Browsing by Author "Pringsheim, Tamara"

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    An Examination of Sensorimotor Function in Children with Autism Spectrum Disorder Using Robotic Measurement
    (2021-04-30) Moghe, Ishita; Murias, Kara; Pringsheim, Tamara; Dukelow, Sean P; Gibbard, William B
    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by social impairments and restricted and stereotyped behaviours. Sensorimotor deficits in children with ASD have been widely reported clinically but lack reproducible quantified measures. Children with ASD can display a wide range of symptoms and symptom severity and sensorimotor abilities vary greatly within the population. The primary aims of this exploratory study were to precisely quantify sensorimotor function in a group of children with ASD, and to determine how sensorimotor function is associated with aspects of daily life and behaviour in children with ASD. We used the Kinarm exoskeleton robot to measure upper limb function through established task protocols. We examined motor abilities (visually guided reaching task), sensory and proprioceptive function (arm position matching task), and cognitive-motor integration (object hit and avoid task). Kinarm scores in the ASD group (n = 31) were standardized using a typically developing group (n = 150), showing significant differences in reaction time, accuracy, consistency, and inhibition. To examine symptom severity in terms of social and adaptive function, we collected Social Responsiveness Scale-2 (SRS) and Vineland Adaptive behaviour Scales-3 (VABS) caregiver responses from the ASD group. We found that Kinarm scores correlated most often with VABS adaptive behaviour composite score and VABS communication domain score, suggesting that sensorimotor impairments are associated with the daily lives and social communication of children with ASD. Overall, we were able to quantify sensorimotor deficits in children with ASD and link them to daily behaviour.
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    Developing a provincial patient support network for children and families affected by Tourette syndrome and/or obsessive–compulsive disorder: results of a stakeholder consultation
    (2021-06-16) Fletcher, Julian; Dimitropoulos, Gina; Martino, Davide; Wilcox, Gabrielle; MacMaster, Frank; Arnold, Paul; Pringsheim, Tamara
    Abstract Background Tourette syndrome and OCD are disorders that frequently occur in children and cause a high level of disability. In Alberta there is a huge delivery gap in providing healthcare services for children with TS and OCD. A stakeholder consultation was performed to ascertain how service delivery could be improved across the province and to inform the development of a provincial information and support organization, the Tourette OCD Alberta Network. Methods A mixed-methods study was employed: 10 parents were recruited for interview and 140 parents responded to a survey. Results Qualitative data showed there was often an absence of a clear pathway to access healthcare for people with TS and OCD. The negative impact of not receiving treatment, information, and resources in a timely and prompt manner was also revealed. Good clinical practice existed across the province but too often it was hindered by a shortage of knowledge about TS and OCD. In schools, learning for students with TS and OCD was also impaired by educators’ lack of knowledge and preparedness in relation to the disorders. Conclusions This study identified ways that challenges with healthcare access, school learning, and seeking information can be overcome. Skills-based training webinars, educational outreach in schools, and peer support were recognized as actions for improving healthcare outcomes for people with TS and OCD. The aim of the Tourette OCD Alberta Network is to provide services and support that directly address the healthcare service delivery shortfalls shown in this study.
