scholarly journals Neuropsychological function after endovascular and neurosurgical treatment of subarachnoid hemorrhage: a systematic review and meta-analysis

2018 ◽  
Vol 128 (3) ◽  
pp. 768-776 ◽  
Author(s):  
Peter Egeto ◽  
R. Loch Macdonald ◽  
Tisha J. Ornstein ◽  
Tom A. Schweizer
Keyword(s):  
Older Patients ◽  
Neuropsychological Functioning ◽  
Meta Analysis ◽  
Posterior Circulation ◽  
Effect Sizes ◽  
Group Differences ◽  
Endovascular Coiling ◽  
Healthy Controls ◽  
Surgical Clipping ◽  
Influence Effect

OBJECTIVESubarachnoid hemorrhage (SAH) is treated with either surgical clipping or endovascular coiling, though the latter is the preferred treatment method given its more favorable functional outcomes. However, neuropsychological functioning after treatment is rarely taken into account. In this meta-analysis, the authors synthesized relevant data from the literature and compared neuropsychological functioning in patients after coiling and clipping of SAH. They hypothesized that the coiled patients would outperform the clipped patients; that group differences would be greater with higher posterior circulation rupture rates, in older patients, and in more recent publications; that group differences would be smaller with greater rates of middle cerebral artery (MCA) rupture; and that anterior communicating artery (ACoA) rupture rates would not influence effect sizes.METHODSThe MEDLINE, Embase, and PsycINFO databases were searched for clinical studies that compared neuropsychological functioning after either endovascular coiling or surgical clipping for SAH. Hedge's g and 95% confidence intervals were calculated using random effects models. Patients who had undergone coiling or clipping were compared on test performance in 8 neuropsychological domains: executive functions, language, attention/processing speed, verbal memory, visual memory, spatial memory, visuospatial functions, and intelligence. Patients were also compared with healthy controls, and meta-regressions were used to explore the relation between effect sizes and publication year, delay between treatment and neuropsychological testing, mean patient age, and rates of posterior circulation, ACoA, and MCA ruptures.RESULTSThirteen studies with 396 clipped cases, 314 coiled cases, and 169 healthy controls were included in the study. The coil-treated patients outperformed the clip-treated patients on executive function (g = 0.17, 95% CI 0.08–0.25) and language tests (g = 0.23, 95% CI 0.07–0.39), and all patients were impaired relative to healthy controls (g ranged from −0.93 to −0.29). Coiled patients outperformed clipped patients to a greater degree in more recent publications, over longer posttreatment testing delays, and among older patients. Higher rates of posterior circulation and MCA aneurysms were associated with smaller group differences, while ACoA rupture rates did not influence effect sizes.CONCLUSIONSCoiling of SAH may promote superior neuropsychological functioning under certain circumstances and could have applications for the specialized care of SAH patients.

scholarly journals A-17 Category Test performance in individuals with alcohol versus methamphetamine dependence

2019 ◽  
Vol 34 (6) ◽  
pp. 876-876
Author(s):  
A Walker ◽  
A Hauson ◽  
S Sarkissians ◽  
A Pollard ◽  
C Flora-Tostado ◽  
...  
Keyword(s):  
Effect Size ◽  
Test Performance ◽  
Neuropsychological Functioning ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Significant Heterogeneity ◽  
Category Test ◽  
Methamphetamine Dependence ◽  
Significant Difference ◽  
Axis I

Abstract Objective The Category Test (CT) has consistently been found to be sensitive at detecting the effects of alcohol on the brain. However, this test has not been as widely used in examining the effects of methamphetamine. The current meta-analysis compared effect sizes of studies that have examined performance on the CT in alcohol versus methamphetamine dependent participants. Data selection Three researchers independently searched nine databases (e.g., PsycINFO, Pubmed, ProceedingsFirst), extracted required data, and calculated effect sizes. Inclusion criteria identified studies that had (a) compared alcohol or methamphetamine dependent groups to healthy controls and (b) matched groups on either age, education, or IQ (at least 2 out of 3). Studies were excluded if participants were reported to have Axis I diagnoses (other than alcohol or methamphetamine dependence) or comorbidities known to impact neuropsychological functioning. Sixteen articles were coded and analyzed for the current study. Data synthesis Alcohol studies showed a large effect size (g = 0.745, p < 0.001) while methamphetamine studies evidenced a moderate effect size (g = 0.406, p = 0.001); both without statistically significant heterogeneity (I2 = 0). Subgroup analysis revealed a statistically significant difference between the effect sizes from alcohol versus methamphetamine studies (Q-between = 5.647, p = 0.017). Conclusions The CT is sensitive to the effects of both alcohol and methamphetamine and should be considered when examining dependent patients who might exhibit problem solving, concept formation, and set loss difficulties in everyday living.

