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British Journal of Anaesthesia Jun 2023Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis.
METHODS
Electronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed quality. After extraction of neuroimaging data, activation likelihood estimate meta-analysis was performed to identify significant brain regions associated with these comorbidities.
RESULTS
Forty-nine of 2414 studies were eligible, of which 43 investigated adverse childhood experiences and MDD and six investigated adverse childhood experiences and chronic pain. None investigated adverse childhood experiences, chronic pain, and MDD together. Functional and structural brain abnormalities were identified in the superior frontal, lingual gyrus, hippocampus, insula, putamen, superior temporal, inferior temporal gyrus, and anterior cerebellum in patients with MDD exposed to adverse childhood experiences. In addition, brain function abnormalities were identified for patients with MDD or chronic pain and exposure to adverse childhood experiences in the cingulate gyrus, inferior parietal lobule, and precuneus in task-based functional MRI studies.
CONCLUSIONS
We found that adverse childhood experiences exposure can result in different functional and structural brain alterations in adults with MDD or chronic pain compared with those without adverse childhood experiences.
SYSTEMATIC REVIEW PROTOCOL
PROSPERO CRD42021233989.
Topics: Adult; Humans; Depressive Disorder, Major; Chronic Pain; Adverse Childhood Experiences; Depression; Likelihood Functions; Magnetic Resonance Imaging; Brain
PubMed: 37087334
DOI: 10.1016/j.bja.2023.03.008 -
Clinical Endocrinology Jul 2021To describe the presentation and outcomes of patients with adrenal ganglioneuromas (AGNs).
OBJECTIVE
To describe the presentation and outcomes of patients with adrenal ganglioneuromas (AGNs).
DESIGN
Single-centre retrospective cohort study (1 January 1995 to 31 December 2019) and systematic review of literature (1 January 1980 to 19 November 2019).
PATIENTS
Diagnosed with histologically confirmed AGN.
MEASUREMENTS
Baseline clinical, imaging and biochemical characteristics, recurrence rates and mortality. Subgroup analysis was performed on tumours with histologic elements of ganglioneuroma and pheochromocytoma (ie composite tumours).
RESULTS
The cohort study included 45 patients with AGN, 20 (44%) of which had composite tumours. Compared to pure AGN, patients with composite tumour were older (median age, 62.5 vs. 35 years, p < .001), had smaller tumours (median size, 3.9 vs. 5.7 cm, p = .016) and were discovered incidentally less frequently (65% vs. 84%, p = .009). No recurrences or ganglioneuroma-specific mortality occurred during follow-up (range, 0-266 months). The systematic review included 14 additional studies and 421 patients. The mean age of diagnosis was 39 years, and 47% were women. AGNs were discovered incidentally in 72% of patients, were predominantly unilateral (99%) and had a mean diameter of 5.8 cm and an unenhanced computed tomography (CT) attenuation of -118 to 49 Hounsfield units (HU). On imaging, 69% of AGNs were homogenous, 41% demonstrated calcifications, and 40% were lobulated.
CONCLUSIONS
AGNs are rare benign tumours that present with variable imaging features including large size, unenhanced CT attenuation >20 HU, calcifications and lobulated shape. Imaging characteristics can assist in establishing a diagnosis and avoiding an unnecessary adrenalectomy. The association of pheochromocytomas with AGNs is frequent. Diagnosis should include biochemical testing.
Topics: Adrenal Gland Neoplasms; Adult; Cohort Studies; Female; Ganglioneuroma; Humans; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies
PubMed: 33721367
DOI: 10.1111/cen.14460 -
Cerebellum (London, England) Oct 2023The cerebellum's role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for... (Meta-Analysis)
Meta-Analysis
The cerebellum's role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified clusters within the posterior cerebellar hemispheres (bilateral lobule VI/Crus I/II), the vermis, and left lobule V/VI that were likely to be activated across studies, while implicit tasks activated clusters including bilateral lobules VI/Crus I/II, right Crus II/lobule VIII, anterior lobule VI, and lobules I-IV/V. A direct comparison between these categories revealed five overlapping clusters in right lobules VI/Crus I/Crus II and left lobules V/VI/Crus I of the cerebellum common to both the explicit and implicit task contrasts. There were also three clusters activated significantly more for explicit emotion tasks compared to implicit tasks (right lobule VI, left lobule VI/vermis), and one cluster activated more for implicit than explicit tasks (left lobule VI). These findings support previous studies indicating affective processing activates both the lateral hemispheric lobules and the vermis of the cerebellum. The common and distinct activation of posterior cerebellar regions by tasks with explicit and implicit attention demonstrates the supportive role of this structure in recognizing, appraising, and reacting to emotional stimuli.