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    Inhibitory Control Deficits in Children with Tic Disorders Revealed by Object-Hit-and-Avoid Task
    (2021-07-02) Cothros, Nicholas; Medina, Alex; Martino, Davide; Dukelow, Sean P.; Hawe, Rachel L.; Kirton, Adam; Ganos, Christos; Nosratmirshekarlou, Elaheh; Pringsheim, Tamara
    Background. Tic disorders may reflect impaired inhibitory control. This has been evaluated using different behavioural tasks, yielding mixed results. Our objective was to test inhibitory control in children with tics through simultaneous presentation of multiple, mobile stimuli. Methods. Sixty-four children with tics (mean age 12.4 years; 7.5-18.5) were evaluated using a validated robotic bimanual exoskeleton protocol (Kinarm) in an object-hit-and-avoid task, in which target and distractor objects moved across a screen and participants aimed to hit only the targets while avoiding distractors. Performance was compared to 146 typically developing controls (mean age 13 years; 6.1-19.9). The primary outcome was the percentage of distractors struck. Results. ANCOVA (age as covariate) showed participants struck significantly more distractors (participants without comorbid ADHD, 22.71% [SE 1.47]; participants with comorbid ADHD, 23.56% [1.47]; and controls, 15.59% [0.68]). Participants with comorbid ADHD struck significantly fewer targets (119.74 [2.77]) than controls, but no difference was found between participants without comorbid ADHD (122.66 [2.77]) and controls (127.00 [1.28]). Participants and controls did not differ significantly in movement speed and movement area. Just over 20% of participants with tics fell below the age-predicted norm in striking distractors, whereas fewer than 10% fell outside age-predicted norms in other task parameters. Conclusions. In children with tics (without comorbid ADHD), acting upon both targets and distractors suggests reduced ability to suppress responses to potential triggers for action. This may be related to increased sensorimotor noise or abnormal sensory gating.
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    Is the Prevalence of Major Depression Increasing in Canadian Adolescents? Assessing Trends from 2000 to 2014.
    (2016) Wiens, Kathryn; Patten, Scott; Duffy, Anne; Pringsheim, Tamara; Sajobi, Tolulope
    Objective: The aim of this thesis was to determine whether there is evidence of an epidemic of major depression in Canadian adolescents. Methods: Prevalence estimates for major depressive episodes (MDE) were derived from a series of Canadian Community Health Surveys. Meta regression and graphical analyses were used to evaluate trends over time. Results: The findings do not support an increase in MDE prevalence in Canadian adolescents from 2000 to 2014 (=0.0006; p=0.532). Age and sex groups did not modify the observance of trends. A post hoc analysis observed mood disorder diagnosis to increase from 2003 to 2014 (=0.0012; p=0.024). Conclusion: MDE prevalence in adolescents has remained relatively stable over the past 15 years. These results suggest mood disorder diagnosis is increasing, which may contribute to the popular belief of an epidemic in adolescents. Policy makers may need to incorporate increasing need of services into future planning.
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    Perspectives on neurological patient registries: a literature review and focus group study
    (BioMed Central, 2013-11-09) Korngut, Lawrence; MacKean, Gail; Casselman, Lisa; Johnston, Megan; Day, Lundy; Lam, Darren; Lorenzetti, Diane; Warner, Janet; Jetté, Nathalie; Pringsheim, Tamara
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    Prenatal risk factors for Tourette Syndrome: a systematic review
    (BioMed Central, 2014-01-30) Chao, Ting-Kuang; Hu, Jing; Pringsheim, Tamara
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    Second-Generation Antipsychotics and Metabolic Side Effects in the Canadian Population
    (2016) Hirsch, Lauren Elizabeth; Pringsheim, Tamara; Patten, Scott; Jette, Nathalie; Bresee, Lauren
    The use of second-generation antipsychotic (SGA) has increased substantially in Canada over the last decade. Though an association has been found between SGAs and metabolic dysfunction in randomized controlled trials (RCTs), this information might not be generalizable to all SGA users. Furthermore, SGA use has been inadequately characterized in the population. This thesis aimed to quantify trends in SGA use and the effect of SGAs on indicators of metabolic dysfunction in the Canadian population through two studies: i) a systematic review the literature on population-based studies of SGA use and their associated metabolic harms, and ii) a cross-sectional analysis of SGA use using the Canadian Health Measures Survey (CHMS). The results of this thesis showed SGA use has tripled in Canada between 2007 and 2013 and confirmed the presence of metabolic dysfunction and poor health in SGA users in the general household population.
