-
Frontiers in Psychology 2022Although an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard...
PURPOSE
Although an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard therapeutic and prophylactic modality in patients with brain tumors. This review was aimed to abstract and evaluate the prediction models for radiation-induced neurocognitive decline in patients with primary or secondary brain tumors.
METHODS
MEDLINE was searched on October 31, 2021 for publications containing relevant truncation and MeSH terms related to "radiotherapy," "brain," "prediction model," and "neurocognitive impairments." Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool.
RESULTS
Of 3,580 studies reviewed, 23 prediction models were identified. Age, tumor location, education level, baseline neurocognitive score, and radiation dose to the hippocampus were the most common predictors in the models. The Hopkins verbal learning ( = 7) and the trail making tests ( = 4) were the most frequent outcome assessment tools. All studies used regression ( = 14 linear, = 8 logistic, and = 4 Cox) as machine learning method. All models were judged to have a high risk of bias mainly due to issues in the analysis.
CONCLUSION
Existing models have limited quality and are at high risk of bias. Following recommendations are outlined in this review to improve future models: developing cognitive assessment instruments taking into account the peculiar traits of the different brain tumors and radiation modalities; adherence to model development and validation guidelines; careful choice of candidate predictors according to the literature and domain expert consensus; and considering radiation dose to brain substructures as they can provide important information on specific neurocognitive impairments.
PubMed: 35432113
DOI: 10.3389/fpsyg.2022.853472 -
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 -
Schizophrenia Research. Cognition Jun 2022Cognitive impairments are core features of established schizophrenia spectrum disorders (SSD). However, it remains unclear whether specific cognitive functions are...
Cognitive impairments are core features of established schizophrenia spectrum disorders (SSD). However, it remains unclear whether specific cognitive functions are differentially impaired pre-onset and at what age these impairments can be detected. The purpose of this review was to elucidate these issues through a systematic summary of results from longitudinal studies investigating impairment in specific cognitive domains as antecedents of SSD. Relevant studies were identified by electronic and manual literature searches and included any original study of cognitive domains any time pre-onset of SSDs that included a control group. Effect sizes were calculated by domain for studies comparing high-risk participants who developed SSD with those who did not. The strongest evidence for impairment pre-onset was for mental processing speed, verbal learning and memory, executive function, and social cognition. Some verbal impairments, like language abilities at age 3 and verbal learning and memory at age 7, may develop as static deficits. Conversely, some non-verbal impairments, like mental processing speed, visuospatial abilities, and visual working memory manifest as developmental lag and become significant later in life. Most effect sizes were small to moderate, except for verbal fluency (d' = 0,85), implying this impairment as central in high-risk participants who develop SSD. The present review documents extensive cognitive impairments pre-onset of SSD, and that these impairments start early in life, in line with the neurodevelopmental hypothesis of schizophrenia. Increased knowledge about cognitive impairments preonset can provide a better basis for understanding the complex pathogenesis of SSD as well as informing cognitive remediation programs.
PubMed: 35251943
DOI: 10.1016/j.scog.2022.100246 -
Pharmaceuticals (Basel, Switzerland) Nov 2021Curcumin is a polyphenol with strong antioxidant and anti-inflammatory effects that has been shown to be effective in ameliorating cognitive decline in animal studies.... (Review)
Review
Curcumin is a polyphenol with strong antioxidant and anti-inflammatory effects that has been shown to be effective in ameliorating cognitive decline in animal studies. However, its clinical effectiveness is inconclusive, and relevant gastrointestinal adverse events (AEs) have been reported. The aim of this meta-analysis was to summarize the existing evidence from randomized controlled trials (RCTs) of effects of curcumin on overall cognitive function, individual cognitive domains, and gastrointestinal AE. The study includes 8 RCTs and 389 participants. A random-effects model was used for the meta-analysis. Compared with the placebo group, the curcumin group was associated with an improvement in working memory (Hedges' = 0.396, 95% confidence interval (CI) = 0.078 to 0.714, = 0.015) and a borderline benefit in processing speed (Hedges' = 0.303, 95% CI = -0.013 to 0.619, = 0.06). In the domains of language, episodic memory/visual learning, verbal memory, cognitive flexibility/problem solving, and overall cognitive function, no significant difference existed for the comparison between the curcumin and placebo groups. The curcumin group had a significantly higher risk of gastrointestinal AEs than the placebo group (odds ratio = 3.019, 95% CI = 1.118 to 8.150, = 0.029). In the future, the effects of curcumin on working memory, processing speed, and gastrointestinal AE should be further investigated.
PubMed: 34959636
DOI: 10.3390/ph14121235 -
Neurological Sciences : Official... Feb 2022Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to... (Meta-Analysis)
Meta-Analysis Review
Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.
