1
|
Bob P, Privara M. ADHD, stress, and anxiety. Front Psychiatry 2025; 16:1536207. [PMID: 40171307 PMCID: PMC11959059 DOI: 10.3389/fpsyt.2025.1536207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/21/2025] [Indexed: 04/03/2025] Open
Abstract
Recent findings on stress and anxiety in attention deficit hyperactivity disorder (ADHD) suggest that specific processes related to brain developmental disorganization could create a vulnerable background that increases sensitivity to stress stimuli from the psychosocial environment. These basic neurodevelopmental processes are closely related to the developmental mechanisms of primitive functions and their integration or disintegration. In this context, the psychopathological processes that manifest in ADHD are linked to the mechanisms of disturbed inhibitory functions that may cause incongruent neural interactions ("neural interference") between the more primitive functions and the higher levels of attentional and cognitive neural processes. These disturbed developmental processes may also determine increased sensitivity to stressful experiences that, in ADHD cases, could lead to the manifestations of various psychopathological symptoms such as disturbed attentional and motor functions, anxiety, and depression, among other cognitive and affective disturbances. These findings, based on previous research, suggest novel framework and hypothesis on how this neurodevelopment-based increased sensitivity to stress stimuli could manifest in the etiopathogenesis of ADHD in its relationship with cognitive, affective, and motor deficits.
Collapse
Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine, Charles University, Prague, Czechia
| | | |
Collapse
|
2
|
Jarvers I, Kandsperger S, Schleicher D, Ando A, Resch F, Koenig J, Kaess M, Brunner R. The relationship between adolescents' externalizing and internalizing symptoms and brain development over a period of three years. Neuroimage Clin 2022; 36:103195. [PMID: 36137498 PMCID: PMC9668616 DOI: 10.1016/j.nicl.2022.103195] [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: 04/12/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Adolescence is a crucial period for both brain maturation and the emergence of mental health disorders. Associations between brain morphology and internalizing/externalizing symptomatology have been identified in clinical or at-risk samples, but age-related developmental differences were rarely considered. The current study investigated the longitudinal relationship between internalizing/externalizing symptoms and brain development in the absence of psychiatric disorders during early and late adolescence. METHODS 98 healthy adolescents within two cohorts (younger: 9 years, older: 12 years) participated in annual assessments for three years; a clinical assessment measuring their externalizing and internalizing symptoms (SDQ) and an MRI assessment measuring their brain volume and white matter microstructure, including fractional anisotropy (FA), mean diffusivity (MD) and average path length. RESULTS Linear mixed effect models and cross-lagged panel models showed that larger subcortical gray matter volume predicted more externalizing symptoms in older adolescents whereas decreases of subcortical gray matter volume predicted more externalizing symptoms for younger adolescents. Additionally, longer average white matter path length predicted more externalizing symptoms for older adolescents, while decreases in cerebral white matter volume were predictive of more externalizing symptoms for younger adolescents. There were no predictive effects for internalizing symptoms, FA or MD. CONCLUSIONS Delays in subcortical brain maturation, in both early and late adolescence, are associated with increases in externalizing behavior which indicates a higher risk for psychopathology and warrants further investigations.
Collapse
Affiliation(s)
- Irina Jarvers
- Department for Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Germany,Corresponding author at: Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Universitätsstraße 84, Regensburg, Bavaria 93053, Germany.
| | - Stephanie Kandsperger
- Department for Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Daniel Schleicher
- Department for Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Ayaka Ando
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Franz Resch
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Michael Kaess
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Romuald Brunner
- Department for Child and Adolescent Psychiatry and Psychotherapy, University of Regensburg, Germany
| |
Collapse
|
3
|
Leisman G, Melillo R. Front and center: Maturational dysregulation of frontal lobe functional neuroanatomic connections in attention deficit hyperactivity disorder. Front Neuroanat 2022; 16:936025. [PMID: 36081853 PMCID: PMC9446472 DOI: 10.3389/fnana.2022.936025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/29/2022] [Indexed: 12/21/2022] Open
Abstract
Frontal lobe function may not universally explain all forms of attention deficit hyperactivity disorder (ADHD) but the frontal lobe hypothesis described supports an internally consistent model for integrating the numerous behaviors associated with ADHD. The paper examines the developmental trajectories of frontal and prefrontal lobe development, framing ADHD as maturational dysregulation concluding that the cognitive, motor, and behavioral abilities of the presumptive majority of ADHD children may not primarily be disordered or dysfunctional but reflect maturational dysregulation that is inconsistent with the psychomotor and cognitive expectations for the child’s chronological and mental age. ADHD children demonstrate decreased activation of the right and middle prefrontal cortex. Prefrontal and frontal lobe regions have an exuberant network of shared pathways with the diencephalic region, also having a regulatory function in arousal as well as with the ascending reticular formation which has a capacity for response suppression to task-irrelevant stimuli. Prefrontal lesions oftentimes are associated with the regulatory breakdown of goal-directed activity and impulsivity. In conclusion, a presumptive majority of childhood ADHD may result from maturational dysregulation of the frontal lobes with effects on the direct, indirect and/or, hyperdirect pathways.
Collapse
Affiliation(s)
- Gerry Leisman
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
- Department of Neurology, University of Medical Sciences of Havana, Havana, Cuba
- *Correspondence: Gerry Leisman,
| | - Robert Melillo
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
| |
Collapse
|
4
|
Abstract
During evolution, the cerebral cortex advances by increasing in surface and the introduction of new cytoarchitectonic areas among which the prefrontal cortex (PFC) is considered to be the substrate of highest cognitive functions. Although neurons of the PFC are generated before birth, the differentiation of its neurons and development of synaptic connections in humans extend to the 3rd decade of life. During this period, synapses as well as neurotransmitter systems including their receptors and transporters, are initially overproduced followed by selective elimination. Advanced methods applied to human and animal models, enable investigation of the cellular mechanisms and role of specific genes, non-coding regulatory elements and signaling molecules in control of prefrontal neuronal production and phenotypic fate, as well as neuronal migration to establish layering of the PFC. Likewise, various genetic approaches in combination with functional assays and immunohistochemical and imaging methods reveal roles of neurotransmitter systems during maturation of the PFC. Disruption, or even a slight slowing of the rate of neuronal production, migration and synaptogenesis by genetic or environmental factors, can induce gross as well as subtle changes that eventually can lead to cognitive impairment. An understanding of the development and evolution of the PFC provide insight into the pathogenesis and treatment of congenital neuropsychiatric diseases as well as idiopathic developmental disorders that cause intellectual disabilities.
Collapse
Affiliation(s)
- Sharon M Kolk
- Department of Molecular Neurobiology, Donders Institute for Brain, Cognition and Behaviour and Faculty of Science, Radboud University, Nijmegen, The Netherlands.
| | - Pasko Rakic
- Department of Neuroscience and Kavli Institute for Neuroscience, Yale University, New Haven, Connecticut, USA.
| |
Collapse
|
5
|
Yu M, Gao X, Niu X, Zhang M, Yang Z, Han S, Cheng J, Zhang Y. Meta-analysis of structural and functional alterations of brain in patients with attention-deficit/hyperactivity disorder. Front Psychiatry 2022; 13:1070142. [PMID: 36683981 PMCID: PMC9853532 DOI: 10.3389/fpsyt.2022.1070142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND A large and growing body of neuroimaging research has concentrated on patients with attention-deficit/hyperactivity disorder (ADHD), but with inconsistent conclusions. This article was intended to investigate the common and certain neural alterations in the structure and function of the brain in patients with ADHD and further explore the differences in brain alterations between adults and children with ADHD. METHODS We conducted an extensive literature search of whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies associated with ADHD. Two separate meta-analyses with the seed-based d mapping software package for functional neural activation and gray matter volume (GMV) were carried out, followed by a joint analysis and a subgroup analysis. RESULTS This analysis included 29 VBM studies and 36 fMRI studies. Structurally, VBM analysis showed that the largest GMV diminutions in patients with ADHD were in several frontal-parietal brain regions, the limbic system, and the corpus callosum. Functionally, fMRI analysis discovered significant hypoactivation in several frontal-temporal brain regions, the right postcentral gyrus, the left insula, and the corpus callosum. CONCLUSION This study showed that abnormal alterations in the structure and function of the left superior frontal gyrus and the corpus callosum may be the key brain regions involved in the pathogenesis of ADHD in patients and may be employed as an imaging metric for patients with ADHD pending future research. In addition, this meta-analysis discovered neuroanatomical or functional abnormalities in other brain regions in patients with ADHD as well as findings that can be utilized to guide future research.
Collapse
Affiliation(s)
- Miaomiao Yu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Xinyu Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Xiaoyu Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Zhengui Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
| |
Collapse
|
6
|
Berberat J, Huggenberger R, Montali M, Gruber P, Pircher A, Lövblad KO, Killer HE, Remonda L. Brain activation patterns in medicated versus medication-naïve adults with attention-deficit hyperactivity disorder during fMRI tasks of motor inhibition and cognitive switching. BMC Med Imaging 2021; 21:53. [PMID: 33740903 PMCID: PMC7977301 DOI: 10.1186/s12880-021-00579-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Adult-attention-deficit-hyperactive-disorder (ADHD) is often unrecognized condition. FMRI examination along with neuropsychological testing might strengthen the diagnosis. We hypothesized that ADHD-adults with and without medication would show different fMRI pattern compared to healthy controls while testing tasks of motor inhibition and cognitive switching. Methods 45 subjects in three age-matched groups: (1) controls, (2) ADHD-adults under medication (ADHD+) and (3) medication-naïve adults with ADHD (ADHD−) underwent fMRI and neuropsychological testing. Group analysis and population-based statistics were performed. Results DTVP-A, intellectual ability as well as attention capability, visual-perceptual and visual-motor abilities showed no significant differences between the groups. However, fMRI revealed statistically significant differences between the ADHD+, ADHD− and control groups on tasks of motor inhibition and cognitive switching on adults in bilateral fronto-striatal brain regions, inferior fronto-frontal, fronto-cingulate and fronto-parietal networks as well as in the parietal lobe (p < 0.05). Conclusions fMRI offers the potential to differentiate between the ADHD+, ADHD− and control groups. FMRI possibly opens a new window for monitoring the therapeutic effect of ADHD medication. Trial registration NCT02578342, registered at August 2015 to clinical trial registry (https://ichgcp.net/clinical-trials-registry/NCT02578342).
