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Neuropsychology Review Jun 2024In recent years, there has been an increasing quest in improving our understanding of the neurocognitive deficits underlying adult attention-deficit/hyperactivity... (Meta-Analysis)
Meta-Analysis Review
In recent years, there has been an increasing quest in improving our understanding of the neurocognitive deficits underlying adult attention-deficit/hyperactivity disorder (ADHD). Current statistical manuals of psychiatric disorders emphasize inattention and hyperactivity-impulsivity symptoms, but empirical studies have also shown consistent alterations in inhibitory control. To date, there is no established neuropsychological test to assess inhibitory control deficits in adult ADHD. A common paradigm for assessing response inhibition is the stop-signal task (SST). Following PRISMA-selection criteria, our systematic review and meta-analysis integrated the findings of 26 publications with 27 studies examining the SST in adult ADHD. The meta-analysis, which included 883 patients with adult ADHD and 916 control participants, revealed reliable inhibitory control deficits, as expressed in prolonged SST response times, with a moderate effect size = 0.51 (95% CI: 0.376-0.644, < 0.0001). The deficits were not moderated by study quality, sample characteristics or clinical parameters, suggesting that they may be a phenotype in this disorder. The analyses of secondary outcome measures revealed greater SST omission errors and reduced go accuracy in patients, indicative of altered sustained attention. However, only few (N < 10) studies were available for these measures. Our meta-analysis suggests that the SST, in conjunction with other tests and questionnaires, could become a valuable tool for assessing inhibitory control deficits in adult ADHD.
Topics: Humans; Attention Deficit Disorder with Hyperactivity; Inhibition, Psychological; Adult; Neuropsychological Tests; Executive Function; Reaction Time
PubMed: 37300725
DOI: 10.1007/s11065-023-09592-5 -
Schizophrenia Bulletin Sep 2023Intestinal microbiota is intrinsically linked to human health. Evidence suggests that the composition and function of the microbiome differs in those with schizophrenia... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND HYPOTHESIS
Intestinal microbiota is intrinsically linked to human health. Evidence suggests that the composition and function of the microbiome differs in those with schizophrenia compared with controls. It is not clear how these alterations functionally impact people with schizophrenia. We performed a systematic review and meta-analysis to combine and evaluate data on compositional and functional alterations in microbiota in patients with psychosis or schizophrenia.
STUDY DESIGN
Original studies involving humans and animals were included. The electronic databases PsycINFO, EMBASE, Web of Science, PubMed/MEDLINE, and Cochrane were systematically searched and quantitative analysis performed.
STUDY RESULTS
Sixteen original studies met inclusion criteria (1376 participants: 748 cases and 628 controls). Ten were included in the meta-analysis. Although observed species and Chao 1 show a decrease in diversity in people with schizophrenia compared with controls (SMD = -0.14 and -0.66 respectively), that did not reach statistical significance. We did not find evidence for variations in richness or evenness of microbiota between patients and controls overall. Differences in beta diversity and consistent patterns in microbial taxa were noted across studies. We found increases in Bifidobacterium, Lactobacillus, and Megasphaera in schizophrenia groups. Variations in brain structure, metabolic pathways, and symptom severity may be associated with compositional alterations in the microbiome. The heterogeneous design of studies complicates a similar evaluation of functional readouts.
CONCLUSIONS
The microbiome may play a role in the etiology and symptomatology of schizophrenia. Understanding how the implications of alterations in microbial genes for symptomatic expression and clinical outcomes may contribute to the development of microbiome targeted interventions for psychosis.
