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European Journal of Obstetrics,... Jun 2024Isntroduction. Polycystic ovary syndrome (PCOS) is a multifaceted endocrine-gynecological condition affecting a substantial number of women during their reproductive... (Review)
Review
Comparative efficacy of metformin combined with cabergoline versus metformin alone in patients with PCOS and hyperprolactinemia: A systematic review and meta-analysis of randomized controlled trials.
UNLABELLED
Isntroduction. Polycystic ovary syndrome (PCOS) is a multifaceted endocrine-gynecological condition affecting a substantial number of women during their reproductive years. Metformin (MET) has been shown to improve ovarian function in PCOS-related conditions, while cabergoline is recognized for its powerful and sustained ability to reduce prolactin levels. This study investigates the potential impact of combining cabergoline with metformin while comparing it with metformin alone in the treatment of PCOS alongside hyperprolactinemia.
METHOD
To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials involving patients with PCOS and hyperprolactinemia. Outcome measures included changes in the levels of prolactin, testosterone, DHEAS, BMI and menstrual irregularities. RevMan version 5.4 was used to analyze outcomes.
RESULT
This study incorporated three Randomized Controlled Trials (RCTs) involving 405 participants in total. Patients receiving a combination of metformin and cabergoline experienced significant reductions in prolactin and testosterone levels (p= <0.0001 and p=<0.0001, respectively). Conversely, alterations in DHEAS levels and BMI did not reach statistical significance (p = 0.19 and p = 0.71, respectively). Notably, women solely prescribed metformin exhibited significantly higher rates of menstrual irregularities compared to those receiving both metformin and cabergoline (p=<0.0001).
CONCLUSION
Our analysis underscores the synergistic effect achieved by pairing metformin and cabergoline in patients with PCOS and hyperprolactinemia. However, we encountered only a restricted number of studies meeting our criteria. It is imperative to consistently assess the combined effects of metformin and cabergoline to gain deeper insights into their effectiveness in addressing PCOS and hyperprolactinemia.
PubMed: 38945085
DOI: 10.1016/j.ejogrb.2024.06.037 -
Neuroscience and Biobehavioral Reviews Jun 2024The prenatal and neonatal periods are two of the most important developmental stages of the human brain. It is therefore crucial to understand normal brain development... (Review)
Review
The prenatal and neonatal periods are two of the most important developmental stages of the human brain. It is therefore crucial to understand normal brain development and how early connections are established during these periods, in order to advance the state of knowledge on altered brain development and eventually identify early brain markers of neurodevelopmental disorders and diseases. In this systematic review (Prospero ID: CRD42024511365), we compiled resting state functional magnetic resonance imaging (fMRI) studies in healthy fetuses and neonates, in order to outline the main characteristics of typical development of the functional brain connectivity during the prenatal and neonatal periods. A systematic search of five databases identified a total of 12 573 articles. Of those, 28 articles met pre-established selection criteria based determined by the authors after surveying and compiling the major limitations reported within the literature. Inclusion criteria were: (1) resting state studies; (2) presentation of original results; (3) use of fMRI with minimum one Tesla; (4) a population ranging from 20 weeks of GA to term birth (around 37-42 weeks of PMA); (5) singleton pregnancy with normal development (absence of any complications known to alter brain development). Exclusion criteria were: (1) preterm studies; (2) post-mortem studies; (3) clinical or pathological studies; (4) twin studies; (5) papers with a sole focus on methodology (i.e. focused on tool and analysis development); (6) volumetric studies; (7) activation map studies; (8) cortical analysis studies; (9) conference papers. A risk of bias assessment was also done to evaluate each article's methodological rigor. 1877 participants were included across all the reviewed articles. Results consistently revealed a developmental gradient of increasing functional brain connectivity from posterior to anterior regions and from proximal-to-distal regions. A decrease in local small-world organization shortly after birth was also observed; small-world characteristics were present in fetuses and newborns, but appeared weaker in the latter group. Also, the posterior-to-anterior gradient could be associated with earlier development of the sensorimotor networks in the posterior regions while more complex higher-order networks (e.g. attention-related) mature later in the anterior regions. The main limitations of this systematic review stem from the inherent limitations of functional imaging in fetuses, mainly: unevenly distributed populations and limited sample sizes; fetal movements in the womb and other imaging obstacles; and a large voxel resolution when imaging a small brain. Another limitation specific to this review is the relatively small number of included articles compared to very a large search result, which may have led to relevant articles having been overlooked.
