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Ojuri B, DeRonda A, Plotkin M, Mostofsky SH, Rosch KS. The Impact of Sex on Cognitive Control in ADHD: Girls Slow to Inhibit, Boys Inhibit Less, and Both Show Higher Response Variability. J Atten Disord 2024; 28:1275-1288. [PMID: 38491856 PMCID: PMC11166527 DOI: 10.1177/10870547241237242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To determine whether girls and boys with ADHD show distinct impairments in components of cognitive control across multiple tasks (go/no-go, stop signal, and flanker) and performance metrics (response speed, variability, and errors). METHOD A total of 300 children, ages 8 to 12 years with ADHD (n = 210, 58 girls) or typically developing (TD; n = 99, 37 girls), completed all tasks. Traditional response measures (e.g., mean and standard deviation of reaction time, inhibition errors, and stop signal reaction time) and ex-Gaussian modeling of reaction times (mu, sigma, and tau) were analyzed. RESULTS Girls showed intact response inhibition in the context of slower response speed, while boys made more inhibition errors and did not slow their response speed. Both girls and boys with ADHD showed higher response variability and poorer interference control than TD children. CONCLUSION Girls and boys with ADHD show distinct impairments in cognitive control that may be important for understanding the pathophysiology of ADHD.
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Affiliation(s)
| | | | | | - Stewart H. Mostofsky
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School Medicine, Baltimore, MD, USA
| | - Keri S. Rosch
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School Medicine, Baltimore, MD, USA
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2
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Li X, Motwani C, Cao M, Martin E, Halperin JM. Working Memory-Related Neurofunctional Correlates Associated with the Frontal Lobe in Children with Familial vs. Non-Familial Attention Deficit/Hyperactivity Disorder. Brain Sci 2023; 13:1469. [PMID: 37891836 PMCID: PMC10605263 DOI: 10.3390/brainsci13101469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence, heritability, and heterogeneity. Children with a positive family history of ADHD have a heightened risk of ADHD emergence, persistence, and executive function deficits, with the neural mechanisms having been under investigated. The objective of this study was to investigate working memory-related functional brain activation patterns in children with ADHD (with vs. without positive family histories (ADHD-F vs. ADHD-NF)) and matched typically developing children (TDC). Voxel-based and region of interest analyses were conducted on two-back task-based fMRI data of 362 subjects, including 186, 96, and 80 children in groups of TDC, ADHD-NF, and ADHD-F, respectively. Relative to TDC, both ADHD groups had significantly reduced activation in the left inferior frontal gyrus (IFG). And the ADHD-F group demonstrated a significant positive association of left IFG activation with task reaction time, a negative association of the right IFG with ADHD symptomatology, and a negative association of the IFG activation laterality index with the inattention symptom score. These results suggest that working memory-related functional alterations in bilateral IFGs may play distinct roles in ADHD-F, with the functional underdevelopment of the left IFG significantly informing the onset of ADHD symptoms. Our findings have the potential to assist in tailored diagnoses and targeted interventions in children with ADHD-F.
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Affiliation(s)
- Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (C.M.); (M.C.); (E.M.)
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Chirag Motwani
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (C.M.); (M.C.); (E.M.)
- Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ 07102, USA
| | - Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (C.M.); (M.C.); (E.M.)
- Graduate School of Biomedical Sciences, Rutgers University, Newark, NJ 07102, USA
| | - Elizabeth Martin
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA; (C.M.); (M.C.); (E.M.)
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jeffrey M. Halperin
- Department of Psychology, Queens College, City University of New York, New York, NY 11367, USA;
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Tallberg P, Rastam M, Hallin AL, Perrin S, Gustafsson P. A longitudinal investigation of parental ratings and performance metrics for executive functioning and symptom severity in clinically referred youth with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:259-271. [PMID: 36126650 DOI: 10.1080/21622965.2022.2093113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from childhood/adolescence to young adulthood. This was done by examining possible improvements in parent-rated EF and performance-based measures of inattention and inhibition over a three-year interval and their relationship to ADHD outcomes in 137 clinically referred youth with ADHD (mean age = 12.4 years, SD = 3.1). Participants' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Swanson-Nolan-Pelham Scale at baseline and follow-up. Participants completed the Conners' Continuous Performance Test, Version II (CPT II) at baseline and follow-up. Statistical analyses were performed with Linear Mixed Models. The sex- and age-standardized measures Commission and Hit reaction time (RT) subscales of the CPT II and parent-rated metacognitive, and behavior regulation composites of the BRIEF were largely stable between measuring points. CPT Omissions, Hit RT standard error (reaction time variability), and parent-rated ADHD symptom scores improved slightly. BRIEF composites and reaction time variability were related to ADHD symptoms using longitudinal data. Overall, behavioral aspects of EF, as observed by parents in the home context, appear to play a significant role in the trajectory of childhood ADHD.
