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The Cochrane Database of Systematic... Jun 2013Infantile spasms (West's Syndrome) is a syndrome that includes a peculiar type of epileptic seizure-the spasms-and an electroencephalographic (EEG) abnormality often... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Infantile spasms (West's Syndrome) is a syndrome that includes a peculiar type of epileptic seizure-the spasms-and an electroencephalographic (EEG) abnormality often called hypsarrhythmia. Psychomotor retardation is frequently found at follow-up. Approximately two-thirds of affected infants will have a detectable underlying neurological abnormality, but still little is known about the pathophysiological basis for infantile spasms, and treatment remains problematic.
OBJECTIVES
To compare the effects of single pharmaceutical therapies used to treat infantile spasms in terms of control of the spasms, resolution of the EEG, relapse rates, psychomotor development, subsequent epilepsy, side effects, and mortality.
SEARCH METHODS
To identify published data, we searched the Cochrane Epilepsy Group Specialised Register (October 2012), CENTRAL (The Cochrane Library 2012, Issue 9), MEDLINE (1946 to September Week 4, 2012), EMBASE (1980 to March 2003), and the reference lists of all retrieved articles.To identify unpublished data, we searched the ISRCTN Register (www.controlled-trials.com), corresponded with colleagues and drug companies, and made requests at international conferences.
SELECTION CRITERIA
All randomised controlled trials (RCTs) of the administration of drug therapy to patients with infantile spasms.
DATA COLLECTION AND ANALYSIS
Data collection from all relevant publications was independently undertaken by three review authors (before 2010) or by two review authors using a standard proforma. Analysis included assessment of study quality and a search for sources of heterogeneity.
MAIN RESULTS
We found 16 small RCTs (fewer than 100 patients enrolled) and 2 larger RCTs (more than 100 patients enrolled). These 18 studies looked at a total of 916 patients treated with a total of 12 different pharmaceutical agents. Overall methodology of the studies was poor, in part because of ethical dilemmas such as giving placebo injections to children. Two studies showed that placebo was not as good as active treatment in resolving the spasms. The strongest evidence suggested that hormonal treatment (prednisolone or tetracosactide depot) leads to resolution of spasms faster and in more infants than does vigabatrin. Responses without subsequent relapse may be no different. The same study suggests that hormonal treatments might improve the long-term developmental outcome compared with vigabatrin in infants not found to have an underlying cause for their infantile spasms.
AUTHORS' CONCLUSIONS
To date, few well-designed RCTs have considered the treatment of infantile spasms, and the numbers of patients enrolled have been small. In the majority, methodology has been poor, hence it is not clear which treatment is optimal in the treatment of this epilepsy syndrome. Hormonal treatment resolves spasms in more infants than vigabatrin, but this may or may not translate into better long-term outcomes. If prednisolone or vigabatrin is used, high dosage is recommended. Vigabatrin may be the treatment of choice in tuberous sclerosis. Resolution of the EEG features may be important, but this has not been proven. Further research using large studies with robust methodology is required.
Topics: Anticonvulsants; Cosyntropin; Hormones; Humans; Infant; Prednisolone; Psychomotor Performance; Randomized Controlled Trials as Topic; Spasms, Infantile; Vigabatrin
PubMed: 23740534
DOI: 10.1002/14651858.CD001770.pub3 -
Neuroscience and Biobehavioral Reviews Nov 2022Traditional and more modern conceptualizations of psychopathy cite problems with impulse control. However, the extent to which these problems represent a cardinal... (Meta-Analysis)
Meta-Analysis Review
Traditional and more modern conceptualizations of psychopathy cite problems with impulse control. However, the extent to which these problems represent a cardinal feature of the disorder has been debated. In this study, we conducted a preregistered systematic review and meta-analysis, searching Embase, Medline, PsycINFO, and PubMed, for studies from inception to January 6th, 2022. We included 21 studies, published between 2009 and 2021, that reported on the relationship of psychopathy with performance on the go/no-go or stop signal task. A multilevel random-effects meta-analysis, including 43 effect sizes from 17 studies (total N = 1394), showed a significant pooled association between psychopathy and response inhibition r = -0.143 (95 % CI: -0.250 to -0.034). The relatively small effect size, although statistically significant, calls in to question the extent to which difficulties in response inhibition should be considered a cardinal feature of psychopathic personality. The strength of the relationship did not significantly differ between non-criminal and criminal samples, gender, task type, tasks with or without an affective component, or by psychopathy trait dimension.