PubMed: 38936564
DOI: 10.1016/j.neubiorev.2024.105778 -
Schizophrenia Bulletin Jun 2024N-Methyl-d-aspartate receptor (NMDA-R) hypofunctioning has been hypothesized to be involved in circuit dysfunctions in schizophrenia (ScZ). Yet, it remains to be...
Effects of N-Methyl-d-Aspartate Receptor Antagonists on Gamma-Band Activity During Auditory Stimulation Compared With Electro/Magneto-encephalographic Data in Schizophrenia and Early-Stage Psychosis: A Systematic Review and Perspective.
BACKGROUND AND HYPOTHESIS
N-Methyl-d-aspartate receptor (NMDA-R) hypofunctioning has been hypothesized to be involved in circuit dysfunctions in schizophrenia (ScZ). Yet, it remains to be determined whether the physiological changes observed following NMDA-R antagonist administration are consistent with auditory gamma-band activity in ScZ which is dependent on NMDA-R activity.
STUDY DESIGN
This systematic review investigated the effects of NMDA-R antagonists on auditory gamma-band activity in preclinical (n = 15) and human (n = 3) studies and compared these data to electro/magneto-encephalographic measurements in ScZ patients (n = 37) and 9 studies in early-stage psychosis. The following gamma-band parameters were examined: (1) evoked spectral power, (2) intertrial phase coherence (ITPC), (3) induced spectral power, and (4) baseline power.
STUDY RESULTS
Animal and human pharmacological data reported a reduction, especially for evoked gamma-band power and ITPC, as well as an increase and biphasic effects of gamma-band activity following NMDA-R antagonist administration. In addition, NMDA-R antagonists increased baseline gamma-band activity in preclinical studies. Reductions in ITPC and evoked gamma-band power were broadly compatible with findings observed in ScZ and early-stage psychosis patients where the majority of studies observed decreased gamma-band spectral power and ITPC. In regard to baseline gamma-band power, there were inconsistent findings. Finally, a publication bias was observed in studies investigating auditory gamma-band activity in ScZ patients.
CONCLUSIONS
Our systematic review indicates that NMDA-R antagonists may partially recreate reductions in gamma-band spectral power and ITPC during auditory stimulation in ScZ. These findings are discussed in the context of current theories involving alteration in E/I balance and the role of NMDA hypofunction in the pathophysiology of ScZ.
PubMed: 38934800
DOI: 10.1093/schbul/sbae090 -
Equine Veterinary Journal Jun 2024The resistivity index (RI) evaluates haemodynamic based on arterial resistance. Alterations in renal blood flow are important for the early detection of kidney damage,... (Review)
Review
BACKGROUND
The resistivity index (RI) evaluates haemodynamic based on arterial resistance. Alterations in renal blood flow are important for the early detection of kidney damage, as perfusion might be one of the first affected aspects.
OBJECTIVES
To retrieve published studies on equine renal RI to develop a standardised method of renal ultrasonographic examination and to evaluate the current reference range for the renal RI in horses.
STUDY DESIGN
Systematic review.
METHODS
An electronic search in Science Direct, PubMed, Scopus and Web of Science databases was performed in February 2023 using the terms 'RI' OR 'resistivity index' OR 'IP' OR 'pulsatility index' AND (kidney OR renal) AND (equine OR horse) in titles, keywords and abstracts. The studies were screened for inclusion based on pre-determined criteria and data on the variables of interest were collected from included studies. The SYRCLE risk of bias tool was used to assess the methodological quality.
