Determinants of neurological disease: Synthesis of systematic reviews

Krewski, Daniel; Barakat-Haddad, Caroline; Donnan, Jennifer; Martino, Rosemary; Pringsheim, Tamara; Tremlett, Helen; Lieshout, Pascal van; Walsh, Stephanie J.; Birkett, Nicholas; Gomes, James; Little, Julian; Bowen, Sonya E.; Candundo, Hamilton; Chao, Ting-Kuang; Collins, Kayla; Crispo, James A.G.; Duggan, Tom; Sherif, Reem El; Farhat, Nawal; Fortin, Yannick; Gaskin, Janet; Gupta, Pallavi; Hersi, Mona; Hu, Jing; Irvine, Brittany; Jahanfar, Shayesteh; MacDonald, Don; McKay, Kyla A.; Morrissey, Andrea; Quach, Pauline; Rashid, Ruksana; Shin, Sabina; Sikora, Lindsey; Tkachuk, Stacey; Taher, Mohamed Kadry; Wang, Mingdong; Darshan, Shalu; Cashman, Neil R.

doi:10.1016/j.neuro.2017.04.002

Cited by 25 publications

(17 citation statements)

References 66 publications

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“…This has been described in previous studies of all types of dystonia (Pekmezović et al, 2003) and cervical dystonia (Marras et al, 2007) Among patients with cervical dystonia, significantly more were female than male. These findings are consistent with those of Krewski et al (2017) it is strongly associated with quality of life (Zetterberg et al, 2009). Newman et al (2014) have reported an association between idiopathic isolated dystonia and cigarette smoking, and a case report demonstrated that smoking worsened the cranial dystonia in one patient (Prashantha & Pal, 2009).…”

Section: Discussionsupporting

confidence: 87%

A survey of lifestyle factors in dystonia

Söderlund

Nyholm

2020

Brain and Behavior

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is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned, twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action associated with overflow muscle activation." (Albanese et al., 2013). Dystonia was first described in 1911, but still today the definition is being updated and debated (Albanese et al., 2013; De Pablo-Fernandez & Warner, 2017). The latest updated definition, quoted above, was presented in 2013. In addition to motor symptoms, increasing evidence indicates that nonmotor symptoms are troublesome for patients (Stamelou et al., 2012), leading to reduced quality of life (Müller et al., 2002; Timmers et al., 2017). Nonmotor symptoms can be pain, impaired sensory functions, neuropsychiatric disorders, sleep disturbances, and cognitive disturbances (Kuyper et al., 2011; Stamelou et al., 2012). There is a reported connection between dystonia and psychiatric disorders, such as generalized anxiety disorder, obsessive-compulsive disorder, alcohol dependence, and depression. Whether these symptoms are effects of dystonia or side effects of treatment remains unclear. A coherent understanding about the prevalence and risk factors for dystonia is still missing. Studies on prevalence of dystonia present varying numbers, ranging from 5 to 40 per 100,000 (Government of Canada and Neurological Health Charities Canada, 2014; Steeves et al., 2012) A systematic review by Krewski et al. (2017) found possible susceptibility to cervical dystonia among females. For blepharospasm, they proposed that there is no significant gender difference. Higher, rather than lower, consumption of coffee and alcohol has shown to be protective for onset of specific forms of dystonia, blepharospasm, and myoclonal dystonia, respectively, although the protective effect of alcohol is debated (Krewski et al., 2017).

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Section: Discussionsupporting

confidence: 87%

A survey of lifestyle factors in dystonia

Söderlund

Nyholm

2020

Brain and Behavior

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“…The finding that infants of affected women have longer delivery hospitalizations may be related to providers keeping infants hospitalized until their mothers are released. The increased risk of malformations among infants of women with SB may be due to familial genetic traits . However, infants of women with these disabilities were not at increased injury risk, suggesting that their mothers are able to care for their babies adequately.…”

Section: Discussionmentioning

confidence: 99%

“…The increased risk of malformations among infants of women with SB may be due to familial genetic traits. 45,46 However, infants of women with these disabilities were not at increased injury risk, suggesting that their mothers are able to care for their babies adequately. It is also reassuring that infants born to women with these disabilities were not at increased risk of rehospitalization or death.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes in Women with Spinal Cord Injuries: A Population‐Based Study