Topics: Humans; Antisocial Personality Disorder; Task Performance and Analysis
PubMed: 36113781
DOI: 10.1016/j.neubiorev.2022.104868 -
Jornal de Pediatria 2014to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children. (Review)
Review
OBJECTIVES
to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children.
SOURCES
this was a systematic review of studies published in the past ten years indexed in MEDLINE/Pubmed, MEDLINE/BVS; LILACS/BVS; IBECS/BVS; Cochrane/BVS, CINAHL, Web of Science, Scopus, and PsycNET in three languages (Portuguese, Spanish, and English). Observational and experimental studies that assessed motor development and/or behavior and/or academic performance and whose target-population consisted of preterm children aged 8 to 10 years were included. Article quality was assessed by the Strengthening the reporting of observational studies in epidemiology (STROBE) and Physiotherapy Evidence Database (PEDro) scales; articles that did not achieve a score of 80% or more were excluded.
SUMMARY OF FINDINGS
the electronic search identified 3,153 articles, of which 33 were included based on the eligibility criteria. Only four studies found no effect of prematurity on the outcomes (two articles on behavior, one on motor performance and one on academic performance). Among the outcomes of interest, behavior was the most searched (20 articles, 61%), followed by academic performance (16 articles, 48%) and motor impairment (11 articles, 33%).
CONCLUSION
premature infants are more susceptible to motor development, behavior and academic performance impairment when compared to term infants. These types of impairments, whose effects are manifested in the long term, can be prevented through early parental guidance, monitoring by specialized professionals, and interventions.
Topics: Adolescent; Child; Child Behavior; Cognition Disorders; Educational Status; Female; Humans; Infant, Newborn; Infant, Premature; Learning Disabilities; Motor Skills Disorders; Pregnancy; Premature Birth; Psychomotor Disorders; Time
PubMed: 24370176
DOI: 10.1016/j.jped.2013.05.010 -
Journal of Epidemiology Sep 2018Deterioration of hand motor function is a possible risk factor of cognitive impairment in older adults. Despite a growing body of research, a lack of clarity exists... (Review)
Review
BACKGROUND
Deterioration of hand motor function is a possible risk factor of cognitive impairment in older adults. Despite a growing body of research, a lack of clarity exists regarding the relationships. This review offers a synthesis of existing observational studies evaluating the associations of handgrip strength and hand dexterity with cognitive performance in community-dwelling older adults.
METHODS
PubMed, PsycINFO, and ScienceDirect were systematically searched (search dates: 1990-2016), and relevant articles were cross-checked for related and relevant publications.
RESULTS
Twenty-two observational studies assessed the association of handgrip strength or hand dexterity with cognitive performance; none evaluated handgrip strength and hand dexterity together. Handgrip strength was associated with global cognition, mostly assessed using the Mini-Mental State Examination, cross-sectionally and longitudinally. Also, one cross-sectional and three longitudinal studies found an association with cognitive domains, such as language, memory, visuospatial ability, working memory, and processing speed. Hand dexterity was only assessed cross-sectionally in four studies. These studies found an association with cognitive domains, such as executive function.
CONCLUSIONS
Although handgrip strength was associated with cognitive performance, it is unclear which variable at baseline affects the other in the long-term. Cross-sectional studies indicate an association between hand dexterity and cognitive performance, yet longitudinal studies are needed to elucidate this association. The interaction effects of both decreased grip strength and hand dexterity on cognitive performance is still unclear; therefore, future studies will need to consider the interaction of the three variables cross-sectionally and longitudinally.
