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Grissom A, Finke E, Zane E. Verbal fluency and autism: Reframing current data through the lens of monotropism. Autism Res 2024; 17:324-337. [PMID: 38100264 DOI: 10.1002/aur.3071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
The purpose of this study was to reexamine research that used verbal fluency tasks to reinforce assumed deficits in word knowledge and retrieval in the autistic population. We identified seventeen articles that compared the performance of autistic and non-autistic people on verbal fluency measures and provided an interpretation of the observed performance. In this narrative review, we summarize many components of these studies, including a comprehensive account of how authors framed their research findings. Overall, results of the studies showed variation both between and within groups in terms of total number of correct words, how many subsequent words fell into subcategories, and how frequently participants switched between subcategories. Despite wide variation in findings across studies, authors consistently interpreted results as revealing or reinforcing autistic deficits. To contrast the deficit narrative, we offer an alternative interpretation of findings by considering how they could provide support for the autistic-led theory of monotropism. This alternative interpretation accounts for the inconsistencies in findings between studies, since wide individual variation in performance is an expected feature of the monotropic theory. We use our review as an exercise in reframing a body of literature from a neurodiversity-affirming perspective. We propose this as a case example and model for how autism research and clinical practice can move away from the consistent narrative of autism deficits that has pervaded our field for decades. Accordingly, we offer suggestions for future research and clinical practice.
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Affiliation(s)
- Alaina Grissom
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Erinn Finke
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Emily Zane
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia, USA
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Feehan A, Charest M. A scoping review of oral language and social communication abilities in children with Tourette syndrome. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:143-164. [PMID: 37667569 DOI: 10.1111/1460-6984.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/09/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been extensively researched. AIMS This scoping review maps the literature on the oral language and social communication abilities of children with TS in order to describe the nature of the current literature, present a summary of major findings and identify where gaps exist. METHODS A scoping review was completed to identify studies measuring the oral language or social communication abilities of children with TS. A systematic search of six electronic databases was conducted to obtain published and unpublished literature. All English studies measuring the oral language or social communication abilities of children with TS were included. Information was extracted from records and knowledge was synthesised in a narrative summary. MAIN CONTRIBUTION We identified 56 records for inclusion. Almost all records were located in journals within the fields of psychology and psychiatry. Skills most often studied were verbal IQ and verbal fluency. The literature suggests an increased prevalence of language disorders and social communication problems in children with TS; however, literature comprehensively detailing these challenges was scarce. Language strengths were identified in verbal intelligence, story/sentence recall, categorisation and performance on tasks at the single-word level. CONCLUSIONS Oral language and social communication skills are important for academic and social success. This review brings scattered literature together to provide up-to-date information about language in children with TS and highlights that there are considerable gaps in our knowledge about language and communication in this population. This scoping review can inform future research and support speech language pathologists in the assessment of young people with TS. WHAT THIS PAPER ADDS What is already known on the subject Speech-language pathologists (SLPs) working in various contexts (e.g., schools, mental health teams) are likely to encounter children with Tourette syndrome (TS); however, the description of this population and potential communication characteristics is not well represented in the SLP literature. Previous literature reviews have reported strengths in verbal fluency and morphological processing. Challenges in expressive language, higher order language, social cognition and a propensity towards autistic traits have also been identified. What this paper adds to existing knowledge This review differs from previous narrative reviews by employing a systematic approach to searching for literature. As a result, we identified 25 additional studies that had not been cited in previous reviews and additional relevant findings in 23 previously reviewed studies. This review confirms several previous conclusions about language in children with TS and extends or clarifies several others, thereby providing the most current information on oral language and social communication abilities. The use of current taxonomies of language and social communication helps to organise this literature for clinicians and researchers in speech-language pathology and identifies a need for further research from the SLP perspective. What are the potential or actual clinical implications of this work? These results imply that SLPs should screen children with TS for language disorders and investigate social communication and social interaction development. Clinicians can expect greater challenges in language and communication development for children with complex forms of TS (i.e., those who exhibit co-occurring conditions such as attention-deficit/hyperactivity disorder). The multidisciplinary nature of the current literature implies that clinical collaboration with other disciplines will be of particular benefit to serving this group of children.
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Affiliation(s)
- Angela Feehan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Monique Charest
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Capturing Subtle Neurocognitive Differences in Children with and without Tourette Syndrome through a Fine-Grained Analysis of Design Fluency Profiles. J Clin Med 2022; 11:jcm11071946. [PMID: 35407554 PMCID: PMC8999369 DOI: 10.3390/jcm11071946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 12/10/2022] Open
Abstract
BACKGROUND Tourette syndrome (TS) can be accompanied by neurocognitive impairment. Only a few studies have focused on executive function assessment in TS using design fluency, providing preliminary results. This study aimed to characterize the detailed design fluency profile of children with TS compared with neurotypical children, while addressing the central concern of frequent comorbidities in studies on TS by considering tic severity and attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis. METHODS Sixty-one children aged between 6 and 15 years participated and were divided into a TS group (n = 28 (with ADHD n = 15)) and a control group (n = 33). Our objective was addressed by examining a wide range of measures of the Five-Point-Test, presumably sensitive to frontostriatal dysfunction. The total number of designs, repetitions, repetition ratio, unique designs, and numerical, spatial, and total strategies were examined for the total duration of the test (global measures) and at five equal time intervals (process measures). RESULTS The TS group produced significantly fewer numerical strategies. Groups did not differ in other global or process measures. ADHD did not affect performance. CONCLUSIONS Children with TS do not inherently show general executive dysfunction but may present with subtle neurocognitive characteristics here revealed by comprehensive design fluency profiles.
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Wajman JR, Cecchini MA. A simple counting of verbal fluency errors discriminates between normal cognition, mild cognitive impairment and Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 30:370-387. [PMID: 35174776 DOI: 10.1080/13825585.2022.2035668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
For this observational cross-sectional study, different modalities of verbal fluency tasks (VFTs) were compared between 143 participants: 35 cognitively healthy controls (CHCs), 71 mild cognitive impairment (MCI) and 37 mild Alzheimer's disease (AD) patients. Binomial logistic regression models were defined to identify VFT variables associated with MCI and AD, with respect to CHC. The results showed that the best errors/repetitions variable associated with MCI and AD was the phonemic task, and with every error the odds of being in the MCI group increased 9.9 times and 12.2 times in AD group, accompanied by high accuracy values (MCI: AUC = 0.824, sensitivity = 0.676, specificity = 0.943; AD: AUC = 0.883, sensitivity = 0.784, specificity = 0.943). The results suggest that, in addition to solely register raw scores, a simple counting of errors and repetitions during VFT can offer valuable clues in detecting MCI and AD, especially in the phonemic task.