Collapse
Affiliation(s)
- Jatta Berberat
- Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland. .,Department of Radiology and Medical Informatics, University of Geneva, 1202, Geneva, Switzerland.
| | | | - Margherita Montali
- Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.,Department of Ophthalmology, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Philipp Gruber
- Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Achmed Pircher
- Department of Ophthalmology, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Karl-Olof Lövblad
- Department of Radiology and Medical Informatics, University of Geneva, 1202, Geneva, Switzerland
| | - Hanspeter E Killer
- Department of Ophthalmology, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - Luca Remonda
- Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.,University of Bern, 3011, Bern, Switzerland
| |
Collapse
|
7
|
Scheres A, Solanto MV. Do ADHD Symptoms, Executive Function, and Study Strategies Predict Temporal Reward Discounting in College Students with Varying Levels of ADHD Symptoms? A Pilot Study. Brain Sci 2021; 11:brainsci11020181. [PMID: 33540665 PMCID: PMC7912943 DOI: 10.3390/brainsci11020181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to examine the relationship between temporal reward discounting and attention deficit hyperactivity disorder (ADHD) symptoms in college students. Additionally, we examined whether temporal reward discounting was associated with executive functioning in daily life and with learning and study strategies in this group. Thirty-nine college students (19 with ADHD and 20 controls) participated after meeting criteria for ADHD or non-ADHD based on standardized assessment. Strong preferences for small immediate rewards were specifically associated with the ADHD symptom domain hyperactivity–impulsivity. Additionally, these preferences were associated with daily life executive function problems and with weak learning and study strategies. This suggests that steep temporal discounting may be a key mechanism playing a role in the daily life challenges that college students with ADHD symptoms face. If these findings are replicated in larger samples, then intervention strategies may profitably be developed to counteract this strong preference for small immediate rewards in college students with ADHD symptoms.
Collapse
Affiliation(s)
- Anouk Scheres
- Behavioural Science Institute, Radboud University, 6525 GA Nijmegen, The Netherlands
- Correspondence:
| | - Mary V. Solanto
- Zucker School of Medicine at Hofstra-Northwell, New York, NY 11042, USA;
| |
Collapse
|
8
|
Bob P, Konicarova J, Raboch J. Disinhibition of Primitive Reflexes in Attention Deficit and Hyperactivity Disorder: Insight Into Specific Mechanisms in Girls and Boys. Front Psychiatry 2021; 12:430685. [PMID: 34819879 PMCID: PMC8606578 DOI: 10.3389/fpsyt.2021.430685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: Cognitive and motor disintegration and other functional disturbances in various neuropsychiatric disorders may be related to inhibitory deficits that may manifest as a persistence or re-expression of primitive reflexes and few recent data suggest that these deficits may occur in Attention Deficit and Hyperactivity Disorder (ADHD). Methods: We have tested a hypothesis to which extent ADHD symptoms and balance deficits are related to persisting primitive reflexes, such as Asymmetric Tonic Neck Reflex (ATNR) and Symmetric Tonic Neck Reflex (STNR) in 80 medication-naïve children with ADHD (40 boys and 40 girls) in the school age (8-11 years) and compared these data with a control group of 60 children (30 boys and 30 girls). Results: These data show new finding that ADHD symptoms and balance deficits are strongly and specifically associated with persistent ATNR in girls and STNR in boys. Conclusions: These results provide first evidence in medical literature that ADHD in girls and boys is specifically related to distinguished neurological developmental mechanisms related to disinhibition of primitive reflexes.
Collapse
Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
| | - Jana Konicarova
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia.,Stroder Therapy Center, Cham, Germany
| | - Jiri Raboch
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
| |
Collapse
|
9
|
Fish AM, Nadig A, Seidlitz J, Reardon PK, Mankiw C, McDermott CL, Blumenthal JD, Clasen LS, Lalonde F, Lerch JP, Chakravarty MM, Shinohara RT, Raznahan A. Sex-biased trajectories of amygdalo-hippocampal morphology change over human development. Neuroimage 2019; 204:116122. [PMID: 31470127 PMCID: PMC7485527 DOI: 10.1016/j.neuroimage.2019.116122] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/08/2019] [Accepted: 08/23/2019] [Indexed: 11/25/2022] Open
Abstract
The amygdala and hippocampus are two adjacent allocortical structures implicated in sex-biased and developmentally-emergent psychopathology. However, the spatiotemporal dynamics of amygdalo-hippocampal development remain poorly understood in healthy humans. The current study defined trajectories of volume and shape change for the amygdala and hippocampus by applying a multi-atlas segmentation pipeline (MAGeT-Brain) and semi-parametric mixed-effects spline modeling to 1,529 longitudinally-acquired structural MRI brain scans from a large, single-center cohort of 792 youth (403 males, 389 females) between the ages of 5 and 25 years old. We found that amygdala and hippocampus volumes both follow curvilinear and sexually dimorphic growth trajectories. These sex-biases were particularly striking in the amygdala: males showed a significantly later and slower adolescent deceleration in volume expansion (at age 20 years) than females (age 13 years). Shape analysis localized significant hot-spots of sex-biased anatomical development in sub-regional territories overlying rostral and caudal extremes of the CA1/2 in the hippocampus, and the centromedial nuclear group of the amygdala. In both sexes, principal components analysis revealed close integration of amygdala and hippocampus shape change along two main topographically-organized axes – low vs. high areal expansion, and early vs. late growth deceleration. These results (i) bring greater resolution to our spatiotemporal understanding of amygdalo-hippocampal development in healthy males and females, and (ii) uncover focal sex-differences in the structural maturation of the brain components that may contribute to differences in behavior and psychopathology that emerge during adolescence.
Collapse
Affiliation(s)
- Ari M Fish
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Ajay Nadig
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Jakob Seidlitz
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Paul K Reardon
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Catherine Mankiw
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Cassidy L McDermott
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Jonathan D Blumenthal
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Liv S Clasen
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Francois Lalonde
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Jason P Lerch
- Department of Medical Biophysics, University of Toronto, Toronto, ON, M5T 1R8, Canada; Neurosciences and Mental Health, the Hospital for Sick Children, Toronto, ON, M5T 3H7, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada, H3A OG4; Departments of Psychiatry and Biological and Biomedical Engineering, McGill University, Montreal, QC, H3A OG4, Canada
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Armin Raznahan
- Developmental Neurogenomics Unit, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, 20892, USA.
| |
Collapse
|
10
|
Prehn-Kristensen A, Zimmermann A, Tittmann L, Lieb W, Schreiber S, Baving L, Fischer A. Reduced microbiome alpha diversity in young patients with ADHD. PLoS One 2018; 13:e0200728. [PMID: 30001426 PMCID: PMC6042771 DOI: 10.1371/journal.pone.0200728] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 07/02/2018] [Indexed: 12/16/2022] Open
Abstract
ADHD is a psychiatric disorder which is characterized by hyperactivity, impulsivity and attention problems. Due to recent findings of microbial involvement in other psychiatric disorders like autism and depression, a role of the gut microbiota in ADHD pathogenesis is assumed but has not yet been investigated. In this study, the gut microbiota of 14 male ADHD patients (mean age: 11.9 yrs.) and 17 male controls (mean age: 13.1 yrs.) was examined via next generation sequencing of 16S rDNA and analyzed for diversity and biomarkers. We found that the microbial diversity (alpha diversity) was significantly decreased in ADHD patients compared to controls (pShannon = 0.036) and that the composition (beta diversity) differed significantly between patients and controls (pANOSIM = 0.033, pADONIS = 0.006, pbetadisper = 0.002). In detail, the bacterial family Prevotellacae was associated with controls, while patients with ADHD showed elevated levels of Bacteroidaceae, and both Neisseriaceae and Neisseria spec. were found as possible biomarkers for juvenile ADHD. Our results point to a possible link of certain microbiota with ADHD, with Neisseria spec. being a very promising ADHD-associated candidate. This finding provides the basis for a systematic, longitudinal assessment of the role of the gut microbiome in ADHD, yielding promising potential for both prevention and therapeutic intervention.
Collapse
Affiliation(s)
- Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Alexandra Zimmermann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lukas Tittmann
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfgang Lieb
- Institute for Epidemiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
- Clinic of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Lioba Baving
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Annegret Fischer
- Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
11
|
The Association between Sleep and Theory of Mind in School Aged Children with ADHD. Med Sci (Basel) 2017; 5:medsci5030018. [PMID: 29099034 PMCID: PMC5635805 DOI: 10.3390/medsci5030018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 12/30/2022] Open
Abstract
Theory of Mind (ToM) is defined as the ability to infer a range of internal mental states of others, including beliefs, intentions, desires, and emotions. These abilities are associated with children’s ability to socialize effectively with peers. ToM impairments are associated with peer rejection and psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD). Previous studies have found poor sleep negatively impacts executive functioning (EF) and emotional information processing, which are essential for the effective use of ToM. Youth with ADHD have EF deficits and sleep problems. However, the relationship between sleep, executive functioning, and ToM in children with ADHD has not been studied. In this review, we propose that the poor social and interpersonal skills characterizing individuals with ADHD could be explained by the impact of poor sleep on the emotional and cognitive mechanisms underlying ToM.
Collapse
|
12
|
Abstract
Abstract
According to current findings, in the history of neurology proposed by Hughlings Jackson, certain later developed functions during ontogenesis of the central nervous system (CNS) tend to replace the older ones. In this context, recent and historical findings suggest that certain later developed cognitive and motor functions during brain ontogenesis related to higher levels of coordination tend to replace the older ones and their persistence is linked to various neuropsychiatric disorders. Particularly important functional disturbances in ADHD developed early in life likely linked to dissolution process are balance deficits linked to dysfunctions of higher levels of coordination related to neurophysiological and mental functions that typically occur in ADHD. In this context, recent data suggest that one of the important aspects of normal development that may play a role in ADHD is suppression of the so-called primitive reflexes. Taken together these data suggest that ADHD symptoms may present a compensatory process related to interference of more primitive neural mechanism, as related to primitive reflexes, with higher levels of brain functions linked to coordination and balance due to insufficiently developed cognitive and motor integration.