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Affiliation(s)
- Pia Tallberg
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Maria Rastam
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Skane, Lund, Sweden
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Wolff B, Franco VR, Magiati I, Pestell CF, Glasson EJ. Neurocognitive and self-reported psychosocial and behavioral functioning in siblings of individuals with neurodevelopmental conditions: a study using remote self-administered testing. J Clin Exp Neuropsychol 2023; 45:513-536. [PMID: 37779193 DOI: 10.1080/13803395.2023.2259042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE This study compared and explored the neurocognitive profiles of siblings of persons with and without neurodevelopmental conditions (NDCs) and associations between objective test performance and self-reported psychosocial functioning. METHODS Siblings of persons with and without NDCs (64 NDC and 64 control siblings; mean age 19.88 years, range 11-27 years, 73.44% female, 75.78% White Caucasian) completed self-report questionnaires and self-administered computerized neurocognitive tests of executive functioning (EF). Using Bayesian analyses, we examined cross-sectional associations between self-reported psychosocial functioning and cognitive test performance, and predictors of EF over 15 months. RESULTS NDC siblings had poorer working memory, inhibition, attention, and shifting compared to controls, as measured by experimental paradigms on the backward Corsi span, N-Back 2-back task, Stop Signal Task, Sustained Attention to Response Task, and the Wisconsin Card Sorting Test (effect size δ ranging 0.49 to 0.64). Bayesian cross-sectional networks revealed negative emotion reactivity and working memory difficulties were central to the NDC sibling network. Over 15 months, poorer EF (k low test scores) was predicted by negative emotion reactivity, sleep problems, and anxiety, over and above effects of age and subclinical autistic and ADHD traits. Siblings of autistic individuals and persons with fetal alcohol spectrum disorder had higher rates of neurocognitive and psychiatric difficulties than other NDCs and controls (Bayes factors >20). CONCLUSIONS Neurocognitive difficulties were associated with transdiagnostic vulnerability to poorer wellbeing in NDC siblings. These findings demonstrate the feasibility of remote online cognitive testing and highlight the importance of individualized prevention and intervention for NDC siblings.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
- Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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Longitudinal investigation in children and adolescents with ADHD and healthy controls: A 2-year ERP study. Int J Psychophysiol 2023; 183:117-129. [PMID: 36356923 DOI: 10.1016/j.ijpsycho.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
Cross-sectional group comparisons have shown altered neurocognitive and neurophysiological profiles in individuals with attention-deficit/hyperactivity disorder (ADHD). We report a two-year longitudinal observational study of ADHD children and adolescents (N = 239) regarding ADHD symptoms, behavioral metrics, and event-related potentials (ERP) and compared them to healthy controls (N = 91). The participants were assessed up to five times with a cued Go/NoGo task while ERPs were recorded. We fitted the trajectories of our variables of interest with univariate and bivariate latent growth curve models. At baseline, the ADHD group had increased reaction time variability, higher number of omission and commission errors, and attenuated CNV and P3d amplitudes compared to controls. The task performance in terms of behavioral metrics improved in both groups over two years; however, with differential patterns: the decrease in reaction time and omission errors were stronger in the control group, and the reduction of commission errors was more substantial in the ADHD group. The cueP3, CNV, and N2d amplitudes changed slightly over two years, with negligible differences between both groups. Furthermore, the parent-rated symptom burden in the ADHD group decreased by 22 % (DSM-5-based questionnaire). We did not identify any associations between the changes in symptoms and the changes in the behavioral or neurophysiological metrics. The lack of association between the changes in symptoms and the behavioral or ERP metrics supports the trait liability hypothesis, which claims that the neurocognitive deficits are independent of symptom alleviation. Furthermore, the change in symptom burden was substantial, questioning the stability of the reported ADHD symptoms.
