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Trauma, Violence & Abuse Jul 2023Intimate partner violence (IPV) is a public health and human rights issue, with millions of children affected worldwide. While several reviews have explored the...
Intimate partner violence (IPV) is a public health and human rights issue, with millions of children affected worldwide. While several reviews have explored the emotional-behavioural functioning of children exposed to IPV, this review aimed to examine the relationship between children's exposure to IPV and their cognitive development, and to identify associated factors such as aspects of parenting. The databases MEDLINE, PsycInfo, EMBASE, Family and Society Studies Worldwide, CINAHL, and ERIC were searched using key words related to IPV, such as domestic, family, partner, interparental, spousal, marital, violence, abuse, aggression, assault, combined with key words related to cognitive functioning, such as neuropsychological, executive, intelligence, learning, memory, and key words related to children and adolescents. A total of 38 studies met the criteria for review which included reporting an estimate of the relationship between IPV and cognition using direct assessments of cognitive functioning. Approximately 70% of studies found a relationship between IPV and poorer cognitive functioning, with general IQ the most frequently assessed domain of functioning, followed by verbal abilities and academic skills. Most studies assessed skills during early childhood, with fewer studies assessing children during middle childhood and adolescence. Results were consistent across cognitive domains and developmental stages. In terms of factors associated with IPV and cognition, a range of demographic, individual, and family factors were included, with several studies exploring mediating and moderating mechanisms. The findings suggest that IPV in childhood is associated with poorer cognitive skills across a range of domains. Implications for policy, practice and research are discussed.
Topics: Child; Humans; Child, Preschool; Adolescent; Intimate Partner Violence; Child Abuse; Aggression; Crime Victims; Cognition
PubMed: 35666939
DOI: 10.1177/15248380221082081 -
Neuroscience and Biobehavioral Reviews May 2022Early life exposure to air pollution has been associated with neurodevelopmental disorders. Emerging evidence are highlighting a possible impact of air pollution on... (Review)
Review
Early life exposure to air pollution has been associated with neurodevelopmental disorders. Emerging evidence are highlighting a possible impact of air pollution on typically developing children. Thirty papers were included in this review to systematically evaluate the association between air pollutants exposure in prenatal and/or postnatal periods and specific neurodevelopmental skills (i.e. intellective functioning, memory and learning, attention and executive functions, verbal language, numeric ability and motor and/or sensorimotor functions) in preschool- and school-age children. Detrimental effects of air pollutants on children's neurodevelopmental skills were observed, although they do not show clinically relevant performance deficits. The most affected domains were global intellective functioning and attention/executive functions. The pollutants that seem to represent the greatest risk are PM2.5, NO₂ and PAHs. Prenatal exposure is primarily associated with child neurodevelopment at pre-school and school ages. Early exposure to air pollutants is related to adverse neurodevelopmental outcomes in the general population of children. Further research is needed to support stronger conclusions.
Topics: Air Pollutants; Air Pollution; Child; Child, Preschool; Environmental Exposure; Female; Humans; Neurodevelopmental Disorders; Particulate Matter; Pregnancy
PubMed: 35331818
DOI: 10.1016/j.neubiorev.2022.104623 -
Journal of Neuro-oncology Jul 2023We systematically reviewed the current landscape of hippocampal-avoidance radiotherapy, focusing specifically on rates of hippocampal tumor recurrence and changes in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We systematically reviewed the current landscape of hippocampal-avoidance radiotherapy, focusing specifically on rates of hippocampal tumor recurrence and changes in neurocognitive function.
METHODS
PubMed was queried for studies involving hippocampal-avoidance radiation therapy and results were screened using PRISMA guidelines. Results were analyzed for median overall survival, progression-free survival, hippocampal relapse rates, and neurocognitive function testing.