Topics: Cognition; Cognitive Dysfunction; Executive Function; Humans; Telerehabilitation
PubMed: 34822030
DOI: 10.1007/s10072-021-05770-6 -
Clinical Epidemiology 2021The priority of interventions to alleviate cognitive deficits in patients with bipolar disorder (BD) is inconclusive. We systematically evaluate the efficacy of...
Effect of Pharmacological and Neurostimulation Interventions for Cognitive Domains in Patients with Bipolar Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
INTRODUCTION
The priority of interventions to alleviate cognitive deficits in patients with bipolar disorder (BD) is inconclusive. We systematically evaluate the efficacy of pharmacological or neurostimulation interventions for cognitive function in BD through a network meta-analysis.
METHODS
The PubMed, PsycINFO, Embase, and Cochrane Library databases were searched from database inception to September 30, 2021. Following PRISMA guidelines, all eligible studies were randomized controlled trials of adult bipolar patients that provided detailed cognitive outcomes. Studies were excluded if participants limited to comorbid substance use disorder or the intervention was a psychotherapy. Network meta-analysis comparing different interventions was conducted for 8 cognitive domains. Partially ordered set with Hasse diagram was used to resolve conflicting rankings between outcomes. The study was preregistered on PROSPERO database (CRD42020152044).
RESULTS
Total 21 RCTs including 42 tests for assessing intervention effects on cognition were retrieved. Adjunctive erythropoietin (SMD = 0.61, 95% CI = 0.00-1.23), (SMD = 0.58, 95% CI = 0.03-1.13), and galantamine (SMD = 1.22, 95% CI = 0.10-2.35) was more beneficial for attention, working memory, and verbal learning in euthymic BD patients than treatment as usual, respectively. Hasse diagram suggested ranking of choice when multiple domains were combined.
CONCLUSION
Considerable variability in measurements of cognitive domains in BD was observed, and no intervention resulted in superior benefits across all domains. We suggested interventions priority can be tailored according to individual patients' cognitive deficits. As current findings from relatively small and heterogeneous dataset, future trials with consensus should be applied for building further evidence.
PubMed: 34744458
DOI: 10.2147/CLEP.S335584 -
Frontiers in Medicine 2021Remimazolam is a new ultrashort-acting benzodiazepine. Remimazolam has been approved for procedural sedation by the US Food and Drug Administration in 2020. However,...
Remimazolam is a new ultrashort-acting benzodiazepine. Remimazolam has been approved for procedural sedation by the US Food and Drug Administration in 2020. However, prior trials and the participants they enrolled were limited. In this meta-analysis, we investigated the effectiveness and adverse events (AEs) of remimazolam during procedural sedation. The study protocol was registered (doi: 10.37766/inplasy2020.8.0043), and six databases were searched. We performed meta-analysis, trial sequential analysis (TSA), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology for judging the certainty of evidence (CoE). A total of five randomized controlled trials with 1,248 participants were included. Compared with the use of midazolam, the utilization of remimazolam resulted in an increase in procedure success rate [odds ratio (OR) = 9.01, 95% confidence interval (CI): 2.35-34.57], a reduction in the application of rescue medication (OR = 13.58, 95% CI: 3.46-53.28), a decrease in time to recovery [minutes, weighted mean difference (WMD) = -5.70, 95% CI: -8.68 to -2.72], and a better cognitive recovery of Hopkins Verbal Learning Test-Revised (WMD = 5.22, 95% CI: 2.88-7.55). No difference was found in completion of procedure (OR = 1.68, 95% CI: 0.72-3.90) with inconclusive in TSA. Despite no difference of total AEs (OR = 0.60, 95% CI: 0.24-1.50), more detailed analysis of AEs remained inconclusive in TSA. The GRADE assessment demonstrated low to very low CoE. Our analysis suggested that remimazolam may be a better choice for procedural sedation than midazolam. Nevertheless, further studies are warranted to conclusively establish its safety.
PubMed: 34386505
DOI: 10.3389/fmed.2021.641866 -
Frontiers in Psychology 2021In instructional-learning contexts, the relationship between teacher verbal and non-verbal immediacy and student motivation has gained increasing attention. However, no...
In instructional-learning contexts, the relationship between teacher verbal and non-verbal immediacy and student motivation has gained increasing attention. However, no systematic research has been done to review the empirical studies conducted on the impact of teacher immediacy on students' motivation. Hence, the aim of the present study was to systematically review the available literature on different types of teacher immediacy and student motivation. Some common databases were searched and 30 eligible manuscripts were identified. With regard to the key features of the included studies, the review's findings were categorized into different sections, namely "the measures of teacher immediacy employed," "the measures of student motivation employed," "designs," and "educational contexts". The main findings of the studies were also discussed. The reviewed studies pointed to positive associations between teacher immediacy and student motivation. Finally, limitations of the included studies are discussed and some practical directions for further research are offered, accordingly.
