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Wu ZM, Wang P, Zhong YY, Liu Y, Liu XC, Wang JJ, Cao XL, Liu L, Sun L, Yang L, Zang YF, Qian Y, Cao QJ, Wang YF, Yang BR. The underlying neuropsychological and neural correlates of the impaired Chinese reading skills in children with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02422-w. [PMID: 38662058 DOI: 10.1007/s00787-024-02422-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/15/2024] [Indexed: 04/26/2024]
Abstract
Impaired basic academic skills (e.g., word recognition) are common in children with Attention Deficit Hyperactivity Disorder (ADHD). The underlying neuropsychological and neural correlates of impaired Chinese reading skills in children with ADHD have not been substantially explored. Three hundred and two children with ADHD (all medication-naïve) and 105 healthy controls underwent the Chinese language skill assessment, and 175 also underwent fMRI scans (84 ADHD and 91 controls). Between-group and mediation analyses were applied to explore the interrelationships of the diagnosis of ADHD, cognitive dysfunction, and impaired reading skills. Five ADHD-related brain functional networks, including the default mode network (DMN) and the dorsal attention network (DAN), were built using predefined regions of interest. Voxel-based group-wise comparisons were performed. The ADHD group performed worse than the control group in word-level reading ability tests, with lower scores in Chinese character recognition (CR) and word chains (WS) (all P < 0.05). With full-scale IQ and sustained attention in the mediation model, the direct effect of ADHD status on the CR score became insignificant (P = 0.066). The underlying neural correlates for the orthographic knowledge (OT) and CR differed between the ADHD and the control group. The ADHD group tended to recruit more DMN regions to maintain their reading performance, while the control group seemed to utilize more DAN regions. Children with ADHD generally presented impaired word-level reading skills, which might be caused by impaired sustained attention and lower IQ. According to the brain functional results, we infer that ADHD children might utilize a different strategy to maintain their orthographic knowledge and character recognition performance.
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Affiliation(s)
- Zhao-Min Wu
- Shenzhen Childrens Hospital, Shenzhen, China.
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shenzhen, China.
| | | | | | - Yun Liu
- Shenzhen Childrens Hospital, Shenzhen, China
| | | | - Jiu-Ju Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | | | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Yang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yu-Feng Zang
- Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Ying Qian
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Qing-Jiu Cao
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Yu-Feng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Tang S, Liu X, Nie L, Qian F, Chen W, He L, Yang M. Diffusion kurtosis imaging reveals abnormal gray matter and white matter development in some brain regions of children with attention-deficit/hyperactivity disorder. J Neurosci Res 2024; 102:e25284. [PMID: 38284864 DOI: 10.1002/jnr.25284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 01/30/2024]
Abstract
In this study, we explored the application of diffusion kurtosis imaging (DKI) technology in the brains of children with attention-deficit/hyperactivity disorder (ADHD). Seventy-two children with ADHD and 79 age- and sex-matched healthy controls were included in the study. All children were examined by means of 3D T1-weighted image, DKI, and conventional sequence scanning. The volume and DKI parameters of each brain region were obtained by software postprocessing (GE ADW 4.6 workstation) and compared between the two groups of children to determine the imaging characteristics of children with ADHD. The result showed the total brain volume was lower in children with ADHD than in healthy children (p < .05). The gray and white matter volumes in the frontal lobe, temporal lobe, hippocampus, caudate nucleus, putamen, globus pallidus, and other brain regions were lower in children with ADHD than in healthy children (p < .05). The axial kurtosis (Ka), mean kurtosis (MK), fractional anisotropy (FA), and radial kurtosis(Kr) values in the frontal lobe, temporal lobe, and caudate nucleus of children with ADHD were lower than those of healthy children, while the mean diffusivity(MD) and fractional anisotropy of kurtosis (FAK) values were higher than those of healthy children (p < .05). Additionally, the Ka, MK, FA, and Kr values in the frontal lobe, caudate nucleus, and temporal lobe could be used to distinguish children with ADHD (AUC > .05, p < .05). In conclusion, DKI showed abnormal gray matter and white matter development in some brain regions of children with ADHD.