RESULTS
The electronic searches identified 134 studies, of which 5 were eligible for inclusion in this review. The studies had been conducted in healthy non-sedated horses through the transabdominal technique. The upper limit of normality for the renal RI was 0.58 ± 0.06 for the right kidney of untrained horses, which is considerably lower than the value of 0.70 currently used for humans, cats and dogs. There were heterogenous outcomes among the studies: two of the five demonstrated a difference between the right and left renal RI values, and one of the five showed an increased renal RI in elderly horses compared with foals and adult horses.
MAIN LIMITATIONS
Data regarding the RI in horses are still scarce.
CONCLUSIONS
Additional studies that establish a reference range for the renal RI in horses are needed and there is a need to ensure consistency of techniques.
PubMed: 38924139
DOI: 10.1111/evj.14125 -
Journal of Neuroengineering and... Jun 2024Repeated transcranial magnetic stimulation (rTMS) could induce alterations in cortical excitability and promote neuroplasticity. To precisely quantify these effects,... (Meta-Analysis)
Meta-Analysis Review
Impact of repetitive transcranial magnetic stimulation on cortical activity: a systematic review and meta-analysis utilizing functional near-infrared spectroscopy evaluation.
BACKGROUND
Repeated transcranial magnetic stimulation (rTMS) could induce alterations in cortical excitability and promote neuroplasticity. To precisely quantify these effects, functional near-infrared spectroscopy (fNIRS), an optical neuroimaging modality adept at detecting changes in cortical hemodynamic responses, has been employed concurrently alongside rTMS to measure and tailor the impact of diverse rTMS protocols on the brain cortex.
OBJECTIVE
This systematic review and meta-analysis aimed to elucidate the effects of rTMS on cortical hemodynamic responses over the primary motor cortex (M1) as detected by fNIRS.
METHODS
Original articles that utilized rTMS to stimulate the M1 cortex in combination with fNIRS for the assessment of cortical activity were systematically searched across the PubMed, Embase, and Scopus databases. The search encompassed records from the inception of these databases up until April, 2024. The assessment for risk of bias was also conducted. A meta-analysis was also conducted in studies with extractable raw data.
RESULTS
Among 312 studies, 14 articles were eligible for qualitative review. 7 studies were eligible for meta-analysis. A variety of rTMS protocols was employed on M1 cortex. In inhibitory rTMS, multiple studies observed a reduction in the concentration of oxygenated hemoglobin [HbO] at the ipsilateral M1, contrasted by an elevation at the contralateral M1. Meta-analysis also corroborated this consistent trend. Nevertheless, certain investigations unveiled diminished [HbO] in bilateral M1. Several studies also depicted intricate inhibitory or excitatory interplay among distinct cortical regions.
CONCLUSION
Diverse rTMS protocols led to varied patterns of cortical activity detected by fNIRS. Meta-analysis revealed a trend of increasing [HbO] in the contralateral cortices and decreasing [HbO] in the ipsilateral cortices following low frequency inhibitory rTMS. However, due to the heterogeneity between studies, further research is necessary to comprehensively understand rTMS-induced alterations in brain activity.
Topics: Transcranial Magnetic Stimulation; Spectroscopy, Near-Infrared; Humans; Motor Cortex
PubMed: 38915003
DOI: 10.1186/s12984-024-01407-9 -
Frontiers in Neuroanatomy 2024Literature suggests a common pathophysiological ground between carotid atherosclerosis (CAS) and white matter alterations in the brain. However, the association between...
INTRODUCTION
Literature suggests a common pathophysiological ground between carotid atherosclerosis (CAS) and white matter alterations in the brain. However, the association between carotid intima-media thickness (CIMT) and white matter hyperintensities (WMH) has not been conclusively reported. The current systematic review explores and reports the relationship between CIMT and WMH among asymptomatic/non-stroke adults.
METHODS
A recent literature search on PubMed, SCOPUS, and Web of Science databases was conducted in compliance with the PRISMA protocol. The pre-defined Population-Intervention-Comparison-Outcome-Study (PICOS) criteria included observational studies investigating the CIMT-WMH association among non-stroke adults undergoing magnetic resonance imaging and carotid ultrasound.