RESULTS
Of 3709 search results, 19 articles were included and a total of 1611 patients analyzed. Of these studies, 7 were randomized controlled trials, 4 prospective cohort studies, and 8 retrospective cohort studies. All studies evaluated hippocampal-avoidance whole brain radiation treatment (WBRT) and/or prophylactic cranial irradiation (PCI) in patients with brain metastases. Hippocampal relapse rates were low (overall effect size = 0.04; 95% confidence interval [0.03, 0.05]) and there was no significant difference in risk of relapse between the five studies that compared HA-WBRT/HA-PCI and WBRT/PCI groups (risk difference = 0.01; 95% confidence interval [- 0.02, 0.03]; p = 0.63). 11 out of 19 studies included neurocognitive function testing. Significant differences were reported in overall cognitive function and memory and verbal learning 3-24 months post-RT. Differences in executive function were reported by one study, Brown et al., at 4 months. No studies reported differences in verbal fluency, visual learning, concentration, processing speed, and psychomotor speed at any timepoint.
CONCLUSION
Current studies in HA-WBRT/HA-PCI showed low hippocampal relapse or metastasis rates. Significant differences in neurocognitive testing were most prominent in overall cognitive function, memory, and verbal learning. Studies were hampered by loss to follow-up.
Topics: Humans; Prospective Studies; Retrospective Studies; Neoplasm Recurrence, Local; Cranial Irradiation; Brain Neoplasms; Hippocampus
PubMed: 37395975
DOI: 10.1007/s11060-023-04384-6 -
Association between myasthenia gravis and cognitive function: A systematic review and meta-analysis.Annals of Indian Academy of Neurology 2015The course of myasthenia gravis (MG) is complicated by increased reports of cognitive defects in both human and animal models, which suggests potential central nervous... (Review)
Review
The course of myasthenia gravis (MG) is complicated by increased reports of cognitive defects in both human and animal models, which suggests potential central nervous system (CNS) damage. We conducted a systematic review of the relationships between MG and cognitive function. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Major databases were searched to examine the neuropsychological studies of adults with MG. Weighted effect sizes were pooled by cognitive domain. Eight studies representing 300 subjects were included. Eight cognitive domain categories were identified: (i) Mini-Mental State Examination (MMSE), (ii) language, (iii) processing speed, (iv) verbal learning and memory, (v) visual learning and memory, (vi) attention span, (vii) response fluency, and (viii) motor performance. Nine (cognitive domain categories, MMSE, language, processing speed, verbal learning and memory (except for delayed recall memory), and motor performance) of 16 cognitive tasks revealed significant moderate effect sizes. Verbal logical-delayed memory, finger tapping with the preferred hand, and the Symbol Digit Modalities Test showed a greater magnitude relationship to cognitive function than did other specific cognitive domains. Verbal learning and memory seems to be the most significant affected according to cognitive domain categories. For MG, the ability of attention, response fluency, visual learning, and memory seems to be reserved. The MG patients seem to perform significantly worse than the non-MG controls in a range of cognitive domains. Our findings should be interpreted with caution because of the clinical and methodological heterogeneity of included studies.
PubMed: 26019407
DOI: 10.4103/0972-2327.156560 -
Journal of Addiction Medicine 2014Cocaine use disorder is associated with cognitive deficits. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are the... (Review)
Review
BACKGROUND
Cocaine use disorder is associated with cognitive deficits. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are the most impaired in cocaine use disorder and to how duration of abstinence affects cognitive recovery. Here, we performed a meta-analysis to determine the cognitive domains impaired in cocaine abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery.
METHODS
A literature search yielded 46 studies that assessed cognitive dysfunction in subjects with cocaine abuse/dependence. Effect-size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 11 cognitive domains: attention, executive functions, impulsivity, speed of processing, verbal fluency/language, verbal learning and memory, visual learning and memory, visuospatial abilities, and working memory. Within these 11 domains, effect-size estimates were calculated on the basis of abstinence duration: short- (positive for drugs urine screening), intermediate- (≤12 weeks), and long-term (≥20 weeks) abstinence.
RESULTS
Findings revealed moderate impairment across 8 cognitive domains during intermediate abstinence. The most impaired domains were attention, impulsivity, verbal learning/memory, and working memory. For some domains (attention, speed of processing, and verbal learning/memory), impairments were smaller during short-term abstinence than during intermediate abstinence. Finally, small effect-size estimates were found for long-term abstinence.
DISCUSSION
These results suggest significant impairment across multiple cognitive domains in cocaine abusers, and that some of these deficits may be partially masked by the residual or acute withdrawal effects of cocaine. Cognitive dysfunctions remain stable during the first months of abstinence and may abate after 5 months of sobriety.