Topics: Humans; Cerebellum; Emotions; Cerebellar Vermis; Magnetic Resonance Imaging; Neuroimaging; Brain Mapping
PubMed: 35999332
DOI: 10.1007/s12311-022-01459-4 -
International Journal of Surgery... Sep 2017An accessory spleen (AS) is a lobule of splenic tissue found in ectopic locations. Identification of AS is particularly important in patients with immune... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
An accessory spleen (AS) is a lobule of splenic tissue found in ectopic locations. Identification of AS is particularly important in patients with immune thrombocytopenia (ITP) requiring splenectomy as unrecognized AS can later cause refractory symptoms. The AS can also be a source of significant intraabdominal hemorrhage. The aim of this meta-analysis was to systematically analyze the data on the prevalence, number, location, and morphometry of AS.
MATERIALS AND METHODS
An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the AS. No date or language restrictions were applied. Data on the study type, the prevalence of AS, location, morphometry and number of AS per patient were extracted from the eligible studies and pooled into a meta-analysis.
RESULTS
A total of 81 studies (n = 22,487 subjects) were included into the quantitative analysis. The overall pooled prevalence of AS was 14.5% (95%CI: 12.4-16.7), while the pooled prevalence of AS in ITP patients was 16.7% (95%CI: 12.1-21.7). The majority of accessory spleens were located in the splenic hilum (62.1% [95%CI:51.5-76.3]). Moreover, 26% of ITP patients with an AS have more than one.
CONCLUSIONS
The findings of this study provide an evidence-based foundation of anatomical knowledge about the AS. Surgeons should take particular caution in identifying an AS, as unnoticed AS during splenectomy can lead to recurrence of hematological diseases or can be a potential source of bleeding in the future.
Topics: Adult; Choristoma; Female; Humans; Prevalence; Purpura, Thrombocytopenic, Idiopathic; Spleen; Splenectomy
PubMed: 28716661
DOI: 10.1016/j.ijsu.2017.07.045 -
Journal of Psychiatry & Neuroscience :... May 2017Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However, owing to inclusion of medicated patients in these studies, it is difficult to conclude whether these reported alterations are associated with MDD or confounded by medication effects. A meta-analysis of DTI studies on medication-free (medication-naive and medication washout) patients with MDD would therefore be necessary to disentangle MDD-specific effects.
METHODS
We analyzed white matter alterations between medication-free patients with MDD and healthy controls using anisotropic effect size-signed differential mapping (AES-SDM). We used DTI query software for fibre tracking.
RESULTS
Both pooled and subgroup meta-analyses in medication washout patients showed robust fractional anisotropy (FA) reductions in white matter of the right cerebellum hemispheric lobule, body of the corpus callosum (CC) and bilateral superior longitudinal fasciculus III (SLF III), whereas FA reductions in the genu of the CC and right anterior thalamic projections were seen in only medication-naive patients. Fibre tracking showed that the main tracts with observed FA reductions included the right cerebellar tracts, body of the CC, bilateral SLF III and arcuate fascicle.
LIMITATIONS
The analytic techniques, patient characteristics and clinical variables of the included studies were heterogeneous; we could not exclude the effects of nondrug therapies owing to a lack of data.
CONCLUSION
By excluding the confounding influences of current medication status, findings from the present study may provide a better understanding of the underlying neuropathology of MDD.
Topics: Brain; Depressive Disorder, Major; Diffusion Tensor Imaging; Humans; White Matter
PubMed: 27780031
DOI: 10.1503/jpn.150341 -
Frontiers in Oncology 2022Establishing risk-based follow-up management strategies is crucial to the surveillance of subsolid pulmonary nodules (SSNs). However, the risk factors for SSN growth are...
BACKGROUND
Establishing risk-based follow-up management strategies is crucial to the surveillance of subsolid pulmonary nodules (SSNs). However, the risk factors for SSN growth are not currently clear. This study aimed to perform a systematic review and meta-analysis to identify clinical and CT features correlated with SSN growth.
