no significant improvement.
CONCLUSION
Cognitive improvement effect of TMS was demonstrated in MCI and AD patients in both short-term assessment and long-lasting outcomes, and the efficiency of TMS is affected by the stimulation frequency, stimulation site, and participant characteristics. Further RCTs are needed to validate the findings of our subgroup analysis.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345482, identifier: CRD42022345482.
PubMed: 37528850
DOI: 10.3389/fneur.2023.1209205 -
JAMA Network Open May 2024Noninvasive brain stimulation (NIBS) interventions have been shown to be efficacious in several mental disorders, but the optimal dose stimulation parameters for each... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Noninvasive brain stimulation (NIBS) interventions have been shown to be efficacious in several mental disorders, but the optimal dose stimulation parameters for each disorder are unknown.
OBJECTIVE
To define NIBS dose stimulation parameters associated with the greatest efficacy in symptom improvement across mental disorders.
DATA SOURCES
Studies were drawn from an updated (to April 30, 2023) previous systematic review based on a search of PubMed, OVID, and Web of Knowledge.
STUDY SELECTION
Randomized clinical trials were selected that tested transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) for any mental disorder in adults aged 18 years or older.
DATA EXTRACTION AND SYNTHESIS
Two authors independently extracted the data. A 1-stage dose-response meta-analysis using a random-effects model was performed. Sensitivity analyses were conducted to test robustness of the findings. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.
MAIN OUTCOMES AND MEASURES
The main outcome was the near-maximal effective doses of total pulses received for TMS and total current dose in coulombs for tDCS.
RESULTS
A total of 110 studies with 4820 participants (2659 men [61.4%]; mean [SD] age, 42.3 [8.8] years) were included. The following significant dose-response associations emerged with bell-shaped curves: (1) in schizophrenia, high-frequency (HF) TMS on the left dorsolateral prefrontal cortex (LDLPFC) for negative symptoms (χ2 = 9.35; df = 2; P = .009) and TMS on the left temporoparietal junction for resistant hallucinations (χ2 = 36.52; df = 2; P < .001); (2) in depression, HF-DLPFC TMS (χ2 = 14.49; df = 2; P < .001); (3) in treatment-resistant depression, LDLPFC tDCS (χ2 = 14.56; df = 2; P < .001); and (4) in substance use disorder, LDLPFC tDCS (χ2 = 33.63; df = 2; P < .001). The following significant dose-response associations emerged with plateaued or ascending curves: (1) in depression, low-frequency (LF) TMS on the right DLPFC (RDLPFC) with ascending curve (χ2 = 25.67; df = 2; P = .001); (2) for treatment-resistant depression, LF TMS on the bilateral DLPFC with ascending curve (χ2 = 5.86; df = 2; P = .004); (3) in obsessive-compulsive disorder, LF-RDLPFC TMS with ascending curve (χ2 = 20.65; df = 2; P < .001) and LF TMS on the orbitofrontal cortex with a plateaued curve (χ2 = 15.19; df = 2; P < .001); and (4) in posttraumatic stress disorder, LF-RDLPFC TMS with ascending curve (χ2 = 54.15; df = 2; P < .001). Sensitivity analyses confirmed the main findings.
CONCLUSIONS AND RELEVANCE
The study findings suggest that NIBS yields specific outcomes based on dose parameters across various mental disorders and brain regions. Clinicians should consider these dose parameters when prescribing NIBS. Additional research is needed to prospectively validate the findings in randomized, sham-controlled trials and explore how other parameters contribute to the observed dose-response association.