Collapse
|
13
|
Acer N, Dolu N, Zararsiz G, Dogan MS, Gumus K, Ozmen S, Kara AY, Soysal H, Per H, Bilgen M. Anatomical characterization of ADHD using an atlas-based analysis: A diffusion tensor imaging study. THE EUROBIOTECH JOURNAL 2017. [DOI: 10.24190/issn2564-615x/2017/01.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Abstract
Purpose: To examine brain diffusion characteristics in pediatric patients with attention deficit hyperactivity disorder (ADHD) using diffusion tensor imaging (DTI) and an atlas-based anatomical analysis of the whole brain and to investigate whether these images have unique characteristics that can support functional diagnoses. Materials and Methods: Seventeen children with ADHD and ten control subjects (all age-matched) underwent MRI scans. The Institutional Ethics Board approved this study. Morphometric analysis was performed using MriStudio software. The diffusion images were normalized using a linear transformation, followed by large deformation diffeomorphic metric mapping (LDDMM). For 189 parcellated brain regions, the volume, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured. Results: Children with ADHD were found to have increase in the body of lateral ventricle volumes compared to the control. Increased MD was found in the deep gray matter, amygdala, thalamus, substantia nigra, and also the cerebellum left and right side. Increased RD was found in the deep gray matter, caudate, thalamus, substantia nigra and hippocampus left and right side compared to the control. Significant elevated FA was found in the bilateral splenium of the corpus callosum in ADHD patients. Conclusion: Children with ADHD display abnormal diffusion characteristics and anatomical features compared to healthy controls. DTI can provide sensitive information on integrity of white matter (WM) and intra-WM structures in ADHD.
Collapse
Affiliation(s)
- Niyazi Acer
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Nazan Dolu
- Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Gokmen Zararsiz
- Departmentof Biostatistics, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Mehmet Sait Dogan
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Kazim Gumus
- Biomedical Imaging Research Center, Erciyes University, Kayseri , Turkey
| | - Sevgi Ozmen
- Department of Child Psychiatry, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Ali Yucel Kara
- Department of Physiology, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Handan Soysal
- Department of Anatomy, Faculty of Medicine, Baskent University, Ankara , Turkey
| | - Huseyin Per
- Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri , Turkey
| | - Mehmet Bilgen
- Department of Biophysics, Medical Faculty, Adnan Menderes University, Aydin , Turkey
| |
Collapse
|
14
|
Rubio B, Boes AD, Laganiere S, Rotenberg A, Jeurissen D, Pascual-Leone A. Noninvasive Brain Stimulation in Pediatric Attention-Deficit Hyperactivity Disorder (ADHD): A Review. J Child Neurol 2016; 31:784-96. [PMID: 26661481 PMCID: PMC4833526 DOI: 10.1177/0883073815615672] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/10/2015] [Indexed: 01/08/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in the pediatric population. The clinical management of ADHD is currently limited by a lack of reliable diagnostic biomarkers and inadequate therapy for a minority of patients who do not respond to standard pharmacotherapy. There is optimism that noninvasive brain stimulation may help to address these limitations. Transcranial magnetic stimulation and transcranial direct current stimulation are 2 methods of noninvasive brain stimulation that modulate cortical excitability and brain network activity. Transcranial magnetic stimulation can be used diagnostically to probe cortical neurophysiology, whereas daily use of repetitive transcranial magnetic stimulation or transcranial direct current stimulation can induce long-lasting and potentially therapeutic changes in targeted networks. In this review, we highlight research showing the potential diagnostic and therapeutic applications of transcranial magnetic stimulation and transcranial direct current stimulation in pediatric ADHD. We also discuss the safety and ethics of using these tools in the pediatric population.
Collapse
Affiliation(s)
- Belen Rubio
- Child and Adolescent Psychiatry Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain Both are co-primary authors
| | - Aaron D Boes
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Department of Pediatric Neurology, Massachusetts General Hospital, Boston, MA, USA Both are co-primary authors.
| | - Simon Laganiere
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alexander Rotenberg
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA Pediatric Neuromodulation Program, Division of Epilepsy and Neurophysiology, Department of Neurology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
| | - Danique Jeurissen
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA Department of Vision and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| |
Collapse
|
15
|
Orsini CA, Setlow B, DeJesus M, Galaviz S, Loesch K, Ioerger T, Wallis D. Behavioral and transcriptomic profiling of mice null for Lphn3, a gene implicated in ADHD and addiction. Mol Genet Genomic Med 2016; 4:322-43. [PMID: 27247960 PMCID: PMC4867566 DOI: 10.1002/mgg3.207] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 01/08/2023] Open
Abstract
Background The Latrophilin 3 (LPHN3) gene (recently renamed Adhesion G protein‐coupled receptor L3 (ADGRL3)) has been linked to susceptibility to attention deficit/hyperactivity disorder (ADHD) and vulnerability to addiction. However, its role and function are not well understood as there are no known functional variants. Methods To characterize the function of this little known gene, we phenotyped Lphn3 null mice. We assessed motivation for food reward and working memory via instrumental responding tasks, motor coordination via rotarod, and depressive‐like behavior via forced swim. We also measured neurite outgrowth of primary hippocampal and cortical neuron cultures. Standard blood chemistries and blood counts were performed. Finally, we also evaluated the transcriptome in several brain regions. Results Behaviorally, loss of Lphn3 increases both reward motivation and activity levels. Lphn3 null mice display significantly greater instrumental responding for food than wild‐type mice, particularly under high response ratios, and swim incessantly during a forced swim assay. However, loss of Lphn3 does not interfere with working memory or motor coordination. Primary hippocampal and cortical neuron cultures demonstrate that null neurons display comparatively enhanced neurite outgrowth after 2 and 3 days in vitro. Standard blood chemistry panels reveal that nulls have low serum calcium levels. Finally, analysis of the transcriptome from prefrontal cortical, striatal, and hippocampal tissue at different developmental time points shows that loss of Lphn3 results in genotype‐dependent differential gene expression (DGE), particularly for cell adhesion molecules and calcium signaling proteins. Much of the DGE is attenuated with age, and is consistent with the idea that ADHD is associated with delayed cortical maturation. Conclusions Transcriptome changes likely affect neuron structure and function, leading to behavioral anomalies consistent with both ADHD and addiction phenotypes. The data should further motivate analyses of Lphn3 function in the developmental timing of altered gene expression and calcium signaling, and their effects on neuronal structure/function during development.
Collapse
Affiliation(s)
- Caitlin A Orsini
- Department of Psychiatry McKnight Brain Institute University of Florida College of Medicine Gainesville Florida 32610
| | - Barry Setlow
- Department of Psychiatry McKnight Brain Institute University of Florida College of Medicine Gainesville Florida 32610
| | - Michael DeJesus
- Department of Computer Science and Engineering Texas A&M University College Station Texas 77843
| | - Stacy Galaviz
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
| | - Kimberly Loesch
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
| | - Thomas Ioerger
- Department of Computer Science and Engineering Texas A&M University College Station Texas 77843
| | - Deeann Wallis
- Department of Biochemistry and Biophysics Texas A&M University College Station Texas 77843
| |
Collapse
|
16
|
van Belle J, van Hulst BM, Durston S. Developmental differences in intra-individual variability in children with ADHD and ASD. J Child Psychol Psychiatry 2015; 56:1316-26. [PMID: 25871802 DOI: 10.1111/jcpp.12417] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Intra-individual variability reflects temporal variation within an individual's performance on a cognitive task. Children with developmental disorders, such as ADHD and ASD show increased levels of intra-individual variability. In typical development, intra-individual variability decreases sharply between the ages 6 and 20. The tight link between intra-individual variability and age has led to the suggestion that it may be marker of neural development. As there is accumulating evidence that ADHD and ASD are characterised by atypical neurodevelopmental trajectories, we set out to explore developmental changes in intra-individual variability in subjects with ADHD and ASD. METHOD We used propensity score matching to match a cross-sectional sample of children with ADHD, ASD and control subjects (N = 405, aged 6-19 years old) for age, IQ and gender. We used ex-Gaussian distribution parameters to characterise intra-individual variability on fast responses (sigma) and slow responses (tau). RESULT Results showed that there was a similar decrease in mean response times with age across groups, and an interaction between age and group for measures of variability, where there was a much lower rate of change in the variability parameters (sigma and tau) for subjects with ASD compared with the other two groups. Subjects with ADHD had higher intra-individual variability, reflected by both sigma and tau, but the rate of decrease in variability with age was similar to that of the controls. CONCLUSION These results suggest that subjects with ADHD, ASD and controls differ in the rate at which intra-individual variability decreases during development, and support the idea that intra-individual variability may be a marker of neural development, mimicking the neurodevelopmental changes in these disorders.
Collapse
Affiliation(s)
- Janna van Belle
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Branko M van Hulst
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Magnus Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
17
|
Munz MT, Prehn-Kristensen A, Thielking F, Mölle M, Göder R, Baving L. Slow oscillating transcranial direct current stimulation during non-rapid eye movement sleep improves behavioral inhibition in attention-deficit/hyperactivity disorder. Front Cell Neurosci 2015; 9:307. [PMID: 26321911 PMCID: PMC4531340 DOI: 10.3389/fncel.2015.00307] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 07/27/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Behavioral inhibition, which is a later-developing executive function (EF) and anatomically located in prefrontal areas, is impaired in attention-deficit and hyperactivity disorder (ADHD). While optimal EFs have been shown to depend on efficient sleep in healthy subjects, the impact of sleep problems, frequently reported in ADHD, remains elusive. Findings of macroscopic sleep changes in ADHD are inconsistent, but there is emerging evidence for distinct microscopic changes with a focus on prefrontal cortical regions and non-rapid eye movement (non-REM) slow-wave sleep. Recently, slow oscillations (SO) during non-REM sleep were found to be less functional and, as such, may be involved in sleep-dependent memory impairments in ADHD. OBJECTIVE By augmenting slow-wave power through bilateral, slow oscillating transcranial direct current stimulation (so-tDCS, frequency = 0.75 Hz) during non-REM sleep, we aimed to improve daytime behavioral inhibition in children with ADHD. METHODS Fourteen boys (10-14 years) diagnosed with ADHD were included. In a randomized, double-blind, cross-over design, patients received so-tDCS either in the first or in the second experimental sleep night. Inhibition control was assessed with a visuomotor go/no-go task. Intrinsic alertness was assessed with a simple stimulus response task. To control for visuomotor performance, motor memory was assessed with a finger sequence tapping task. RESULTS SO-power was enhanced during early non-REM sleep, accompanied by slowed reaction times and decreased standard deviations of reaction times, in the go/no-go task after so-tDCS. In contrast, intrinsic alertness, and motor memory performance were not improved by so-tDCS. CONCLUSION Since behavioral inhibition but not intrinsic alertness or motor memory was improved by so-tDCS, our results suggest that lateral prefrontal slow oscillations during sleep might play a specific role for executive functioning in ADHD.