METHODS
Relevant studies were retrieved from Web of Science, PubMed, Cochrane Library, and EMBASE. The correlations of clinical and CT features with SSN growth were pooled using a random-effects model or fixed-effects model depending on heterogeneity, which was examined by the test and test. Pooled odds ratio (OR) or pooled standardized mean differences (SMD) based on univariate analyses were calculated to assess the correlation of clinical and CT features with SSN growth. Pooled ORs based on multivariate analyses were calculated to find out independent risk factors to SSN growth. Subgroup meta-analysis was performed based on nodule consistency (pure ground-glass nodule (pGGN) and part-solid nodule (PSN). Publication bias was examined using funnel plots.
RESULTS
Nineteen original studies were included, consisting of 2444 patients and 3012 SSNs. The median/mean follow-up duration of these studies ranged from 24.2 months to 112 months. Significant correlations were observed between SSN growth and eighteen features. Male sex, history of lung cancer, nodule size > 10 mm, nodule consistency, and age > 65 years were identified as independent risk factors for SSN growth based on multivariate analyses results. Eight features, including male sex, smoking history, nodule size > 10 mm, larger nodule size, air bronchogram, higher mean CT attenuation, well-defined border, and lobulated margin were detected to be significantly correlated with pGGNs growth. Smoking history showed no significant correlation with pGGN growth based on the multivariate analysis results.
CONCLUSIONS
Eighteen clinical and CT features were identified to be correlated with SSN growth, among which male sex, history of lung cancer, nodule size > 10 mm, nodule consistency and age > 65 years were independent risk factors while history of lung cancer was not correlated with pGGN growth. These factors should be considered when making risk-based follow-up plans for SSN patients.
PubMed: 35860567
DOI: 10.3389/fonc.2022.929174 -
Cognitive, Affective & Behavioral... Feb 2024All experiences preserved within episodic memory contain information on the space and time of events. The hippocampus is the main brain region involved in processing... (Meta-Analysis)
Meta-Analysis Review
All experiences preserved within episodic memory contain information on the space and time of events. The hippocampus is the main brain region involved in processing spatial and temporal information for incorporation within episodic memory representations. However, the other brain regions involved in the encoding and retrieval of spatial and temporal information within episodic memory are unclear, because a systematic review of related studies is lacking and the findings are scattered. The present study was designed to integrate the results of functional magnetic resonance imaging and positron emission tomography studies by means of a systematic review and meta-analysis to provide converging evidence. In particular, we focused on identifying the brain regions involved in the retrieval of spatial and temporal information. We identified a spatial retrieval network consisting of the inferior temporal gyrus, parahippocampal gyrus, superior parietal lobule, angular gyrus, and precuneus. Temporal context retrieval was supported by the dorsolateral prefrontal cortex. Thus, the retrieval of spatial and temporal information is supported by different brain regions, highlighting their different natures within episodic memory.
Topics: Humans; Memory, Episodic; Brain Mapping; Brain; Temporal Lobe; Parietal Lobe; Magnetic Resonance Imaging; Mental Recall
PubMed: 38030912
DOI: 10.3758/s13415-023-01140-1 -
Frontiers in Neuroscience 2021Systematic reviews of neuroimaging studies confirm stimulus-induced activity in response to verbal and non-verbal self-referential processing (SRP) in cortical midline... (Review)
Review
Systematic reviews of neuroimaging studies confirm stimulus-induced activity in response to verbal and non-verbal self-referential processing (SRP) in cortical midline structures, temporoparietal cortex and insula. Whether SRP can be causally modulated by way of non-invasive brain stimulation (NIBS) has also been investigated in several studies. Here we summarize the NIBS literature including 27 studies of task-based SRP comparing response between verbal and non-verbal SRP tasks. The studies differed in design, experimental tasks and stimulation parameters. Results support the role of left inferior parietal lobule (left IPL) in verbal SRP and for the medial prefrontal cortex when valenced stimuli were used. Further, results support roles for the bilateral parietal lobe (IPL, posterior cingulate cortex), the sensorimotor areas (the primary sensory and motor cortex, the premotor cortex, and the extrastriate body area) and the insula in non-verbal SRP (bodily self-consciousness). We conclude that NIBS may differentially modulate verbal and non-verbal SRP by targeting the corresponding brain areas.
