NEUROPSYCHOMOTOR DEVELOPMENT IN CHILDREN AND ADOLESCENTS WITH LIVER DISEASES: SYSTEMATIC REVIEW WITH META-ANALYSIS
ABSTRACT BACKGROUND: The nature of liver disease, the evolutionary course and duration of liver diseases, as well as the degree of severity and disability can trigger multiple outcomes with repercussions on neuromotor acquisition and development. OBJECTIVE: To systematically review and conduct a met...
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| Published in | Arquivos de gastroenterologia Vol. 58; no. 2; pp. 217 - 226 |
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| Language | English Portuguese |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE
01.06.2021
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
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| Abstract | ABSTRACT BACKGROUND: The nature of liver disease, the evolutionary course and duration of liver diseases, as well as the degree of severity and disability can trigger multiple outcomes with repercussions on neuromotor acquisition and development. OBJECTIVE: To systematically review and conduct a meta-analysis to evaluate the effects of liver disease on the neuropsychomotor development of children and adolescents with their native livers and those who underwent liver transplantation. METHODS: Observational studies published since the early 1980s until June 2019 were sought in the PubMed and Scopus databases. An α value of 0.05 was considered significant. The statistical heterogeneity of the treatment effect between the studies was assessed by the Cochran’s Q test and the I2 inconsistency test, in which values above 25 and 50% were considered indicative of moderate and high heterogeneity, respectively. Analyses were performed with Review Manager 5.3. RESULTS: Twenty-five studies met the eligibility criteria, including 909 children and adolescents with liver disease. Meta-analyses showed deficits in total IQ -0.41 (95%CI: -0.51 to -0.32; N: 9,973), verbal IQ -0.38 (95%CI: -0.57 to -0.18; N: 10,284) and receptive language -0.85 (95%CI: -1.16 to -0.53; N: 921) in liver transplantation, and those with native livers who had symptoms early had total and verbal IQ scores (85±8.8; 86.3±10.6 respectively) lower than the scores of those with late manifestations (99.5±13.8; 96.2±9.2). Gross motor skill was reduced -46.29 (95%CI: -81.55 to -11.03; N: 3,746). CONCLUSION: Acute or chronic liver disease can cause declines in cognitive, motor and language functions. Although the scores improve after liver transplantation, children remain below average when compared to healthy children.
RESUMO CONTEXTO: A natureza da doença hepática, curso evolutivo e duração das hepatopatias, bem como grau de severidade e incapacidade podem desencadear desfechos múltiplos e com repercussões na aquisição e desenvolvimento neuromotores. OBJETIVO: Revisar sistematicamente e avaliar por meta-análise os efeitos da doença hepática sobre o desenvolvimento neuropsicomotor de crianças e adolescentes com seus fígados nativos e aquelas que realizaram transplante hepático. MÉTODOS: As buscas foram realizadas nas bases de dados PubMed e periódicos Scopus desde as primeiras publicações na década de 1980 até junho de 2019, de estudos observacionais. Um valor de 0,05 foi considerado significativo. A heterogeneidade estatística do efeito do tratamento entre os estudos foi avaliada pelo teste Q de Cochran e o teste de inconsistência I2, no qual valores acima de 25 e 50% foram considerados indicativos de heterogeneidade moderada e alta, respectivamente. As análises foram realizadas com o Review Manager 5.3. RESULTADOS Vinte e cinco estudos preencheram os critérios de elegibilidade, incluindo 909 crianças e adolescentes com doenças hepáticas. As meta-análises mostraram déficits QI total -0,41 (IC 95%: -0,51 até -0,32; N: 9.973), QI verbal -0,38 (IC 95%; -0,57 até -0,18; N: 10.284) e linguagem receptiva -0,85 IC 95%: -1,16 até -0,53; N: 921) nos transplantes hepáticos e as com fígados nativos que apresentaram sintomas precocemente tinham escores de QI total e verbal (85±8,8; 86,3±10,6 respectivamente) menores do que aquelas com manifestações tardias (99,5±13,8; 96,2±9,2). Habilidade motora grossa apresentou-se reduzida -46,29 (IC 95%: -81,55 até -11,03; N: 3.746). CONCLUSÃO: A doença hepática aguda ou crônica pode determinar declínios nas funções cognitivas, motoras e de linguagem. Muito embora, os escores melhorem após transplante hepático, as crianças continuam abaixo da média quando comparadas às crianças sadias. |