Collapse
Affiliation(s)
- Manuel T. Munz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University KielKiel, Germany
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University KielKiel, Germany
| | - Frederieke Thielking
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University KielKiel, Germany
| | - Matthias Mölle
- Institute of Neuroendocrinology, School of Medicine, University of LübeckLübeck, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University KielKiel, Germany
| | - Lioba Baving
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University KielKiel, Germany
| |
Collapse
|
18
|
Impact of cross-disorder polygenic risk on frontal brain activation with specific effect of schizophrenia risk. Schizophr Res 2015; 161:484-9. [PMID: 25468172 PMCID: PMC4396692 DOI: 10.1016/j.schres.2014.10.046] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/03/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022]
Abstract
Evidence suggests that there is shared genetic aetiology across the major psychiatric disorders conferred by additive effects of many common variants. Measuring their joint effects on brain function may identify common neural risk mechanisms. We investigated the effects of a cross-disorder polygenic risk score (PGRS), based on additive effects of genetic susceptibility to the five major psychiatric disorders, on brain activation during performance of a language-based executive task. We examined this relationship in healthy individuals with (n=82) and without (n=57) a family history of bipolar disorder to determine whether this effect was additive or interactive dependent on the presence of family history. We demonstrate a significant interaction for polygenic loading×group in left lateral frontal cortex (BA9, BA6). Further examination indicated that this was driven by a significant positive correlation in those without a family history (i.e. healthy unrelated volunteers), with no significant relationships in the familial group. We then examined the effect of the individual diagnoses contributing to the PGRS to determine evidence of disorder-specificity. We found a significant association with the schizophrenia polygenic score only, with no other significant relationships. These findings indicate differences in left lateral frontal brain activation in association with increased cross-disorder PGRS in individuals without a family history of psychiatric illness. Lack of effects in the familial group may reflect epistatic effects, shared environmental influences or effects not captured by the PGRS. The specific relationship with loading for schizophrenia is notably consistent with frontal cortical inefficiency as a circumscribed phenotype of psychotic disorders.
Collapse
|
19
|
Verhulst FC, Tiemeier H. Epidemiology of child psychopathology: major milestones. Eur Child Adolesc Psychiatry 2015; 24:607-17. [PMID: 25701924 PMCID: PMC4452764 DOI: 10.1007/s00787-015-0681-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 01/13/2015] [Indexed: 01/13/2023]
Abstract
Child psychiatric epidemiology has developed rapidly from descriptive, cross-sectional studies in the 1960s to the current large-scale prospective cohorts that unravel aetiological mechanisms. The objective of the study was to give an overview of epidemiological studies that have influenced child psychiatry. A chronological overview of selected major milestone studies was obtained to demonstrate the development of child psychiatric epidemiology, with a more in-depth discussion of findings and methodological issues exemplified in one cohort, the Generation R Study. Epidemiological studies have been successful in describing the frequency and course of child psychiatric problems. The high expectations that biological factors can be used to better explain, diagnose or predict child psychiatric problems have not been met. More ambitious large-scale child psychiatric cohort studies are needed, carefully applying genetics, neuroscience or other molecular research to better understand how the brain produces maladaptive behaviour. Progress will only be attained if the basic sciences are systematically integrated in cohorts with rigorous epidemiological designs rather than hurriedly inserted in child psychiatric studies.
Collapse
Affiliation(s)
- Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands,
| | | |
Collapse
|
20
|
van Belle J, van Raalten T, Bos DJ, Zandbelt BB, Oranje B, Durston S. Capturing the dynamics of response variability in the brain in ADHD. Neuroimage Clin 2014; 7:132-41. [PMID: 25610775 PMCID: PMC4299975 DOI: 10.1016/j.nicl.2014.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/12/2014] [Accepted: 11/23/2014] [Indexed: 01/21/2023]
Abstract
ADHD is characterized by increased intra-individual variability in response times during the performance of cognitive tasks. However, little is known about developmental changes in intra-individual variability, and how these changes relate to cognitive performance. Twenty subjects with ADHD aged 7-24 years and 20 age-matched, typically developing controls participated in an fMRI-scan while they performed a go-no-go task. We fit an ex-Gaussian distribution on the response distribution to objectively separate extremely slow responses, related to lapses of attention, from variability on fast responses. We assessed developmental changes in these intra-individual variability measures, and investigated their relation to no-go performance. Results show that the ex-Gaussian measures were better predictors of no-go performance than traditional measures of reaction time. Furthermore, we found between-group differences in the change in ex-Gaussian parameters with age, and their relation to task performance: subjects with ADHD showed age-related decreases in their variability on fast responses (sigma), but not in lapses of attention (tau), whereas control subjects showed a decrease in both measures of variability. For control subjects, but not subjects with ADHD, this age-related reduction in variability was predictive of task performance. This group difference was reflected in neural activation: for typically developing subjects, the age-related decrease in intra-individual variability on fast responses (sigma) predicted activity in the dorsal anterior cingulate gyrus (dACG), whereas for subjects with ADHD, activity in this region was related to improved no-go performance with age, but not to intra-individual variability. These data show that using more sophisticated measures of intra-individual variability allows the capturing of the dynamics of task performance and associated neural changes not permitted by more traditional measures.
Collapse
Affiliation(s)
- Janna van Belle
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tamar van Raalten
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dienke J. Bos
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bram B. Zandbelt
- Department of Psychological Sciences, Vanderbilt University, Nashville, USA
| | - Bob Oranje
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Rudolf Magnus Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
21
|
Poblano A, Luna B, Reynoso C. Differential motor alterations in children with three types of attention deficit hyperactivity disorder. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:856-61. [DOI: 10.1590/0004-282x20140147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 08/07/2014] [Indexed: 11/21/2022]
Abstract
Objective To determine frequency of motor alterations in children with attention deficit hyperactivity disorder (ADHD). Method We evaluated 19 children aged 7-12 years with ADHD classified in three sub-types: Combined (ADHD-C), with Inattention (ADHD-I), and with Hyperactivity (ADHD-H). Controls were age- and gender matched healthy children. We utilized Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) for measuring motor skills. Results We observed differences between children with ADHD and controls in BOTMP general score and in static coordination, dynamic general- and hand- coordination, and in synkinetic movements. We also found differences in dynamic hand coordination between controls and children with ADHD-C; in dynamic general coordination between controls and children with ADHD-H; and in frequency of synkinetic movements between controls and children with ADHD-H. Conclusion Children with ADHD with a major degree of hyperactivity showed greater frequency of motor alterations.
Collapse
|
22
|
Kappel V, Lorenz RC, Streifling M, Renneberg B, Lehmkuhl U, Ströhle A, Salbach-Andrae H, Beck A. Effect of brain structure and function on reward anticipation in children and adults with attention deficit hyperactivity disorder combined subtype. Soc Cogn Affect Neurosci 2014; 10:945-51. [PMID: 25338631 DOI: 10.1093/scan/nsu135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/20/2014] [Indexed: 11/13/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with decreased ventral-striatal responsiveness during reward anticipation. However, previous research mostly focused on adults with heterogeneous ADHD subtype and divers drug treatment status while studies in children with ADHD are sparse. Moreover, it remains unclear to what degree ADHD is characterized by a delay of normal brain structure or function maturation. We therefore attempt to determine whether results from structural and functional magnetic resonance imaging (fMRI) are associated with childhood and adult ADHD combined subtype (ADHD-CT). This study used fMRI to compare VS structure and function of 30 participants with ADHD-CT (16 adults, 14 children) and 30 controls (20 adults, 10 children), using a monetary incentive delay task. Joint analyses of structural and functional imaging data were conducted with Biological Parametric Mapping. Reward anticipation elicited decreased ventral-striatal responsiveness in adults but not in children with ADHD-CT. Children and adults with ADHD showed reduced ventral-striatal volume. Taking these gray matter differences into account, the results remained the same. These results suggest that decreased ventral-striatal responsiveness during reward anticipation is present in adults but not in children with ADHD-CT, irrespective of structural characteristics. The question arises whether ventral-striatal hypoactivity is an ADHD correlate that develops during the course of illness.
Collapse
Affiliation(s)
- Viola Kappel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Robert C Lorenz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Martina Streifling
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Babette Renneberg
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Ulrike Lehmkuhl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Andreas Ströhle
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Harriet Salbach-Andrae
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| | - Anne Beck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany, Clinical Psychology and Psychotherapy, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany, and Department of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany
| |
Collapse
|
23
|
Dang LC, Samanez-Larkin GR, Young JS, Cowan RL, Kessler RM, Zald DH. Caudate asymmetry is related to attentional impulsivity and an objective measure of ADHD-like attentional problems in healthy adults. Brain Struct Funct 2014; 221:277-86. [PMID: 25269835 DOI: 10.1007/s00429-014-0906-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 09/24/2014] [Indexed: 10/24/2022]
Abstract
Case-control studies comparing ADHD with typically developing individuals suggest that anatomical asymmetry of the caudate nucleus is a marker of attention deficit hyperactivity disorder (ADHD). However, there is no consensus on whether the asymmetry favors the right or left caudate nucleus in ADHD, or whether the asymmetry is increased or decreased in ADHD. The current study aimed to clarify this relationship by applying a dimensional approach to assessing ADHD symptoms that, instead of relying on clinical classification, utilizes the natural behavioral continuum of traits related to ADHD. Structural T1-weighted MRI was collected from 71 adults between 18 and 35 years and analyzed for caudate asymmetry. ADHD-like attentional symptoms were assessed with an objective measure of attentional problems, the ADHD score from the Test of Variables of Attention (TOVA). Impulsivity, a core feature in ADHD, was measured using the Barratt Impulsiveness Scale, a self-report measure that assesses attentional, non-planning, and motor features of impulsivity. We found that larger right relative to left caudate volumes correlated with both higher attentional impulsiveness and worse ADHD scores on the TOVA. Higher attentional impulsiveness also correlated with worse ADHD scores, establishing coherence between the objective measure and the self-report measure of attentional problems. These results suggest that a differential passage of information through frontal-striatal networks may produce instability leading to attentional problems. The findings also demonstrate the utility of a dimensional approach to understanding structural correlates of ADHD symptoms.