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Affiliation(s)
- Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianfan Liu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing, China
| | - Fangfang Qian
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Wushuang Chen
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Mei Yang
- Department of Neonatal Diagnosis and Treatment Center, Children's Hospital of Chongqing Medical University, Chongqing, China
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Sarisuta P, Chunsuwan I, Hansakunachai T, Sritipsukho P. Attention-deficit/hyperactive-impulsive disorder symptoms among grade 1 students with reading disorder in Thailand. Clin Exp Pediatr 2023; 66:485-492. [PMID: 37873565 PMCID: PMC10626022 DOI: 10.3345/cep.2023.00773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Reading disorder is the most common comorbid condition with attention-deficit/hyperactive-impulsive disorder (ADHD) in school-aged children. PURPOSE This study compared symptoms of ADHD among children in grade 1 at risk of reading disorder with children not at risk. METHODS This cross-sectional study included 703 students in grade 1 aged 6-8 years from 8 schools in Pathumthani Province, Thailand, in 2019. Reading disorder was assessed using tools developed by Vibulpatanavong and Evans for Thai teachers, whereas the Thai parent and teacher versions of the Swanson, Nolan, and Pelham IV Rating Scale (SNAP-IV) was used to evaluate ADHD symptoms. Demographic data were collected from parents using a self-reported questionnaire. RESULTS Among the 703 students with almost equal number of male (n=350) and female (n=353), and the average age of 6.56±0.57 years, 95 (13.51%) were classified (significantly male) at risk of reading disorder. The mean SNAP-IV scores of children with reading disorder reported by parents and teachers (20.23±10.95 and 20.75±15.08, respectively) were significantly higher than those of neurotypical children (16.04 ±8.59 and 9.00±10.14, respectively, P<0.05). Of the 95 students with reading disorder reported by parents and teachers, 29 (30.53%) and 20 (21.05%) respectively, were defined as having ADHD according to the standard cutoff SNAP-IV scores, which were significantly higher than 608 neurotypical students at 108 (17.76%) and 20 (5.59%) (P<0.05). The odds ratios of children with reading disorder having ADHD symptoms according to teacher reports were 3.32 (95% confidence interval [CI], 1.14-9.67; P<0.05), 3.75 (95% CI, 1.60-8.79; P<0.05), and 4.41 (95% CI, 1.20-16.15; P<0.05) for inattentive, hyperactive, and combined presentations, respectively. CONCLUSION Grade 1 students with reading disorder had a significantly higher prevalence of ADHD symptoms than neurotypical students. Therefore, children with reading disorders should undergo ADHD assessments and receive proactive intervention.
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Affiliation(s)
- Patcharapun Sarisuta
- Department of Pediatrics, Panyananthapikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Issarapa Chunsuwan
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Rangsit Center, Pathumthani, Thailand
| | - Tippawan Hansakunachai
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Rangsit Center, Pathumthani, Thailand
| | - Paskorn Sritipsukho
- Center of Excellence in Applied Epidemiology, Thammasat University, Rangsit Center, Pathumthani, Thailand
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Slaby RJ, Arrington CN, Malins J, Sevcik RA, Pugh KR, Morris R. Properties of white matter tract diffusivity in children with developmental dyslexia and comorbid attention deficit/hyperactivity disorder. J Neurodev Disord 2023; 15:25. [PMID: 37550628 PMCID: PMC10408076 DOI: 10.1186/s11689-023-09495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Developmental dyslexia (DD) and attention deficit/hyperactivity disorder (ADHD) are highly comorbid neurodevelopmental disorders. Individuals with DD or ADHD have both been shown to have deficits in white matter tracts associated with reading and attentional control networks. However, white matter diffusivity in individuals comorbid with both DD and ADHD (DD + ADHD) has not been specifically explored. METHODS Participants were 3rd and 4th graders (age range = 7 to 11 years; SD = 0.69) from three diagnostic groups ((DD (n = 40), DD + ADHD (n = 22), and typical developing (TD) (n = 20)). Behavioral measures of reading and attention alongside measures of white matter diffusivity were collected for all participants. RESULTS DD + ADHD and TD groups differed in mean fractional anisotropy (FA) for the left and right Superior Longitudinal Fasciculus (SLF)-Parietal Terminations and SLF-Temporal Terminations. Mean FA for the DD group across these SLF tracts fell between the lower DD + ADHD and higher TD averages. No differences in mean diffusivity nor significant brain-behavior relations were found. CONCLUSIONS Findings suggest that WM diffusivity in the SLF increases along a continuum across DD + ADHD, DD, and TD.