Topics: Aged; Cognition; Functional Laterality; Hand Strength; Humans; Independent Living; Observational Studies as Topic; Psychomotor Performance
PubMed: 29526916
DOI: 10.2188/jea.JE20170041 -
Annals of Global Health 2016In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide... (Review)
Review
In the region of the Americas, approximately 100,000 children under the age of 5 years die each year due to environmental hazards. Brazil, due to its large size and wide range of environmental challenges, presents numerous hazards to children's health. The aim of this study was to systematically review the scientific literature that describes children's exposures to environmental pollutants in Brazil and their effects on Brazilian children's health. A systematic review of the scientific literature was performed without language restrictions and time of publication (years). The literature search was conducted in the following key resources: PubMed (MEDLINE), Scopus and Web of Science with the MeSH Terms: Environmental exposure AND Brazil (filters: Human, Child [birth to 18 years] and Affiliation Author). The Virtual Health Library was also employed to access the databases Scielo and Lilacs. The search strategy was [DeCS Terms]: Child OR adolescent AND Environmental exposure AND Brazil. Health effects in children associated with exposure to environmental pollutants in Brazil were reported in 74 studies, during the period between 1995 and 2015. The most frequently cited effect was hospital admission for respiratory causes including wheezing, asthma, and pneumonia among children living in areas with high concentrations of air pollutants. A broad spectrum of other health effects possibly linked to pollutants also was found such as prematurity, low birth weight, congenital abnormality (cryptorchidism, hypospadia, micropenis), poor performance in tests of psychomotor and mental development, and behavioral problems. Exposure to pesticides in utero and postnatally was associated with a high risk for leukemia in children <2 years old. These results show that there is a need in Brazil for stricter monitoring of pollutant emissions and for health surveillance programs especially among vulnerable populations such as pregnant women and young children.
Topics: Air Pollutants; Brazil; Child; Environment; Environmental Exposure; Environmental Health; Environmental Monitoring; Female; Health Status; Humans; Male; Pregnancy
PubMed: 27325071
DOI: 10.1016/j.aogh.2016.02.007 -
American Journal of Public Health Mar 2014We conducted a systematic review and meta-analysis of the literature examining the relationship between driving performance and engaging in secondary tasks. We extracted... (Meta-Analysis)
Meta-Analysis Review
We conducted a systematic review and meta-analysis of the literature examining the relationship between driving performance and engaging in secondary tasks. We extracted data from abstracts of 206 empirical articles published between 1968 and 2012 and developed a logistic regression model to identify correlates of a detrimental relationship between secondary tasks and driving performance. Of 350 analyses, 80% reported finding a detrimental relationship. Studies using experimental designs were 37% less likely to report a detrimental relationship (P = .014). Studies examining mobile phone use while driving were 16% more likely to find such a relationship (P = .009). Quasi-experiments can better determine the effects of secondary tasks on driving performance and consequently serve to inform policymakers interested in reducing distracted driving and increasing roadway safety.
Topics: Attention; Automobile Driving; Humans; Risk-Taking; Safety; Task Performance and Analysis; United States
PubMed: 24432925
DOI: 10.2105/AJPH.2013.301750 -
Chiropractic & Manual Therapies Sep 2023Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of... (Review)
Review
BACKGROUND
Spinal manipulation (SM) is a recommended and effective treatment for musculoskeletal disorders. Biomechanical (kinetic) parameters (e.g. preload/peak force, rate of force application and thrust duration) can be measured during SM, quantifying the intervention. Understanding these force-time characteristics is the first step towards identifying possible active ingredient/s responsible for the clinical effectiveness of SM. Few studies have quantified SM force-time characteristics and with considerable heterogeneity evident, interpretation of findings is difficult. The aim of this study was to synthesise the literature describing force-time characteristics of manual SM.
METHODS
This scoping literature review is reported following the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) statement. Databases were searched from inception to October 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro and Cochrane Library. The following search terms and their derivatives were adapted for each platform: spine, spinal, manipulation, mobilization or mobilisation, musculoskeletal, chiropractic, osteopathy, physiotherapy, naprapathy, force, motor skill, biomechanics, dosage, dose-response, education, performance, psychomotor, back, neck, spine, thoracic, lumbar, pelvic, cervical and sacral. Data were extracted and reported descriptively for the following domains: general study characteristics, number of and characteristics of individuals who delivered/received SM, region treated, equipment used and force-time characteristics of SM.