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Affiliation(s)
- José R Wajman
- Department of Neurology and Neurosurgery, Hospital São Paulo, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mário A Cecchini
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, Edinburgh, UK
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5
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Valcan DS, Davis HL, Pino-Pasternak D, Malpique AA. Executive functioning as a predictor of children’s mathematics, reading and writing. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1016/j.appdev.2020.101196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Eördegh G, Pertich Á, Tárnok Z, Nagy P, Bodosi B, Giricz Z, Hegedűs O, Merkl D, Nyujtó D, Oláh S, Őze A, Vidomusz R, Nagy A. Impairment of visually guided associative learning in children with Tourette syndrome. PLoS One 2020; 15:e0234724. [PMID: 32544176 PMCID: PMC7297359 DOI: 10.1371/journal.pone.0234724] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 06/02/2020] [Indexed: 12/18/2022] Open
Abstract
The major symptoms of Tourette syndrome are motor and vocal tics, but Tourette syndrome is occasionally associated with cognitive alterations as well. Although Tourette syndrome does not affect the majority of cognitive functions, some of them improve. There is scarce evidence on the impairment of learning functions in patients with Tourette syndrome. The core symptoms of Tourette syndrome are related to dysfunction of the basal ganglia and the frontostriatal loops. Acquired equivalence learning is a kind of associative learning that is related to the basal ganglia and the hippocampi. The modified Rutgers Acquired Equivalence Test was used in the present study to observe the associative learning function of patients with Tourette syndrome. The cognitive learning task can be divided into two main phases: the acquisition and test phases. The latter is further divided into two parts: retrieval and generalization. The acquisition phase of the associative learning test, which mainly depends on the function of the basal ganglia, was affected in the entire patient group, which included patients with Tourette syndrome with attention deficit hyperactivity disorder, obsessive compulsive disorder, autism spectrum disorder, or no comorbidities. Patients with Tourette syndrome performed worse in building associations. However, the retrieval and generalization parts of the test phase, which primarily depend on the function of the hippocampus, were not worsened by Tourette syndrome.
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Affiliation(s)
- Gabriella Eördegh
- Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Ákos Pertich
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsanett Tárnok
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Péter Nagy
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Balázs Bodosi
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsófia Giricz
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Orsolya Hegedűs
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Dóra Merkl
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Diána Nyujtó
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Szabina Oláh
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Attila Őze
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Réka Vidomusz
- Vadaskert Child and Adolescent Psychiatry, Budapest, Hungary
| | - Attila Nagy
- Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
- * E-mail:
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Nguyen TQ, Del Tufo SN, Cutting LE. Readers Recruit Executive Functions to Self-Correct Miscues During Oral Reading Fluency. SCIENTIFIC STUDIES OF READING : THE OFFICIAL JOURNAL OF THE SOCIETY FOR THE SCIENTIFIC STUDY OF READING 2020; 24:462-483. [PMID: 33716490 PMCID: PMC7954224 DOI: 10.1080/10888438.2020.1720025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Reading fluency undoubtedly underlies reading competence; yet, the role of executive functions (EF) is less well understood. Here, we investigated the relationship between children's reading fluency and EF. Children's (n = 82) reading and language performance was determined by standardized assessments and EF by parental questionnaire. Results revealed that production of more miscues was explained by poorer reading and language performance and EF. Yet, self-correcting a miscue was predicted by better EF, beyond reading and language abilities. Intriguingly, EF partially mediated the relationship between reading and self-correction, suggesting that self-correction reflects parallel recruitment and coordination of domain-specific and domain-general processes.
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Affiliation(s)
- Tin Q Nguyen
- Vanderbilt Kennedy Center, Peabody College of Education and Human Development, Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
| | - Stephanie N Del Tufo
- College of Education and Human Development, University of Delaware, Newark, Tennessee, USA
| | - Laurie E. Cutting
- Vanderbilt Kennedy Center, Peabody College of Education and Human Development, Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
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Zaytseva Y, Fajnerová I, Dvořáček B, Bourama E, Stamou I, Šulcová K, Motýl J, Horáček J, Rodriguez M, Španiel F. Theoretical Modeling of Cognitive Dysfunction in Schizophrenia by Means of Errors and Corresponding Brain Networks. Front Psychol 2018; 9:1027. [PMID: 30026711 PMCID: PMC6042473 DOI: 10.3389/fpsyg.2018.01027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 05/31/2018] [Indexed: 01/22/2023] Open
Abstract
The current evidence of cognitive disturbances and brain alterations in schizophrenia does not provide the plausible explanation of the underlying mechanisms. Neuropsychological studies outlined the cognitive profile of patients with schizophrenia, that embodied the substantial disturbances in perceptual and motor processes, spatial functions, verbal and non-verbal memory, processing speed and executive functioning. Standardized scoring in the majority of the neurocognitive tests renders the index scores or the achievement indicating the severity of the cognitive impairment rather than the actual performance by means of errors. At the same time, the quantitative evaluation may lead to the situation when two patients with the same index score of the particular cognitive test, demonstrate qualitatively different performances. This may support the view why test paradigms that habitually incorporate different cognitive variables associate weakly, reflecting an ambiguity in the interpretation of noted cognitive constructs. With minor exceptions, cognitive functions are not attributed to the localized activity but eventuate from the coordinated activity in the generally dispersed brain networks. Functional neuroimaging has progressively explored the connectivity in the brain networks in the absence of the specific task and during the task processing. The spatio-temporal fluctuations of the activity of the brain areas detected in the resting state and being highly reproducible in numerous studies, resemble the activation and communication patterns during the task performance. Relatedly, the activation in the specific brain regions oftentimes is attributed to a number of cognitive processes. Given the complex organization of the cognitive functions, it becomes crucial to designate the roles of the brain networks in relation to the specific cognitive functions. One possible approach is to identify the commonalities of the deficits across the number of cognitive tests or, common errors in the various tests and identify their common "denominators" in the brain networks. The qualitative characterization of cognitive performance might be beneficial in addressing diffuse cognitive alterations presumably caused by the dysconnectivity of the distributed brain networks. Therefore, in the review, we use this approach in the description of standardized tests in the scope of potential errors in patients with schizophrenia with a subsequent reference to the brain networks.
