Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta-Analysis.

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Abstrakt

Tytuł:: Neuropsychological Functioning in Primary Dystonia: Updated and Expanded Multidomain Meta-Analysis.
Autorzy:: Aita SL; Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.; Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Del Bene VA; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Marotta DA; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.; Alabama College of Osteopathic Medicine, Dothan, Alabama, USA.
Pizer JH; Department of Psychology, University of South Alabama, Mobile, Alabama, USA.
Hawley NA; Department of Psychology, University of South Alabama, Mobile, Alabama, USA.
Niccolai L; Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida, USA.
Walker HC; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Gerstenecker A; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Martin RC; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Clay OJ; Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Crowe M; Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Triebel KL; Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Hill BD; Department of Psychology, University of South Alabama, Mobile, Alabama, USA.
Źródło:: Movement disorders : official journal of the Movement Disorder Society [Mov Disord] 2022 Jul; Vol. 37 (7), pp. 1483-1494. Date of Electronic Publication: 2022 Apr 06.
Typ publikacji:: Journal Article; Meta-Analysis
Język:: English
Imprint Name(s):: Publication: <2001->: New York, NY : Wiley-Liss
Original Publication: [New York, N.Y.] : Raven Press, [c1986-
MeSH Terms:: Dystonia*
Dystonic Disorders*
Cognition ; Executive Function ; Humans ; Neuropsychological Tests
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Contributed Indexing:: Keywords: cognition; meta-analysis; neuropsychology; nonmotor symptoms; primary dystonia
Entry Date(s):: Date Created: 20220406 Date Completed: 20220722 Latest Revision: 20220811
Update Code:: 20240105
DOI:: 10.1002/mds.29022
PMID:: 35385165
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Background: Primary dystonia is conventionally considered as a motor disorder, though an emerging literature reports associated cognitive dysfunction.
Objectives: Here, we conducted meta-analyses on studies comparing clinical measures of cognition in persons with primary dystonia and healthy controls (HCs).
Methods: We searched PubMed, Embase, Cochrane Library, Scopus, and PsycINFO (January 2000-October 2020). Analyses were modeled under random effects. We used Hedge's g as a bias-corrected estimate of effect size, where negative values indicate lower performance in dystonia versus controls. Between-study heterogeneity and bias were primarily assessed with Cochran's Q, I 2 , and Egger's regression.
Results: From 866 initial results, 20 studies met criteria for analysis (dystonia n = 739, controls n = 643; 254 effect sizes extracted). Meta-analysis showed a significant combined effect size of primary dystonia across all studies (g = -0.56, P < 0.001), with low heterogeneity (Q = 25.26, P = 0.15, I 2 = 24.78). Within-domain effects of primary dystonia were motor speed = -0.84, nonmotor speed = -0.83, global cognition = -0.65, language = -0.54, executive functioning = -0.53, learning/memory = -0.46, visuospatial/construction = -0.44, and simple/complex attention = -0.37 (P-values <0.01). High heterogeneity was observed in the motor/nonmotor speed and learning/memory domains. There was no evidence of publication bias. Moderator analyses were mostly negative but possibly underpowered. Blepharospasm samples showed worse performance than other focal/cervical dystonias. Those with inherited (ie, genetic) disease etiology demonstrated worse performance than acquired.
Conclusions: Dystonia patients consistently demonstrated lower performances on neuropsychological tests versus HCs. Effect sizes were generally moderate in strength, clustering around -0.50 SD units. Within the speed domain, results suggested cognitive slowing beyond effects from motor symptoms. Overall, findings indicate dystonia patients experience multidomain cognitive difficulties, as detected by neuropsychological tests. © 2022 International Parkinson and Movement Disorder Society.
(© 2022 International Parkinson and Movement Disorder Society.)

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