Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis

Abstract 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, I2 = 0%), in learning and memory domains (SMD = 0.26, 95% CI −0.22, 0.74, I2 = 24%), in verbal fluency (SMD = 0.08, 95% CI −0.47, 0.62, I2 = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I2 = 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.

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Effects of Sport-Based Interventions on Children’s Executive Function: A Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11060755 ◽

2021 ◽

Vol 11 (6) ◽

pp. 755

Author(s):

Falonn Contreras-Osorio ◽

Christian Campos-Jara ◽

Cristian Martínez-Salazar ◽

Luis Chirosa-Ríos ◽

Darío Martínez-García

Keyword(s):

Systematic Review ◽

Working Memory ◽

Executive Function ◽

Inhibitory Control ◽

Cognitive Flexibility ◽

Meta Analysis ◽

Scientific Evidence ◽

Healthy Children ◽

Meta Analyses ◽

The Impact

One of the most studied aspects of children’s cognitive development is that of the development of the executive function, and research has shown that physical activity has been demonstrated as a key factor in its enhancement. This meta-analysis aims to assess the impact of specific sports interventions on the executive function of children and teenagers. A systematic review was carried out on 1 November 2020 to search for published scientific evidence that analysed different sports programs that possibly affected executive function in students. Longitudinal studies, which assessed the effects of sports interventions on subjects between 6 and 18 years old, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of eight studies, with 424 subjects overall, met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibitory control, and cognitive flexibility. The random-effects model for meta-analyses was performed with RevMan version 5.3 to facilitate the analysis of the studies. Large effect sizes were found in all categories: working memory (ES −1.25; 95% CI −1.70; −0.79; p < 0.0001); inhibitory control (ES −1.30; 95% CI −1.98; −0.63; p < 0.00001); and cognitive flexibility (ES −1.52; 95% CI −2.20; −0.83; p < 0.00001). Our analysis concluded that healthy children and teenagers should be encouraged to practice sports in order to improve their executive function at every stage of their development.

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Trend of Hospital Admission and Outcome Study of Patients Admitted in a Neurology Unit at a Tertiary Care Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v4i2.38917 ◽

2018 ◽

Vol 4 (2) ◽

pp. 69-74

Author(s):

Md Tauhidul Islam Chowdhury ◽

Mohammad Shah Jahirul Hoque Choudhury ◽

KM Ahasan Ahmed ◽

Mohammad Sadekur Rahman Sarkar ◽

Md Abdullah Yusuf ◽

...

Keyword(s):

Neurological Disorders ◽

Neurological Diseases ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Retrospective Chart Review ◽

Total Death ◽

Neurological Patients ◽

Study Population ◽

The Mean ◽

Day By Day

Background: Neurological disorders is becoming a growing concern both for developed and developing countries. Magnitude of the problem is increasing day by day. Among all neurological disorders, stroke is the leading cause of morbidity and mortality globally.Objectives: The purpose of the study was to see the trend of admission of patients with neurological diseases and to study the outcome of patients at referral neurology hospital in Bangladesh.Methodology: This retrospective chart review was conducted in the blue unit of the Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from 1st January to 31st December 2016 for a period of one (01) year. All the admitted patients with both sexes were selected as study population. The outcome was observed among the study population.Result: A total number of 1044 patients were admitted during the study period. Majority of the patients were in the age group of the 41 to 50 years which was 417(39.9%) cases. Both male and female were in highest number in the month of May which was 63 and 48 cases respectively. The total death of the study population was 146(14.0%) cases. The mean length of hospital stay was 8.4±2.31 days.Conclusion: Middle aged male is the main bulk of the neurological patients, admitted in a referral neurology hospital in Bangladesh. Highest admission and mortality was observed in stroke patients.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 69-74

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Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Complexity ◽

10.1155/2021/5569346 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Bo Yang ◽

Shuming Wang

Keyword(s):