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Thorell LB, Fuermaier ABM, Christiansen H, Steinmayr R, Baeyens D, de la Peña AG, Groom MJ, Idrees I, van der Oord S, van den Hoofdakker BJ, Luman M, Mammarella IC, Skoglund C. Distance learning during the COVID-19 pandemic for children with ADHD and/or ASD: a European multi-center study examining the role of executive function deficits and age. Child Adolesc Psychiatry Ment Health 2022; 16:101. [PMID: 36514179 PMCID: PMC9745722 DOI: 10.1186/s13034-022-00540-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND One of the COVID-19 pandemic consequences that has affected families the most is school lockdowns. Some studies have shown that distance learning has been especially challenging for families with a child with neurodevelopmental disorders such as ADHD or ASD. However, previous studies have not taken the heterogeneity of these disorders into account. The aim of the present study was therefore to investigate differences between families with a child with ADHD, ASD, or both conditions, and to examine the role of underlying deficits in executive functioning (EF) in both children and parents in relation to negative and positive effects of distance learning. METHODS Survey data assessing both negative and positive experiences of distance learning were collected from parents with a child aged 5-19 years in seven Western European countries: the UK, Germany, Spain, Sweden, the Netherlands, Italy, and Belgium. Altogether, the study included 1010 families with a child with ADHD and/or ASD and an equally large comparison group of families with a child without mental health problems. We included measures of three different types of negative effects (i.e., effects on the child, effects on the parent, and lack of support from school) and positive effects on the family. RESULTS Results confirmed that families with a child with ADHD, ASD or a combination of ADHD and ASD showed higher levels of both negative and positive effects of distance learning than the comparison group. However, few differences were found between the clinical groups. Group differences were more pronounced for older compared to younger children. Regarding the role of both ADHD/ASD diagnosis and EF deficits, primarily children's EF deficits contributed to high levels of negative effects. Parent EF deficits did not contribute significantly beyond the influence of child EF deficits. Families of children with ADHD/ASD without EF deficits experienced the highest levels of positive effects. CONCLUSIONS School closings during COVID-19 have a major impact on children with EF problems, including children with neurodevelopmental disorders. The present study emphasizes that schools should not focus primarily on whether a student has a neurodevelopmental disorder, but rather provide support based on the student's individual profile of underlying neuropsychological deficits.
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Affiliation(s)
- Lisa B. Thorell
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9, 17177 Stockholm, Sweden
| | | | | | | | - Dieter Baeyens
- grid.5596.f0000 0001 0668 7884KU Leuven, Leuven, Belgium
| | | | | | - Iman Idrees
- grid.4563.40000 0004 1936 8868University of Nottingham, Nottingham, UK
| | | | - Barbara J. van den Hoofdakker
- grid.4494.d0000 0000 9558 4598University Medical Center Groningen, University of Groningen & Accare Child Study Center, Groningen, The Netherlands
| | - Marjolein Luman
- grid.16872.3a0000 0004 0435 165XVrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, & Levvel, Specialists in Youth and Family Care, Amsterdam, The Netherlands
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The three-year outcome of emotional symptoms in clinically referred youth with ADHD and their relationship to neuropsychological functions. Scand J Child Adolesc Psychiatr Psychol 2022; 10:72-86. [PMID: 35903554 PMCID: PMC9284941 DOI: 10.2478/sjcapp-2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Further knowledge is needed regarding long-term outcome of emotional symptoms, and the interplay between these symptoms and neuropsychological functioning in youth with attention deficit hyperactivity disorder (ADHD). Objective We aimed to explore the effect of performance-based neurocognitive functions and parent-rated behavioral executive functioning (EF) on self-rated and parent-rated internalizing symptoms longitudinally in clinically referred youth with ADHD (n = 137; mean age = 12.4 years). We also aimed to examine the change in self-rated emotional symptoms in the ADHD group and a Control group (n = 59; mean age = 11.9 years). Method At baseline, and three years later, parents completed rating scales of their child’s ADHD symptoms (Swanson Nolan Pelham Scale, Version IV – SNAP-IV), emotional symptoms (Five To Fifteen Questionnaire, Strengths, and Difficulties Questionnaire), and EF (Behavior Rating Inventory of Executive Function). At the same time, the child completed self-report measures of Anxiety, Depression, and Anger Inventories (the Beck Youth Inventories) and neurocognitive measures (Conner’s Continuous Performance Test, Version II (CPT-II), Working Memory and Processing Speed composites (Wechsler Intelligence Scales). Statistical analyses were linear and logistic mixed models. Results Using longitudinal data, parent- and self-ratings of emotional symptoms were associated with parent-ratings of EF behavior in youth with ADHD. Plan/organizing deficits were associated with Anxiety and Anger over and above other metacognitive subscales, while Emotional Control was related to Anger over and above other behavior regulation subscales. In the ADHD group, Anger symptoms improved across measuring points. When controlling for age, Anxiety, and Depression symptoms were largely stable in both groups, however at higher levels in the ADHD group. The differences in anxiety and depression symptoms across groups decreased over time. Conclusions The current study emphasizes the importance of identification, monitoring, and treatment of emotional symptoms, and behavioral aspects of EF in youth with ADHD.