PubMed: 34177450
DOI: 10.3389/fnins.2021.671020 -
Brain and Behavior Dec 2023Dysregulated appetite control is characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and obesity (OB). Studies using a broad range of methods suggest the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Dysregulated appetite control is characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and obesity (OB). Studies using a broad range of methods suggest the cerebellum plays an important role in aspects of weight and appetite control, and is implicated in both AN and OB by reports of aberrant gray matter volume (GMV) compared to nonclinical populations. As functions of the cerebellum are anatomically segregated, specific localization of aberrant anatomy may indicate the mechanisms of its relationship with weight and appetite in different states. We sought to determine if there were consistencies in regions of cerebellar GMV changes in AN/BN and OB, as well as across normative (NOR) variation.
METHOD
Systematic review and meta-analysis using GingerALE.
RESULTS
Twenty-six publications were identified as either case-control studies (n = 277; n = 510) or regressed weight from NOR data against brain volume (total n = 3830). AN/BN and OB analyses both showed consistently decreased GMV within Crus I and Lobule VI, but volume reduction was bilateral for AN/BN and unilateral for OB. Analysis of the NOR data set identified a cluster in right posterior lobe that overlapped with AN/BN cerebellar reduction. Sensitivity analyses indicated robust repeatability for NOR and AN/BN cohorts, but found OB-specific heterogeneity.
DISCUSSION
Findings suggest that more than one area of the cerebellum is involved in control of eating behavior and may be differentially affected in normal variation and pathological conditions. Specifically, we hypothesize an association with sensorimotor and emotional learning via Lobule VI in AN/BN, and executive function via Crus I in OB.
Topics: Humans; Appetite; Anorexia Nervosa; Bulimia Nervosa; Gray Matter; Cerebellum; Obesity
PubMed: 37830247
DOI: 10.1002/brb3.3286 -
Translational Cancer Research Aug 2022This study aimed to systematically evaluate and compare the diagnostic value of bubble lucency, interface, lobulated margin and spiculation in distinguishing early...
Diagnostic value of double low-dose targeted perfusion CT imaging for the diagnosis of invasive and preinvasive pulmonary ground-glass nodules: systematic review and meta-analysis.
BACKGROUND
This study aimed to systematically evaluate and compare the diagnostic value of bubble lucency, interface, lobulated margin and spiculation in distinguishing early invasive and preinvasive intrapulmonary ground-glass nodules (GGNs) using evidence-based meta-analysis methods. Dual low-dose targeted perfusion computed tomography (CT) imaging is controversial in the diagnosis of invasive and preinvasive ground-glass nodules. Different studies have different views and opinions. Therefore, it is necessary to conduct a systematic review of this subject in the form of meta-analysis to guide clinical diagnosis and treatment.
METHODS
PubMed, Web of Science, Cochrane library and Embase were searched for recent documentation on the diagnostic value of different signs in invasive and preinvasive pulmonary GGNs. CT imaging signs of bubble lucency, speculation, interface, lobulated margin, and spiculation were used as diagnostic references to discriminate pre-invasive and invasive disease. The sensitivity, specificity, summary receiver operating characteristic (SROC) curves, and the area under the SROC curve (AUC) were calculated to evaluate diagnostic efficiency.
RESULTS
The diagnostic sensitivity and specificity using bubble lucency as a reference of invasive ground-glass opacity (GGO) discrimination was 0.33 (0.24-0.44) and 0.74 (0.62-0.83) respectively. For interface, lobulated margin, and speculation, the diagnostic sensitivity were 0.30 (0.21-0.41), 0.49 (0.39-0.60) and 0.22 (0.14-0.33); and the specificity were 0.83 (0.74-0.89), 0.66 (0.49-0.80) and 0.86 (0.67-0.95). The pooled ROC curve was drawn by sensitivity against 1-specificity using Stata version 15.0. The area under the ROC curve (AUC) values were 0.53, 0.60, 0.58, and 0.43 for bubble lucency, speculation, lobulated margin, and pleural indentation of GGO for discriminating pre-invasive and invasive disease.
CONCLUSIONS
The diagnostic value of a single CT imaging sign of GGO, such as bubble lucency, speculation, interface, lobulated margin, and spiculation is limited for discriminating pre-invasive and invasive disease because of low sensitivity, specificity, and AUC.
PubMed: 36093551
DOI: 10.21037/tcr-22-790