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Archives of Clinical Neuropsychology :... Oct 2023Despite decades of research, neuropsychological tests (NPTs) that clearly differentiate between Alzheimer's disease (AD) and late-life depression (LLD) have yet to be... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Despite decades of research, neuropsychological tests (NPTs) that clearly differentiate between Alzheimer's disease (AD) and late-life depression (LLD) have yet to be agreed upon. Given this gap in knowledge and the rapid deployment of disease-modifying drugs for the two disorders, accurate clinical diagnosis using evidence-based assessment is essential. This study aims to systematically examine the literature to identify NPTs that would be able to differentiate AD and LLD.
METHOD
Databases and bibliographies were searched to identify articles for analysis. Two major inclusion criteria were that the studies compared neuropsychological functioning of AD versus LLD using normed NPTs and provided data for effect size calculation. Risk of bias was minimized by having independent coders for all steps in the review.
RESULTS
Forty-one studies met inclusion criteria (N = 2,797) and provided effect sizes for tests that were classified as belonging to 15 domains of functioning. The two groups were well differentiated by tasks of delayed contextual verbal memory as compared to immediate or non-contextual memory, recognition cueing, confrontation naming, visuospatial construction, and conceptualization. Specific NPTs that appear to be useful for differential diagnosis include the Rey Auditory Verbal Learning Test-Delayed Recognition; Boston Naming Test; the Dementia Rating Scale's memory, conceptualization, and construction subscales; and the CERAD Constructional Praxis.
CONCLUSIONS
The NPTs highlighted in this systematic review could be used as a relatively simple and cost-effective method to differentiate between patients with cognitive dysfunction due to AD versus LLD.
Topics: Humans; Alzheimer Disease; Depression; Neuropsychological Tests; Cognitive Dysfunction; Language Tests
PubMed: 37332152
DOI: 10.1093/arclin/acad036 -
European Child & Adolescent Psychiatry May 2023Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a... (Review)
Review
Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence.
PubMed: 37199754
DOI: 10.1007/s00787-023-02221-9 -
Geriatric Nursing (New York, N.Y.) 2023Non-pharmaceutical interventions have been implemented for people with dementia or mild cognitive impairment (MCI). Researchers have used exergaming in dementia to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Non-pharmaceutical interventions have been implemented for people with dementia or mild cognitive impairment (MCI). Researchers have used exergaming in dementia to alleviate cognitive decline in patients with dementia.
AIMS
We assessed the effects of exergaming interventions on MCI and dementia.
METHODS
We conducted a systematic review and meta-analysis (PROSPERO [CRD42022347399]). PubMed, Cochrane Library, Web of Science, CINAHL, and Embase electronic databases were searched for randomized controlled trials (RCTs). The impact of exergaming on cognitive function, physical performance, and quality of life in patients with MCI and dementia was investigated.
RESULTS
Ten RCTs met the eligibility criteria and were included in our systematic review. The results of the meta-analysis demonstrated a statistically significant difference in the Mini-mental State Examination, Montreal Cognitive Assessment, Trail Making Test, Chinese version of the Verbal Learning Test, Berg Balance Scale, Short Physical Performance Battery, and Physical Activity Scale for the Elderly in people with dementia and MCI who participated in exergaming. However, there were no significant improvements in the Activities of Daily Living, Instrumental Activity of Daily Living or Quality of Life.
CONCLUSION
Although there were significant differences in cognitive and physical functions, these results should be interpreted with caution because of heterogeneity. The additional benefits of exergaming remain to be confirmed in future studies.
Topics: Humans; Aged; Exergaming; Cognitive Dysfunction; Cognition; Exercise; Dementia
PubMed: 37099867
DOI: 10.1016/j.gerinurse.2023.03.028 -
Frontiers in Neurology 2023To determine the effectiveness of traditional Chinese mind-body exercises in improving cognition, memory, and executive function in older adults with cognitive...
OBJECTIVE
To determine the effectiveness of traditional Chinese mind-body exercises in improving cognition, memory, and executive function in older adults with cognitive impairment.
DATA SOURCES
Relevant English and Chinese language studies published until September 14th, 2022 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases.
REVIEW METHODS
Randomized controlled trials assessing traditional Chinese mind-body exercises (Tai Chi, Baduanjin, Qigong, Mind-Body Therapies, and Yijinjing) in older adults with cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. A risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool.
RESULTS
This study included 15 randomized controlled trials (1,127 participants) from China, Thailand and American. Most studies had a high risk of bias in the blinding of participants and researchers, one study had a high risk of bias in the random sequence generation and two studies had a high risk of bias in the incomplete outcome data. Compared with conventional therapy alone, traditional Chinese mind-body exercises significantly improved global cognitive function ( < 0.00001), and Baduanjin could improve the global cognitive function ( < 0.00001), memory function ( < 0.0001), and executive function ( < 0.0001) outcomes after treatment, and significantly improved some dimensional scores on the auditory verbal learning test after treatment ( = 0.04).