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Marx I, Cortese S, Koelch MG, Hacker T. Meta-analysis: Altered Perceptual Timing Abilities in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:866-880. [PMID: 34923055 DOI: 10.1016/j.jaac.2021.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We meta-analyzed studies comparing perceptual timing abilities in the range of milliseconds to several seconds in persons with attention-deficit/hyperactivity disorder (ADHD) and neurotypical participants, using the well-established time discrimination, time estimation, time production, and time reproduction paradigms. METHOD We searched PubMed, OVID databases, and Web of Knowledge through September 17, 2020. From 2,266 records, 55 studies were retained and meta-analyzed with random effects models. We conducted meta-regression analyses to explore moderating effects of task parameters and neuropsychological measures of working memory, attention, and inhibition on timing performance. RESULTS Compared with persons without ADHD, those with ADHD had significantly more severe difficulties in discriminating stimuli of very brief durations, especially in the sub-second range. They also had more variability in estimating the duration of stimuli lasting several seconds. Moreover, they showed deficits in time estimation and time production accuracy, indicative of an accelerated internal clock. Additional deficits in persons with ADHD were also found in the time reproduction paradigm, involving attentional (slower counting at short time intervals due to distraction) and motivational (faster counting at long time intervals due to increased delay aversion) functions. CONCLUSION There is meta-analytic evidence of a broad range of timing deficits in persons with ADHD. Results have implications for advancing our knowledge in the field (eg, for refinement of recent timing models in ADHD) and clinical practice (eg, testing timing functions to characterize the clinical phenotype of the patient and implementation of interventions to improve timing abilities).
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Affiliation(s)
- Ivo Marx
- Rostock University Medical Center, Rostock, Germany.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, United Kingdom; New York University Grossman School of Medicine, New York
| | | | - Thomas Hacker
- Rostock University Medical Center, Rostock, Germany; Helios Hanseklinikum Stralsund, Stralsund, Germany
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Münger M, Sele S, Candrian G, Kasper J, Abdel-Rehim H, Eich-Höchli D, Müller A, Jäncke L. Longitudinal Analysis of Self-Reported Symptoms, Behavioral Measures, and Event-Related Potential Components of a Cued Go/NoGo Task in Adults With Attention-Deficit/Hyperactivity Disorder and Controls. Front Hum Neurosci 2022; 16:767789. [PMID: 35250513 PMCID: PMC8894259 DOI: 10.3389/fnhum.2022.767789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
This study characterizes a large sample of adults with attention-deficit/hyperactivity disorder (ADHD) and healthy controls regarding their task performance and neurophysiology; cross-sectionally and longitudinally. Self-reported symptoms, behavioral measures, and event-related potentials from a classical cued Go/NoGo task were used to outline the symptom burden, executive function deficits and neurophysiological features, and the associations between these domains. The study participants (N = 210 ADHD, N = 158 controls, age: 18–62 years) were assessed five (ADHD) or three (controls) times over two years. We describe cross-sectional and longitudinal group differences, and associations between symptom burden, and behavioral and event-related potential (ERP) components variables by latent growth curve models, including random slopes and intercepts. The ADHD group showed increased reaction time variability, increased commission and omission errors, and attenuated cueP3, CNV, N2d, and P3d amplitudes. We observed a decrease in self-reported symptoms in the ADHD group over the two years. The behavioral measures (reaction time variability, number of omission, and commission errors) did not change over time, whereas the cueP3, P3d, and N2d amplitude attenuated in both groups. There was no evidence for a robust association between symptom burden and behavioral or ERP measures. The changes in the ERP components with stable task performance, potentially indicate more efficient neuronal processing over the two years. Whether the lack of association between symptom burden and behavioral or ERP measures might be due to the low reliability of the ADHD assessment criteria, or the inappropriateness of the objective measures cannot be inferred.