Collapse
Affiliation(s)
- Linh C Dang
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN, 37203, USA.
| | | | - Jacob S Young
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN, 37203, USA
| | - Ronald L Cowan
- Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Ave South, Nashville, TN, 37212, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Robert M Kessler
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, 219 Wilson Hall, 111 21st Avenue South, Nashville, TN, 37203, USA.,Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Ave South, Nashville, TN, 37212, USA
| |
Collapse
|
24
|
Davies W. Sex differences in attention Deficit Hyperactivity Disorder: candidate genetic and endocrine mechanisms. Front Neuroendocrinol 2014; 35:331-46. [PMID: 24680800 DOI: 10.1016/j.yfrne.2014.03.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/13/2014] [Accepted: 03/17/2014] [Indexed: 02/07/2023]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental condition characterised by severe inattention, pathological impulsivity and hyperactivity; it is relatively common affecting up to 6% of children, and is associated with a risk of long-term adverse educational and social consequences. Males are considerably more likely to be diagnosed with ADHD than females; the course of the disorder and its associated co-morbidities also appear to be sensitive to sex. Here, I discuss fundamental biological (genetic and endocrine) mechanisms that have been shown to, or could theoretically, contribute towards these sexually dimorphic phenomena. Greater understanding of how and why the sexes differ with respect to ADHD vulnerability should allow us to identify and characterise novel protective and risk factors for the disorder, and should ultimately facilitate improved diagnosis, prognosis and treatment.
Collapse
Affiliation(s)
- William Davies
- Behavioural Genetics Group, Neuroscience and Mental Health Research Institute, Schools of Psychology and Medicine, Cardiff University, Tower Building, Park Place, Cardiff CF10 3AT, UK; Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Hadyn Ellis Building, Cardiff CF24 4HQ, UK.
| |
Collapse
|
25
|
Age dependent electroencephalographic changes in attention-deficit/hyperactivity disorder (ADHD). Clin Neurophysiol 2014; 125:1626-38. [DOI: 10.1016/j.clinph.2013.12.118] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/11/2013] [Accepted: 12/17/2013] [Indexed: 01/20/2023]
|
26
|
Saute R, Dabbs K, Jones JE, Jackson DC, Seidenberg M, Hermann BP. Brain morphology in children with epilepsy and ADHD. PLoS One 2014; 9:e95269. [PMID: 24760032 PMCID: PMC3997349 DOI: 10.1371/journal.pone.0095269] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 03/26/2014] [Indexed: 11/18/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is a common comorbidity of childhood epilepsy, but the neuroanatomical correlates of ADHD in epilepsy have yet to be comprehensively characterized. Methods Children with new and recent-onset epilepsy with (n = 18) and without (n = 36) ADHD, and healthy controls (n = 46) underwent high resolution MRI. Measures of cortical morphology (thickness, area, volume, curvature) and subcortical and cerebellar volumes were compared between the groups using the program FreeSurfer 5.1. Results Compared to the control group, children with epilepsy and ADHD exhibited diffuse bilateral thinning in the frontal, parietal and temporal lobes, with volume reductions in the brainstem and subcortical structures (bilateral caudate, left thalamus, right hippocampus). There were very few group differences across measures of cortical volume, area or curvature. Conclusions Children with epilepsy and comorbid ADHD exhibited a pattern of bilateral and widespread decreased cortical thickness as well as decreased volume of subcortical structures and brainstem. These anatomic abnormalities were evident early in the course of epilepsy suggesting the presence of antecedent neurodevelopmental changes, the course of which remains to be determined.
Collapse
Affiliation(s)
- Ricardo Saute
- Faculty of Medicine, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Kevin Dabbs
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Jana E. Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Daren C. Jackson
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University of Science and Medicine, North Chicago, Illinois, United States of America
| | - Bruce P. Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
- * E-mail:
| |
Collapse
|
27
|
Bolea-Alamañac B, Nutt DJ, Adamou M, Asherson P, Bazire S, Coghill D, Heal D, Müller U, Nash J, Santosh P, Sayal K, Sonuga-Barke E, Young SJ. Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2014; 28:179-203. [PMID: 24526134 DOI: 10.1177/0269881113519509] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common condition with a high societal burden. The present guidelines summarise current literature, generating expert consensus recommendations for the treatment of ADHD in children and adults. These guidelines also provide a review of recent research in the fields of neuroimaging, neuropsychology and genetics of ADHD. Novel discoveries in these areas have informed physiological models for the disease. Since the publication of the previous British Association for Psychopharmacology guidelines in 2008, new drugs have been licensed and further compounds are being investigated. The publication of randomised controlled trials of psychological interventions has contributed to the range of treatment options for ADHD. As the disorder has been diagnosed more frequently there has been greater focus on comorbid conditions and how they impact treatment. Services have continued to develop for the treatment of ADHD in adults and care agreements have been introduced to facilitate access to treatment.
Collapse
|
28
|
Campbell BM, Charych E, Lee AW, Möller T. Kynurenines in CNS disease: regulation by inflammatory cytokines. Front Neurosci 2014; 8:12. [PMID: 24567701 PMCID: PMC3915289 DOI: 10.3389/fnins.2014.00012] [Citation(s) in RCA: 279] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/20/2014] [Indexed: 12/27/2022] Open
Abstract
The kynurenine pathway (KP) metabolizes the essential amino acid tryptophan and generates a number of neuroactive metabolites collectively called the kynurenines. Segregated into at least two distinct branches, often termed the “neurotoxic” and “neuroprotective” arms of the KP, they are regulated by the two enzymes kynurenine 3-monooxygenase and kynurenine aminotransferase, respectively. Interestingly, several enzymes in the pathway are under tight control of inflammatory mediators. Recent years have seen a tremendous increase in our understanding of neuroinflammation in CNS disease. This review will focus on the regulation of the KP by inflammatory mediators as it pertains to neurodegenerative and psychiatric disorders.
Collapse
Affiliation(s)
- Brian M Campbell
- Neuroinflammation Disease Biology Unit, Lundbeck Research USA Paramus, NJ, USA
| | - Erik Charych
- Neuroinflammation Disease Biology Unit, Lundbeck Research USA Paramus, NJ, USA
| | - Anna W Lee
- Neuroinflammation Disease Biology Unit, Lundbeck Research USA Paramus, NJ, USA
| | - Thomas Möller
- Neuroinflammation Disease Biology Unit, Lundbeck Research USA Paramus, NJ, USA
| |
Collapse
|
29
|
Barnea-Goraly N, Frazier TW, Piacenza L, Minshew NJ, Keshavan MS, Reiss AL, Hardan AY. A preliminary longitudinal volumetric MRI study of amygdala and hippocampal volumes in autism. Prog Neuropsychopharmacol Biol Psychiatry 2014; 48:124-8. [PMID: 24075822 PMCID: PMC8655120 DOI: 10.1016/j.pnpbp.2013.09.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/03/2013] [Accepted: 09/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies suggest that amygdala volume, when compared with healthy controls, is increased in young children with autism, is unchanged in cohorts of older youth, and is smaller in adults. Hippocampal volume, however, does not appear to have age-related changes, and it is unclear whether individuals with autism have volumetric differences in this structure. The goal of this pilot investigation is to characterize the developmental trajectories of the amygdala and hippocampus in children with autism between the ages of 8 and 14years and to examine clinical correlates of volume change. METHODS Twenty-three children with autism and 23 controls between the ages of 8 and 12 underwent a magnetic resonance imaging procedure of the brain (T1-weighted) at two time points. Nine children with autism and 14 controls had good quality scans from both time points; however, all usable scans from all subjects (15 children with autism and 22 controls) were included in a mixed effect analysis. Regression models were used to estimate group differences in amygdala and hippocampal volumes. Changes in amygdala and hippocampal volumes (Time 2-Time 1) were correlated with clinical severity measures. RESULTS Amygdala volume changes with time were similar between the two groups. Within the autism group, right amygdala volume change was correlated with the ability to establish appropriate eye contact. Right hippocampal volume was significantly increased in the autism group when compared with controls. Differences in right hippocampal volume change with time between the two groups approached significance. CONCLUSION This study provides preliminary evidence of normalization of amygdala volumes in late childhood and adolescence. It also suggests that hippocampal volumetric differences may exist in autism in late childhood and adolescence.
Collapse
Affiliation(s)
- Naama Barnea-Goraly
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford,Corresponding author
| | | | - Lucia Piacenza
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford
| | - Nancy J. Minshew
- Department of Psychiatry and Neurology, University of Pittsburgh
| | | | - Allan L. Reiss
- Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford,Department of Pediatrics Stanford University, Stanford, CA,Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, United States
| |
Collapse
|
30
|
Konicarova J, Bob P, Raboch J. Balance deficits and ADHD symptoms in medication-naïve school-aged boys. Neuropsychiatr Dis Treat 2014; 10:85-8. [PMID: 24476629 PMCID: PMC3896312 DOI: 10.2147/ndt.s56017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Functional disturbances developed early in life include balance deficits which are linked to dysfunctions of higher levels of cognitive and motor integration. According to our knowledge, there are only a few studies suggesting that balance deficits are related to behavioral disturbances in attention-deficit/hyperactivity disorder (ADHD). METHODS We tested the extent to which balance deficits were related to ADHD symptoms in 35 medication-naïve boys of school age (8-11 years) and compared the results with a control group of 30 boys of the same age. RESULTS ADHD symptoms in medication-naïve boys had specific relationships to disturbances of postural and gait balance. CONCLUSION To our knowledge, this study provides the first evidence in the medical literature for a direct relationship between ADHD symptoms and balance deficits, that cannot be attributed to medication and the presence of any neurological disease.
Collapse
Affiliation(s)
- Jana Konicarova
- Center for Neuropsychiatric Rsearch of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Bob
- Center for Neuropsychiatric Rsearch of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic ; Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Raboch
- Center for Neuropsychiatric Rsearch of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| |
Collapse
|
31
|
Cortese S, Imperati D, Zhou J, Proal E, Klein RG, Mannuzza S, Ramos-Olazagasti MA, Milham MP, Kelly C, Castellanos FX. White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder. Biol Psychiatry 2013; 74:591-8. [PMID: 23566821 PMCID: PMC3720804 DOI: 10.1016/j.biopsych.2013.02.025] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 02/02/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is increasingly conceived as reflecting altered functional and structural brain connectivity. The latter can be addressed with diffusion tensor imaging (DTI). We examined fractional anisotropy (FA), a DTI index related to white matter structural properties, in adult male subjects diagnosed with ADHD in childhood (probands) and matched control subjects without childhood ADHD. Additionally, we contrasted FA among probands with and without current ADHD in adulthood and control subjects. METHODS Participants were from an original cohort of 207 boys and 178 male control subjects. At 33-year follow-up, analyzable DTI scans were obtained in 51 probands (41.3 ± 2.8 yrs) and 66 control subjects (41.2 ± 3.1 yrs). Voxel-based FA was computed with tract-based spatial statistics, controlling for multiple comparisons. RESULTS Probands with childhood ADHD exhibited significantly lower FA than control subjects without childhood ADHD in the right superior and posterior corona radiata, right superior longitudinal fasciculus, and in a left cluster including the posterior thalamic radiation, the retrolenticular part of the internal capsule, and the sagittal stratum (p<.05, corrected). Fractional anisotropy was significantly decreased relative to control subjects in several tracts in both probands with current and remitted ADHD, who did not differ significantly from each other. Fractional anisotropy was not significantly increased in probands in any region. CONCLUSIONS Decreased FA in adults with childhood ADHD regardless of current ADHD might be an enduring trait of ADHD. White matter tracts with decreased FA connect regions involved in high-level as well as sensorimotor functions, suggesting that both types of processes are involved in the pathophysiology of ADHD.