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| AbstractList | BACKGROUNDThe nature of liver disease, the evolutionary course and duration of liver diseases, as well as the degree of severity and disability can trigger multiple outcomes with repercussions on neuromotor acquisition and development. OBJECTIVETo systematically review and conduct a meta-analysis to evaluate the effects of liver disease on the neuropsychomotor development of children and adolescents with their native livers and those who underwent liver transplantation. METHODSObservational studies published since the early 1980s until June 2019 were sought in the PubMed and Scopus databases. An α value of 0.05 was considered significant. The statistical heterogeneity of the treatment effect between the studies was assessed by the Cochran's Q test and the I2 inconsistency test, in which values above 25 and 50% were considered indicative of moderate and high heterogeneity, respectively. Analyses were performed with Review Manager 5.3. RESULTSTwenty-five studies met the eligibility criteria, including 909 children and adolescents with liver disease. Meta-analyses showed deficits in total IQ -0.41 (95%CI: -0.51 to -0.32; N: 9,973), verbal IQ -0.38 (95%CI: -0.57 to -0.18; N: 10,284) and receptive language -0.85 (95%CI: -1.16 to -0.53; N: 921) in liver transplantation, and those with native livers who had symptoms early had total and verbal IQ scores (85±8.8; 86.3±10.6 respectively) lower than the scores of those with late manifestations (99.5±13.8; 96.2±9.2). Gross motor skill was reduced -46.29 (95%CI: -81.55 to -11.03; N: 3,746). CONCLUSIONAcute or chronic liver disease can cause declines in cognitive, motor and language functions. Although the scores improve after liver transplantation, children remain below average when compared to healthy children. ABSTRACT BACKGROUND: The nature of liver disease, the evolutionary course and duration of liver diseases, as well as the degree of severity and disability can trigger multiple outcomes with repercussions on neuromotor acquisition and development. OBJECTIVE: To systematically review and conduct a meta-analysis to evaluate the effects of liver disease on the neuropsychomotor development of children and adolescents with their native livers and those who underwent liver transplantation. METHODS: Observational studies published since the early 1980s until June 2019 were sought in the PubMed and Scopus databases. An α value of 0.05 was considered significant. The statistical heterogeneity of the treatment effect between the studies was assessed by the Cochran’s Q test and the I2 inconsistency test, in which values above 25 and 50% were considered indicative of moderate and high heterogeneity, respectively. Analyses were performed with Review Manager 5.3. RESULTS: Twenty-five studies met the eligibility criteria, including 909 children and adolescents with liver disease. Meta-analyses showed deficits in total IQ -0.41 (95%CI: -0.51 to -0.32; N: 9,973), verbal IQ -0.38 (95%CI: -0.57 to -0.18; N: 10,284) and receptive language -0.85 (95%CI: -1.16 to -0.53; N: 921) in liver transplantation, and those with native livers who had symptoms early had total and verbal IQ scores (85±8.8; 86.3±10.6 respectively) lower than the scores of those with late manifestations (99.5±13.8; 96.2±9.2). Gross motor skill was reduced -46.29 (95%CI: -81.55 to -11.03; N: 3,746). CONCLUSION: Acute or chronic liver disease can cause declines in cognitive, motor and language functions. Although the scores improve after liver transplantation, children remain below average when compared to healthy children. ABSTRACT BACKGROUND: The nature of liver disease, the evolutionary course and duration of liver diseases, as well as the degree of severity and disability can trigger multiple outcomes with repercussions on neuromotor acquisition and development. OBJECTIVE: To systematically review and conduct a meta-analysis to evaluate the effects of liver disease on the neuropsychomotor development of children and adolescents with their native livers and those who underwent liver transplantation. METHODS: Observational studies published since the early 1980s until June 2019 were sought in the PubMed and Scopus databases. An α value of 0.05 was considered significant. The statistical heterogeneity of the treatment effect between the studies was assessed by the Cochran’s Q test and the I2 inconsistency test, in which values above 25 and 50% were considered indicative of moderate and high heterogeneity, respectively. Analyses were performed with Review Manager 5.3. RESULTS: Twenty-five studies met the eligibility criteria, including 909 children and adolescents with liver disease. Meta-analyses showed deficits in total IQ -0.41 (95%CI: -0.51 to -0.32; N: 9,973), verbal IQ -0.38 (95%CI: -0.57 to -0.18; N: 10,284) and receptive language -0.85 (95%CI: -1.16 to -0.53; N: 921) in liver transplantation, and those with native livers who had symptoms early had total and verbal IQ scores (85±8.8; 86.3±10.6 respectively) lower than the scores of those with late manifestations (99.5±13.8; 96.2±9.2). Gross motor skill was reduced -46.29 (95%CI: -81.55 to -11.03; N: 