Topics: Humans; Schizophrenia; Gastrointestinal Microbiome; Psychotic Disorders
PubMed: 37210594
DOI: 10.1093/schbul/sbad049 -
The Journal of Maternal-fetal &... Dec 2023The majority of expectant mothers report sleep alterations during pregnancy and almost 40% report poor sleep quality. There is growing evidence that sleep quality (SQ)... (Review)
Review
BACKGROUND
The majority of expectant mothers report sleep alterations during pregnancy and almost 40% report poor sleep quality. There is growing evidence that sleep quality (SQ) during pregnancy influences maternal health. This review focuses on how SQ during pregnancy relates to maternal health-related quality of life (HRQoL). The review also aims to identify whether this relation varies between pregnancy trimesters, and for different subdomains of HRQoL.
METHODS
A systematic review was performed according to PRISMA guidelines and registered on Prospero in August 2021 with ID no: CRD42021264707. Pubmed, Psychinfo, Embase, Cochrane, and trial registries were searched up to June 2021. Studies with any design that investigated the relation between SQ and quality of life/HRQoL in pregnant women, published in English, and peer-reviewed, were included. Two independent reviewers screened titles, abstracts, and full texts, and extracted data from the included papers. The quality of the studies was evaluated using the Newcastle-Ottawa Scale.
RESULTS
Three hundred and thirteen papers were identified in the initial search, of which 10 met the inclusion criteria. Data included 7330 participants from six different countries. The studies had longitudinal ( = 1) or cross-sectional designs ( = 9). In nine studies SQ was reported subjectively by self-report questionnaires. Actigraphic data was available from two studies. HRQoL was assessed by validated questionnaires in all studies. Due to high levels of clinical and methodological heterogeneity in included studies, a narrative synthesis was employed. Nine studies found that poor sleep quality was related to a lower overall HRQoL during pregnancy. Effect sizes were low to medium. This relation was reported most during the third trimester. Especially sleep disturbances and subjective low SQ seemed to be related consistently to lower HRQoL. Furthermore, an indication was found that SQ might have a relation with the mental and physical domain of HRQoL. The social and environmental domain may also be associated with overall SQ.
CONCLUSION
Despite the scarcity of studies available, this systematic review found evidence that low SQ is related to low HRQoL during pregnancy. An indication was found that the relationship between SQ and HRQoL during the second trimester might be less prominent.
Topics: Humans; Female; Pregnancy; Quality of Life; Sleep Quality; Cross-Sectional Studies; Pregnant Women; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 37197986
DOI: 10.1080/14767058.2023.2212829 -
Clinical Rehabilitation Nov 2023The objectives of this systematic review were to describe the current dose and content of usual care upper limb motor intervention for inpatients following stroke and...
OBJECTIVE
The objectives of this systematic review were to describe the current dose and content of usual care upper limb motor intervention for inpatients following stroke and examine if context factors alter dose and content.
DATA SOURCES
A systematic search (EMBASE, MEDLINE) was completed from January 2015 to February 2023 (PROSPERO CRD42021281986).
METHODS
Studies were eligible if they reported non-protocolised usual care upper limb motor intervention dose data for stroke inpatients. Studies were rated using the Johanna Briggs Institute critical appraisal tool. Data were descriptively reported for dose dimensions of time (on task or, in therapy) and intensity (repetitions, repetition/minute), content (intervention type/mode), and context (e.g., severity strata).
RESULTS
Eight studies were included from four countries, largely reflecting inpatient rehabilitation. Time in therapy ranged from 23 to 121 min/day. Time on task ranged from 8 to 44 min/day. Repetitions ranged from 36 to 57/session, and 15 to 282/day. Time on task was lowest in the stratum of people with severe upper limb impairment (8 min/day), the upper limit for this stratum was 41.5 min/day. There was minimal reporting of usual care content across all studies.
CONCLUSION
Upper limb motor intervention dose appears to be increasing in usual care compared to prior reports (e.g., average 21 min/day and 23 to 32 repetitions/session). Context variability suggests that doses are lowest in the stratum of patients with a severely impaired upper limb. Consistent reporting of the multiple dimensions of dose and content is necessary to better understand usual care offered during inpatient rehabilitation.