CONCLUSION
Compared with conventional therapy, traditional Chinese mind-body exercises (Tai Chi, Baduanjin, and Qigong) significantly improved global cognitive function, and Baduanjin could improve global cognitive function, memory function, and executive function in older adults with cognitive impairment.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, CRD42022327563.
PubMed: 37077563
DOI: 10.3389/fneur.2023.1086417 -
Brain and Behavior Jun 2023Multiple sclerosis (MS) is a chronic demyelinating/neurodegenerative disease associated with change in cognitive function (CF) over time. This systematic review aims to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple sclerosis (MS) is a chronic demyelinating/neurodegenerative disease associated with change in cognitive function (CF) over time. This systematic review aims to describe the instruments used to measure change in CF over time in people with MS (PwMS).
METHODS
PubMed, OVID, Web of Science, and Scopus databases were searched in English until May 2021. Articles were included if they had at least 100 participants and at least a 1-year interval between baseline and last follow-up measurement of CF. Results were quantitatively synthesized, presented in tables and risk of bias was assessed with the Newcastle-Ottawa Scale.
RESULTS
Fifty-seven articles met the inclusion criteria (41,623 PwMS and 1105 controls). An intervention (drug/rehabilitation) was assessed in 22 articles. In the studies that used a test battery, Visual and verbal learning and memory were the most frequently measured domains, but when studies that used test battery or a single test are combined, Information processing speed was the most measured. The Symbol Digit Modalities Test (SDMT) was the most frequently used test as a single test and in a test battery combined. Most studied assessed "change in CF" as cognitive decline defined as 1 or more tests measured as ≥ 1.5 SD from the study control or normative mean in a test battery at baseline and follow-up. Meta-analysis of change in SDMT scores with seven articles indicated a nonstatistically significant -0.03 (95% CI -0.14, 0.09) decrease in mean SDMT score per year.
CONCLUSION
This study highlights the slow rate of measured change in cognition in PwMS and emphasizes the lack of a gold standard test and consistency in measuring cognitive change at the population level. More sensitive testing utilizing multiple domains and longer follow-up may define subgroups where CF change follows different trajectories thus allowing targeted interventions to directly support those where CF is at greatest risk of becoming a clinically meaningful issue.
Topics: Humans; Multiple Sclerosis; Cognition Disorders; Neurodegenerative Diseases; Cognition; Cognitive Dysfunction; Neuropsychological Tests
PubMed: 37062948
DOI: 10.1002/brb3.3009 -
Journal of Medical Internet Research Apr 2023Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis.
OBJECTIVE
This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment.
METHODS
Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate.
RESULTS
Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning.
CONCLUSIONS
Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods.
TRIAL REGISTRATION
PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa.
Topics: Aged; Humans; Alzheimer Disease; Cognitive Dysfunction; Exercise; Learning; Memory, Episodic; Exergaming
PubMed: 37043277
DOI: 10.2196/43607 -
Psychosomatic Medicine May 2023In past decades, the field of nocebo research has focused on studying how sensory perception can be shaped by learning. Nocebo effects refer to aggravated sensory... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
In past decades, the field of nocebo research has focused on studying how sensory perception can be shaped by learning. Nocebo effects refer to aggravated sensory experiences or increased sensitivity to sensations such as pain and itch resulting from treatment-related negative experiences. Behavioral conditioning and verbal suggestions of a negative treatment outcome may aggravate pain and itch perception. Gaining a comprehensive view of the magnitude of nocebo effects and contributing factors will help steer nocebo research toward fruitful directions for understanding complex sensory phenomena.
METHODS
We conducted a systematic review and meta-analysis of a total of 37 distinct experimental nocebo studies on healthy participants (all published in English between 2008 and 2021), with four separate meta-analyses for nocebo effects on pain or itch. We conducted subgroup analyses and meta-regression on factors such as type and intensity of sensory stimuli, and length of conditioning paradigms.
RESULTS
This meta-analysis showed that, on average, effect sizes of nocebo effects were moderate to large (Hedges g between 0.26 and 0.71 for the four primary outcomes). The combination of conditioning and verbal suggestions yielded stronger nocebo responses on pain in particular. Subgroup analyses, including factors such as the type of sensory stimulation, did not explain the moderate heterogeneity in nocebo magnitudes between different studies. Risk of bias was generally low and was not related to nocebo magnitudes either.
CONCLUSIONS
We discuss these results in relation to the role of conditioning and aversive learning, and we recommend more consistency in designing and reporting nocebo experiments.