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Affiliation(s)
- Yuliya Zaytseva
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | | | | | - Eva Bourama
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Ilektra Stamou
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Kateřina Šulcová
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Jiří Motýl
- National Institute of Mental Health, Klecany, Czechia
| | - Jiří Horáček
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | | | - Filip Španiel
- National Institute of Mental Health, Klecany, Czechia
- 3rd Faculty of Medicine, Charles University in Prague, Prague, Czechia
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9
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Morand-Beaulieu S, Leclerc JB, Valois P, Lavoie ME, O'Connor KP, Gauthier B. A Review of the Neuropsychological Dimensions of Tourette Syndrome. Brain Sci 2017; 7:E106. [PMID: 28820427 PMCID: PMC5575626 DOI: 10.3390/brainsci7080106] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022] Open
Abstract
Neurocognitive functioning in Tourette syndrome (TS) has been the subject of intensive research in the past 30 years. A variety of impairments, presumably related to frontal and frontostriatal dysfunctions, have been observed. These impairments were found in various domains, such as attention, memory, executive functions, language, motor and visuomotor functions, among others. In line with contemporary research, other neurocognitive domains have recently been explored in TS, bringing evidence of altered social reasoning, for instance. Therefore, the aims of this review are to give an overview of the neuropsychological dimensions of TS, to report how neuropsychological functions evolve from childhood to adulthood, and to explain how various confounding factors can affect TS patients' performance in neuropsychological tasks. Finally, an important contribution of this review is to show how recent research has confirmed or changed our beliefs about neuropsychological functioning in TS.
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Affiliation(s)
- Simon Morand-Beaulieu
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de neurosciences, Université de Montréal, 2960 Chemin de la Tour, Montréal, QC H3T 1J4, Canada.
| | - Julie B Leclerc
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
| | - Philippe Valois
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
| | - Marc E Lavoie
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de neurosciences, Université de Montréal, 2960 Chemin de la Tour, Montréal, QC H3T 1J4, Canada.
- Département de psychiatrie, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada.
| | - Kieron P O'Connor
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
- Département de psychiatrie, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada.
| | - Bruno Gauthier
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université de Montréal, Campus Laval, 1700 rue Jacques-Tétreault, Laval, QC H7N 0B6, Canada.
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Ren X, Lu J, Liu X, Shen C, Zhang X, Ma X, Sun J, Sun G, Feng K, Xu B, Liu P. Decreased prefrontal brain activation during verbal fluency task in patients with somatoform pain disorder: An exploratory multi-channel near-infrared spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:153-160. [PMID: 28499896 DOI: 10.1016/j.pnpbp.2017.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pain is a common phenomenon. Patients with somatoform pain disorder (SPD) suffer from lasting chronic pain which may cause cognitive impairment. The dysfunction of prefrontal cortex (PFC) may be involved in pain-induced cognition impairment, which is the most important part in regulating of cognitive function. Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique being used to detect the prefrontal cortex activation during cognitive tasks to demonstrate the relationship between PFC dysfunction and cognition impairment in SPD patients. METHODS 24 patients with SPD and 24 age-, gender- and education level-matched healthy controls were examined by NIRS of the relative concentration of oxygenated hemoglobin (oxy-Hb) in PFC during verbal fluency task (VFT). All data analysis procedures were accomplished under MATLAB, SPM and SPM-fNIRS which is an SPM12-based software for fNIRS analysis. RESULTS 1. The number of words generated during the VFT tasks in SPD patients were fewer than healthy controls. 2. The activated areas in SPD patients were smaller than healthy controls. 3. The average activation strength of [oxy-Hb] in SPD patients was much lower than healthy controls. 4. The difference of activation areas between left and right lobe were particularly obvious in SPD patients. CONCLUSION There are evidences suggested that the markedly dysfunction in PFC especially bilateral dorsolateral prefrontal cortex (DLPFC) areas may be involved in the cognitive deficiency in patients with SPD.
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Affiliation(s)
- Xiajin Ren
- Medical Center, Tsinghua University, Beijing, China; Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Jinlong Lu
- Guangwai Community Health Service Center, Beijing, China
| | - Xiaomin Liu
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Chenyu Shen
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Xiaoqian Zhang
- Medical Center, Tsinghua University, Beijing, China; Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Xiangyun Ma
- Medical Center, Tsinghua University, Beijing, China; Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Jingjing Sun
- Medical Center, Tsinghua University, Beijing, China; Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Gaoxiang Sun
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Kun Feng
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Bo Xu
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China
| | - Pozi Liu
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, China.
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Profiles of Executive Function Across Children with Distinct Brain Disorders: Traumatic Brain Injury, Stroke, and Brain Tumor. J Int Neuropsychol Soc 2017; 23:529-538. [PMID: 28502261 DOI: 10.1017/s1355617717000364] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder. METHODS Participants were children with traumatic brain injury (N=82; 8-13 years of age), arterial ischemic stroke (N=36; 6-16 years of age), and brain tumor (N=74; 9-18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children's Version (TEA-Ch) subtests: Creature Counting, Walk-Don't-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age. RESULTS As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups. CONCLUSIONS Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017, 23, 529-538).
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12
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Hovik KT, Egeland J, Isquith PK, Gioia G, Skogli EW, Andersen PN, Øie M. Distinct Patterns of Everyday Executive Function Problems Distinguish Children With Tourette Syndrome From Children With ADHD or Autism Spectrum Disorders. J Atten Disord 2017; 21:811-823. [PMID: 25253683 DOI: 10.1177/1087054714550336] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim is to investigate the everyday executive function (EF) in children with Tourette syndrome (TS), Inattentive or Combined presentations of ADHD (ADHD-I/ADHD-C), autism spectrum disorders (ASD), and typically developing children (TDC). METHOD Nineteen TS, 33 ADHD-C, 43 ADHD-I, 34 ASD, and 50 TDC participated (8-17 years). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS TS, ADHD-C, ADHD-I, or ASD were rated with significantly more regulation problems on all scales compared with TDC. Considerable overlap of symptoms between clinical groups made differentiation difficult on individual scales. Scale configurations showed children with TS to have more problems with emotional control (EC) than cognitive flexibility in relation to children with ASD, more problems with EC than inhibitory control in relation to ADHD-C, and more problems with EC than planning/organizing in relation to ADHD-I. CONCLUSION Paired BRIEF scales dissociated EF problems in children with TS from children with ADHD-C, ADHD-I, or ASD. Clinical relevance is discussed.