Topics: Cocaine; Cocaine-Related Disorders; Cognition; Cognition Disorders; Humans
PubMed: 25187977
DOI: 10.1097/ADM.0000000000000066 -
Psychiatria Danubina Sep 2022rTMS is an adequately safe intervention that is approved for treatment of various neuropsychiatric conditions. There is ongoing research on the application of rTMS for...
BACKGROUND
rTMS is an adequately safe intervention that is approved for treatment of various neuropsychiatric conditions. There is ongoing research on the application of rTMS for the treatment of resistant auditory verbal hallucinations (AVH) in schizophrenia (SZ), and also for alleviating negative and cognitive symptoms in patients with chronic SZ states. Language decline, as a part of thought, language and communication disorders, is one of the key symptoms of SZ, having a significant bearing on decreased social/interpersonal functioning of these patients. In this regard rTMS may be a promising treatment approach, while serving as an important research tool in the field of SZ studies. The aim of our present study was to compile and evaluate the existing data on whether rTMS affects verbal function in SZ patients, and if rTMS has any efficacy for the treatment of language disturbances in SZ spectrum disorders.
SUBJECTS AND METHODS
Our systematic search over the PubMed database revealed a total of 200 articles, of which 21 met criteria for inclusion in this analysis. We have reviewed in detail the study designs, inclusion and exclusion criteria, rTMS protocols and cognitive (in particular, speech/language domain) assessments reported in these articles.
RESULTS
The 21 studies focused on two key topic clusters: (i) low-frequency rTMS treatment of AVH in SZ, and (ii) high-frequency rTMS treatment of negative and cognitive SZ symptoms. The majority of study participants presented with chronic and treatment-resistant states. Most of the low-frequency rTMS studies did not show any difference in verbal test measures in SZ in response to treatment. Less than a half of high-frequency rTMS studies reported a delayed positive effect on language cognitive domains in SZ. There were sporadic reports on dropouts associated with a decline in scores for auditory verbal learning tests.
CONCLUSIONS
Our systematic review found rTMS to be generally safe in relation to verbal/speech function, and suggested that verbal memory tests could serve as a measure of safety of this treatment procedure in SZ patients. Speech effects of rTMS have only been registered over long-term observation periods, such that time-frame which should be considered as an important factor for future studies. In our project "Innovative Neuropsychiatry Research Bank: Priority-2030" we plan to clarify (i) efficient rTMS protocols targeting neurocognitive improvement in SZ, and (ii) the cohort of SZ patients with a particular cognitive endophenotype and language profile amenable to treatment with rTMS, with a focus on language scores.
Topics: Hallucinations; Humans; Language; Schizophrenia; Transcranial Magnetic Stimulation
PubMed: 36170724
DOI: No ID Found -
Psychological Medicine Jan 2022Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia. Of those affected, 70-84% are reported to be treatment resistant from the... (Meta-Analysis)
Meta-Analysis Review
Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia. Of those affected, 70-84% are reported to be treatment resistant from the outset. This raises the possibility that the neurobiological mechanisms of treatment resistance emerge before the onset of psychosis and have a neurodevelopmental origin. Neuropsychological investigations can offer important insights into the nature, origin and pathophysiology of treatment-resistant schizophrenia (TRS), but methodological limitations in a still emergent field of research have obscured the neuropsychological discriminability of TRS. We report on the first systematic review and meta-analysis to investigate neuropsychological differences between TRS patients and treatment-responsive controls across 17 published studies (1864 participants). Five meta-analyses were performed in relation to (1) executive function, (2) general cognitive function, (3) attention, working memory and processing speed, (4) verbal memory and learning, and (5) visual-spatial memory and learning. Small-to-moderate effect sizes emerged for all domains. Similarly to previous comparisons between unselected, drug-naïve and first-episode schizophrenia samples healthy controls in the literature, the largest effect size was observed in verbal memory and learning [ = -0.53; 95% confidence interval (CI) -0.29 to -0.76; = 4.42; < 0.001]. A sub-analysis of language-related functions, extracted from across the primary domains, yielded a comparable effect size ( = -0.53, 95% CI -0.82 to -0.23; = 3.45; < 0.001). Manipulating our sampling strategy to include or exclude samples selected for clozapine response did not affect the pattern of findings. Our findings are discussed in relation to possible aetiological contributions to TRS.