Topics: Humans; Transcranial Magnetic Stimulation; Transcranial Direct Current Stimulation; Mental Disorders; Adult; Male; Female; Middle Aged; Randomized Controlled Trials as Topic
PubMed: 38776083
DOI: 10.1001/jamanetworkopen.2024.12616 -
Clinical Obesity Dec 2023Several studies demonstrated non-invasive brain stimulation (NIBS) techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic... (Meta-Analysis)
Meta-Analysis Review
Several studies demonstrated non-invasive brain stimulation (NIBS) techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are safe and simple techniques that can reduce body weight, food cravings, and food consumption in patients with obesity. However, a systematic to evaluate the efficacy of active NIBS versus sham stimulation in reducing body weight and food cravings in patients with obesity is not available. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) using PubMed, Embase, MEDLINE, and Cochrane Central Register of Control Trial between January 1990 and February 2022. Mean differences (MDs) for continuous outcome variables with 95% confidence intervals (95% CIs) were used to examine the effects of NIBS on body weight and body mass index (BMI), whereas the hedges's g test was used to measure the effects on food craving. Nineteen RCTs involving 571 participants were included in this study. Active neurostimulation (TMS and tDCS) was significantly more likely than sham stimulation to reduce body weight (TMS: -3.29 kg, 95% CI [-5.32, -1.26]; I = 48%; p < .001; tDCS: -0.82 kg, 95% CI [-1.01, -0.62]; I = 0.0%; p = .00) and BMI (TMS: -0.74, 95% CI [-1.17, -0.31]; I = 0% p = .00; tDCS: MD = -0.55, 95% CI [-2.32, 1.21]; I = 0% p = .54) as well as food cravings (TMS: g = -0.91, 95% CI [-1.68, -0.14]; I = 88 p = .00; tDCS: g = -0.32, 95% CI [-0.62, -0.02]; p = .04). Compared with sham stimulation, our findings indicate that active NIBS can significantly help to reduce body weight and food cravings. Hence, these novel techniques may be used as primary or adjunct tools in treating patients with obesity.
Topics: Humans; Craving; Transcranial Magnetic Stimulation; Transcranial Direct Current Stimulation; Obesity; Brain
PubMed: 37577814
DOI: 10.1111/cob.12611 -
Psychiatry Research 2012This meta-analysis evaluates alterations of neurometabolites in schizophrenia and bipolar disorder. PubMed was searched to find controlled studies evaluating... (Meta-Analysis)
Meta-Analysis Review
This meta-analysis evaluates alterations of neurometabolites in schizophrenia and bipolar disorder. PubMed was searched to find controlled studies evaluating N-acetylaspartate (NAA), Choline (Cho) and Creatine (Cr) assessed with ((1))H-MRS (proton magnetic resonance spectroscopy) in patients with schizophrenia and bipolar disorder up to September 2010. Random effects meta-analyses were conducted to estimate pooled standardized mean differences. The statistic was used to quantify inconsistencies. Subgroup analyses were conducted to explore potential explanations for inconsistencies. The systematic review included 146 studies with 5643 participants. NAA levels were affected in schizophrenia and bipolar disorder. Decreased levels in the basal ganglia and frontal lobe were the most consistent findings in schizophrenia; decreased levels in the basal ganglia were the most consistent findings in bipolar disorder. Cho and Cr levels were not altered in either disorder. Findings for Cr were most consistent in the thalamus, frontal lobe and dorsolateral prefrontal cortex in schizophrenia and the basal ganglia and frontal lobe in bipolar disorder. Findings for Cho were most consistent in the thalamus, frontal lobe and anterior cingulate cortex in schizophrenia and basal ganglia in bipolar disorder. Large, carefully designed studies are needed to better estimate the extent of alterations in neurometabolites.
Topics: Aspartic Acid; Basal Ganglia; Bipolar Disorder; Choline; Creatine; Gyrus Cinguli; Humans; Magnetic Resonance Spectroscopy; Prefrontal Cortex; Reference Values; Schizophrenia; Schizophrenic Psychology; Thalamus
PubMed: 22981426
DOI: 10.1016/j.pscychresns.2012.02.003 -
Developmental Cognitive Neuroscience Dec 2023Resting-state functional connectivity (rsFC) has the potential to shed light on how childhood abuse and neglect relates to negative psychiatric outcomes. However, a... (Review)
Review
Resting-state functional connectivity (rsFC) has the potential to shed light on how childhood abuse and neglect relates to negative psychiatric outcomes. However, a comprehensive review of the impact of childhood maltreatment on the brain's resting state functional organization has not yet been undertaken. We systematically searched rsFC studies in children and youth exposed to maltreatment. Nineteen studies (total n = 3079) met our inclusion criteria. Two consistent findings were observed. Childhood maltreatment was linked to reduced connectivity between the anterior insula and dorsal anterior cingulate cortex, and with widespread heightened amygdala connectivity with key structures in the salience, default mode, and prefrontal regulatory networks. Other brain regions showing altered connectivity included the ventral anterior cingulate cortex, dorsolateral prefrontal cortex, and hippocampus. These patterns of altered functional connectivity associated with maltreatment exposure were independent of symptoms, yet comparable to those seen in individuals with overt clinical disorder. Summative findings indicate that rsFC alterations associated with maltreatment experience are related to poor cognitive and social functioning and are prognostic of future symptoms. In conclusion, maltreatment is associated with altered rsFC in emotional reactivity, regulation, learning, and salience detection brain circuits. This indicates patterns of recalibration of putative mechanisms implicated in maladaptive developmental outcomes.