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Affiliation(s)
- Ryan J Slaby
- Department of Psychology, Georgia State University, 140 Decatur St SE, Atlanta, GA, 30303, USA
- GSU/Georgia Tech Center for Advanced Brain Imaging, 831 Marietta St NW, Atlanta, GA, 30318, USA
- Department of Psychology, University of Milano-Bicocca, Piazza Dell' Ateneo Nuovo,1, 20126, Milan, Italy
| | - C Nikki Arrington
- Department of Psychology, Georgia State University, 140 Decatur St SE, Atlanta, GA, 30303, USA.
- GSU/Georgia Tech Center for Advanced Brain Imaging, 831 Marietta St NW, Atlanta, GA, 30318, USA.
- Georgia State University, Center for Translational Research in Neuroimaging and Data Science, 55 Park Place, 18th Floor, Atlanta, GA, 30303, USA.
| | - Jeffrey Malins
- Department of Psychology, Georgia State University, 140 Decatur St SE, Atlanta, GA, 30303, USA
- GSU/Georgia Tech Center for Advanced Brain Imaging, 831 Marietta St NW, Atlanta, GA, 30318, USA
| | - Rose A Sevcik
- Department of Psychology, Georgia State University, 140 Decatur St SE, Atlanta, GA, 30303, USA
| | - Kenneth R Pugh
- Yale University, Haskins Laboratories, 300 George Street, Suite 900, New Haven, CT, 06511, USA
| | - Robin Morris
- Department of Psychology, Georgia State University, 140 Decatur St SE, Atlanta, GA, 30303, USA
- GSU/Georgia Tech Center for Advanced Brain Imaging, 831 Marietta St NW, Atlanta, GA, 30318, USA
- Georgia State University, Center for Translational Research in Neuroimaging and Data Science, 55 Park Place, 18th Floor, Atlanta, GA, 30303, USA
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Luo X, Lin X, Ide JS, Luo X, Zhang Y, Xu J, Wang L, Chen Y, Cheng W, Zheng J, Wang Z, Yu T, Taximaimaiti R, Jing X, Wang X, Cao Y, Tan Y, Li CSR. Male-specific, replicable and functional roles of genetic variants and cerebral gray matter volumes in ADHD: a gene-wide association study across KTN1 and a region-wide functional validation across brain. Child Adolesc Psychiatry Ment Health 2023; 17:4. [PMID: 36609385 PMCID: PMC9824933 DOI: 10.1186/s13034-022-00536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with reduction of cortical and subcortical gray matter volumes (GMVs). The kinectin 1 gene (KTN1) has recently been reported to significantly regulate GMVs and ADHD risk. In this study, we aimed to identify sex-specific, replicable risk KTN1 alleles for ADHD and to explore their regulatory effects on mRNA expression and cortical and subcortical GMVs. We examined a total of 1020 KTN1 SNPs in one discovery sample (ABCD cohort: 5573 males and 5082 females) and three independent replication European samples (Samples #1 and #2 each with 802/122 and 472/141 male/female offspring with ADHD; and Sample #3 with 14,154/4945 ADHD and 17,948/16,246 healthy males/females) to identify replicable associations within each sex. We examined the regulatory effects of ADHD-risk alleles on the KTN1 mRNA expression in two European brain cohorts (n = 348), total intracranial volume (TIV) in 46 European cohorts (n = 18,713) and the ABCD cohort, as well as the GMVs of seven subcortical structures in 50 European cohorts (n = 38,258) and of 118 cortical and subcortical regions in the ABCD cohort. We found that four KTN1 variants significantly regulated the risk of ADHD with the same direction of effect in males across discovery and replication samples (0.003 ≤ p ≤ 0.041), but none in females. All four ADHD-risk alleles significantly decreased KTN1 mRNA expression in all brain regions examined (1.2 × 10-5 ≤ p ≤ 0.039). The ADHD-risk alleles significantly increased basal ganglia (2.8 × 10-22 ≤ p ≤ 0.040) and hippocampus (p = 0.010) GMVs but reduced amygdala GMV (p = 0.030) and TIV (0.010 < p ≤ 0.013). The ADHD-risk alleles also significantly reduced some cortical (right superior temporal pole, right rectus) and cerebellar but increased other cortical (0.007 ≤ p ≤ 0.050) GMVs. To conclude, we identified a set of replicable and functional risk KTN1 alleles for ADHD, specifically in males. KTN1 may play a critical role in the pathogenesis of ADHD, and the reduction of specific cortical and subcortical, including amygdalar but not basal ganglia or hippocampal, GMVs may serve as a neural marker of the genetic effects.