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Affiliation(s)
- Marionna Münger
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- *Correspondence: Marionna Münger,
| | - Silvano Sele
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
| | - Gian Candrian
- Brain and Trauma Foundation Grisons, Chur, Switzerland
| | - Johannes Kasper
- Praxisgemeinschaft Psychiatrie und Psychotherapie, Lucerne, Switzerland
| | | | - Dominique Eich-Höchli
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Lutz Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
- Lutz Jäncke,
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An examination of the relationships between attention/deficit hyperactivity disorder symptoms and functional connectivity over time. Neuropsychopharmacology 2022; 47:704-710. [PMID: 33558680 PMCID: PMC8782893 DOI: 10.1038/s41386-021-00958-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 01/30/2023]
Abstract
Previous cross-sectional work has demonstrated resting-state connectivity abnormalities in children and adolescents with attention/deficit hyperactivity disorder (ADHD) relative to typically developing controls. However, it is unclear to what extent these neural abnormalities confer risk for later symptoms of the disorder, or represent the downstream effects of symptoms on functional connectivity. Here, we studied 167 children and adolescents (mean age at baseline = 10.74 years (SD = 2.54); mean age at follow-up = 13.3 years (SD = 2.48); 56 females) with varying levels of ADHD symptoms, all of whom underwent resting-state functional magnetic resonance imaging and ADHD symptom assessments on two occasions during development. Resting-state functional connectivity was quantified using eigenvector centrality mapping. Using voxelwise cross-lag modeling, we found that less connectivity at baseline within right inferior frontal gyrus was associated with more follow-up symptoms of inattention (significant at an uncorrected cluster-forming threshold of p ≤ 0.001 and a cluster-level familywise error corrected threshold of p < 0.05). Findings suggest that previously reported cross-sectional abnormalities in functional connectivity within inferior frontal gyrus in patients with ADHD may represent a longitudinal risk factor for the disorder, in line with efforts to target this region with novel therapeutic methods.
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Rotem A, Ben-Sheetrit J, Newcorn J, Danieli Y, Peskin M, Golubchik P, Ben-Hayun R, Weizman A, Manor I. The Placebo Response in Adult ADHD as Objectively Assessed by the TOVA Continuous Performance Test. J Atten Disord 2021; 25:1311-1320. [PMID: 31965885 DOI: 10.1177/1087054719897819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: We compared the placebo response (PR) as measured by the Test of Variables of Attention (TOVA) and the Conners' Adult ADHD Rating Scale (CAARS) scores. Method: A retrospective data analysis from a double-blind placebo-controlled study of metadoxine-ER in adults with ADHD. An additional database was used for comparison to TOVA response after methylphenidate challenge (TOVA-MPH-R). Results: PR was highest when calculated from the TOVA-Attention Composite Score (ACS). The PR showed significantly fewer variables improving concomitantly compared with MPH-R. The most prominent correlation between the CAARS-PR and the TOVA-PR was in the Omissions score (p = .032), which was age-dependent (b = .0007, p <.001). Discussion: TOVA-PR has an index-specific profile compared with CAARS-PR and TOVA-MPH-R. The partial correlation of TOVA-PR with CAARS-PR suggests that a composite score of TOVA specific indices and CAARS could have a synergic impact to improve the reliability of the response assessment in adult ADHD.