Topics: Adolescent; Humans; Child; Brain; Amygdala; Brain Mapping; Gyrus Cinguli; Child Abuse; Magnetic Resonance Imaging
PubMed: 37952287
DOI: 10.1016/j.dcn.2023.101322 -
Progress in Neuro-psychopharmacology &... Jan 2024Traumatic brain injury (TBI) is a major cause of long-term disability with conventional treatments frequently falling short to restore a good quality-of-life.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Traumatic brain injury (TBI) is a major cause of long-term disability with conventional treatments frequently falling short to restore a good quality-of-life. Non-invasive brain stimulation (NIBS) techniques have shown potential as therapeutic options for neuropsychiatric conditions, including TBI sequelae. This study aims at providing a systematic review and meta-analysis on the effectiveness of repetitive transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) on post-TBI symptoms.
METHODS
Fifteen randomized controlled trials (RCTs) on adult TBI patients that examined the effects of multiple treatment sessions of NIBS techniques were selected from five databases. Symptoms were clustered into four categories: depression, anxiety, headache and cognitive dysfunctions. Meta-analysis was performed using correlated and hierarchical effects models.
RESULTS
There were only few and heterogeneous studies with generally small sample sizes. Most studies targeted the dorsolateral prefrontal cortex (dlPFC). Overall, the effects of NIBS were small. However, there was a significant effect for overall symptoms (0.404, p = 0.031). Moreover, subgroup analyses revealed significant overall effects for anxiety (0.195, p = 0.020) and headache (0.354, p = 0.040).
CONCLUSIONS
To date, there is limited evidence supporting the effectiveness of NIBS concerning treatment for TBI sequelae. The observed effect sizes were modest, suggesting subtle improvements rather than drastic changes. While NIBS techniques remain promising for treating neuropsychiatric conditions, larger RCT studies with longer follow-ups, optimized stimulation parameters and standardized methodology are required to establish their efficacy in addressing TBI sequelae.
Topics: Humans; Transcranial Magnetic Stimulation; Transcranial Direct Current Stimulation; Brain Injuries, Traumatic; Randomized Controlled Trials as Topic; Treatment Outcome; Chronic Disease
PubMed: 37709126
DOI: 10.1016/j.pnpbp.2023.110863 -
Neuropsychology Review Mar 2016Oppositional defiant disorder (ODD) and conduct disorder (CD) are common behavioural disorders in childhood and adolescence and are associated with brain abnormalities.... (Meta-Analysis)
Meta-Analysis Review
A Systematic Review and Meta-analysis of Neuroimaging in Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) Taking Attention-Deficit Hyperactivity Disorder (ADHD) Into Account.
Oppositional defiant disorder (ODD) and conduct disorder (CD) are common behavioural disorders in childhood and adolescence and are associated with brain abnormalities. This systematic review and meta-analysis investigates structural (sMRI) and functional MRI (fMRI) findings in individuals with ODD/CD with and without attention-deficit hyperactivity disorder (ADHD). Online databases were searched for controlled studies, resulting in 12 sMRI and 17 fMRI studies. In line with current models on ODD/CD, studies were classified in hot and cool executive functioning (EF). Both the meta-analytic and narrative reviews showed evidence of smaller brain structures and lower brain activity in individuals with ODD/CD in mainly hot EF-related areas: bilateral amygdala, bilateral insula, right striatum, left medial/superior frontal gyrus, and left precuneus. Evidence was present in both structural and functional studies, and irrespective of the presence of ADHD comorbidity. There is strong evidence that abnormalities in the amygdala are specific for ODD/CD as compared to ADHD, and correlational studies further support the association between abnormalities in the amygdala and ODD/CD symptoms. Besides the left precuneus, there was no evidence for abnormalities in typical cool EF related structures, such as the cerebellum and dorsolateral prefrontal cortex. Resulting areas are associated with emotion-processing, error-monitoring, problem-solving and self-control; areas associated with neurocognitive and behavioural deficits implicated in ODD/CD. Our findings confirm the involvement of hot, and to a smaller extent cool, EF associated brain areas in ODD/CD, and support an integrated model for ODD/CD (e.g. Blair, Development and Psychopathology, 17(3), 865-891, 2005).
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Attention Deficit and Disruptive Behavior Disorders; Brain; Brain Mapping; Child; Conduct Disorder; Female; Humans; Magnetic Resonance Imaging; Male; Young Adult
PubMed: 26846227
DOI: 10.1007/s11065-015-9315-8