Working Memory ◽

Executive Function ◽

Exercise Intervention ◽

Combined Therapy ◽

Meta Analysis ◽

Cochrane Library ◽

Treatment Protocols ◽

Cognitive Domains ◽

Chi Squared ◽

Cognitive Benefit

ObjectiveThe objective of this paper is to evaluate the cognitive benefit of exercise after stroke, so as to provide more accurate and reliable guidance for targeted exercise intervention. Methods. Randomized controlled trials of the relationship between exercise and cognition after stroke were identified in Cochrane Library and PubMed. Methodological quality was assessed using the Cochrane tool of bias. SMD and 95% confidence intervals were calculated, and Chi-squared test (Q) was adopted to estimate the heterogeneity. Results. (a) Twenty-three studies met inclusion criteria, including 1528 participants. Heterogeneity was from low to high such as attention (I2 = 0.00%), executive function (I2 = 0.00%), cognition (I2 = 64%), and working memory (I2 = 77%). (b) The overall effect on cognition was small (SMD = 0.16 [0.04, 0.28]) but significant and there is a difference between cognitive domains in attention (SMD = −0.35 [−0.57, −0.14]), executive function (SMD = −0.24 [−0.40, −0.08]), and working memory (SMD = 0.36 [0.20, 0.53]). (c) Exercise training was less effective before the 18th month after stroke. Higher benefits on cognition were found after combined therapy compared with other exercise programs, and the older the stroke survivors, the less the cognitive benefit of exercise. Conclusion. Small-to-moderate effect of exercise on cognitive benefit after stroke was found, and the effect was moderated by treatment protocols and sample characteristics.

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Corpus callosal atrophy and associations with cognitive impairment in Parkinson disease

Neurology ◽

10.1212/wnl.0000000000003764 ◽

2017 ◽

Vol 88 (13) ◽

pp. 1265-1272 ◽

Cited By ~ 37

Author(s):

Jennifer G. Goldman ◽

Ian O. Bledsoe ◽

Doug Merkitch ◽

Vy Dinh ◽

Bryan Bernard ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Executive Function ◽

Corpus Callosum ◽

Parkinson Disease ◽

Clinical Manifestations ◽

Cognitive Domain ◽

Intracranial Volume ◽

Volume Loss ◽

Cognitive Domains

Objective:To investigate atrophy of the corpus callosum on MRI in Parkinson disease (PD) and its relationship to cognitive impairment.Methods:One hundred patients with PD and 24 healthy control participants underwent clinical and neuropsychological evaluations and structural MRI brain scans. Participants with PD were classified as cognitively normal (PD-NC; n = 28), having mild cognitive impairment (PD-MCI; n = 47), or having dementia (PDD; n = 25) by Movement Disorder Society criteria. Cognitive domain (attention/working memory, executive function, memory, language, visuospatial function) z scores were calculated. With the use of FreeSurfer image processing, volumes for total corpus callosum and its subsections (anterior, midanterior, central, midposterior, posterior) were computed and normalized by total intracranial volume. Callosal volumes were compared between participants with PD and controls and among PD cognitive groups, covarying for age, sex, and PD duration and with multiple comparison corrections. Regression analyses were performed to evaluate relationships between callosal volumes and performance in cognitive domains.Results:Participants with PD had reduced corpus callosum volumes in midanterior and central regions compared to healthy controls. Participants with PDD demonstrated decreased callosal volumes involving multiple subsections spanning anterior to posterior compared to participants with PD-MCI and PD-NC. Regional callosal atrophy predicted cognitive domain performance such that central volumes were associated with the attention/working memory domain; midposterior volumes with executive function, language, and memory domains; and posterior volumes with memory and visuospatial domains.Conclusions:Notable volume loss occurs in the corpus callosum in PD, with specific neuroanatomic distributions in PDD and relationships of regional atrophy to different cognitive domains. Callosal volume loss may contribute to clinical manifestations of PD cognitive impairment.

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The Physiological Basis of Executive Function and Working Memory

The Neuroscientist ◽

10.1177/107385849600200612 ◽

1996 ◽

Vol 2 (6) ◽

pp. 345-352 ◽

Cited By ~ 33

Author(s):

Mark D'Esposito ◽

Murray Grossman

Keyword(s):

Working Memory ◽

Executive Function ◽

Cognitive Abilities ◽

Brain Regions ◽

Cognitive Domain ◽

Distributed Network ◽

Cortical Function ◽

Physiological Basis ◽

Appropriate Behavior ◽

Prefrontal Cortical

The term “executive function” has been used to capture the highest order of cognitive abilities, including the planning, flexibility, organization and regulation necessary for the execution of an appropriate behavior. Executive function, although an elusive cognitive domain, may be highly dependent on working memory, which refers to the temporary storage and manipulation of information. The physiology of working memory is beginning to be mapped in both monkey and human studies at the neuroanatomical and neurochemical levels. Working memory is likely subserved by a distributed network of brain regions in which the prefrontal cortex is critical, subserving the process of maintaining representations across time. There is also a relationship between dopaminergic projections in the brain and working memory. Improved understanding of the physiological basis of executive functioning and working memory will provide a narrower view of prefrontal cortical function and may lead to new therapies in patients with cognitive dysfunction.