Collapse
Affiliation(s)
- Samuele Cortese
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, New York University Langone School of Medicine, New York; Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy; UMR_S INSERM U 930, CNRS ERL 3106, François-Rabelais University, Child Psychiatry Centre, University Hospital, Tours, France.
| | - Davide Imperati
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Juan Zhou
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Duke-NUS Graduate Medical School, Neuroscience and Behavioral Disorders Program, & the Agency for Science, Technology and Research, Neuroscience Research Partnership, Singapore
| | - Erika Proal
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Neuroingenia Clinical and Research Center, México, D.F., México
| | - Rachel G. Klein
- Anita Saltz Institute for Anxiety and Mood Disorders, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Salvatore Mannuzza
- Anita Saltz Institute for Anxiety and Mood Disorders, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Maria A. Ramos-Olazagasti
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Michael P. Milham
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA,Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Clare Kelly
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - F. Xavier Castellanos
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| |
Collapse
|
32
|
Ramos-Quiroga JA, Montoya A, Kutzelnigg A, Deberdt W, Sobanski E. Attention deficit hyperactivity disorder in the European adult population: prevalence, disease awareness, and treatment guidelines. Curr Med Res Opin 2013; 29:1093-104. [PMID: 23742051 DOI: 10.1185/03007995.2013.812961] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder with childhood onset and persistence into adolescence and adulthood. METHODS Our literature review reports scientific publications and guidelines on the treatment of adult ADHD, with a particular focus on European countries, identified by literature searches in Medline and Embase. The final literature search was performed in July 2012, incorporating literature from 1974 to 2012. The primary research parameters were 'Europe' (including single European countries), 'ADHD', 'attention deficit disorder', 'attention deficit', 'attention disorder', and 'hyperactivity'. Secondary search parameters were 'comorbid', 'epidemiology' or 'prevalence', 'disease management', 'drug therapy', or 'therapy'. The main searches were also limited to adults and English language publications. The papers identified by this literature review were selected for inclusion by consensus of the authors based on clinical relevance. RESULTS Appropriate resources for the diagnosis and treatment of adult ADHD in Europe are scarce, and many cases go untreated, particularly because of the frequent presence of psychiatric comorbidities. Apart from atomoxetine, and an extended-release form of methylphenidate in Germany, no other medications have been approved for starting treatment in adult ADHD patients in the European Union. However, a variety of stimulant and non-stimulant medications are used off-label, and a number of studies have confirmed that these medications are well tolerated and effective in adult patients with ADHD. CONCLUSIONS Our results emphasize the need for broader access to effective treatments for adult ADHD patients in Europe.
Collapse
|
33
|
Urbain C, Galer S, Van Bogaert P, Peigneux P. Pathophysiology of sleep-dependent memory consolidation processes in children. Int J Psychophysiol 2013; 89:273-83. [DOI: 10.1016/j.ijpsycho.2013.06.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/13/2013] [Accepted: 06/17/2013] [Indexed: 11/30/2022]
|
34
|
Konicarova J, Bob P, Raboch J. Persisting primitive reflexes in medication-naïve girls with attention-deficit and hyperactivity disorder. Neuropsychiatr Dis Treat 2013; 9:1457-61. [PMID: 24092983 PMCID: PMC3788695 DOI: 10.2147/ndt.s49343] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent and historical findings suggest that later-developed functions during brain ontogenesis related to higher levels of cognitive and motor integration tend to replace the older, more primitive, ones, and the persistence of the older functions may be linked to specific neuropsychiatric disorders. Currently, there is growing evidence to suggest that persisting primitive reflexes may be related to developmental and neurodegenerative disorders. Preliminary data also suggest that persisting primitive reflexes may be specifically linked to attention-deficit and hyperactivity disorder (ADHD). METHODS In the study reported here, we tested to what extent the persisting primitive asymmetric tonic neck reflex and symmetric tonic neck reflex are related to ADHD symptoms measured by Conners' Parent Questionnaire in 35 medication-naïve girls of school age (8-11 years) with ADHD. The results were compared with those of a control group of 30 girls of the same age. RESULTS This study showed that persisting primitive reflexes are closely linked to ADHD symptoms. CONCLUSION The data suggest that ADHD symptoms may be linked to more primitive neural mechanisms interfering with higher brain functions due to insufficiently developed cognitive and motor integration.
Collapse
Affiliation(s)
- Jana Konicarova
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech republic
| | | | | |
Collapse
|
35
|
Nguyen AT, Nishijo M, Hori E, Nguyen NM, Pham TT, Fukunaga K, Nakagawa H, Tran AH, Nishijo H. Influence of Maternal Exposure to 2,3,7,8-Tetrachlorodibenzo-p-dioxin on Socioemotional Behaviors in Offspring Rats. ENVIRONMENTAL HEALTH INSIGHTS 2013; 7:1-14. [PMID: 23493046 PMCID: PMC3588853 DOI: 10.4137/ehi.s10346] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Effects of dioxins on cognitive functions were reported in previous studies conducted in humans and animals. In the present study, we investigated the influence of dioxin exposure during pregnancy on social interaction and on the activity of offspring, which are related to neurodevelopmental disturbances. In addition, we analyzed neurochemical alterations of the limbic system of rat brains to suggest one mechanism of dioxin effects on brain function. We believe that this manuscript is suitable for publication in "Environmental Health Insights" because it provides an interesting topic for a wide global audience. To clarify the relationships between maternal dioxin exposure and socioemotional functions of rat offspring, dams were given TCDD (1.0 μg/kg) on gestational day 15. Social interactions and forced swimming time were compared between TCDD-exposed and control offspring in each gender. Frequency and duration of locomotion were higher, and durations per one behavior of proximity and social contact were significantly lower in the exposed males, while only the duration of proximity was lower in the exposed females. Forced swimming time on the first day was significantly longer in the exposed males. In the limbic system of the rat brain, the levels and/or activity of CaMKIIα were decreased in males and were increased in females in the exposed offspring. These results suggest that prenatal TCDD exposure induces hyperactivity and socioemotional deficits, particularly in the male offspring due to alterations in CaMKIIα activity in the limbic system of the brain.
Collapse
Affiliation(s)
- Anh T.N. Nguyen
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Muneko Nishijo
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
- Corresponding author
| | - Etsuro Hori
- System Emotional Science, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Nui M. Nguyen
- System Emotional Science, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Tai T. Pham
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
- Biomedical Pharmaceutical Research Center, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Kohji Fukunaga
- Department of Pharmacology, Graduate School of Pharmaceutical Science, Tohoku University, Miyagi, Japan
| | - Hideaki Nakagawa
- Department of Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Anh H. Tran
- Department of Physiology, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine, University of Toyama, Toyama, Japan
| |
Collapse
|
36
|
Adler LA, Kroon RA, Stein M, Shahid M, Tarazi FI, Szegedi A, Schipper J, Cazorla P. A translational approach to evaluate the efficacy and safety of the novel AMPA receptor positive allosteric modulator org 26576 in adult attention-deficit/hyperactivity disorder. Biol Psychiatry 2012; 72:971-7. [PMID: 22771238 DOI: 10.1016/j.biopsych.2012.05.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 04/21/2012] [Accepted: 05/07/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND It has been posited that glutamate dysregulation contributes to the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). Modulation of glutamate neurotransmission may provide alternative therapeutic options. The novel 2-amino-3-(5-methyl-3-oxo-1,2-oxazol-4-yl)propanoic acid receptor positive allosteric modulator Org 26576 was investigated with a translational approach including preclinical and clinical testing. METHODS Neonatal rat 6-hydroxydopamine lesion-induced hyperactivity was used as preclinical model. Seventy-eight ADHD adults entered a multicenter, double-blind, placebo-controlled, two-period crossover trial. After 1 week placebo lead-in, 67 subjects were randomized into one of four treatment sequences: sequence A (n = 15) Org 26576 (100 mg b.i.d.) for 3 weeks, followed by a 2-week placebo crossover and 3 weeks placebo; sequence B (n = 16) 5 weeks placebo followed by 3 weeks Org 26576 (100 mg b.i.d.); sequence C (n = 18) Org 26576 flexible dose (100-300 mg b.i.d.) for 3 weeks, then 5 weeks placebo; sequence D (n = 18) 5 weeks placebo followed by 3 weeks Org 26576 (100-300 mg b.i.d.). The Adult ADHD Investigator Symptom Rating Scale was used to assess changes in ADHD symptomatology. RESULTS Org 26576 (1, 3, 10 mg/kg intraperitoneal) produced dose-dependent inhibition of locomotor hyperactivity in 6-hydroxydopamine-lesioned rats. Org 26576 (100 mg b.i.d.) was superior to placebo in treating symptoms of adult ADHD subjects. The primary Adult ADHD Investigator Symptom Rating Scale results were supported by some secondary analyses. However, Org 26576 (100-300 mg b.i.d.) did not confirm these results. Most frequently reported adverse events were nausea, dizziness, and headache. CONCLUSIONS These preclinical and clinical findings suggest that Org 25676 may have utility in the treatment of ADHD.
Collapse
Affiliation(s)
- Lenard A Adler
- Departments of Psychiatry and Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10017, USA
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Xia S, Li X, Kimball AE, Kelly MS, Lesser I, Branch C. Thalamic shape and connectivity abnormalities in children with attention-deficit/hyperactivity disorder. Psychiatry Res 2012; 204:161-7. [PMID: 23149038 PMCID: PMC3518751 DOI: 10.1016/j.pscychresns.2012.04.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 02/03/2012] [Accepted: 04/22/2012] [Indexed: 11/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by widespread structural and functional abnormalities in the cortico-striato-thalmo-cortical (CSTC) loops that subserve attention and executive functions. In this study, we analyzed thalamic shape and its white matter connections using structural magnetic resonance imaging and diffusion (DTI) data acquired from children with ADHD (n=19) and controls (n=19). Shape morphology of the thalamus was assessed using shape-based analysis, while connectivity between the thalamus and other brain regions was determined using probabilistic diffusion tractography. Shape-based analysis indicated significant regional atrophy in the left thalamus in children with ADHD compared to controls. Group analyses of white matter connectivity measures showed significantly decreased mean fractional anisotropy (FA) and volume of the tracts between thalamus and striatum, hippocampus, and prefrontal lobe in children with ADHD compared to controls. The structural abnormalities within the thalamus and the reduced integrity of the white matter tracks between the thalamus and other brain regions, as shown from the results of this study, may be the anatomical bases of the impaired cognitive performances in the attention and executive function domains in ADHD.