A meta-analysis on pain sensitivity in self-injury

2016 ◽  
Vol 46 (8) ◽  
pp. 1597-1612 ◽  
Author(s):  
J. Koenig ◽  
J. F. Thayer ◽  
M. Kaess
Keyword(s):  
Pain Intensity ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Meta Analysis ◽  
Pain Tolerance ◽  
Effect Sizes ◽  
Current Evidence ◽  
Healthy Controls ◽  
Hand Search ◽  
Self Injury

Individuals engaging in self-injurious behavior (SIB) frequently report absence of pain during acts of SIB. While altered pain sensitivity is discussed as a risk factor for the engagement in SIB, results have been mixed with considerable variance across reported effect sizes, in particular with respect to the effect of co-morbid psychopathology. The present meta-analysis aimed to summarize the current evidence on pain sensitivity in individuals engaging in SIB and to identify covariates of altered pain processing. Three databases were searched without restrictions. Additionally a hand search was performed and reference lists of included studies were checked for potential studies eligible for inclusion. Thirty-two studies were identified after screening 720 abstracts by two independent reviewers. Studies were included if they reported (i) an empirical investigation, in (ii) humans, including a sample of individuals engaging in (iii) SIB and a group of (iv) healthy controls, (v) receiving painful stimulation. Random-effects meta-analysis was performed on three pain-related outcomes (pain threshold, pain tolerance, pain intensity) and several population- and study-level covariates (i.e. age, sex, clinical etiology) were subjected to meta-regression. Meta-analysis revealed significant main effects associated with medium to large effect sizes for all included outcomes. Individuals engaging in SIB show greater pain threshold and tolerance and report less pain intensity compared to healthy controls. Clinical etiology and age are significant covariates of pain sensitivity in individuals engaging in SIB, such that pain threshold is further increased in borderline personality disorder compared to non-suicidal self-injury. Mechanisms underlying altered pain sensitivity are discussed.

scholarly journals Social anxiety in the eating disorders: a systematic review and meta-analysis

2018 ◽  
Vol 48 (15) ◽  
pp. 2477-2491 ◽  
Author(s):  
Jess Kerr-Gaffney ◽  
Amy Harrison ◽  
Kate Tchanturia
Keyword(s):  
Eating Disorders ◽  
Social Anxiety ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Self Report ◽  
Effect Sizes ◽  
Healthy Controls ◽  
Comorbid Conditions ◽  
Current Review ◽  
Meta Analyses

AbstractSocial anxiety disorder is one of the most common comorbid conditions in eating disorders (EDs). The aim of the current review and meta-analysis is to provide a qualitative summary of what is known about social anxiety (SA) in EDs, as well as to compare levels of SA in those with EDs and healthy controls. Electronic databases were systematically searched for studies using self-report measures of SA in ED populations. In total, 38 studies were identified, 12 of which were included in the meta-analyses. For both anorexia nervosa (AN) and bulimia nervosa, there were significant differences between ED groups and HCs, with medium to large effect sizes. Findings from the qualitative review indicate that levels of SA are similar across the ED diagnoses, and SA improves with treatment in AN. In addition, high levels of SA are associated with more severe ED psychopathology, but not body mass index. These findings add to the wider literature on socio-emotional functioning in EDs, and may have implications for treatment strategies.

scholarly journals A-27 Stroop Color-Word Interference Test in Alcohol Use Disorder

2019 ◽  
Vol 34 (6) ◽  
pp. 886-886
Author(s):  
A Holt ◽  
A Hauson ◽  
P Ujj ◽  
K Reszegi ◽  
N Nemanim ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Inhibitory Control ◽  
Alcohol Use Disorder ◽  
Color Word ◽  
Neuropsychological Functioning ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Calculated Effect ◽  
Interference Test ◽  
Axis I