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Affiliation(s)
- Xingguang Luo
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Xiandong Lin
- Laboratory of Radiation Oncology and Radiobiology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuzhou, 350014, China
| | - Jaime S Ide
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Xinqun Luo
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350004, Fujian, China
| | - Yong Zhang
- Tianjin Mental Health Center, Tianjin, 300222, China
| | - Jianying Xu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai, 519000, Guangdong, China
| | - Leilei Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Wenhong Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jianming Zheng
- National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University School of Medicine, Shanghai, 200030, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Ting Yu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Reyisha Taximaimaiti
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiaozhong Jing
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiaoping Wang
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Yuping Cao
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center On Mental Disorders, China National Technology Institute On Mental Disorders, Changsha, 410011, Hunan, China.
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
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Dissociating Executive Function and ADHD Influences on Reading Ability in Children with Dyslexia. Cortex 2022; 153:126-142. [DOI: 10.1016/j.cortex.2022.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/24/2022] [Accepted: 03/04/2022] [Indexed: 11/19/2022]
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Neuroimaging in Attention-Deficit/Hyperactivity Disorder: Recent Advances. AJR. AMERICAN JOURNAL OF ROENTGENOLOGY 2021; 218:321-332. [PMID: 34406053 DOI: 10.2214/ajr.21.26316] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition, leading to impaired attention and impulsive behaviors diagnosed in, but not limited to, children. ADHD can cause symptoms throughout life. This article summarizes structural (conventional, volumetric, and diffusion tensor imaging MRI) and functional [task-based functional MRI (fMRI), resting state fMRI, PET, and MR spectroscopy] brain findings in patients with ADHD. Consensus is lacking regarding altered anatomic or functional imaging findings of the brain in children with ADHD, likely because of the disorder's heterogeneity. Most anatomic studies report abnormalities in the frontal lobes, basal ganglia, and corpus callosum; decreased surface area in the left ventral frontal and right prefrontal cortex; thinner medial temporal lobes; and smaller caudate nuclei. Using fMRI, researchers have focused on the prefrontal and temporal regions, reflecting perception-action mapping alterations. Artificial intelligence models evaluating brain anatomy have highlighted changes in cortical thickness and shape of the inferior frontal cortex, bilateral sensorimotor cortex, left temporal lobe, and insula. Early intervention and/or normal brain maturation can alter imaging patterns and convert functional imaging studies to a normal pattern. While the imaging findings provide insight into the disease's neuropathophysiology, no definitive structural or functional pattern defines the disorder from a neuroradiologic perspective.
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Kibby MY, Newsham G, Imre Z, Schlak JE. Is executive dysfunction a potential contributor to the comorbidity between basic reading disability and attention-deficit/hyperactivity disorder? Child Neuropsychol 2021; 27:888-910. [PMID: 33849390 DOI: 10.1080/09297049.2021.1908532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Our study is one of the few to analyze executive functioning (EF) in a comprehensive, multi-modal fashion as a potential contributor to the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and basic reading disability (RD). We included multiple, traditional, neuropsychological measures of EF, along with the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire, to assess inhibit, shift, working memory (WM), planning, generation fluency, and problem-solving. Participants included 263 children, ages 8-12 years, with RD, ADHD, RD/ADHD, and typically developing controls. When using the traditional measures in a 2 × 2 MANCOVA, we found both RD and ADHD had poor cognitive EF in most areas at the group level, with phonological loop deficits being more specific to RD and behavioral regulation deficits being more specific to ADHD. Children with RD/ADHD performed comparably to those with RD and ADHD alone. Results were similar on the BRIEF. In contrast, only WM predicted both basic reading and inattention when the data were assessed in a continuous fashion. It also explained the correlations between basic reading and inattention, being worthy of longitudinal research to determine if it is a shared contributor to RD/ADHD. When comparing hypotheses as to the nature of RD/ADHD, we found the multiple deficit hypothesis was better supported by our EF data than the phenocopy hypothesis or the cognitive subtype hypothesis.