Topics: Humans; Nocebo Effect; Placebo Effect; Pain; Learning; Pruritus
PubMed: 36961347
DOI: 10.1097/PSY.0000000000001194 -
Cerebrovascular Diseases (Basel,... 2023The aim of this study was to evaluate the effect of mechanical thrombectomy (MT) on the incidence of poststroke cognitive impairment (PSCI) in anterior circulation... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The aim of this study was to evaluate the effect of mechanical thrombectomy (MT) on the incidence of poststroke cognitive impairment (PSCI) in anterior circulation stroke.
METHODS
Literature research was performed on PubMed/OVID/Cochrane CENTRAL for studies published in 2015-2022. A review of the references of the included papers was performed for further eligible articles. Clinical characteristics, NIHSS, dementia tests, and outcomes were recorded. The exclusion criteria were nonhuman and non-English. Studies qualities were assessed with MINORS/RoB2 and GRADE. A meta-analysis was performed using the standardized mean difference (Cohen's d) to measure effect size.
RESULTS
Four studies were included in the systematic review after screening 749 articles. No significant differences were found for age and gender (years: 66.70 ± 11.14 vs. 67.59 ± 10.11, p = 0.37; male 53.8% vs. 56.4%, p = 0.57). MT patients had a more severe stroke than that of the control group (NIHSS: 14.70 ± 4.31 vs. 11.17 ± 4.12; p < 0.0001). The control group consisted of medical therapy-alone patients in all studies. I2 was 76.95%, and Q was 43.4%. MT patients have better performance in overall cognition (d = 0.33 [0.074-0.58]) and in several cognitive domains than in the control group (TMT-A, d = 0.37 [0.04-0.70]; TMT-B, d = 0.35 [0.12-0.58]; digit span test [backward], d = 0.61 [0.18-1.06]; colored progressive matrices, d = 0.48 [0.05-0.91]; Stroop test [word reading], d = 0.60 [0.17-1.03]; color naming, d = 0.51 [0.08-0.94]; Rey-Osterrieth Complex Figure [immediate recall], d = 0.79 [0.35-1.23]; Rey Auditory Verbal Learning Test [immediate recall], d = 0.79 [0.36-1.23]; delayed recall, d = 0.46 [0.035-0.89]; and MOCA, d = 0.46 [-0.04 to 0.96]). Medical therapy patients had a higher score in coping strategy than MT patients (COPE-28 acceptance, d = -1.00 [-1.53 to -0.48]).
CONCLUSIONS
The incidence of PSCI is lower in MT patients than in the control group.
Topics: Humans; Male; Incidence; Stroke; Cognitive Dysfunction; Cognition; Thrombectomy; Treatment Outcome
PubMed: 36958299
DOI: 10.1159/000529265 -
Bipolar Disorders Jun 2023Cognitive impairment is a core feature of mood disorders and has been identified as an important treatment target. A better understanding of the factors contributing to... (Review)
Review
BACKGROUND
Cognitive impairment is a core feature of mood disorders and has been identified as an important treatment target. A better understanding of the factors contributing to cognitive impairment in mood disorders would be beneficial in developing interventions to address cognitive impairment. One key factor is childhood trauma. The aim of this review was to systematically synthesise and review research examining associations between reported childhood trauma and cognitive functioning in mood disorders.
METHODS
Studies in adult samples examining the relationship between objective cognitive function and reported childhood trauma in major depressive disorder and/or bipolar disorder (in-episode or euthymia) were identified. Searches were conducted on PubMed, Embase and PsycINFO until January 2022. A narrative review technique was used due to the heterogeneity of group comparisons, cognitive tests and data analysis across studies.
RESULTS
Seventeen studies met the criteria for inclusion (mood disorders N = 1723, healthy controls N = 797). Evidence for childhood trauma being related to poorer cognitive functioning was consistent across global cognitive functioning and executive function domains for euthymic patients and psychomotor speed for in-episode patients. There was mixed evidence for verbal learning and memory and executive function for in-episode patients. Identification of patterns within other domains was difficult due to limited number of studies.
CONCLUSION
Findings from this review suggest childhood trauma is associated with poorer cognitive functioning in people with mood disorders. Targeted interventions to improve cognition may be warranted for this group.
Topics: Adult; Humans; Mood Disorders; Bipolar Disorder; Depressive Disorder, Major; Adverse Childhood Experiences; Cognition Disorders; Cognition; Cyclothymic Disorder; Neuropsychological Tests
PubMed: 36949602
DOI: 10.1111/bdi.13321 -
Frontiers in Neuroscience 2023Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable...
BACKGROUND
Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research.
OBJECTIVE
To understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature.
METHODS
A systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022).
RESULTS
From 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills.
CONCLUSION
The use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures.
SYSTEMATIC REVIEW REGISTRATION
https://doi.org/10.17605/OSF.IO/Z3G7W.
PubMed: 36816114
DOI: 10.3389/fnins.2023.1046669