Abstract Objective Poor inhibitory control is a characteristic of Alcohol Use Disorder (AUD) that might be associated with worse treatment outcomes because of its contribution to the likelihood of relapse. One valid and efficient tool to examine inhibitory control is the Stroop Color-Word Interference Test (Stroop inhibition). The purpose of this meta-analysis was to examine the consistency of findings on the Stroop inhibition subtest and its relationship to length of use and duration of abstinence in AUD. Data Selection Three researchers independently searched nine databases (e.g., PsycINFO, Pubmed, ProceedingsFirst), extracted required data, and calculated effect sizes. Inclusion criteria identified studies that had (a) compared participants with AUD to healthy controls and (b) matched groups on either age, education, or IQ. Studies were excluded if participants were reported to have Axis I diagnoses (other than AUD) or comorbidities known to impact neuropsychological functioning. Twelve articles were coded and analyzed for the current study. Data Synthesis Studies comparing AUD to controls showed a medium statistically significant effect size (g = 0.355, p < 0.001) with no heterogeneity (I2 = 0). Length of use and duration of abstinence did not predict effect sizes. Conclusions The Stroop inhibition measure distinguishes between AUD participants and controls. Given the robustness of this finding, the lack of heterogeneity among studies, and the extensive past use of the Stroop to measure inhibitory control; this test should be considered when examining AUD patients. This is especially important when patients exhibit poor inhibition in daily functioning.

Choice of the Metric for Effect Size in Meta-analysis

1980 ◽  
Vol 17 (3) ◽  
pp. 325-337 ◽  
Author(s):  
Barry McGaw ◽  
Gene V Glass
Keyword(s):  
Error Term ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Effect Sizes ◽  
Group Differences ◽  
Factorial Designs ◽  
Gain Scores ◽  
Standardized Mean Difference ◽  
And Control ◽  
Express Group

Meta-analysis, as a procedure for integrating the results of empirical studies, depends on the quantification of the results of individual investigations. The standardized mean difference in performance between treatment and control conditions has been conventionally used for this purpose. There are difficulties with this technique when group standard deviations are not homogeneous, when a control condition is not included in a particular study, or when no control condition exists. There are also difficulties in expressing effect sizes on a common metric when some studies use transformed scales, such as gain scores, to express group differences, or use factorial designs or covariance adjustments to obtain a reduced error term. This paper discusses these problems, proposes a common metric on which effect sizes may be standardized, and describes procedures for computing appropriate effect sizes for all such cases.

scholarly journals Type 2 Diabetes and Cognitive Functions in Middle Age: A Meta-Analysis

2018 ◽  
Vol 25 (2) ◽  
pp. 215-229 ◽  
Author(s):  
Elina Pelimanni ◽  
Mervi Jehkonen
Keyword(s):  
Type 2 Diabetes ◽  
Processing Speed ◽  
Visual Memory ◽  
Middle Age ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
Cognitive Domains

AbstractObjectives: Type 2 diabetes mellitus has been linked with cognitive decrement and an increased risk of dementia in older people. Less is known about whether diabetes affects cognition at younger ages. The objective of this meta-analysis was to examine possible differences (effect sizes) in cognitive performance between middle-aged type 2 diabetic patients and healthy controls. Secondary aim was to examine whether age is related to the magnitude of effect sizes. Methods: Electronic databases and lists of references of selected articles were used to search for studies examining type 2 diabetes and cognition in patients under age 65 compared to healthy controls. Twelve studies met the inclusion criteria. Standardized mean differences (Hedges’s g) were calculated for main cognitive domains and their subdomains. Association between age and effect sizes was evaluated with meta-regression analyses. Publication bias and methodological quality of the studies were assessed. Results: Patients performed worse than controls in several cognitive functions. The largest differences were found in information processing speed (g = −0.68), attention/concentration (g = −0.55), executive functions (g = −0.51), and working memory (g = −0.51). There was no significance difference in visual memory (g = −0.15). Age was significantly related to the effect size in information processing speed, language, verbal memory and visual memory. However, the direction of association varied across these cognitive domains. Conclusions: The results suggest that cognitive decrement in diabetes is not restricted to older people, but may begin to appear in middle age. More attention should be paid to early recognition and treatment of diabetes-related cognitive decrement in healthcare systems. (JINS, 2019, 25, 215–229)

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