RESULTS
Of 7,607 records identified, 66 (0.9%) fulfilled the eligibility criteria and were included in the analysis. Of these, SM was delivered to the cervical spine in 12 (18.2%), the thoracic spine in 40 (60.6%) and the lumbopelvic spine in 19 (28.8%) studies. In 6 (9.1%) studies, the spinal region was not specified. For SM applied to all spinal regions, force-time characteristics were: preload force (range: 0-671N); peak force (17-1213N); rate of force application (202-8700N/s); time to peak thrust force (12-938ms); and thrust duration (36-2876ms).
CONCLUSIONS
Considerable variability in the reported kinetic force-time characteristics of SM exists. Some of this variability is likely due to differences in SM delivery (e.g. different clinicians) and the measurement equipment used to quantify force-time characteristics. However, improved reporting in certain key areas could facilitate more sophisticated syntheses of force-time characteristics data in the future. Such syntheses could provide the foundation upon which dose-response estimates regarding the clinical effectiveness of SM are made.
Topics: Humans; Biomechanical Phenomena; Bone Diseases; Cervical Vertebrae; Chiropractic; Manipulation, Spinal
PubMed: 37705030
DOI: 10.1186/s12998-023-00512-1 -
The Cochrane Database of Systematic... Oct 2018Action observation (AO) is a physical rehabilitation approach that facilitates the occurrence of neural plasticity through the activation of the mirror-neural system,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Action observation (AO) is a physical rehabilitation approach that facilitates the occurrence of neural plasticity through the activation of the mirror-neural system, promoting motor recovery in people with stroke.
OBJECTIVES
To assess whether action observation enhances motor function and upper limb motor performance and cortical activation in people with stroke.
SEARCH METHODS
We searched the Cochrane Stroke Group Trials Register (last searched 4 September 2017), the Central Register of Controlled Trials (24 October 2017), MEDLINE (1946 to 24 October 2017), Embase (1974 to 24 October 2017) and five additional databases. We also searched trial registries and reference lists.
SELECTION CRITERIA
Randomized controlled trials (RCTs) of AO, alone or associated with physical practice in adults after stroke. The primary outcome was upper limb motor function. Secondary outcomes included dependence on activities of daily living (ADL), motor performance, cortical activation, quality of life, and adverse effects.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials according to the pre-defined inclusion criteria, extracted data, assessed risk of bias, and applied the GRADE approach to assess the quality of the evidence. The reviews authors contacted trial authors for clarification and missing information.
MAIN RESULTS
We included 12 trials involving 478 individuals. A number of trials showed a high risk of bias and others an unclear risk of bias due to poor reporting. The quality of the evidence was 'low' for most of the outcomes and 'moderate' for hand function, according to the GRADE system. In most of the studies, AO was followed by some form of physical activity.
PRIMARY OUTCOME
the impact of AO on arm function showed a small significant effect (standardized mean difference (SMD) 0.36, 95% CI 0.13 to 0.60; 8 studies; 314 participants; low-quality evidence); and a large significant effect (mean difference (MD) 2.90, 95% CI 1.13 to 4.66; 3 studies; 132 participants; moderate-quality evidence) on hand function.
SECONDARY OUTCOMES
there was a large significant effect for ADL outcome (SMD 0.86, 95% CI 0.11 to 1.61; 4 studies, 226 participants; low-quality evidence). We were unable to pool other secondary outcomes to extract the evidence. Only two studies reported adverse effects without significant adverse AO events.
AUTHORS' CONCLUSIONS
We found evidence that AO is beneficial in improving upper limb motor function and dependence in activities of daily living (ADL) in people with stroke, when compared with any control group; however, we considered the quality of the evidence to be low. We considered the effect of AO on hand function to be large, but it does not appear to be clinically relevant, although we considered the quality of the evidence as moderate. As such, our confidence in the effect estimate is limited because it will likely change with future research.