3,746). CONCLUSION: Acute or chronic liver disease can cause declines in cognitive, motor and language functions. Although the scores improve after liver transplantation, children remain below average when compared to healthy children. RESUMO CONTEXTO: A natureza da doença hepática, curso evolutivo e duração das hepatopatias, bem como grau de severidade e incapacidade podem desencadear desfechos múltiplos e com repercussões na aquisição e desenvolvimento neuromotores. OBJETIVO: Revisar sistematicamente e avaliar por meta-análise os efeitos da doença hepática sobre o desenvolvimento neuropsicomotor de crianças e adolescentes com seus fígados nativos e aquelas que realizaram transplante hepático. MÉTODOS: As buscas foram realizadas nas bases de dados PubMed e periódicos Scopus desde as primeiras publicações na década de 1980 até junho de 2019, de estudos observacionais. Um valor de 0,05 foi considerado significativo. A heterogeneidade estatística do efeito do tratamento entre os estudos foi avaliada pelo teste Q de Cochran e o teste de inconsistência I2, no qual valores acima de 25 e 50% foram considerados indicativos de heterogeneidade moderada e alta, respectivamente. As análises foram realizadas com o Review Manager 5.3. RESULTADOS Vinte e cinco estudos preencheram os critérios de elegibilidade, incluindo 909 crianças e adolescentes com doenças hepáticas. As meta-análises mostraram déficits QI total -0,41 (IC 95%: -0,51 até -0,32; N: 9.973), QI verbal -0,38 (IC 95%; -0,57 até -0,18; N: 10.284) e linguagem receptiva -0,85 IC 95%: -1,16 até -0,53; N: 921) nos transplantes hepáticos e as com fígados nativos que apresentaram sintomas precocemente tinham escores de QI total e verbal (85±8,8; 86,3±10,6 respectivamente) menores do que aquelas com manifestações tardias (99,5±13,8; 96,2±9,2). Habilidade motora grossa apresentou-se reduzida -46,29 (IC 95%: -81,55 até -11,03; N: 3.746). CONCLUSÃO: A doença hepática aguda ou crônica pode determinar declínios nas funções cognitivas, motoras e de linguagem. Muito embora, os escores melhorem após transplante hepático, as crianças continuam abaixo da média quando comparadas às crianças sadias. |
| Author | GOMES NETO, Mansueto SILVA, Luciana Rodrigues SANTOS, Josiane de Lima dos SAQUETTO, Micheli Bernardone SANTOS, Juliana Costa |
| AuthorAffiliation | Escola Bahiana de Medicina e Saúde Pública Universidade Federal da Bahia |
| AuthorAffiliation_xml | – name: Universidade Federal da Bahia – name: Escola Bahiana de Medicina e Saúde Pública |
| Author_xml | – sequence: 1 givenname: Juliana Costa orcidid: 0000-0002-4718-2353 surname: SANTOS fullname: SANTOS, Juliana Costa organization: Universidade Federal da Bahia, Brasil; Escola Bahiana de Medicina e Saúde Pública, Brasil – sequence: 2 givenname: Micheli Bernardone orcidid: 0000-0003-3211-8102 surname: SAQUETTO fullname: SAQUETTO, Micheli Bernardone organization: Universidade Federal da Bahia, Brasil – sequence: 3 givenname: Mansueto orcidid: 0000-0002-0717-9694 surname: GOMES NETO fullname: GOMES NETO, Mansueto organization: Universidade Federal da Bahia, Brasil – sequence: 4 givenname: Josiane de Lima dos orcidid: 0000-0001-7143-0583 surname: SANTOS fullname: SANTOS, Josiane de Lima dos organization: Universidade Federal da Bahia, Brasil – sequence: 5 givenname: Luciana Rodrigues orcidid: 0000-0003-2995-8581 surname: SILVA fullname: SILVA, Luciana Rodrigues organization: Universidade Federal da Bahia, Brasil |
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| Cites_doi | 10.1002/hep.1840190629 10.1111/jvh.12373 10.1016/j.jpeds.2014.03.032 10.1111/ajt.14924 10.1111/petr.12246 10.1111/ajt.12408 10.1111/j.1600-6143.2008.02480.x 10.1097/MPG.0000000000000575 10.1542/peds.87.3.367 10.1034/j.1399-3046.2003.00026.x 10.1097/MPG.0000000000000757 10.1002/lt.24443 10.1111/j.1600-6143.2010.03363.x 10.1097/MPG.0b013e318259ed20 10.53841/bpsecp.2005.22.4.56 10.1111/ped.13369 10.1016/S0022-3476(89)80696-1 10.1111/j.1399-3046.2010.01451.x 10.1097/00005176-200003000-00011 10.1016/j.jpeds.2017.12.048 10.1016/j.jpeds.2018.01.030 10.1016/S0022-3476(97)70039-8 10.1097/TP.0b013e3181fe1398 10.6061/clinics/2017(06)04 10.1097/MPG.0000000000001981 10.1097/MPG.0b013e318185998f 10.1515/REVNEURO.2008.19.6.395 10.1016/j.jpeds.2009.12.014 |
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| Keywords | child development Doença hepática transplante de fígado desenvolvimento infantil liver transplantation Liver disease |
| Language | English Portuguese |
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In: Neuropsicologia do desenvolvimento: conceitos e abordagens contributor: fullname: Muszkat, M; Mello, CB |
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| Title | NEUROPSYCHOMOTOR DEVELOPMENT IN CHILDREN AND ADOLESCENTS WITH LIVER DISEASES: SYSTEMATIC REVIEW WITH META-ANALYSIS |
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