Topics: Humans; Antipsychotic Agents; Memory, Short-Term; Neuropsychological Tests; Psychotic Disorders; Schizophrenia
PubMed: 36415088
DOI: 10.1017/S0033291721004128 -
Progress in Neuro-psychopharmacology &... Dec 2023Negative symptoms (NS) are a core symptom domain in schizophrenia spectrum disorders and are associated with poorer social and vocational functioning, and with increased... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Negative symptoms (NS) are a core symptom domain in schizophrenia spectrum disorders and are associated with poorer social and vocational functioning, and with increased likelihood and durations of hospital admission. NS are not well understood, limiting available interventions. However, numerous studies have reported associations between neurocognitive domains and NS severity. Thus, one promising area in understanding NS is in relation to neurocognition. Currently, the specificity of the relationship between NS and neurocognition is unknown, meaning that there is no consensus regarding which neurocognitive domain is most strongly associated with NS. There is a need to systematically examine the relationship between NS and various neurocognitive domains within study samples.
METHODS
A systematic search of Ovid PsycINFO, Ovid MEDLINE and Web of Science was performed for articles published since 2004 (year of MATRICS Consensus publication). Inclusion criteria were: 1) individuals with schizophrenia spectrum disorders, first episode psychosis or clinical high risk 2) assessed all six MATRICS neurocognitive domains (processing speed, attention, working memory, verbal learning & memory, visual learning & memory, reasoning & problem solving), 3) reported correlations between all six MATRICS neurocognitive domains and global NS. A three-level random effects hierarchical meta-analysis was performed to assess the relationship between NS (global, expressive, and experiential dimensions) and the six MATRICS neurocognitive domains.
RESULTS
21 studies were included in the review (n = 3619). All MATRICS neurocognitive domains had small significant correlations with global NS (r = -0.16 to -0.20, p < 0.0001). This relationship was significantly moderated by diagnosis and the moderating effect of sex/ gender trended on significance. Analysis of a subset of the studies revealed that MATRICS neurocognitive domains also had small significant correlations with the two NS dimensions, expressive and experiential. Correlations were stronger with the expressive NS dimension.
CONCLUSIONS
This review is novel in assessing the relationship between multiple neurocognitive domains and NS within the same sample, by synthesizing close to two decades of research. Our results suggest that there is a non-specific relationship between neurocognition and NS, and that expressive NS may have a stronger relationship with neurocognitive functioning-based on the MATRICS classification of neurocognition and the neurocognitive assessments used in the included studies. This has implications on our understanding of NS and neurocognition, as well as their treatments. As we gain better understanding of the directionality of the NS-cognition relationship, it could suggest that NS, particularly in the expressive domain, could be improved by targeting cognition globally or that neurocognitive treatments could be more effective if NS are addressed first. Further implications of these results are discussed.
Topics: Humans; Schizophrenia; Psychotic Disorders; Cognition Disorders; Learning; Memory, Short-Term; Neuropsychological Tests
PubMed: 37482283
DOI: 10.1016/j.pnpbp.2023.110833 -
Progress in Neuro-psychopharmacology &... Mar 2023Schizophrenia is a complex psychiatric disorder that includes positive and negative symptoms but also debilitating cognitive deficits. Current pharmacological... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Schizophrenia is a complex psychiatric disorder that includes positive and negative symptoms but also debilitating cognitive deficits. Current pharmacological interventions do not target these deficits. Recent evidence suggests a connection between some inflammatory markers (including C-reactive protein) and cognitive impairment, but did not address other inflammatory markers. In the current study, we try to fill the gap by focusing on the association of Interleukin-6 (IL-6), IL-1β, Tumor Necrosis Factor-α and CRP with cognitive dysfunction.
METHODS
PUBMED and Web of Science databases were searched for all studies published until July 2022. A total of 25 studies were included in an analysis of the association between cognitive performance and variation in IL-6, IL-1β, TNF-α and CRP.