Topics: Humans; Stroke Rehabilitation; Stroke; Upper Extremity; Activities of Daily Living; Inpatients
PubMed: 37151039
DOI: 10.1177/02692155231172295 -
Neuropsychology Review Mar 2024Olfactory and gustatory dysfunction have been reported in mild and major neurocognitive disorders (NCDs), with variable results. While olfactory dysfunction has been... (Meta-Analysis)
Meta-Analysis
Olfactory and gustatory dysfunction have been reported in mild and major neurocognitive disorders (NCDs), with variable results. While olfactory dysfunction has been consistently explored, reports on gustatory alterations are limited. We systematically reviewed case-control studies evaluating gustatory function in NCDs with various etiologies and different neuropathology. Eighteen studies were included in the systematic review, and eight were included in the meta-analysis. Most studies were on Alzheimer's disease (AD) and Parkinson's disease (PD). Pooled analyses showed worse global taste threshold and identification (sour in particular) scores in AD than controls and worse global, sweet, and sour scores in AD compared to mild cognitive impairment (MCI). PD with MCI showed worse global, sweet, salty, and sour scores than controls and cognitively unimpaired PD. Taste dysfunction was differentially associated with the severity of cognitive deficits. Gustatory dysfunction may represent a potential cross-disease chemosensory biomarker of NCD. Whether gustatory alterations may be a pre-clinical biomarker of NCD requires further studies.
Topics: Humans; Alzheimer Disease; Biomarkers; Cognitive Dysfunction; Parkinson Disease; Smell; Taste; Taste Disorders
PubMed: 36806051
DOI: 10.1007/s11065-023-09578-3 -
Psychological Medicine Aug 2023Impaired brain metabolism may be central to schizophrenia pathophysiology, but the magnitude and consistency of metabolic dysfunction is unknown. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Impaired brain metabolism may be central to schizophrenia pathophysiology, but the magnitude and consistency of metabolic dysfunction is unknown.
METHODS
We searched MEDLINE, PsychINFO and EMBASE between 01/01/1980 and 13/05/2021 for studies comparing regional brain glucose metabolism using FDG-PET, in schizophrenia/first-episode psychosis controls. Effect sizes (Hedges ) were pooled using a random-effects model. Primary measures were regional absolute and relative CMRGlu in frontal, temporal, parietal and occipital lobes, basal ganglia and thalamus.
RESULTS
Thirty-six studies (1335 subjects) were included. Frontal absolute glucose metabolism (Hedge's = -0.74 ± 0.54, = 0.01; = 67%) and metabolism relative to whole brain ( = -0.44 ± 0.34, = 0.01; = 55%) were lower in schizophrenia controls with moderate heterogeneity. Absolute frontal metabolism was lower in chronic ( = -1.18 ± 0.73) first-episode patients ( = -0.09 ± 0.88) and controls. Medicated patients showed frontal hypometabolism relative to controls (-1.04 ± 0.26) while metabolism in drug-free patients did not differ significantly from controls. There were no differences in parietal, temporal or occipital lobe or thalamic metabolism in schizophrenia controls. Excluding outliers, absolute basal ganglia metabolism was lower in schizophrenia controls (-0.25 ± 0.24, = 0.049; = 5%). Studies identified reporting voxel-based morphometry measures of absolute FDG uptake (eight studies) were also analysed using signed differential mapping analysis, finding lower FDG uptake in the left anterior cingulate gyrus ( = -4.143; = 0.007) and the left inferior orbital frontal gyrus ( = -4.239; = 0.02) in schizophrenia.
CONCLUSIONS
We report evidence for hypometabolism with large effect sizes in the frontal cortex in schizophrenia without consistent evidence for alterations in other brain regions. Our findings support the hypothesis of hypofrontality in schizophrenia.
Topics: Humans; Glucose; Schizophrenia; Fluorodeoxyglucose F18; Brain; Positron-Emission Tomography
PubMed: 35730361
DOI: 10.1017/S003329172200174X