Collapse
Affiliation(s)
- Shugao Xia
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Xiaobo Li
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
- Department of Radiology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
- Department of Neuroscience, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
- Address all correspondence to: Xiaobo Li, Ph.D., Department of Radiology, Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Avenue, Gruss 204, Bronx, NY 10461, U.S, Phone: 718-430-4015, Fax: 728-430-3399, ;
| | - Ariane E. Kimball
- Ferkauf School of Graduate Psychology, Yeshiva University, Bronx, NY
| | - Mary S. Kelly
- Department of Pediatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Iris Lesser
- Department of Pediatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Craig Branch
- Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
- Department of Radiology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| |
Collapse
|
38
|
Atypical pulvinar-cortical pathways during sustained attention performance in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2012; 51:1197-1207.e4. [PMID: 23101745 PMCID: PMC3734849 DOI: 10.1016/j.jaac.2012.08.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 07/09/2012] [Accepted: 08/10/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The neurobiological basis of inattentiveness, a core feature of attention-deficit/hyperactivity disorder (ADHD), is not yet well understood. Structural abnormalities in thalamus, especially the pulvinar nuclei, have recently been reported in ADHD. Pulvinar nuclei maintain reciprocal connections with cortical/subcortical areas, and play a central coordinating role during visual attention processing. The objective of this study was to test the hypothesis that children and young adolescents with ADHD would show atypical pulvinar-cortical functional pathways during sustained attention performance, and that these functional abnormalities would be associated with the inattentive symptoms of the disorder. METHOD Visual attention task-based functional magnetic resonance imaging (fMRI) data from 22 children and young adolescents with ADHD and 22 demographically matched, normal control subjects were analyzed. Cortical activation maps and temporal correlations of activity patterns between pulvinar nuclei and the remainder of brain were constructed for each participant. Correlations between activation magnitude of pulvinar and diagnostic measures were calculated in subjects with ADHD. RESULTS Compared to controls, subjects with ADHD showed significantly reduced pulvinar activations bilaterally, significantly decreased functional connectivity between bilateral pulvinar and right prefrontal regions, and significantly increased connectivity between the right pulvinar and bilateral occipital regions. In addition, the activation magnitude in the left pulvinar was negatively correlated with the DSM-IV inattentive index in ADHD group. CONCLUSIONS Allied with previous evidence of structural abnormalities in pulvinar, the current data suggest that inappropriate development of pulvinar may lead to disrupted functional circuits for visual attention processing, and that these disruptions contribute significantly to the pathophysiological mechanisms of the inattentiveness symptoms in ADHD.
Collapse
|
39
|
Grant JA, Duerden EG, Courtemanche J, Cherkasova M, Duncan GH, Rainville P. Cortical thickness, mental absorption and meditative practice: possible implications for disorders of attention. Biol Psychol 2012; 92:275-81. [PMID: 23046904 DOI: 10.1016/j.biopsycho.2012.09.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 09/12/2012] [Accepted: 09/12/2012] [Indexed: 11/20/2022]
Abstract
Mental training techniques rooted in meditation are associated with attention improvement, increased activation and cortical thickening of attention/executive-related brain areas. Interestingly, attention-deficit/hyperactivity disorder (ADHD) is associated with behavioural deficits, hypo-activation and cortical thinning of similar networks. This study assessed the relationship between prior meditative training, attentional absorption, and cortical thickness. Grey matter thickness was measured in 18 meditators and 18 controls. Subjective reports of attentional absorption were modestly higher in meditators and across the entire sample correlated positively with cortical thickness in several regions corresponding to cingulo-fronto-parietal attention networks. Within these regions the meditation group had greater cortical thickness which was positively related to the extent of prior training. Evidence suggesting that meditative practice activates these cortical areas, improves attention and may ameliorate symptoms of ADHD by targeting vulnerable brain regions is discussed.
Collapse
Affiliation(s)
- Joshua A Grant
- Département de Physiologie, Université de Montréal, Montréal, QC, Canada.
| | | | | | | | | | | |
Collapse
|
40
|
Labbe A, Liu A, Atherton J, Gizenko N, Fortier MÈ, Sengupta SM, Ridha J. Refining psychiatric phenotypes for response to treatment: contribution of LPHN3 in ADHD. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:776-85. [PMID: 22851411 DOI: 10.1002/ajmg.b.32083] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 07/05/2012] [Indexed: 11/10/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder characterized by inappropriate levels of attention, hyperactivity, and impulsivity. Although a strong genetic component to the disorder has been established, the molecular genetic underpinnings of this disorder remain elusive. Recently, several studies have reported an association between polymorphisms within the latrophilin 3 gene (LPHN3) and ADHD. Interestingly, the same single-nucleotide polymorphism conferring susceptibility to ADHD has also been found to predict efficacy of stimulant medication in children. The main objectives of the current article are: (i) To tackle the phenotype heterogeneity issue in ADHD by defining an objective and quantitative measure of response to treatment in a sample of ADHD children based on a hand held automatic device (Actiwatch) and (ii) to use this measure to reproduce for the first time the association between LPHN3 variants and response to methylphenidate (MPH) using a double-blind, placebo-controlled crossover experimental design. The results of our study confirm the hypothesis that LPHN3 is associated with response to MPH in ADHD children. Although this will require further validation, our work suggests that the use of an objective measure of response to treatment, such as the change in the child's motor activity measured by Actiwatch, has the potential to uncover genetic association signals that in some conditions might not be obtained using more subjective measures, such as the clinical consensus rating, for example.
Collapse
Affiliation(s)
- Aurelie Labbe
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | | | | | | | | | | | | |
Collapse
|
41
|
The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know. Eur J Paediatr Neurol 2012; 16:422-33. [PMID: 22306277 DOI: 10.1016/j.ejpn.2012.01.009] [Citation(s) in RCA: 179] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 12/18/2011] [Accepted: 01/12/2012] [Indexed: 01/07/2023]
Abstract
This review, addressed mainly to clinicians, considers commonly asked questions related to the neuroimaging, neurophysiology, neurochemistry and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD). It provides answers based on the most recent meta-analyses and systematic reviews, as well as additional relevant original studies. Empirical findings from neurobiological research into ADHD reflect a shift in the conceptualisation of this disorder from simple theoretical views of a few isolated dysfunctions to more complex models integrating the heterogeneity of the clinical manifestations of ADHD. Thus, findings from structural and functional neuroimaging suggest the involvement of developmentally abnormal brain networks related to cognition, attention, emotion and sensorimotor functions. Brain functioning alterations are confirmed by neurophysiological findings, showing that individuals with ADHD have elevated theta/beta power ratios, and less pronounced responses and longer latencies of event-related potentials, compared with controls. At a molecular level, alterations in any single neurotransmitter system are unlikely to explain the complexity of ADHD; rather, the disorder has been linked to dysfunctions in several systems, including the dopaminergic, adrenergic, serotoninergic and cholinergic pathways. Genetic studies showing a heritability of ∼60-75% suggest that a plethora of genes, each one with a small but significant effect, interact with environmental factors to increase the susceptibility to ADHD. Currently, findings from neurobiological research do not have a direct application in daily clinical practice, but it is hoped that in the near future they will complement the diagnostic process and contribute to the long-term effective treatment of this impairing condition.
Collapse
|
42
|
Sleep-dependent memory consolidation – What can be learnt from children? Neurosci Biobehav Rev 2012; 36:1718-28. [DOI: 10.1016/j.neubiorev.2012.03.002] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 02/20/2012] [Accepted: 03/02/2012] [Indexed: 11/20/2022]
|
43
|
Choudhry Z, Sengupta SM, Grizenko N, Fortier ME, Thakur GA, Bellingham J, Joober R. LPHN3 and attention-deficit/hyperactivity disorder: interaction with maternal stress during pregnancy. J Child Psychol Psychiatry 2012; 53:892-902. [PMID: 22486528 DOI: 10.1111/j.1469-7610.2012.02551.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous behavioral disorder, complex both in etiology and clinical expression. Both genetic and environmental factors have been implicated, and it has been suggested that gene-environment interactions may play a pivotal role in the disorder. Recently, a significant association was reported between ADHD and LPHN3 (which codes for latrophilin 3), and replicated in independent samples. METHODS We have examined the association between tag single nucleotide polymorphisms (SNPs) in LPHN3 within the region previously implicated in ADHD. Family based association tests (FBAT) were conducted (n = 380 families) with the categorical diagnosis of ADHD, behavioral and cognitive phenotypes related to ADHD, and response to treatment (given a fixed dose of methylphenidate, 0.5 mg/day). Stratified FBAT analyses, based on maternal smoking and stress during pregnancy, was conducted. RESULTS Whereas limited association was observed in the total sample, highly significant interaction between four LPHN3 tag SNPs (rs6551665, rs1947274, rs6858066, rs2345039) and maternal stress during pregnancy was noted. Analysis conducted in the sub-group of mothers exposed to minimal stress during pregnancy showed significant associations with ADHD, behavioral and cognitive dimensions related to ADHD, as well as treatment response. Although extensive association was observed with the candidate SNPs, the findings are partially inconsistent with previously published results with the opposite alleles over-transmitted in these studies. CONCLUSIONS These results provide evidence for the interaction between a genetic and environmental factor independently shown to be associated with ADHD. If confirmed in independent large studies, they may present a step forward in unraveling the complex etiology of ADHD.