RESULTS
A total of 2398 patients were included in this study. Meta-analyses results showed a significant inverse relationship between performance in five cognitive domains (attention-processing speed, executive function, working memory, verbal and visual learning and memory) and systemic IL-6, IL-1β, TNF-α and CRP plasma levels in patients with schizophrenia. The meta-analyses results showed a significant decline in the cognitive performances with the evaluated inflammatory markers with effect sizes ranging from -0.136 to -0.181 for IL-6, -0.188 to -0.38 for TNF-α -0.372 to -0.476 for IL-1β and - 0.168 to -0.311 for CRP.
CONCLUSION
Findings from the current study shows that cognitive deficits are reflective of elevated proinflammatory biomarkers (IL-6, IL-1β, TNF-α and CRP) levels. The results obtained indicate relatedness between inflammation and cognitive decline in patients with schizophrenia. Understanding the underlying pathways between them could have a significant impact on the disease progression and quality of life in schizophrenia patients.
Topics: Humans; Schizophrenia; Interleukin-6; Tumor Necrosis Factor-alpha; Quality of Life; Cognitive Dysfunction; C-Reactive Protein; Biomarkers; Inflammation
PubMed: 36283512
DOI: 10.1016/j.pnpbp.2022.110668 -
JAMA Psychiatry May 2024Cognitive impairment contributes significantly to clinical outcome and level of function in individuals with psychotic disorders. These impairments are present already... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Cognitive impairment contributes significantly to clinical outcome and level of function in individuals with psychotic disorders. These impairments are present already at psychosis onset at a group level; however, the question of heterogeneity in cognitive function among patients has not been systematically investigated.
OBJECTIVE
To provide an updated quantification of cognitive impairment at psychosis onset before patients receive potentially confounding antipsychotic treatment, and to investigate variability in cognitive function compared with healthy controls.
DATA SOURCES
In this systematic review and meta-analysis, PubMed articles were searched up to September 15, 2022.
STUDY SELECTION
Original studies reporting data on cognitive function in antipsychotic drug-naive patients with first-episode psychosis (FEP) were included.
DATA EXTRACTION AND SYNTHESIS
Data were independently extracted by 2 researchers. Cognitive tasks were clustered according to 6 domains of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery and the domain of executive function. Random-effects model meta-analyses of mean differences and coefficient of variation ratios (CVRs) were performed, as well as meta-regressions, assessment of study quality, and publication bias.
MAIN OUTCOMES AND MEASURES
The main outcome measure was Hedges g for mean differences in cognition and CVR for within-group variability.
RESULTS
Fifty studies were included in the analysis with a total of 2625 individuals with FEP (mean [SD] age, 25.2 [3.6] years, 60% male; 40% female) and 2917 healthy controls (mean [SD] age, 26.0 [4.6]; 55% male; 45% female). In all cognitive domains, the FEP group displayed significant impairment compared with controls (speed of processing: Hedges g = -1.16; 95% CI, -1.35 to -0.98; verbal learning: Hedges g = -1.08; 95% CI, -1.28 to -0.88; visual learning: Hedges g = -1.05; 95% CI, -1.27 to -0.82; working memory: Hedges g = -1.04; 95% CI, -1.35 to -0.73; attention: Hedges g = -1.03; 95% CI, -1.24 to -0.82; reasoning/problem solving: Hedges g = -0.90; 95% CI, -1.12 to -0.68; executive function: Hedges g = -0.88; 95% CI, -1.07 to -0.69). Individuals with FEP also exhibited a larger variability across all domains (CVR range, 1.34-1.92).
CONCLUSIONS AND RELEVANCE
Results of this systematic review and meta-analysis identified cognitive impairment in FEP before the initiation of antipsychotic treatment, with large effect sizes. The high variability within the FEP group suggests the need to identify those individuals with more severe cognitive problems who risk worse outcomes and could benefit the most from cognitive remediation.
Topics: Humans; Psychotic Disorders; Cognitive Dysfunction; Executive Function; Cognition; Antipsychotic Agents; Schizophrenia
PubMed: 38416480
DOI: 10.1001/jamapsychiatry.2024.0016