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Affiliation(s)
- Kjell Tore Hovik
- 1 Innlandet Hospital Trust, Lillehammer, Norway.,2 University of Oslo, Norway
| | - Jens Egeland
- 2 University of Oslo, Norway.,3 Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Gerard Gioia
- 5 Children's National Medical Center, Washington, DC, USA
| | - Erik Winther Skogli
- 1 Innlandet Hospital Trust, Lillehammer, Norway.,2 University of Oslo, Norway
| | | | - Merete Øie
- 1 Innlandet Hospital Trust, Lillehammer, Norway.,2 University of Oslo, Norway
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13
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Continuous performance test in pediatric obsessive-compulsive disorder and tic disorders: the role of sustained attention. CNS Spectr 2015; 20:479-89. [PMID: 25296570 DOI: 10.1017/s1092852914000467] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Pediatric obsessive-compulsive disorder (OCD) and tic disorders (TD) are often associated with attention-deficit hyperactivity disorder (ADHD). In order to clarify the role of attention and inhibitory control in pediatric OCD and TD, a continuous performance test (CPT) was administered to a cohort of children and adolescents with OCD alone, TD alone, and OCD+TD. METHODS A clinical cohort of 48 children and adolescents with OCD alone (n=20), TD alone (n=15), or OCD+TD (n=13) was interviewed clinically and administered the Conners Continuous Performance Test II (CPT-II). The Conners CPT-II is a 14-minute normed computerized test consisting of 6 blocks. It taps into attention, inhibitory control, and sustained attention cognitive domains. Key parameters include errors of omission (distractability), commission (inhibitory control), and variable responding over time (sustained attention). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria were applied in a best-estimate process to diagnose OCD, TD, ADHD, and anxiety disorders. RESULTS Children with OCD+TD had more errors of omission (p=0.03), and more hit RT block change (p=0.003) and hit SE block change (p=0.02) than subjects with OCD alone and TD alone. These deficits in sustained attention were associated with younger age and hoarding tendencies. A clinical diagnosis of ADHD in the OCD+TD group also determined worse sustained attention. CONCLUSIONS A deficit in sustained attention, a core marker of ADHD, is also a marker of OCD+TD, compared to OCD alone and TD alone. Biological correlates of sustained attention may serve to uncover the pathophysiology of OCD and TD through genetic and imaging studies.
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Schwam DM, King TZ, Greenberg D. Characteristics of Executive Functioning in a Small Sample of Children With Tourette Syndrome. APPLIED NEUROPSYCHOLOGY-CHILD 2014; 4:297-308. [DOI: 10.1080/21622965.2014.930686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Shao Z, Janse E, Visser K, Meyer AS. What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Front Psychol 2014; 5:772. [PMID: 25101034 PMCID: PMC4106453 DOI: 10.3389/fpsyg.2014.00772] [Citation(s) in RCA: 563] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/01/2014] [Indexed: 12/12/2022] Open
Abstract
This study examined the contributions of verbal ability and executive control to verbal fluency performance in older adults (n = 82). Verbal fluency was assessed in letter and category fluency tasks, and performance on these tasks was related to indicators of vocabulary size, lexical access speed, updating, and inhibition ability. In regression analyses the number of words produced in both fluency tasks was predicted by updating ability, and the speed of the first response was predicted by vocabulary size and, for category fluency only, lexical access speed. These results highlight the hybrid character of both fluency tasks, which may limit their usefulness for research and clinical purposes.
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Affiliation(s)
- Zeshu Shao
- The Psychology of Language Department, Max Planck Institute for Psycholinguistics Nijmegen, Netherlands
| | - Esther Janse
- The Psychology of Language Department, Max Planck Institute for Psycholinguistics Nijmegen, Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Netherlands ; Centre for Language Studies, Radboud University Nijmegen, Netherlands
| | - Karina Visser
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Netherlands
| | - Antje S Meyer
- The Psychology of Language Department, Max Planck Institute for Psycholinguistics Nijmegen, Netherlands ; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Netherlands
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16
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Hurks PPM. Administering Design Fluency Tests in School-aged Children: Analyses of Design Productivity over Time, Clustering, and Switching. Clin Neuropsychol 2013; 27:1131-49. [DOI: 10.1080/13854046.2013.821170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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17
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Ciećko-Michalska I, Wójcik J, Senderecka M, Wyczesany M, Binder M, Szewczyk J, Dziedzic T, Słowik A, Mach T. Cognitive functions in patients with liver cirrhosis: a tendency to commit more memory errors. Med Sci Monit 2013; 19:283-8. [PMID: 23598598 PMCID: PMC3659153 DOI: 10.12659/msm.883890] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Minimal hepatic encephalopathy (MHE) is the mildest form of hepatic encephalopathy (HE). For diagnostic purposes, 2 alternative batteries of psychometric screening tests are recommended. They differ from each other in terms of the cognitive domains assessed. The research was designed to provide a profile of cognitive functioning in patients with liver cirrhosis, using an assessment that covers a wider range of cognitive functions than the usual screening battery. Material/Methods We examined 138 persons, including 88 with liver cirrhosis and 50 healthy volunteers. The Mini Mental State Examination (MMSE) was used for screening and excluding advanced cognitive impairment. Then, to assess cognitive functions in more detail, the following tests were used: Auditory Verbal Learning Test (AVLT), Letter and Semantic Fluency Tests (LF and SF), Trail Making Test (TMT A&B), Digit Symbol Test (DST), Block Design Test (BDT), and Mental Rotation Test (MRT). The MRT task has not been used in MHE diagnosis so far. Finally, 57 patients and 48 controls took part in the entire study. Results Patients with liver cirrhosis commit significantly more errors of intrusions in the AVLT during the delayed free recall trial. Results significantly deviating from the norm in at least 2 tests were found only in 7 cirrhosis patients. Conclusions The results do not provide any specific profile of cognitive disturbances in MHE, but suggest that cirrhosis patients have a tendency to commit more memory errors, probably due to subtle impairments of executive function.
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Affiliation(s)
- Irena Ciećko-Michalska
- Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Krakow, Poland.
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Tic Disorders and Learning Disability: Clinical Characteristics, Cognitive Performance and Comorbidity. ACTA ACUST UNITED AC 2013. [DOI: 10.1017/jse.2013.2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Tics are involuntary movements or sounds. Tourette syndrome is one of a family of tic disorders that affect around 1% of the population but which remains underrecognised in the community. In paediatric special education learning disability classes, the prevalence of individuals with tic disorders is around 20–45% — higher still in special education emotional/behavioural classes. Given the high rates of individuals with tic disorders in special education settings, as well as the unique challenges of working in an educational setting with a person with a tic disorder, it is incumbent upon professionals working in these settings to be cognisant of the possibility of tic disorders in this population. This review seeks to provide an overview of tic disorders and their association with learning and mental health difficulties. The review focuses on an exploration of factors underpinning the association between tic disorders and learning disabilities, including neurocognitive corollaries of tic disorders and the influence of common comorbidities, such as ADHD, as well as upon strategies to support individuals with tic disorders in the classroom.
