Visuospatial and Visuomotor Abilities of Individuals with Neurofibromatosis Type 1: A Systematic Review and Meta-analysis.

This meta-analysis estimated the group differences between individuals with and without neurofibromatosis type 1 (NF1) and explored potential moderators. Systematic literature searches identified 2531 unique articles. Among them, 70 studies (183 effect sizes) were included in this meta-analysis, involving 3503 individuals' visuospatial and visuomotor abilities with NF1 (46.67% female; M_age = 12.60 years) and 3127 individuals without NF1 (52.40% female; M_age = 13.19 years). Robust standard error estimation techniques and random models were used to calculate standardized group differences. The results showed that individuals with (vs. without) NF1 exhibited significantly lower visuospatial (g =  - 0.90; 95% CI [- 1.00, - 0.80], I² = 64.59%) and visuomotor abilities (g =  - 0.90; 95% CI [- 1.05, - 0.75], I² = 74.87%). The moderator analysis revealed that group differences in visuospatial abilities were larger for children with NF1 (g =  - 0.95; 95% CI [- 1.06, - 0.84]) than adolescents (g =  - 0.64; 95% CI [- 0.91, - 0.37]) and adults (g =  - 0.73; 95% CI [- 0.88, - 0.58]). Additionally, a greater between-group difference was found when visuospatial abilities were assessed using Judgment of Line Orientation (g =  - 1.06; 95% CI [- 1.17, - 0.94]) than Wechsler Intelligence Scale-Visual Spatial Index (g =  - 0.70; 95% CI [- 0.86, - 0.54]). Sex composition, NF1 inheritance mode, IQ, learning disorder, ADHD, types of control group, sampling method, and exclusion criteria of NF1 participants were not significant moderators. The substantial visuospatial and visuomotor deficits in the NF1 population highlight the necessity for targeted interventions, and considerable between-study heterogeneity underscores that further exploration of predictors is needed.