RESULTS
Out of 255 potential results, 32 studies were critically assessed for selection, and finally, 10 articles were included, comprising 5,116 patients (females = 60.2%; males = 39.8%) aged between 36-71 years. The included studies earned high quality ratings (6-9) based on the Newcastle-Ottawa-Scale criteria. Qualitative synthesis showed a significantly parallel relationship between increased CIMT and greater WMH burden in 50% of the studies. In addition, significant risk factors related to the CIMT-WMH association included older age, hypertension, depression, migraine, Hispanic ethnicity, and apolipoprotein E (ɛ4) in postmenopausal women.
CONCLUSION
Overall, the cumulative evidence showed a consistent CIMT-WMH association in asymptomatic middle-aged and older non-stroke adults, indicating that CAS may contribute to the progression of pathologically hyperintense white matter in the brain. However, further research is warranted to infer the plausible relationship between CIMT and WMH in the absence of stroke.
PubMed: 38903057
DOI: 10.3389/fnana.2024.1394766 -
Neuroscience and Biobehavioral Reviews Jun 2024Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks... (Review)
Review
Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks implicated in learning and memory. Therefore, this review sought to understand how different learning and memory processes relate to behavioural addictions and to unravel their underlying neural mechanisms. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched four databases - PsycINFO, PubMed, Scopus, and Web of Science using the agreed-upon search string. Findings suggest altered executive function-dependent learning processes and enhanced habit learning in behavioural addiction. Whereas the relationship between working memory and behavioural addiction is influenced by addiction type, working memory aspect, and task nature. Additionally, long-term memory is incoherent in individuals with addictive behaviours. Consistently, neurophysiological evidence indicates alterations in brain areas and networks implicated in learning and memory processes in behavioural addictions. Overall, the present review argues that, like substance use disorders, alteration in learning and memory processes may underlie the development and maintenance of behavioural addictions.
PubMed: 38870547
DOI: 10.1016/j.neubiorev.2024.105747 -
Arthroscopy : the Journal of... May 2024To assess the current scientific literature on the microbiome's relationship with knee osteoarthritis (OA), with specific focuses on the gut microbiome-joint axis and... (Review)
Review
PURPOSE
To assess the current scientific literature on the microbiome's relationship with knee osteoarthritis (OA), with specific focuses on the gut microbiome-joint axis and joint microbiome-joint axis.
METHODS
A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, searching PubMed, Embase, and Cochrane databases for relevant English-language clinical studies on the gut and/or joint microbiomes' association with knee OA in humans. Bias was evaluated using the methodological index for non-randomized studies score.
RESULTS
Thirty-five thousand bacterial species comprise the gut microbiome; approximately 90% are members of the phyla Bacteroides and Firmicutes. Symbiosis between the gut microbiome and host under normal physiological conditions positively affects host growth, development, immunity, and longevity. Gut microbiome imbalance can negatively influence various physiological processes, including immune response, inflammation, metabolism, and joint health including development of knee OA. In addition, next generation gene sequencing suggests the presence of microorganisms in the synovial fluid of osteoarthritic knees, and distinct microbiome profiles detected are presumed to play a role in the development of OA. With regard to the gut microbiome, consistent alterations in microbial composition between OA patients and controls are noted, in addition to several associations between certain gut bacteria with OA-related knee pain, patient-reported outcome measure performance, imaging findings, and changes in metabolic and inflammatory pathways. Regarding the joint microbiome, studies revealed increased levels of lipopolysaccharide (LPS) and LPS-binding protein in synovial fluid are associated with activated macrophages, and correlated with worsened osteophyte severity, joint space narrowing, and pain scores in knee OA patients. In addition, studies demonstrated various microbial composition differences in OA patients compared to control, with certain joint microbes directly associated with OA pathogenesis, inflammation, and metabolic dysregulation.
CONCLUSIONS
The gut microbiome-joint axis and joint microbiome shows alterations in microbial composition between osteoarthritic patients and controls. These alterations are associated with perturbations of metabolic and inflammatory pathways, imaging findings, osteoarthritis-related pain, and patient reported outcome measure performance.