Crane

Doody

Schiff

et al. 2019

PM&R

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Background Pregnant women with congenital or acquired spinal cord injury face challenges due to compromised neurologic function and mobility, factors that may also affect fetal/infant health. Few studies have examined pregnancy course and longer‐term outcomes in this population. Objective To assess pregnancy outcomes among women with spinal cord injury, paralysis, or spina bifida using population‐based data. Design Retrospective cohort study. Setting Washington state linked birth‐hospital discharge records. Participants All women (N = 529) with spinal cord injury, paralysis, or spina bifida with singleton live birth deliveries 1987‐2012, and a comparison group of women without disabilities (N = 5282). Methods Diagnosis codes were screened to identify cases and a 10:1 random sample of comparison women. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated overall and separately for each condition using multivariable regression. Subsequent hospitalizations or death were identified via linkage to hospital discharge/death records for 2 years after delivery. Main Outcome Measurements Pregnancy course (weight gain, gestational diabetes, preeclampsia, infection, venous thromboembolism), delivery/labor characteristics, infant characteristics (birthweight/size, gestational age), and longer‐term outcomes (occurrence/reasons for maternal/infant rehospitalization, mortality). Results Women with these spinal conditions had increased adjusted risks of prenatal urinary tract infection/pyelonephritis (RR 26.43, 95% CI 13.97‐49.99), venous thromboembolism (RR 9.16, 95% CI 2.17‐38.60), preterm rupture of membranes (RR 2.15, 95% CI 1.18‐3.90), and cesarean delivery (RR 1.88, 95% CI 1.70‐2.09). They had longer hospitalizations and increased rehospitalization (RR 1.54, 95% CI 1.28‐1.87), including for postpartum depression (RR 8.15, 4.29‐15.48) or injury (RR 13.05, 95% CI 6.60‐25.81). Their infants were more often small for gestational age (RR 1.65, 95% CI 1.33‐2.06), but had no increased risk of rehospitalization or death. Conclusions We observed no increased long‐term morbidity among infants of women with these conditions. Possible increased maternal morbidities during the first postpartum years indicate areas for intervention. Level of Evidence III.

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“…It is an approach that aims to offer a new perspective of secondary research (meta-research), a field hallmarked by the need to provide the most integrated evidence possible, and in which several novel study designs have appeared during the last years, e.g., series of systematic reviews and meta-analyses in a single Abbreviations: BMI body mass index, OR odds ratio, RR relative risk, 95% CI 95% confidence interval Note: In this table, only statistically significant risk factors that appeared in more than two studies were included publication, where the analytical unit is the umbrella review study design [88]. Likewise, other attempts refer to field-wide meta-analyses, in which a meta-analysis of observational studies is conducted on the sum of risk factors under consideration [87], or to the synthesis of systematic reviews (e.g., in Neurology [89]), systematic reviews of systematic reviews [90], overviews of systematic reviews [91], meta-reviews [92], systematic meta-reviews, comprehensive reviews [93], research-on-research [94], and meta-meta-analyses [95,96]; these are all terms and study designs that future meta-umbrella reviews should include in their search strategy. Therefore, our metaumbrella review could represent another study design added to the armamentarium of meta-research [97].…”

Section: Discussionmentioning

confidence: 99%

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

Mentis

Dardiotis

Efthymiou

et al. 2021

BMC Med

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Background The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on single contributing factors or diseases, no study has systematically captured non-purely genetic risk and/or protective factors for chronic neurological diseases. Methods We performed a systematic analysis of umbrella reviews (meta-umbrella) published until September 20th, 2018, using broad search terms in MEDLINE, SCOPUS, Web of Science, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations & Theses, JBI Database of Systematic Reviews and Implementation Reports, DARE, and PROSPERO. The PRISMA guidelines were followed for this study. Reference lists of the identified umbrella reviews were also screened, and the methodological details were assessed using the AMSTAR tool. For each non-purely genetic factor association, random effects summary effect size, 95% confidence and prediction intervals, and significance and heterogeneity levels facilitated the assessment of the credibility of the epidemiological evidence identified. Results We identified 2797 potentially relevant reviews, and 14 umbrella reviews (203 unique meta-analyses) were eligible. The median number of primary studies per meta-analysis was 7 (interquartile range (IQR) 7) and that of participants was 8873 (IQR 36,394). The search yielded 115 distinctly named non-genetic risk and protective factors with a significant association, with various strengths of evidence. Mediterranean diet was associated with lower risk of dementia, Alzheimer disease (AD), cognitive impairment, stroke, and neurodegenerative diseases in general. In Parkinson disease (PD) and AD/dementia, coffee consumption, and physical activity were protective factors. Low serum uric acid levels were associated with increased risk of PD. Smoking was associated with elevated risk of multiple sclerosis and dementia but lower risk of PD, while hypertension was associated with lower risk of PD but higher risk of dementia. Chronic occupational exposure to lead was associated with higher risk of amyotrophic lateral sclerosis. Late-life depression was associated with higher risk of AD and any form of dementia. Conclusions We identified several non-genetic risk and protective factors for various neurological diseases relevant to preventive clinical neurology, health policy, and lifestyle counseling. Our findings could offer new perspectives in secondary research (meta-research).

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Determinants of neurological disease: Synthesis of systematic reviews

Cited by 25 publications

References 66 publications

A survey of lifestyle factors in dystonia

A survey of lifestyle factors in dystonia

Pregnancy Outcomes in Women with Spinal Cord Injuries: A Population‐Based Study

Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews

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