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Affiliation(s)
- Michelle Y Kibby
- School of Psychological and Behavioral Sciences, Southern Illinois University-Carbondale, Carbondale, IL, USA
| | - Genni Newsham
- School of Psychological and Behavioral Sciences, Southern Illinois University-Carbondale, Carbondale, IL, USA
| | - Zsofia Imre
- School of Psychological and Behavioral Sciences, Southern Illinois University-Carbondale, Carbondale, IL, USA
| | - Jennifer E Schlak
- School of Psychological and Behavioral Sciences, Southern Illinois University-Carbondale, Carbondale, IL, USA
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Mei L, Li X, Zhou G, Ji T, Chen J, Xu Z, Peng Y, Liu Y, Li H, Zhang J, Wang S, Zhang Y, Ge W, Guo Y, Qiu Y, Jia X, Tian J, Zheng L, Liu J, Tai J, Ni X. Effects of obstructive sleep apnoea severity on neurocognitive and brain white matter alterations in children according to sex: a tract-based spatial statistics study. Sleep Med 2020; 82:134-143. [PMID: 33915429 DOI: 10.1016/j.sleep.2020.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate alterations in neurocognitive, attention, paediatric sleep questionnaire (PSQ) scores and whole brain white matter (WM) integrity between children with mild and severe obstructive sleep apnoea (OSA) according to sex and whether these changes are associated with OSA severity. METHODS Fifty-seven children (36 males and 21 females) diagnosed with OSA were recruited for this study. Children of both sexes were divided into mild (male-MG, female-MG) and severe (male-SG, female-SG) groups according to OSA severity. Polysomnography (PSG), neurocognitive, attention and PSQ tests were compared between groups by one-way samples analysis of variance (ANOVA) F test. Diffusion tensor imaging (DTI) was scanned using a 3T GE MRI scanner and analysed by Tract-based Spatial Statistics (TBSS). Spearman correlation was calculated between DTI Eigenvalues and clinical characteristics. RESULTS Compared to mild OSA patients, severe OSA patients presented greater severity of obstructive apnoea hypopnea index (OAHI), neurocognition, PSQ and attention tests in both male and female patients. Brain WM integrity in the male-SG, compared to the male-MG, demonstrated significantly reduced fractional anisotropy (FA) values in the right middle frontal gyrus and the right frontal sub-gyral regions and increased axial diffusivity (AD) values in the right inferior frontal gyrus, left parietal angular gyrus and sub-gyral regions, while no differences were found between the female-MG and female-SG. Alterations in male-SG brain regions were observably correlated with severity in male OSA patients. CONCLUSIONS The integrity of WM, which regulates autonomic, cognitive, and attention functions, is impaired in male, but not female, children with severe OSA.
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Affiliation(s)
- Lin Mei
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xiaodan Li
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Guifei Zhou
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Tingting Ji
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jun Chen
- Big Data and Engineering Research Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Zhifei Xu
- Department of Respiration, Beijing Children's Hospital, Capital Medical University,National Center for Children's Health, Beijing, 100045, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yue Liu
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Hongbin Li
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jie Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Shengcai Wang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yamei Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wentong Ge
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Paediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Yue Qiu
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xinbei Jia
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jinghong Tian
- Department of Neurorehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Li Zheng
- Department of Respiration, Beijing Children's Hospital, Capital Medical University,National Center for Children's Health, Beijing, 100045, China
| | - Jiangang Liu
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, 100191, China
| | - Jun Tai
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China; Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Paediatrics, Beijing, 100020, China.
| | - Xin Ni
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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