LEVEL OF EVIDENCE
Systematic Review; Level III.
PubMed: 38797504
DOI: 10.1016/j.arthro.2024.05.010 -
Clinical Neurophysiology : Official... Jul 2024Fibromyalgia Syndrome (FMS), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID (LC) are similar multisymptom clinical syndromes but with... (Review)
Review
Fibromyalgia Syndrome (FMS), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID (LC) are similar multisymptom clinical syndromes but with difference in dominant symptoms in each individual. There is existing and emerging literature on possible functional alterations of the central nervous system in these conditions. This review aims to synthesise and appraise the literature on resting-state quantitative EEG (qEEG) in FMS, ME/CFS and LC, drawing on previous research on FMS and ME/CFS to help understand neuropathophysiology of the new condition LC. A systematic search of MEDLINE, Embase, CINHAL, PsycINFO and Web of Science databases for articles published between December 1994 and September 2023 was performed. Out of the initial 2510 studies identified, 17 articles were retrieved that met all the predetermined selection criteria, particularly of assessing qEEG changes in one of the three conditions compared to healthy controls. All studies scored moderate to high quality on the Newcastle-Ottawa scale. There was a general trend for decreased low-frequency EEG band activity (delta, theta, and alpha) and increased high-frequency EEG beta activity in FMS, differing to that found in ME/CFS. The limited LC studies included in this review focused mainly on cognitive impairments and showed mixed findings not consistent with patterns observed in FMS and ME/CFS. Our findings suggest different patterns of qEEG brainwave activity in FMS and ME/CFS. Further research is required to explore whether there are phenotypes within LC that have EEG signatures similar to FMS or ME/CFS. This could inform identification of reliable diagnostic markers and possible targets for neuromodulation therapies tailored to each clinical syndrome.
Topics: Humans; Fatigue Syndrome, Chronic; Fibromyalgia; COVID-19; Electroencephalography; Brain
PubMed: 38772083
DOI: 10.1016/j.clinph.2024.04.019 -
Global Change Biology May 2024Amphibians and fishes play a central role in shaping the structure and function of freshwater environments. These organisms have a limited capacity to disperse across...
Amphibians and fishes play a central role in shaping the structure and function of freshwater environments. These organisms have a limited capacity to disperse across different habitats and the thermal buffer offered by freshwater systems is small. Understanding determinants and patterns of their physiological sensitivity across life history is, therefore, imperative to predicting the impacts of climate change in freshwater systems. Based on a systematic literature review including 345 experiments with 998 estimates on 96 amphibian (Anura/Caudata) and 93 freshwater fish species (Teleostei), we conducted a quantitative synthesis to explore phylogenetic, ontogenetic, and biogeographic (thermal adaptation) patterns in upper thermal tolerance (CT) and thermal acclimation capacity (acclimation response ratio, ARR) as well as the influence of the methodology used to assess these thermal traits using a conditional inference tree analysis. We found globally consistent patterns in CT and ARR, with phylogeny (taxa/order), experimental methodology, climatic origin, and life stage as significant determinants of thermal traits. The analysis demonstrated that CT does not primarily depend on the climatic origin but on experimental acclimation temperature and duration, and life stage. Higher acclimation temperatures and longer acclimation times led to higher CT values, whereby Anuran larvae revealed a higher CT than older life stages. The ARR of freshwater fishes was more than twice that of amphibians. Differences in ARR between life stages were not significant. In addition to phylogenetic differences, we found that ARR also depended on acclimation duration, ramping rate, and adaptation to local temperature variability. However, the amount of data on early life stages is too small, methodologically inconsistent, and phylogenetically unbalanced to identify potential life cycle bottlenecks in thermal traits. We, therefore, propose methods to improve the robustness and comparability of CT/ARR data across species and life stages, which is crucial for the conservation of freshwater biodiversity under climate change.
Topics: Animals; Acclimatization; Fishes; Fresh Water; Amphibians; Global Warming; Phylogeny; Climate Change; Temperature
PubMed: 38771091
DOI: 10.1111/gcb.17318