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Marshall CR, Rowley K, Mason K, Herman R, Morgan G. Lexical organization in deaf children who use British Sign Language: evidence from a semantic fluency task. JOURNAL OF CHILD LANGUAGE 2013; 40:193-220. [PMID: 22717181 DOI: 10.1017/s0305000912000116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We adapted the semantic fluency task into British Sign Language (BSL). In Study 1, we present data from twenty-two deaf signers aged four to fifteen. We show that the same 'cognitive signatures' that characterize this task in spoken languages are also present in deaf children, for example, the semantic clustering of responses. In Study 2, we present data from thirteen deaf children with Specific Language Impairment (SLI) in BSL, in comparison to a subset of children from Study 1 matched for age and BSL exposure. The two groups' results were comparable in most respects. However, the group with SLI made occasional word-finding errors and gave fewer responses in the first 15 seconds. We conclude that deaf children with SLI do not differ from their controls in terms of the semantic organization of the BSL lexicon, but that they access signs less efficiently.
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Hurks PPM. Does Instruction in Semantic Clustering and Switching Enhance Verbal Fluency in Children? Clin Neuropsychol 2012; 26:1019-37. [DOI: 10.1080/13854046.2012.708361] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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De Monte VE, Geffen G, Carroll A, Bailey M, Campling N. Dual Task Performance in Children With Tourette Syndrome: Controlling for Comorbid ADHD. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.8.1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractDual task performance in children with Tourette Syndrome (TS) was studied. The participants were children with TS (N = 48, 40 male, 8 female), Attention Deficit Hyperactivity Disorder (ADHD; mixed types N = 44, 34 male, 10 female) and unaffected controls (N = 48, 34 male, 14 female). Eleven of the TS participants had no comorbidities (TS only) and they were compared to matched groups of participants with TS plus comorbidities (TS+), ADHD, and controls. Each participant was administered screening measures of behaviour, intelligence and verbal ability, as well as specific tests of dual task performance. Children with TS-only correctly recalled fewer digit span forward trials, and identified fewer spaceship pairs than controls under single task conditions in the SkySearch subtest of the Test of Everyday Attention for Children. However, the TS-only and control groups showed better counting performance while simultaneously searching for targets, than the TS+ and ADHD groups. Taken together, these results suggest that some previously reported cognitive deficits in children with TS are due to comorbidities, rather than to the syndrome itself.
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Charchat-Fichman H, Oliveira RM, da Silva AM. Performance of Brazilian children on phonemic and semantic verbal fluency tasks. Dement Neuropsychol 2011; 5:78-84. [PMID: 29213727 PMCID: PMC5619301 DOI: 10.1590/s1980-57642011dn05020004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The most used verbal fluency paradigms are semantic and letter fluency tasks.
Studies suggest that these paradigms access semantic memory and executive
function and are sensitive to frontal lobe disturbances. There are few studies
in Brazilian samples on these paradigms.
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Affiliation(s)
- Helenice Charchat-Fichman
- Doutorado, Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Rosinda Martins Oliveira
- Doutorado, Departamento de Psicometria, Instituto de Psicologia, Universidade ederal do Rio de Janeiro, Rio de Janeiro RJ, Brazil
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Lavoie ME, Imbriglio TV, Stip E, O'Connor KP. Neurocognitive Changes Following Cognitive-Behavioral Treatment in Tourette Syndrome and Chronic Tic Disorder. Int J Cogn Ther 2011. [DOI: 10.1521/ijct.2011.4.1.34] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Luton LM, Burns TG, DeFilippis N. Frontal Lobe Epilepsy in Children and Adolescents: A Preliminary Neuropsychological Assessment of Executive Function. Arch Clin Neuropsychol 2010; 25:762-70. [PMID: 20829192 DOI: 10.1093/arclin/acq066] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lindsay M Luton
- Department of Neuropsychology, Children's Healthcare of Atlanta, GA, USA.
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Lande MB, Adams H, Falkner B, Waldstein SR, Schwartz GJ, Szilagyi PG, Wang H, Palumbo D. Parental assessment of executive function and internalizing and externalizing behavior in primary hypertension after anti-hypertensive therapy. J Pediatr 2010; 157:114-9. [PMID: 20227722 PMCID: PMC2904985 DOI: 10.1016/j.jpeds.2009.12.053] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 11/12/2009] [Accepted: 12/30/2009] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the change in parental ratings of executive function and behavior in children with primary hypertension after anti-hypertensive therapy. STUDY DESIGN Parents of subjects with untreated hypertension and control subjects completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess behavioral correlates of executive function and the Child Behavior Checklist (CBCL) to assess internalizing and externalizing behaviors. Subjects with hypertension subsequently received anti-hypertensive therapy to achieve casual blood pressure (BP)<95th percentile. After 12 months, all parents again completed the BRIEF and CBCL. RESULTS Twenty-two subjects with hypertension and 25 normotensive control subjects underwent both baseline and 12-month assessments. The BP of subjects with hypertension improved (24-hour systolic BP [SBP] load: mean baseline versus 12-months, 60% versus 25%, P<.001). Parent ratings of executive function improved from baseline to 12 months in the subjects with hypertension (BRIEF Global Executive Composite T-score, Delta=-5.9, P=0.001), but not in the normotensive control subjects (Delta=-0.36, P=.83). In contrast, T-scores on the CBCL Internalizing and Externalizing summary scales did not change significantly from baseline to 12 months in either subjects with hypertension or control subjects. CONCLUSIONS Children with hypertension demonstrated improvement in parental ratings of executive function after 12 months of anti-hypertensive therapy.
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Affiliation(s)
- Marc B. Lande
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Heather Adams
- Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Bonita Falkner
- Department of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - George J. Schwartz
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Peter G. Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Donna Palumbo
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY
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McCabe DP, Roediger HL, McDaniel MA, Balota DA, Hambrick DZ. The relationship between working memory capacity and executive functioning: evidence for a common executive attention construct. Neuropsychology 2010; 24:222-243. [PMID: 20230116 DOI: 10.1037/a0017619] [Citation(s) in RCA: 448] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Attentional control has been conceptualized as executive functioning by neuropsychologists and as working memory capacity by experimental psychologists. We examined the relationship between these constructs using a factor analytic approach in an adult life span sample. Several tests of working memory capacity and executive function were administered to more than 200 subjects between 18 and 90 years of age, along with tests of processing speed and episodic memory. The correlation between working memory capacity and executive functioning constructs was very strong (r = .97), but correlations between these constructs and processing speed were considerably weaker (rs approximately .79). Controlling for working memory capacity and executive function eliminated age effects on episodic memory, and working memory capacity and executive function accounted for variance in episodic memory beyond that accounted for by processing speed. We conclude that tests of working memory capacity and executive function share a common underlying executive attention component that is strongly predictive of higher level cognition.
