Effectiveness of sensory integration therapy in children,focusing on Korean children:A systematic review and meta-analysis

BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.

Auditory event-related brain potentials for an early discrimination between normal and pathological brain aging

The brain as a system with gradually decreasing resources maximizes its chances by reorganizing neural networks to ensure efficient performance. Auditory event-related potentials were recorded in 28 healthy volunteers comprising 14 young and 14 elderly subjects in auditory discrimination motor task （low frequency tone - right hand movement and high frequency tone - left hand movement）. The amplitudes of the sensory event-related potential components （N1, P2） were more pronounced with increasing age for either tone and this effect for P2 amplitude was more pronounced in the frontal region. The latency relationship of N1 between the groups was tone-dependent, while that of P2 was tone-independent with a prominent delay in the elderly group over all brain regions. The amplitudes of the cognitive components （N2, P3） diminished with increasing age and the hemispheric asymmetry of N2 （but not for P3） reduced with increasing age. Prolonged N2 latency with increasing age was widespread for either tone while between-group difference in P3 latency was tone-dependent. High frequency tone stimulation and movement requirements lead to P3 delay in the elderly group. The amplitude difference of the sensory components between the age groups could be due to a general greater alertness, less expressed habituation, or decline in the ability to retreat attentional resources from the stimuli in the elderly group. With aging, a neural circuit reorganization of the brain activity affects the cognitive processes. The approach used in this study is useful for an early discrimination between normal and pathological brain aging for early treatment of cognitive alterations and dementia.

Psychiatric disorders and pain:The recurrence of a comorbidity

Painful conditions are probably among the most frequent reasons for seeking medical advice and assistance.Although pain is a common complaint among psychiatric patients,clinicians generally separate its presence from the background mental disorder and downplay its importance,trying primarily to control the psychiatric symptomatology.As a sensory modality,the presence of pain and its importance account for an impressive body of scholarly research.Cartesian methodology considered sensations of all modalities in a mechanistic form,which actually sounds obsolete.However,authors have continuously been faced with the same dilemmas plaguing scholars for centuries.We assume that a large portion of the sensory inputs might be generators of distorted perceptions,which subsequently lead to psychopathology.Auditory and visual hallucinations are incontestable examples.Somaesthetic hallucinations also exist,but pain hardly deserves such a denomination.Nevertheless,chronic pain and psychiatric comorbidity is a reality that needs explanation.Painkillers are not effective in treating psychiatric disorders,and antipsychotics do very little,perhaps nothing,to relieve pain.The pharmacological approach opens one door on the horizon and closes many others,while clinicians continue to face a high prevalence of comorbid pain and mental health issues.However,attempts to correlate altered body schemata(as distorted as it may be,for example,in phantom limb pain) with somatic delusions can simplify all these dilemmas,and the basket of psychophysiology,in fact,might be bigger than presumed.

Neurocircuitry of Predatory Hunting

Predatory hunting is an important type of innate behavior evolutionarily conserved across the animal king-dom.It is typically composed of a set of sequential actions,including prey search,pursuit,attack,and consumption.This behavior is subject to control by the nervous system.Early studies used toads as a model to probe the neuroethology of hunting,which led to the proposal of a sensory-triggered release mechanism for hunting actions.More recent stud-ies have used genetically-trackable zebrafish and rodents and have made breakthrough discoveries in the neuroethol-ogy and neurocircuits underlying this behavior.Here,we review the sophisticated neurocircuitry involved in hunting and summarize the detailed mechanism for the circuitry to encode various aspects of hunting neuroethology,including sensory processing,sensorimotor transformation,motivation,and sequential encoding of hunting actions.We also discuss the overlapping brain circuits for hunting and feeding and point out the limitations of current studies.We propose that hunting is an ideal behavioral paradigm in which to study the neuroethology of motivated behaviors,which may shed new light on epidemic disorders,including bingeeating,obesity,and obsessive-compulsive disorders.

Alterations of Audiovisual Integration in Alzheimer’s Disease

Audiovisual integration is a vital information process involved in cognition and is closely correlated with aging and Alzheimer’s disease(AD).In this review,we evaluated the altered audiovisual integrative behavioral symptoms in AD.We further analyzed the relationships between AD pathologies and audiovisual integration alterations bidirectionally and suggested the possible mechanisms of audiovisual integration alterations underlying AD,including the imbalance between energy demand and supply,activity-dependent degeneration,disrupted brain networks,and cognitive resource overloading.Then,based on the clinical characteristics including electrophysiological and imaging data related to audiovisual integration,we emphasized the value of audiovisual integration alterations as potential biomarkers for the early diagnosis and progression of AD.We also highlighted that treatments targeted audiovisual integration contributed to widespread pathological improvements in AD animal models and cognitive improvements in AD patients.Moreover,investigation into audiovisual integration alterations in AD also provided new insights and comprehension about sensory information processes.

Recent advances in the neural regulation of feeding behavior in adult Drosophila

The ability to maintain metabolic homeostasis is a key capability critical for the survival and well-being of animals living in constantly changing environments.Metabolic homeostasis depends on neuromodulators,such as biogenic amines,neuropeptides,and hormones,to signal changes in animals’ internal metabolic status and to orchestrate their behaviors accordingly.An important example is the regulation of feeding behavior by conserved molecular and cellular mechanisms across the animal kingdom.Its relatively simple brain coupled with well-characterized genetics and behavioral paradigms makes the fruit fly Drosophila melanogaster an excellent model for investigating the neuromodulatory regulation of feeding behavior.In this review we discuss the neuromodulators and neural circuits that integrate the internal physiological status with external sensory cues and modulate feeding behavior in adult fruit flies.Studies show that various specific aspects of feeding behavior are subjected to unique neuromodulatory regulation,which permits fruit flies to maintain metabolic homeostasis effectively.