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Affiliation(s)
- Ann Rotem
- Geha Mental Health Center, Petah Tikva, Israel
| | | | | | | | - Miriam Peskin
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel
| | - Pavel Golubchik
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel
| | - Rachel Ben-Hayun
- Rambam Health Care Campus, Haifa, Israel.,Bar-Ilan University, Ramat Gan, Israel
| | - Abraham Weizman
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel.,The Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Iris Manor
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel
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Tombor L, Kakuszi B, Papp S, Réthelyi J, Bitter I, Czobor P. Atypical resting-state gamma band trajectory in adult attention deficit/hyperactivity disorder. J Neural Transm (Vienna) 2021; 128:1239-1248. [PMID: 34164742 PMCID: PMC8321998 DOI: 10.1007/s00702-021-02368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/18/2021] [Indexed: 11/24/2022]
Abstract
Decreased gamma activity has been reported both in children and adults with attention deficit/hyperactivity disorder (ADHD). However, while ADHD is a lifelong neurodevelopmental disorder, our insight into the associations of spontaneous gamma band activity with age is limited, especially in adults. Therefore, we conducted an explorative study to investigate trajectories of resting gamma activity in adult ADHD patients (N = 42) versus matched healthy controls (N = 59). We investigated the relationship of resting gamma activity (30–48 Hz) with age in four right hemispheric electrode clusters where diminished gamma power in ADHD had previously been demonstrated by our group. We found significant non-linear association between resting gamma power and age in the lower frequency gamma1 range (30–39 Hz) in ADHD as compared to controls in all investigated locations. Resting gamma1 increased with age and was significantly lower in ADHD than in control subjects from early adulthood. We found no significant association between gamma activity and age in the gamma2 range (39–48 Hz). Alterations of gamma band activity might reflect altered cortical network functioning in adult ADHD relative to controls. Our results reveal that abnormal gamma power is present at all ages, highlighting the lifelong nature of ADHD. Nonetheless, longitudinal studies are needed to confirm our results.
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Affiliation(s)
- László Tombor
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary.
| | - Brigitta Kakuszi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary
| | - Szilvia Papp
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary
| | - János Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary
| | - István Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary
| | - Pál Czobor
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6., Budapest, U1083, Hungary
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Tallberg P, Rastam M, Perrin S, Hallin AL, Gustafsson P. A longitudinal investigation of cognitive functioning and its relationship to symptom severity and academic functioning in treatment seeking youth with AHDH. Scand J Child Adolesc Psychiatr Psychol 2021; 9:52-63. [PMID: 33928054 PMCID: PMC8077411 DOI: 10.21307/sjcapp-2021-007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Children with ADHD tend to present with poorer cognitive functioning leaving them more vulnerable to a range of negative outcomes. To date, only a handful of longitudinal studies have examined the stability of Wechsler composite scores in children and adolescents with ADHD, and none of them used a more recent version of the Wechsler Intelligence Scales for Children (WISC), than the WISC-III. Objective: The present study investigates the cognitive stability and its longitudinal relationship with the severity of the child’s ADHD symptoms and school grades. Method: Cognitive functioning was measured with the fourth editions of the WISC-IV or the Wechsler Adult Intelligence Scales (WAIS-IV) at baseline and at a 3-4-year follow-up in children with ADHD (n = 125, mean age = 11.40 years, SD = 3.27) and a Control group of schoolchildren (n = 59, mean age = 11.97 years, SD = 2.15). The stability of cognitive functioning and the relationship between cognitive functioning, ADHD and grades were evaluated using linear mixed models and logistic regression. Results: Standardized composite scores of Full scale IQ, Verbal Comprehension, and Processing Speed declined between baseline and follow-up in the ADHD group. ADHD symptom scores were associated with Working Memory scores. Together, the severity of concurrent ADHD symptoms and lower scores for verbal comprehension at baseline and follow-up were associated with an increased risk of not achieving grades at follow-up in youth with ADHD. Conclusions: Youth with ADHD often present with cognitive impairments, not improved over time. Together these increase the risk of poorer academic outcomes. Concurrent evaluation of symptom severity and cognitive functions can add potentially useful information in terms of treatment planning, and school supports to prevent school failure.