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Hurks PPM, Schrans D, Meijs C, Wassenberg R, Feron FJM, Jolles J. Developmental changes in semantic verbal fluency: analyses of word productivity as a function of time, clustering, and switching. Child Neuropsychol 2010; 16:366-87. [PMID: 20373180 DOI: 10.1080/09297041003671184] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We investigated age-related improvement in semantic category verbal fluency (VF) in 309 Dutch schoolchildren attending first to ninth grade. Quantitative analyses of number of correct responses as a function of time as well as qualitative analyses of clustering and switching were conducted. Overall, Dutch VF task performance, i.e., number of correct responses over 60 seconds, was not established before mid-adolescence. This is in line with previously published studies, using VF number of correct responses over 60 seconds as the main outcome measure and examining VF task performance across other cultures and languages (e.g., Italian, French, Hebrew). Next, mean cluster size, a measure of lexico-semantic knowledge, was not established until at least grade 3. In contrast, performance on the VF outcome measures "number of switches/clusters" was established at least 4 years later. Qualitative and quantitative Design Fluency (DF) outcome measures support the notion that the numbers of switches/clusters are valid measures of higher order cognitive functions, such as strategy use and cognitive flexibility. In line of this, VF number of correct responses during 16-60 seconds, a measure of controlled information processing, is established at least 2 years later (i.e., grades 7-8) than number of correct responses during the first 15 seconds time slide, a measure of automatic processing. Finally, environment, i.e., the level of parental education, primarily affected automatic and lexico-semantic knowledge. No effects of sex on VF performance were found. These data suggest that the alternative scoring methods of VF tasks can be used to acquire knowledge on development of lower and higher order cognitive functions in healthy children and the influence of the environment on it.
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29
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Steeves TDL, Ko JH, Kideckel DM, Rusjan P, Houle S, Sandor P, Lang AE, Strafella AP. Extrastriatal dopaminergic dysfunction in tourette syndrome. Ann Neurol 2010; 67:170-81. [DOI: 10.1002/ana.21809] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Khalifa N, Dalan M, Rydell AM. Tourette syndrome in the general child population: cognitive functioning and self- perception. Nord J Psychiatry 2010; 64:11-8. [PMID: 19883191 DOI: 10.3109/08039480903248096] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to examine the cognitive function and self-perception in a school-population-based sample of children with Tourette syndrome (TS). Many studies have examined cognitive and emotional functioning in clinical samples but to our knowledge, there is no population-based study of TS in schoolchildren. In a population-based sample identified in a rigid diagnostic procedure (n = 25), cognitive functioning and self-perception were examined. There was a large variation in the cognitive functioning of children with TS, at least one third obtaining subnormal results. The profile of index scores on the Wechsler Intelligence Scale for Children (WISC) factors was somewhat uneven, with the freedom from distractibility and processing speed factors presenting the lowest median scores. The TS group had more negative self-perceptions than a comparison group. Tic severity or age at onset was not associated with cognitive performance or self-perception. Children who were taking medication had lower full IQ scores than children who were not. Low cognitive abilities and negative self-perception may be common in community-based samples of children with Tourette syndrome.
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Affiliation(s)
- Najah Khalifa
- Najah Khalifa, Department of Neuroscience, Child and Adolescent Psychiatry and Depart of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
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31
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Eddy CM, Rizzo R, Cavanna AE. Neuropsychological aspects of Tourette syndrome: a review. J Psychosom Res 2009; 67:503-13. [PMID: 19913655 DOI: 10.1016/j.jpsychores.2009.08.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 07/08/2009] [Accepted: 08/06/2009] [Indexed: 11/16/2022]
Abstract
Tourette syndrome (TS) is assumed to result from frontostriatal dysfunction, which would be expected to result in impairments in neuropsychological functions. This possibility has been explored in a number of studies that have assessed the performance of patients with TS within major cognitive domains and on tests involving executive functioning. We aim to summarize the main findings of these studies while evaluating the influence of task limitations and potentially critical confounding factors such as the presence of comorbidity. Although there is clearly a need for improved study design, we tentatively suggest that there is considerable evidence for cognitive impairment in a subgroup of patients, and that some difficulties seem to be intrinsic to TS. These impairments may reflect dysfunction of the anterior cingulate network within the frontostriatal pathway.
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Affiliation(s)
- Clare M Eddy
- Department of Psychology, University of Birmingham, Birmingham, UK
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Orth M. Transcranial magnetic stimulation in Gilles de la Tourette syndrome. J Psychosom Res 2009; 67:591-8. [PMID: 19913663 DOI: 10.1016/j.jpsychores.2009.07.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 07/17/2009] [Accepted: 07/17/2009] [Indexed: 10/20/2022]
Abstract
The cause of Gilles de la Tourette syndrome (GTS), a chronic motor and vocal tic disorder of childhood onset, remains unknown. Abnormalities in basal ganglia-thalamo-cortical circuits presumably play an important role in the pathophysiology underlying the involuntary tics. The use of transcranial magnetic stimulation (TMS), a noninvasive and painless tool to examine the excitability of several different circuits in the human motor cortex has advanced our understanding of the pathophysiology. Motor thresholds are similar in GTS and healthy subjects; in the resting state, recruitment of motor evoked potentials (MEPs) above threshold is more gradual in patients than controls. In contrast, recruitment of MEPs during preactivation is similar in both groups, as is the duration of the cortical silent period. This suggests that the distribution of excitability in the corticospinal system in patients at rest is different to that in healthy individuals. Importantly, correlation analysis showed that reduced levels of excitability at rest relate, in pure GTS patients, to video ratings of complex tics, and hand and finger tics, with less excitability predicting fewer tics. The correlations disappear for measures made during voluntary activation. This suggests that this is an adaptive response to abnormal basal ganglia-motor cortex inputs in an effort to reduce unwanted movements, a notion supported by electroencephalography-coherence studies that show increased cortico-cortical coupling. Compared to the healthy control group, short intracortical inhibition (SICI) thresholds are similar. However, above-threshold SICI recruitment and sensory afferent inhibition (SAI), a paradigm to examine sensory motor integration, are reduced in patients. This is consistent with the suggestion that reduced excitability of cortical inhibition is one factor that contributes to the difficulty that patients have in suppressing involuntary tics. In addition the reduced SAI indicates that impaired intracortical inhibition may not be limited to the motor cortex but also involves circuits linking sensory input and motor output. GTS with attention deficit hyperactivity disorder comorbidity is associated with more extensive changes in the excitability of motor cortex circuits than pure GTS or GTS+obsessive-compulsive disorder. The extent to which various different neuronal circuits are affected may be relevant for the phenotype of Tourette spectrum disorders.