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Human Polyomaviruses in the Cerebrospinal Fluid of Neurological Patients

Microorganisms ◽

10.3390/microorganisms8010016 ◽

2019 ◽

Vol 8 (1) ◽

pp. 16 ◽

Cited By ~ 3

Author(s):

Serena Delbue ◽

Diego Franciotta ◽

Sara Giannella ◽

Maria Dolci ◽

Lucia Signorini ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Neurological Disorders ◽

Neurological Diseases ◽

Merkel Cell ◽

Quantitative Real Time Pcr ◽

Neurological Patients ◽

Immunosuppressed Patients ◽

Etiological Agents ◽

Human Polyomaviruses

Background: Central nervous system (CNS) infections by human polyomaviruses (HPyVs), with the exception of JC (JCPyV), have been poorly studied. Methods: In total, 234 cerebrospinal fluid (CSF) samples were collected from patients affected with neurological disorders. DNA was isolated and subjected to quantitative real-time PCR (Q-PCR) for the detection of six HPyVs: JCPyV, BKPyV, Merkel cell PyV (MCPyV), HPyV6, HPyV7, and HPyV9. Where possible, the molecular characterization of the viral strains was carried out by nested PCR and automated sequencing. Results: JCPyV was detected in 3/234 (1.3%), BKPyV in 15/234 (6.4%), MCPyV in 22/234 (9.4%), and HPyV6 in 1/234 (0.4%) CSF samples. JCPyV was detected at the highest (p < 0.05) mean load (3.7 × 107 copies/mL), followed by BKPyV (1.9 × 106 copies/mL), MCPyV (1.9 × 105 copies/mL), and HPyV6 (3.3 × 104 copies/mL). The noncoding control regions (NCCRs) of the sequenced viral strains were rearranged. Conclusions: HPyVs other than JCPyV were found in the CSF of patients affected with different neurological diseases, probably as bystanders, rather than etiological agents of the disease. However, the fact that they can be latent in the CNS should be considered, especially in immunosuppressed patients.

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Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867419893439 ◽

2019 ◽

Vol 54 (5) ◽

pp. 453-466 ◽

Cited By ~ 3

Author(s):

Caitlin OB Yolland ◽

Donal Hanratty ◽

Erica Neill ◽

Susan L Rossell ◽

Michael Berk ◽

...

Keyword(s):

Working Memory ◽

Meta Analysis ◽

Cognitive Domain ◽

Adjunctive Treatment ◽

Adjunct Treatment ◽

Syndrome Scale ◽

Randomised Control Trials ◽

Randomised Controlled ◽

Meta Analyses ◽

Negative Syndrome

Objective: There is accumulating evidence that adjunctive treatment with N-acetylcysteine may be effective for schizophrenia. This study aimed to conduct a comprehensive meta-analysis examining the efficacy of randomised control trials investigating N-acetylcysteine as an adjunct treatment for schizophrenia and the first to investigate cognition as an outcome. Methods: We systematically reviewed Medline, EmCare, PsycINFO, Embase, CINAHL Complete, China Knowledge Resource Integrated Database and the Cochrane Clinical Trials online registry for randomised control trials of N-acetylcysteine for schizophrenia. We undertook pairwise meta-analyses of N-acetylcysteine vs placebo for psychosis symptoms and cognition. Results: Seven studies, including n = 220 receiving N-acetylcysteine and n = 220 receiving placebo, met inclusion criteria for the pairwise meta-analyses. Positive and Negative Syndrome Scale negative and total scores were significantly improved in the N-acetylcysteine group after 24 weeks of treatment. The cognitive domain of working memory improved with N-acetylcysteine supplementation. Conclusion: Evidence supports the notion that N-acetylcysteine may be a useful adjunct to standard treatment for the improvement of schizophrenia symptoms, as well as the cognitive domain of working memory. Treatment effects were observed at the later time point (⩾24 weeks), suggesting that longer interventions are required for the success of N-acetylcysteine treatment.

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Physical Therapy Exercises for Sleep Disorders in a Rehabilitation Setting for Neurological Patients: A Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11091176 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1176

Author(s):

Marco Tramontano ◽

Sara De De Angelis ◽

Giovanni Galeoto ◽

Maria Carmela Cucinotta ◽

Danilo Lisi ◽

...