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Affiliation(s)
- Pia Tallberg
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Maria Rastam
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.,Department of Psychiatry and Neurochemistry, Gillberg Neuropsychiatry Centre, University of Gothenburg, Göteborg, Sweden
| | - Sean Perrin
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Anne-Li Hallin
- Child and Adolescent Psychiatry, Region Skåne, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Skåne University Hospital, Lund University, Lund, Sweden
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14
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Distinct Patterns of Impaired Cognitive Control Among Boys and Girls with ADHD Across Development. Res Child Adolesc Psychopathol 2021; 49:835-848. [PMID: 33646480 DOI: 10.1007/s10802-021-00792-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 11/27/2022]
Abstract
This study examined whether girls and boys with ADHD show similar impairments in cognitive control from childhood into adolescence and the developmental relationship between cognitive control and ADHD symptoms. Participants include 8-17-year-old children with ADHD (n = 353, 104 girls) and typically developing (TD) controls (n = 241, 86 girls) with longitudinal data obtained from n = 137. Participants completed two go/no-go (GNG) tasks that varied in working memory demand. Linear mixed-effects models were applied to compare age-related changes in cognitive control for each GNG task among girls and boys with ADHD and TD controls and in relation to ADHD symptoms. Boys with ADHD showed impaired response inhibition and increased response variability across tasks. In contrast, girls with ADHD showed impaired response inhibition only with greater working memory demands whereas they displayed increased response variability regardless of working memory demands. Analysis of age-related change revealed that deficits in cognitive control under minimal working memory demands increase with age among girls with ADHD and decrease with age among boys with ADHD. In contrast, deficits in cognitive control with greater working memory demands decrease with age among both boys and girls with ADHD compared to TD peers. Among children with ADHD poor response inhibition during childhood predicted inattentive symptoms in adolescence and was associated with less age-related improvement in inattentive symptoms. These findings suggest that girls and boys with ADHD show differential impairment in cognitive control across development and response inhibition in childhood may be an important predictor of ADHD symptoms in adolescence.
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15
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Øie MG, Sundet K, Haug E, Zeiner P, Klungsøyr O, Rund BR. Cognitive Performance in Early-Onset Schizophrenia and Attention-Deficit/Hyperactivity Disorder: A 25-Year Follow-Up Study. Front Psychol 2021; 11:606365. [PMID: 33519613 PMCID: PMC7841368 DOI: 10.3389/fpsyg.2020.606365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/21/2020] [Indexed: 11/13/2022] Open
Abstract
Early-Onset Schizophrenia (EOS) and Attention Deficit-Hyperactivity Disorder (ADHD) are early- onset neurodevelopmental disorders associated with cognitive deficits. The current study represents the first attempt to compare these groups on a comprehensive cognitive test battery in a longitudinal design over 25 years in order to enhance our knowledge of particular patterns resulting from the interaction between normal maturational processes and different illness processes of these disorders. In the baseline study, 19 adolescents with schizophrenia were compared to 20 adolescents with ADHD and 30 healthy controls (HC), all between 12 and 18 years of age. After 13 years (T2) and after 25 years (T3) they were re-evaluated with the cognitive test battery. A cognitive Composite Score was used in a linear mixed model. The EOS group had a significant cognitive stagnation or deterioration from T1 to T2 compared to HC. However, the EOS group had the most positive change from T2 to T3, supporting a stable level of cognitive performance over the 25 year span. The ADHD group improved or had similar development as the HC group from T1 to T2. They continued to improve significantly compared to the HC group from T2 to T3. Individuals in the EOS group performed more impaired on the cognitive composite score compared to the HC group and the ADHD group at all three time points. Results might indicate a neurodevelopmental pathway of EOS with subnormal cognitive development specific in adolescence. In comparison, the ADHD group had a more consistent cognitive maturation supporting a maturational delay hypothesis of ADHD.