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    The Prevalence and Incidence of Dementia Due to Alzheimer's Disease: a Systematic Review and Meta-Analysis
    (CAMBRIDGE UNIV PRESS, 2016) Fiest, Kirsten M.; Roberts, Jodie I.; Maxwell, Colleen J.; Hogan, David B.; Smith, Eric E.; Frolkis, Alexandra; Cohen, Adrienne; Kirk, Andrew; Pearson, Dawn; Pringsheim, Tamara; Venegas-Torres, Andres; Jette, Nathalie
    Background: Updated information on the epidemiology of dementia due to Alzheimer's disease (AD) is needed to ensure that adequate resources are available to meet current and future healthcare needs. We conducted a systematic review and meta-analysis of the incidence and prevalence of AD. Methods: The MEDLINE and EMBASE databases were searched from 1985 to 2012, as well as the reference lists of selected articles. Included articles had to provide an original population-based estimate for the incidence and/or prevalence of AD. Two individuals independently performed abstract and full-text reviews, data extraction and quality assessments. Random-effects models were employed to generate pooled estimates stratified by age, sex, diagnostic criteria, location (i.e., continent) and time (i.e., when the study was done). Results: Of 16,066 abstracts screened, 707 articles were selected for full-text review. A total of 119 studies met the inclusion criteria. In community settings, the overall point prevalence of dementia due to AD among individuals 60 + was 40.2 per 1000 persons (CI95%: 29.1-55.6), and pooled annual period prevalence was 30.4 per 1000 persons (CI95%: 15.6-59.1). In community settings, the overall pooled annual incidence proportion of dementia due to AD among individuals 60 + was 34.1 per 1000 persons (CI95%: 16.4-70.9), and the incidence rate was 15.8 per 1000 person-years (CI95%: 12.9-19.4). Estimates varied significantly with age, diagnostic criteria used and location (i.e., continent). Conclusions: The burden of AD dementia is substantial. Significant gaps in our understanding of its epidemiology were identified, even in a high-income country such as Canada. Future studies should assess the impact of using such newer clinical diagnostic criteria for AD dementia such as those of the National Institute on Aging-Alzheimer's Association and/or incorporate validated biomarkers to confirm the presence of Alzheimer pathology to produce more precise estimates of the global burden of AD.
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    The Prevalence and Incidence of Dementia: a Systematic Review and Meta-analysis
    (CAMBRIDGE UNIV PRESS, 2016) Fiest, Kirsten M.; Jette, Nathalie; Roberts, Jodie I.; Maxwell, Colleen J.; Smith, Eric E.; Black, Sandra E.; Blaikie, Laura; Cohen, Adrienne; Day, Lundy; Holroyd-Leduc, Jayna; Kirk, Andrew; Pearson, Dawn; Pringsheim, Tamara; Venegas-Torres, Andres; Hogan, David B.
    Introduction: Dementia is a common neurological condition affecting many older individuals that leads to a loss of independence, diminished quality of life, premature mortality, caregiver burden and high levels of healthcare utilization and cost. This is an updated systematic review and meta-analysis of the worldwide prevalence and incidence of dementia. Methods: The MEDLINE and EMBASE databases were searched for relevant studies published between 2000 (1985 for Canadian papers) and July of 2012. Papers selected for full-text review were included in the systematic review if they provided an original population-based estimate for the incidence and/or prevalence of dementia. The reference lists of included articles were also searched for additional studies. Two individuals independently performed abstract and full-text review, data extraction, and quality assessment of the papers. Random-effects models and/or meta-regression were used to generate pooled estimates by age, sex, setting (i.e., community, institution, both), diagnostic criteria utilized, location (i.e., continent) and year of data collection. Results: Of 16,066 abstracts screened, 707 articles were selected for full-text review. A total of 160 studies met the inclusion criteria. Among individuals 60 and over residing in the community, the pooled point and annual period prevalence estimates of dementia were 48.62 (CI95%: 41.98-56.32) and 69.07 (CI95%: 52.36-91.11) per 1000 persons, respectively. The respective pooled incidence rate (same age and setting) was 17.18 (CI95%: 13.90-21.23) per 1000 person-years, while the annual incidence proportion was 52.85 (CI95%: 33.08-84.42) per 1,000 persons. Increasing participant age was associated with a higher dementia prevalence and incidence. Annual period prevalence was higher in North America than in South America, Europe and Asia (in order of decreasing period prevalence) and higher in institutional compared to community and combined settings. Sex, diagnostic criteria (except for incidence proportion) and year of data collection were not associated with statistically significant different estimates of prevalence or incidence, though estimates were consistently higher for females than males. Conclusions: Dementia is a common neurological condition in older individuals. Significant gaps in knowledge about its epidemiology were identified, particularly with regard to the incidence of dementia in low- and middle-income countries. Accurate estimates of prevalence and incidence of dementia are needed to plan for the health and social services that will be required to deal with an aging population.