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Affiliation(s)
- Michael Orth
- Department of Neurology, Universitätsklinikum Ulm, Ulm, Germany.
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Executive function deficits and neural discordance in children with Autism Spectrum Disorders. Clin Neurophysiol 2009; 120:1107-15. [PMID: 19442578 DOI: 10.1016/j.clinph.2009.04.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 04/03/2009] [Accepted: 04/05/2009] [Indexed: 11/22/2022]
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Thibault G, O’Connor KP, Stip E, Lavoie ME. Electrophysiological manifestations of stimulus evaluation, response inhibition and motor processing in Tourette syndrome patients. Psychiatry Res 2009; 167:202-20. [PMID: 19395047 PMCID: PMC3757001 DOI: 10.1016/j.psychres.2008.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Revised: 02/22/2008] [Accepted: 03/19/2008] [Indexed: 10/20/2022]
Abstract
Gilles de la Tourette syndrome (GTS) is a neuropsychiatric disorder with childhood onset presenting with multiple fluctuating motor tics and one or more phonic tics. A significant proportion of people suffering from GTS are still symptomatic in adulthood and present other emotional and cognitive difficulties, along with motor problems that often accompany these comorbid conditions. The nature of these difficulties is still poorly understood and multiple comorbidities are often inadequately controlled. The current study investigates both stimulus evaluation and motor processing in GTS while controlling for comorbidity. Fifteen adults with GTS and 20 control participants were matched on gender, laterality and intelligence. The P300 component, the no-go anteriorization (NGA) as well as the stimulus and response-locked lateralized-readiness potentials (S-LRP, R-LRP) were elicited during a stimulus-response compatibility (SRC) paradigm. The standard version of the Stroop Color-Word Test (SCWT) was also administered. Reaction times showed that participants with GTS processed both the SRC and the SCWT more rapidly than the control group, while producing a delayed P300 peak latency. The GTS group also showed faster S-LRP onset in response to the incompatible and faster processing of interference in the SCWT. There was also a tendency toward a greater frontal shift of the NGA in the GTS group. The P300 latency showed that with GTS patients, stimulus evaluation occurs later whereas the overlapping pre-motor response selection processes occur faster. Our findings are congruent with a probable cortical motor over-activation hypothesis of GTS involving faster motor program selection in processing conflicting SR configuration.
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Affiliation(s)
- Genevieve Thibault
- Centre de Recherche Fernand-Seguin and Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada,Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Kieron P. O’Connor
- Centre de Recherche Fernand-Seguin and Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada,Département de Psychiatrie, Université de Montréal, Montréal, Québec, Canada,Département de Psychologie et Psychoéducation, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Emmanuel Stip
- Centre de Recherche Fernand-Seguin and Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada,Département de Psychiatrie, Université de Montréal, Montréal, Québec, Canada
| | - Marc E. Lavoie
- Centre de Recherche Fernand-Seguin and Hôpital Louis-H. Lafontaine, Montréal, Québec, Canada,Département de Psychiatrie, Université de Montréal, Montréal, Québec, Canada,Corresponding author. Fernand-Seguin Research Center, 7331, Hochelaga Street, Montréal, QC, Canada H1N 3V2. Tel.: +1 514 251 4015x3587; fax: +1 514 251 2617. (M.E. Lavoie)
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Huss M. [Attention-deficit hyperactivity disorder: risk factors, protective factors, health supply, quality of life. A brief review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51:602-5. [PMID: 18446300 DOI: 10.1007/s00103-008-0538-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a chronic behavioural disorder diagnosed in 4.8 % of German children and adolescents. Although many studies indicate primarily a neurobiological etiology, the disorder cannot be diagnosed on the basis of specific markers. The principal aspect of diagnosis is the experienced clinician who must also take the differentiation of other behavioural disorders into account. In addition to inheritance, other known risk factors are nicotine exposition in pregnancy, adverse psychosocial conditions and birth complications. Protective factors are cognitive abilities, positive social contacts, and early treatment. The necessary structures in community support are developing; however, substantial enhancement is needed. Studies on quality of life indicate that ADHD should not be reduced to core symptoms since affected children are impaired in almost all areas of daily life.
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Affiliation(s)
- Michael Huss
- Klinikum der Johannes Gutenberg-Universität, Main, BRD.
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Suskauer SJ, Simmonds DJ, Fotedar S, Blankner JG, Pekar JJ, Denckla MB, Mostofsky SH. Functional magnetic resonance imaging evidence for abnormalities in response selection in attention deficit hyperactivity disorder: differences in activation associated with response inhibition but not habitual motor response. J Cogn Neurosci 2008; 20:478-93. [PMID: 18004945 DOI: 10.1162/jocn.2008.20032] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Impaired response inhibition is thought to be a core deficit in attention deficit hyperactivity disorder (ADHD). Prior imaging studies investigating response inhibition in children with ADHD have used tasks involving different cognitive resources, thereby complicating the interpretation of their findings. In this study, a classical go/no-go task with a well-ingrained stimulus-response association (green = go; red = no-go) was used in order to minimize extraneous cognitive demands. Twenty-five children with ADHD and 25 typically developing (TD) children between the ages of 8 and 13 years and group-matched for IQ and performance on the go/no-go task were studied using event-related functional magnetic resonance imaging (fMRI). Analyses were used to examine differences in activation between the ADHD and TD groups for "go" (habitual motor response) and "no-go" (requiring inhibition of the motor response) events. Region-of-interest analyses revealed no between-group difference in activation in association with "go" events. For "no-go" events, the children with ADHD demonstrated significantly less activation than did TD controls within a network important for inhibiting a motor response to a visual stimulus, with frontal differences localized to the pre-supplementary motor area. Although blood oxygenation level-dependent fMRI data show no differences between children with ADHD and TD children in association with a habituated motor "go" response, during "no-go" events, which require selecting not to respond, children with ADHD show diminished recruitment of networks important for response inhibition. The findings suggest that abnormalities in circuits important for motor response selection contribute to deficits in response inhibition in children with ADHD and lend support to the growing awareness of ADHD-associated anomalies in medial frontal regions important for the control of voluntary actions.