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Affiliation(s)
- Merete G Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elisabeth Haug
- Division of Mental Health, Innlandet Hospital Trust, Ottestad, Norway
| | - Pål Zeiner
- Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Bjørn R Rund
- Department of Psychology, University of Oslo, Oslo, Norway.,Vestre Viken Hospital Trust, Drammen, Norway
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16
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Ilbegi S, Buitelaar JK, Hoekstra PJ, Hartman CA, Franke B, Faraone SV, Oosterlaan J, Luman M, van Lieshout M, Rommelse NNJ. Neurocognitive markers of late-onset ADHD: a 6-year longitudinal study. J Child Psychol Psychiatry 2021; 62:244-252. [PMID: 33059383 DOI: 10.1111/jcpp.13272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/05/2020] [Accepted: 04/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is an increased interest in 'late-onset' attention-deficit/hyperactivity disorder (ADHD), referring to the onset of clinically significant ADHD symptoms after the age of 12 years. This study aimed to examine whether unaffected siblings with late-onset ADHD could be differentiated from stable unaffected siblings by their neurocognitive functioning in childhood. METHODS We report findings from a 6-year prospective, longitudinal study of the Dutch part of the International Multicenter ADHD Genetics (IMAGE) study, including individuals with childhood-onset (persistent) ADHD (n = 193), their siblings with late-onset ADHD (n = 34), their stable unaffected siblings (n = 111) and healthy controls (n = 186). At study entry (mean age: 11.3) and follow-up (mean age: 17.01), participants were assessed for ADHD by structured psychiatric interviews and multi-informant questionnaires. Several neurocognitive functions were assessed at baseline and after 6 years, including time reproduction, timing variability (reaction time variability and time production variability), reaction time speed, motor control and working memory; intelligence was taken as a measure of overall neurocognitive functioning. RESULTS Siblings with late-onset ADHD were similar to individuals with childhood-onset ADHD in showing longer reaction times and/or higher error rates on all neurocognitive measures at baseline and follow-up, when compared to healthy controls. They differed from stable unaffected siblings (who were similar to healthy controls) by greater reaction time variability and timing production variability at baseline. No significant group by time interaction was found for any of the tasks. CONCLUSIONS For unaffected siblings of individuals with ADHD, reaction time variability and timing production variability may serve as neurocognitive marker for late-onset ADHD.
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Affiliation(s)
- Shahrzad Ilbegi
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jaap Oosterlaan
- Emma Neuroscience Group, Amsterdam Reproduction & Development, Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam/Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Luman
- Emma Neuroscience Group, Amsterdam Reproduction & Development, Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam/Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marloes van Lieshout
- Emma Neuroscience Group, Amsterdam Reproduction & Development, Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam/Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nanda N J Rommelse
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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17
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[ADHD in the transition to adulthood: prevalence, symptoms, risks, and care]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:910-915. [PMID: 32588062 DOI: 10.1007/s00103-020-03175-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In contrast to earlier assumptions, ADHD at least partially persists into adulthood in 50-80% of the patients.This narrative review article highlights the risks, treatment options, and care requirements associated with the transition to adulthood. Available epidemiological and routine care data and guidelines are reviewed and screened for indications and recommendations to improve the health-care of adolescents with ADHD.Epidemiological and routine care data point to a care gap for adolescents with ADHD in the sensitive phase of transition from adolescence to adulthood. Specific transition concepts should be expanded and their effectiveness scientifically investigated.
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18
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Koltermann G, Becker N, Lopes-Silva JB, Gomides MRDA, Paiva GM, Haase VG, de Salles JF. Are "cool" executive function impairments more salient in ADHD symptoms than in reading disability? Dement Neuropsychol 2020; 14:47-55. [PMID: 32206198 PMCID: PMC7077861 DOI: 10.1590/1980-57642020dn14-010008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Reading disability (RD) and Attention Deficit Hyperactivity Disorder (ADHD)
symptoms often co-occur in school-age children. Methods: The present study evaluated the performance of 216 Brazilian children from
3rd and 4th grades on “cool” executive function
(EF) abilities and phonological processing. The children were divided into
three groups: those with ADHD symptoms only, those with RD only, and
controls. Results: MANOVA analyses, controlling for age and nonverbal intelligence, showed worse
performance for the RD group, compared to the ADHD symptoms group, on
measures of phonological processing (phonemic awareness, phonological
short-term memory, and lexical access) and “cool” EF components
(orthographic verbal fluency and processing speed). The ADHD symptoms group
did not differ from the control group on the majority of the “cool” EF
tasks. Compared to the control group, the ADHD symptoms group and the RD
group both showed significantly more errors in rapid automatized naming of
figures, which evaluates the inhibition component of EF; performance on this
task was similar for these groups. Conclusion: We conclude that children with RD have greater impairment in phonological
processing and “cool” EF compared to those with ADHD symptoms. Furthermore,
deficits in inhibitory control may be shared among children with both
conditions.
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Affiliation(s)
| | - Natália Becker
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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