Keyword(s):

Systematic Review ◽

Physical Therapy ◽

Sleep Disorders ◽

Neurological Disorders ◽

Human Life ◽

Meta Analysis ◽

Well Being ◽

Wide Range ◽

Neurological Patients ◽

Present Systematic Review

Background: Sleep occupies one-third of human life and is essential for health and for emotional, physical, and cognitive well-being. Poor or insufficient sleep is associated with a wide range of dysfunctions that involve different body systems, such as the endocrine, metabolic, and immune systems, thus compromising the higher cortical functions, cognitive performance, mood, and post-physical activity recovery. The present systematic review and meta-analysis aimed to explore the effectiveness of physical therapy exercises on sleep disorders in patients with neurological disorders. Our systematic review identified 10 articles that investigated the effects of physical therapy on sleep disorders in patients with neurological disorders, 6 of which were included in the meta-analysis. Results suggest that physical therapy exercises are a safe and useful strategy for managing sleep disorders in neurorehabilitation.

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Executive Function in Pediatric Sleep-Disordered Breathing: A Meta-analysis

Journal of the International Neuropsychological Society ◽

10.1017/s1355617716000643 ◽

2016 ◽

Vol 22 (8) ◽

pp. 839-850 ◽

Cited By ~ 10

Author(s):

Jonathan J. Mietchen ◽

David P. Bennett ◽

Trevor Huff ◽

Dawson W. Hedges ◽

Shawn D. Gale

Keyword(s):

Working Memory ◽

Executive Function ◽

Executive Functioning ◽

Effect Size ◽

Sleep Disordered Breathing ◽

Meta Analysis ◽

Effect Sizes ◽

Questionnaire Data ◽

Neuropsychological Measures ◽

Pediatric Sleep

AbstractObjectives:Evaluate the association between pediatric sleep-disordered breathing (SDB) and executive functioning.Methods:We searched multiple electronic databases for peer-reviewed journal articles related to pediatric SDB and executive functioning. We included studies that assessed SDBviapolysomnography, included objective or questionnaire measures of executive function, and had an age-matched control group. Fourteen articles met inclusion criteria with a total sample of 1697 children ages 5 to 17 years (M=9.81 years;SD=0.34). We calculated an overall effect size for each of the five executive domains (vigilance, inhibition, working memory, shifting, and generativity) as well as effect sizes according to SDB severity: mild, moderate, severe. We also calculated effect sizes separately for objective and subjective questionnaires of executive functioning.Results:We found a medium effect size (−0.427) for just one of five executive function domains on objective neuropsychological measures (generativity). In contrast, effect sizes on all three executive domains measuredviaquestionnaire data were significant, with effect sizes ranging from medium (−0.64) to large (−1.06). We found no difference between executive domains by severity of SDB.Conclusions:This meta-analysis of executive function separated into five domains in pediatric SDB suggested lower performance in generativity on objective neuropsychological measures. There were no differences associated with SDB severity. Questionnaire data suggested dysfunction across the three executive domains measured (inhibition, working memory, shifting). Overall, limited evidence suggested poorer performance in executive function in children with SDB according to objective testing, and subjective ratings of executive function suggested additional worsened performance. (JINS, 2016,22, 839–850)

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Meta-analysis: Resistance Training Improves Cognition in Mild Cognitive Impairment

International Journal of Sports Medicine ◽

10.1055/a-1186-1272 ◽

2020 ◽

Vol 41 (12) ◽

pp. 815-823

Author(s):

Lulu Zhang ◽

Bin Li ◽

Jingjing Yang ◽

Fengling Wang ◽

Qianyun Tang ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Resistance Training ◽

Meta Analysis ◽

Mean Difference ◽

Cochrane Library ◽

Standardized Mean Difference

AbstractThis study investigated the benefits of resistance training on cognition in patients with mild cognitive impairment. We searched the PubMed, Embase and Cochrane Library databases, and seven randomized controlled trials were reviewed. We evaluated the risk of bias using the Cochrane Collaboration’s bias assessment tool. Standard mean differences with 95% confidence intervals were calculated for statistical analysis. This meta-analysis assessed three variables: general cognitive function, executive function and working memory. The results indicate that general cognitive function improved significantly (standardized mean difference: 0.53, P=0.04), and further subgroup analyses on frequency and duration per session showed that the subgroups ‘twice a week’ (P=0.01) and ‘duration per session >60 min’ (P=0.0006) exhibited better performance than the subgroups ‘three time a week’ (P=0.47) and ‘duration per session <60 min’ (P=0.53). Additionally, a moderate effect size was found in executive function (standardized mean difference: 0.50, P=0.0003), and there was non-significant effect in working memory (P=0.14). In summary, resistance training may mitigate mild cognitive impairment by improving cognition. Larger-scale studies are recommended to demonstrate the relationship between resistance training and cognition in mild cognitive impairment.

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