PubMed: 34248809
DOI: 10.3389/fpsyg.2021.713978 -
International Journal of Environmental... Jun 2021Feedback is an essential factor that may affect students' motor skill learning during physical education (PE) classes. This review aimed to (1) systematically examine... (Review)
Review
OBJECTIVES
Feedback is an essential factor that may affect students' motor skill learning during physical education (PE) classes. This review aimed to (1) systematically examine the evidence for the effectiveness of feedback on students' skill learning during PE classes and (2) summarize the evidence for the effects of feedback elements (i.e., format and content).
METHODS
A systematic search was conducted on seven electronic databases to identify studies that explored the effects of feedback on student learning during PE classes. Twenty-three studies were selected, and the study quality was evaluated using the Physiotherapy Evidence Database scale. The levels of evidence were determined with the best evidence synthesis.
RESULTS
Strong evidence indicates the effectiveness of feedback intervention on students' skill learning compared with those who received no feedback. Limited evidence was found for the effect of visual feedback compared with verbal feedback. There were mixed results for the effectiveness of information feedback compared with praise or corrective feedback.
CONCLUSION
The current evidence suggests that feedback is useful for skill learning during PE classes. Emergent questions still need to be addressed, such as those regarding the efficiency of using different formats and contents for feedback delivery to enhance motor skill learning during PE classes.
Topics: Clinical Competence; Feedback; Humans; Motor Skills; Physical Education and Training; Students
PubMed: 34200657
DOI: 10.3390/ijerph18126281 -
International Journal of Language &... Jul 2021Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with... (Review)
Review
BACKGROUND
Prenatal alcohol exposure (PAE) is associated with growth deficits and neurodevelopmental impairment including foetal alcohol spectrum disorder (FASD). Difficulties with oral and written communication skills are common among children with PAE; however, less is known about how communication skills of adolescents who have PAE compare with those who do not. Adolescence is a critical time for development, supporting the transition into adulthood, but it is considered a high-risk period for those with FASD.
AIMS
We conducted a systematic review to synthesize evidence regarding oral and written communication skills of adolescents with PAE or FASD and how they compare with those with no PAE.
METHODS & PROCEDURES
A comprehensive search strategy used seven databases: Cochrane Library, Cinahl, Embase, Medline, PsycInfo, Eric and Web of Science. Included studies reported on at least one outcome related to oral and written communication for a PAE (or FASD) group as well as a no/low PAE group, both with age ranges of 10-24 years. Quality assessment was undertaken.
MAIN CONTRIBUTION
Communication skills most often assessed in the seven studies included in this review were semantic knowledge, semantic processing, and verbal learning and memory. These communication skills, in addition to reading and spelling, were commonly weaker among adolescents with PAE compared with those with no/low PAE. However, the findings were inconsistent across studies, and studies differed in their methodologies.
CONCLUSIONS & IMPLICATIONS
Our results emphasize that for adolescents with PAE, communication skills in both oral and written modalities should be comprehensively understood in assessment and when planning interventions. A key limitation of the existing literature is that comparison groups often include some participants with a low level of PAE, and that PAE definitions used to allocate participants to groups differ across studies.
WHAT THIS PAPER ADDS
What is already known on the subject PAE and FASD are associated with deficits in oral and written communication skills. Studies to date have mostly focused on children with a FASD diagnosis as well as combined groups of children and adolescents with FASD or PAE. There is a gap in what is known about oral and written communication skills of adolescents, specifically, who have PAE or FASD. This has implications for the provision of assessment and supports during a period of increased social and academic demands. What this study adds to existing knowledge This review provides systematic identification, assessment and synthesis of the current literature related to oral and written communication skills of adolescents with PAE compared with those with no/low PAE. The review revealed a small knowledge base with inconsistent methodologies and findings across studies. However, the findings overall highlight that adolescents with PAE have weaker skills in oral and written language than those with no/low PAE. Results are discussed in relation to education, social and emotional well-being, and forensic contexts. What are the potential or actual clinical implications of this work? Findings emphasize that for adolescents with PAE, comprehensive assessment of both oral and written communication skills, through both standardized and functional tasks, should be undertaken. Speech-language pathologists have a key role in assessment with individuals who have PAE.
Topics: Adolescent; Adult; Child; Communication; Communication Disorders; Female; Fetal Alcohol Spectrum Disorders; Humans; Pregnancy; Prenatal Exposure Delayed Effects; Young Adult
PubMed: 34137136
DOI: 10.1111/1460-6984.12644