Topics: Activities of Daily Living; Hand; Humans; Motor Skills; Neuronal Plasticity; Quality of Life; Randomized Controlled Trials as Topic; Recovery of Function; Stroke Rehabilitation; Upper Extremity
PubMed: 30380586
DOI: 10.1002/14651858.CD011887.pub2 -
Behavioural Brain Research Feb 2022Brain-derived neurotrophic factor (BDNF) gene polymorphisms may modulate neurotransmitter efficiency, thereby influencing motor performance and motor learning. However,... (Meta-Analysis)
Meta-Analysis
Brain-derived neurotrophic factor (BDNF) gene polymorphisms may modulate neurotransmitter efficiency, thereby influencing motor performance and motor learning. However, studies to date have provided no consensus regarding the genetic influence of BDNF genotypes (i.e., Val/Val, Val/Met, or Met/Met type). This study aimed to investigate the effect of BDNF genotype on motor performance and motor learning in healthy human adults via a systematic review and meta-analysis. A total of 19 relevant studies were identified using PubMed and Web of Science search for articles published between 2000 and 2021 with motor performance or motor learning as the primary outcome measures. The results of our systematic review suggest that the BDNF genotype is unlikely to contribute to motor performance and motor learning abilities because only 2/32 datasets (6.3%) from 16 studies on motor performance and 3/19 datasets (17.6%) from 13 studies on motor learning indicated a significant genetic effect. Moreover, a meta-analysis of motor learning publications involving 17 datasets from 11 studies revealed that there was no significant difference in the learning score normalized using baseline data between Val/Val and Met carriers (Val/Met + Met/Met or Val/Met; standardized mean differences = 0.08, P = 0.37) with zero heterogeneity (I = 0) and a relatively low risk of publication bias. Taken together, the BDNF genotype may have only a minor impact on individual motor performance and motor learning abilities.
Topics: Brain-Derived Neurotrophic Factor; Genotype; Heterozygote; Humans; Learning; Polymorphism, Single Nucleotide; Psychomotor Performance
PubMed: 34915075
DOI: 10.1016/j.bbr.2021.113712 -
Cannabis and Cannabinoid Research Feb 2023Δ-Tetrahydrocannabinol (THC), the main intoxicating component of cannabis, can cause cognitive and psychomotor impairment. Whether this impairment is still present... (Review)
Review
Δ-Tetrahydrocannabinol (THC), the main intoxicating component of cannabis, can cause cognitive and psychomotor impairment. Whether this impairment is still present many hours or even days after THC use requires clarification. Possible "next day" effects are of major significance in safety-sensitive workplaces. We therefore conducted a systematic review of studies investigating the "next day" effects of THC. Studies that measured performance on safety-sensitive tasks (e.g., driving, flying) and/or neuropsychological tests >8 h after THC (or cannabis) use using interventional designs were identified by searching two online databases from inception until March 28, 2022. Risk of bias (RoB) was evaluated using the relevant Cochrane tools. Results were described in terms of whether THC had a significant effect on performance relative to the primary comparator (i.e., placebo or baseline, as appropriate). Twenty studies (=458) involving 345 performance tests were reviewed. Most studies administered a single dose of THC (median [interquartile range]: 16 [11-26] mg) and assessed performance between >12 and 24 h post-treatment. =209/345 tests conducted across 16 published studies showed no "next day" effects of THC. Nine of these 16 studies used randomized, double-blind, placebo-controlled designs. Half (=8) had "some" RoB, and half (=8) had a "high" RoB. Notably, =88 of these 209 tests failed to demonstrate "acute" (i.e., <8 h post-treatment) THC-induced impairment. =12/345 tests conducted across five published studies indicated negative (i.e., impairing) "next day" effects of THC. None of these five studies used randomized, double-blind, placebo-controlled designs and all were published >18 years ago (four, >30 years ago). Three had "some" RoB, and two had a "high" RoB. A further =121/345 tests indicated "unclear" "next day" effects of THC with insufficient information provided to assess outcomes. The remaining =3/345 tests indicated positive (i.e., enhancing) "next day" effects of THC. Some lower quality studies have reported "next day" effects of THC on cognitive function and safety-sensitive tasks. However, most studies, including some of higher quality, have found no such effect. Overall, it appears that there is limited scientific evidence to support the assertion that cannabis use impairs "next day" performance. Further studies involving improved methodologies are required to better address this issue.
Topics: Cannabis; Dronabinol; Hallucinogens; Cannabinoid Receptor Agonists; Automobile Driving; Randomized Controlled Trials as Topic
PubMed: 36475998
DOI: 10.1089/can.2022.0185