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    The Prevalence and Incidence of Frontotemporal Dementia: a Systematic Review
    (CAMBRIDGE UNIV PRESS, 2016) Hogan, David B.; Jette, Nathalie; Fiest, Kirsten M.; Roberts, Jodie I.; Pearson, Dawn; Smith, Eric E.; Pamela Roach; Kirk, Andrew; Pringsheim, Tamara; Maxwell, Colleen J.
    Background Population-based prevalence and incidence studies are essential for understanding the burden of frontotemporal dementia (FTD). Methods The MEDLINE and EMBASE databases were searched to identify population-based publications from 1985 to 2012, addressing the incidence and/or prevalence of FTD. References of included articles and prior systematic reviews were searched for additional studies. Two reviewers screened all abstracts and full-text reviews, abstracted data and performed quality assessments. Results Twenty-six studies were included. Methodological limitations led to wide ranges in the estimates for prevalence (point prevalence 0.01-4.6 per 1000 persons; period prevalence 0.16-31.04 per 1000 persons) and incidence (0.0-0.3 per 1000 person-years). FTD accounted for an average of 2.7% (range 0-9.1%) of all dementia cases among prevalence studies that included subjects 65 and older compared to 10.2% (range 2.8-15.7%) in studies restricted to those aged less than 65. The cumulative numbers of male (373 [52.5%]) and female (338 [47.5%]) cases from studies reporting this information were nearly equal (p=0.18). The behavioural variant FTD (bvFTD) was almost four times as common as the primary progressive aphasias. Conclusions Population-based estimates for the epidemiology of FTD varied widely in the included studies. Refinements in the diagnostic process, possibly by the use of validated biomarkers or limiting case ascertainment to specialty services, are needed to obtain more precise estimates of the prevalence and incidence of FTD.
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    Understanding the Barriers to Guideline Use for Depression & Anxiety in Patients with Parkinson's Disease and Dementia.
    (2016) Goodarzi, Zahra; Holroyd-Leduc, Jayna M.; Hanson, Heather; Jette, Nathalie; Patten, Scott; Pringsheim, Tamara
    Background: Depression or anxiety are under-diagnosed and under-treated in those with dementia or Parkinson’s disease (PD). Objectives: The objectives of this thesis were to first understand what high quality guideline recommendations exist for depression or anxiety in dementia or PD. Secondly to explore the barriers and facilitators to implementing these guidelines. Methods: A systematic review of guidelines was completed, following the PRISMA statement and using the AGREE II tool to assess quality. In focus groups with stakeholders, we assessed the barriers and facilitators to guideline use and implementation. Results: Guideline quality scores were lowest for stakeholder involvement, applicability, and editorial independence. Major barriers to use included a lack of evidence, lack of applicability to the practice population, impractical or out of date recommendations. Conclusions: There are guideline recommendations for depression or anxiety in dementia and PD. However, practitioners have difficulty with implementation due to a lack of evidence and applicability.