Collapse
Affiliation(s)
- Zia Choudhry
- Douglas Mental Health University Institute, McGill University, Verdun, QC, Canada
| | | | | | | | | | | | | |
Collapse
|
44
|
Influence of stimulant medication and response speed on lateralization of movement-related potentials in attention-deficit/hyperactivity disorder. PLoS One 2012; 7:e39012. [PMID: 22720017 PMCID: PMC3375242 DOI: 10.1371/journal.pone.0039012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/15/2012] [Indexed: 12/02/2022] Open
Abstract
Background Hyperactivity is one of the core symptoms in attention deficit hyperactivity disorder (ADHD). However, it remains unclear in which way the motor system itself and its development are affected by the disorder. Movement-related potentials (MRP) can separate different stages of movement execution, from the programming of a movement to motor post-processing and memory traces. Pre-movement MRP are absent or positive during early childhood and display a developmental increase of negativity. Methods We examined the influences of response-speed, an indicator of the level of attention, and stimulant medication on lateralized MRP in 16 children with combined type ADHD compared to 20 matched healthy controls. Results We detected a significantly diminished lateralisation of MRP over the pre-motor and primary motor cortex during movement execution (initial motor potential peak, iMP) in patients with ADHD. Fast reactions (indicating increased visuo-motor attention) led to increased lateralized negativity during movement execution only in healthy controls, while in children with ADHD faster reaction times were associated with more positive amplitudes. Even though stimulant medication had some effect on attenuating group differences in lateralized MRP, this effect was insufficient to normalize lateralized iMP amplitudes. Conclusions A reduced focal (lateralized) motor cortex activation during the command to muscle contraction points towards an immature motor system and a maturation delay of the (pre-) motor cortex in children with ADHD. A delayed maturation of the neuronal circuitry, which involves primary motor cortex, may contribute to ADHD pathophysiology.
Collapse
|
45
|
Bolea B, Adamou M, Arif M, Asherson P, Gudjonsson G, Müller U, Nutt DJ, Pitts M, Thome J, Young S. ADHD matures: time for practitioners to do the same? J Psychopharmacol 2012; 26:766-70. [PMID: 21890596 DOI: 10.1177/0269881111410898] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention deficit and hyperactivity disorder (ADHD) is not restricted to children. Abundant evidence from follow-up studies accumulated since the 1970s supports the concept of ADHD in adulthood. Genetic research points to a heritability of 76%, and neuroimaging studies have reported structural and functional brain abnormalities in patients with ADHD. Contrary to popular belief, ADHD is not a culturally bound disorder and has been described worldwide. ADHD has a cost for society, as adults with this disorder suffer from increased rates of unemployment and psychiatric comorbidity, including substance use disorders. Studies undertaken in forensic populations describe high rates of ADHD in these groups, particularly amongst young offenders. One of the main issues in the diagnosis of ADHD in the adult is the fact that most clinicians have not been educated to diagnose and treat ADHD. Effective pharmacological treatments for ADHD are available and should be prescribed for these patients. The National Institute for Health and Clinical Excellence (NICE) and the British Association for Psychopharmacology (BAP) guidelines established a benchmark for service development required to treat ADHD adequately in the adult population. However, the implementation of new services has been slow. More resources are needed to effectively assess and treat ADHD in the adult.
Collapse
Affiliation(s)
- B Bolea
- Psychopharmacology Unit, University of Bristol, Bristol, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
OBJECTIVE Recent theories regarding the neuropathology of bipolar disorder suggest that both neurodevelopmental and neurodegenerative processes may play a role. While magnetic resonance imaging has provided significant insight into the structural, functional, and connectivity abnormalities associated with bipolar disorder, research assessing longitudinal changes has been more limited. However, such research is essential to elucidate the pathophysiology of the disorder. The aim of our review is to examine the extant literature for developmental and progressive structural and functional changes in individuals with and at risk for bipolar disorder. METHODS We conducted a literature review using MEDLINE and the following search terms: bipolar disorder, risk, child, adolescent, bipolar offspring, MRI, fMRI, DTI, PET, SPECT, cross-sectional, longitudinal, progressive, and developmental. Further relevant articles were identified by cross-referencing with identified manuscripts. CONCLUSIONS There is some evidence for developmental and progressive neurophysiological alterations in bipolar disorder, but the interpretation of correlations between neuroimaging findings and measures of illness exposure or age in cross-sectional studies must be performed with care. Prospective longitudinal studies placed in the context of normative developmental and atrophic changes in neural structures and pathways thought to be involved in bipolar disorder are needed to improve our understanding of the neurodevelopmental underpinnings and progressive changes associated with bipolar disorder.
Collapse
Affiliation(s)
- Marguerite Reid Schneider
- Physician Scientist Training Program, Neuroscience Graduate Program Department, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0516, USA
| | | | | | | | | |
Collapse
|
47
|
Muftuler LT, Davis EP, Buss C, Solodkin A, Su MY, Head KM, Hasso AN, Sandman CA. Development of white matter pathways in typically developing preadolescent children. Brain Res 2012; 1466:33-43. [PMID: 22634375 DOI: 10.1016/j.brainres.2012.05.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 04/03/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
Abstract
The first phase of major neuronal rearrangements in the brain takes place during the prenatal period. While the brain continues maturation throughout childhood, a critical second phase of synaptic overproduction and elimination takes place during the preadolescent period. Despite the importance of this developmental phase, few studies have evaluated neural changes taking place during this period. In this study, MRI diffusion tensor imaging data from a normative sample of 126 preadolescent children (59 girls and 67 boys) between the ages of 6 and 10 years were analyzed in order to characterize age-relationships in the white matter microstructure. Tract Based Spatial Statistics (TBSS) method was used for whole brain analysis of white matter tracts without a priori assumption about the location of age associated differences. Our results demonstrate significant age-associated differences in most of the major fiber tracts bilaterally and along the whole body of the tracts. In contrast, developmental differences in the cingulum at the level of the parahippocampal region were only observed in the right hemisphere. We suggest that these age-relationships with a widespread distribution seen during the preadolescent years maybe relevant for the implementation of cognitive and social behaviors needed for a normal development into adulthood.
Collapse
Affiliation(s)
- L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Froedtert Hospital, 9200 W. Wisconsin Ave., Milwaukee WI 53226, USA.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Myatchin I, Lemiere J, Danckaerts M, Lagae L. Within-subject variability during spatial working memory in children with ADHD: an event-related potentials study. Eur Child Adolesc Psychiatry 2012; 21:199-210. [PMID: 22311145 DOI: 10.1007/s00787-012-0253-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 01/23/2012] [Indexed: 11/25/2022]
Abstract
Working memory (WM) dysfunction and increased within-subject variability are known issues in attention deficit/hyperactivity disorder (ADHD) patients. Little is known about the electrophysiological characteristics of this variability. We evaluated behavioral and electrophysiological within-subject variability taking developmental aspects into account in a group of ADHD patients. Multichannel (n = 31) event-related potentials (ERP) were measured during a visuo-spatial backmatching task; 44 children (8-16 years old) were tested: 22 children with ADHD, combined (n = 17) and inattentive (n = 5) type, and 22 age- and intelligence-matched control children. One-backmatching (BM1) and two-backmatching (BM2) tasks were performed. Classical behavioral parameters and target and nontarget ERP were compared between groups. In addition, motor response variability and ERP amplitude variability were studied. Age-related changes in both motor response and ERP amplitude variability were analyzed in each group. Attention deficit/hyperactivity disorder children made more commission errors, which was more pronounced in the difficult (BM2) task. No difference between groups was found in ERP amplitude and in motor response variability. However, ADHD patients had higher ERP amplitude variability, which was again more pronounced in the difficult WM task. A delayed maturation of amplitude variability was seen in ADHD patients with a slower than in controls decrease in variability with age. This amplitude variability was correlated with the number of commissions, but in an opposite way for ADHD and control children. Our findings indicate an impaired visuo-spatial WM processing in ADHD children with greater ERP amplitude variability compared to controls. Our results also support the view of a delayed cortical development of visuo-spatial WM circuits in this disorder.
Collapse
Affiliation(s)
- I Myatchin
- Department of Woman and Child, Section Paediatric Neurology, University Hospitals KULeuven, Herestraat 49, 3000 Leuven, Belgium
| | | | | | | |
Collapse
|
49
|
Wittfoth M, Bornmann S, Peschel T, Grosskreutz J, Glahn A, Buddensiek N, Becker H, Dengler R, Müller-Vahl KR. Lateral frontal cortex volume reduction in Tourette syndrome revealed by VBM. BMC Neurosci 2012; 13:17. [PMID: 22333536 PMCID: PMC3305595 DOI: 10.1186/1471-2202-13-17] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/14/2012] [Indexed: 02/07/2023] Open
Abstract
Background Structural changes have been found predominantly in the frontal cortex and in the striatum in children and adolescents with Gilles de la Tourette syndrome (GTS). The influence of comorbid symptomatology is unclear. Here we sought to address the question of gray matter abnormalities in GTS patients with co-morbid obsessive-compulsive disorder (OCD) and/or attention deficit hyperactivity disorder (ADHD) using voxel-based morphometry (VBM) in twenty-nine adult actually unmedicated GTS patients and twenty-five healthy control subjects. Results In GTS we detected a cluster of decreased gray matter volume in the left inferior frontal gyrus (IFG), but no regions demonstrating volume increases. By comparing subgroups of GTS with comorbid ADHD to the subgroup with comorbid OCD, we found a left-sided amygdalar volume increase. Conclusions From our results it is suggested that the left IFG may constitute a common underlying structural correlate of GTS with co-morbid OCD/ADHD. A volume reduction in this brain region that has been previously identified as a key region in OCD and was associated with the active inhibition of attentional processes may reflect the failure to control behavior. Amygdala volume increase is discussed on the background of a linkage of this structure with ADHD symptomatology. Correlations with clinical data revealed gray matter volume changes in specific brain areas that have been described in these conditions each.
Collapse
Affiliation(s)
- Matthias Wittfoth
- Department of Neurology, Hannover Medical School, Hannover, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Fernández-Jaén A, Fernández-Mayoralas DM, Quiñones Tapia D, Calleja-Pérez B, García-Segura JM, Arribas SL, Muñoz Jareño N. Cortical thickness in fetal alcohol syndrome and attention deficit disorder. Pediatr Neurol 2011; 45:387-91. [PMID: 22115001 DOI: 10.1016/j.pediatrneurol.2011.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 09/06/2011] [Indexed: 01/21/2023]
Abstract
Fetal alcohol syndrome represents the classic and most severe manifestation of epigenetic changes induced by exposure to alcohol during pregnancy. Often these patients develop attention deficit hyperactivity disorder. We analyzed cortical thickness in 20 children and adolescents with fetal alcohol syndrome and attention deficit hyperactivity disorder (group 1), in 20 patients without fetal alcohol syndrome (group 2), and in 20 control cases. The first group revealed total cortical thickness significantly superior to those of the other two groups. In per-lobe analyses of cortical thickness, group 1 demonstrated greater cortical thickness in the frontal, occipital, and right temporal and left frontal lobes compared with the second group, and in both temporal lobes and the right frontal lobe compared with the control group. This study demonstrated greater cortical thickness in patients with attention deficit hyperactivity disorder and heavy prenatal exposure to alcohol, probably as an expression of immature or abnormal brain development.
Collapse
|