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Affiliation(s)
- Stacy J Suskauer
- Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
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Chang SW, McCracken JT, Piacentini JC. Neurocognitive correlates of child obsessive compulsive disorder and Tourette syndrome. J Clin Exp Neuropsychol 2008; 29:724-33. [PMID: 17896198 DOI: 10.1080/13825580600966383] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study investigated the neurocognitive correlates of childhood OCD and TS, which are purported to share frontal-striatal dysfunction. Neurocognitive measures tapping frontal-striatal functions such as executive, attention/memory, and visuomotor abilities were administered to three groups of participants, OCD without comorbid TS (OCD), TS without comorbid OCD (TS), and normal controls. Results suggested that OCD group demonstrated deficits in the area of spatial attention relative to healthy controls. The OCD participants demonstrated no cognitive deficits compared to the TS group. TS participants showed trends towards impairments in the areas of response inhibition, divided attention, and cognitive flexibility relative to the OCD and normal control groups. Spatial attention deficits for the OCD group are partially consistent with adult OCD studies indicating deficits in spatial memory. TS findings were less robust and may be construed tentatively as suggestive of executive function deficits. Future research is needed to delineate the influence of development on neurocognitive deficits associated with OCD and TS.
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Affiliation(s)
- Susanna W Chang
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA.
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Abstract
A developmental approach to the study of psychopathology can broaden understanding of a wide variety of complex psychological disorders. This article reviews research on Tourette's syndrome (TS), a developmental disorder characterized by unwanted motor and vocal tics. Over the past decade, knowledge of the neurobiology and pathophysiology of TS has progressed rapidly. The application of brain imaging techniques, primarily magnetic resonance imaging, to the study of Tourette's has increased knowledge of structural and functional deficits in brain areas associated with behavioral and psychological disturbances in the disorder. By reviewing some of this work, we will describe one way in which knowledge of brain function in TS has both informed and been informed by a developmental science approach. In particular, we will consider the extent to which the cognitive and emotional development of persons with TS may be affected by specific neurobiological characteristics of the disorder.
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Affiliation(s)
- Emily R Stern
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, 2701 Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
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Wodka EL, Mostofsky SH, Prahme C, Gidley Larson JC, Loftis C, Denckla MB, Mahone EM. Process examination of executive function in ADHD: sex and subtype effects. Clin Neuropsychol 2008; 22:826-41. [PMID: 18609314 DOI: 10.1080/13854040701563583] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To examine effects of group (Attention-Deficit/Hyperactivity Disorder [ADHD] versus Typically Developing [TD]), sex, and ADHD subtype on "process/optional" measures of executive functioning, children (n = 123; 54 ADHD, 69 TD) aged 8-16 completed subtests from the D-KEFS. No group, sex, or ADHD subtype effects were found on optional measures from the Trail Making, Color-Word Interference, and Tower tests. A significant interaction was found for Verbal Fluency Total Repetition Errors; boys with Combined/Hyperactive-Impulsive (ADHD-C/HI) type ADHD performed better than ADHD-C/HI girls, whereas girls with Inattentive type ADHD (ADHD-I) performed better than ADHD-I boys. Overall, children with ADHD did not differ from TD on most optional measures from the D-KEFS. When sex and ADHD subtype were considered, children with the subtype of ADHD less common for sex were at greater risk for poorer performance.
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Affiliation(s)
- Ericka L Wodka
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Avenue, Baltimore, MD 21231, USA.
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Wodka EL, Loftis C, Mostofsky SH, Prahme C, Larson JCG, Denckla MB, Mahone EM. Prediction of ADHD in boys and girls using the D-KEFS. Arch Clin Neuropsychol 2008; 23:283-93. [PMID: 18243646 DOI: 10.1016/j.acn.2007.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 10/30/2007] [Accepted: 12/14/2007] [Indexed: 10/22/2022] Open
Abstract
To examine patterns of executive dysfunction associated with ADHD, 123 children (54 ADHD, 69 controls) of ages 8-16 years were administered selected subtests from the Delis-Kaplan Executive Function System (D-KEFS). Children with ADHD performed significantly worse than controls on measures of both basic (less executive demand) skills and those with more executive demand from the Color-Word Interference and Tower subtests; however, no group differences were noted on any of the D-KEFS contrast scores. Most subtype comparisons yielded no differences; however, children with the Combined subtype outperformed children with the Inattentive subtype on measures of both basic and executive skills from the Trail Making Test. Children with ADHD demonstrate executive dysfunction that is identified by D-KEFS summary, but not contrast scores. In this carefully screened sample of children with ADHD, few significant differences were found between groups suggesting limited sensitivity or specificity of the D-KEFS for classifying children with ADHD.
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Lit L, Gilbert DL, Walker W, Sharp FR. A subgroup of Tourette's patients overexpress specific natural killer cell genes in blood: a preliminary report. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:958-63. [PMID: 17503477 DOI: 10.1002/ajmg.b.30550] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gilles de la Tourette Syndrome (TS) is a heritable, neurodevelopmental disorder characterized by motor and vocal tics. As no single gene or region has emerged from standard linkage approaches, TS may result from several as-yet-unidentified genetic factors, and may also occur due to infection-triggered, autoimmune processes. Etiological or pathogenic differences might result in clinically indistinguishable TS subgroups. We have previously used whole genome human oligonucleotide microarrays in an attempt to identify patterns of gene expression in blood linked with TS. In this proof-of-principle study, we applied Principal Components Analysis to a previously collected set of 16 familial TS and 16 control blood samples to identify subgroups. Fourteen genes, primarily Natural Killer Cell (NK) genes, discriminated between TS and all controls. Granzyme B and NKG7 were confirmed using RT-PCR. Five probesets (four genes) reside in chromosomal regions previously linked to familial TS or obsessive-compulsive disorder. Using the 14 genes, a Principal Components Analysis as well as a cluster analysis identified a TS subgroup (n = 10/16) that overexpressed the NK genes. 7/10 subjects within this subgroup were diagnosed with attention-deficit hyperactivity disorder (ADHD), suggesting that this expression profile might be associated with TS and co-morbid ADHD. Principal Components Analysis of gene expression in blood may be useful for identifying subgroups of other complex neurodevelopmental diseases, and the gene expression profile identified in this study may provide a biomarker for at least one subgroup of heritable TS.
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Affiliation(s)
- Lisa Lit
- Genetics Graduate Group, Department of Neurology, M.I.N.D. Institute, University of California at Davis, Sacramento, CA 95817, USA.
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Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. Tourette syndrome and tic disorders: a decade of progress. J Am Acad Child Adolesc Psychiatry 2007; 46:947-968. [PMID: 17667475 DOI: 10.1097/chi.0b013e318068fbcc] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This is a review of progress made in the understanding of Tourette syndrome (TS) during the past decade including models of pathogenesis, state-of-the-art assessment techniques, and treatment. METHOD Computerized literature searches were conducted under the key words "Tourette syndrome," "Tourette disorder," and "tics." Only references from 1996-2006 were included. RESULTS Studies have documented the natural history of TS and the finding that tics usually improve by the end of the second decade of life. It has also become clear that TS frequently co-occurs with attention-deficit/hyperactivity disorder), obsessive-compulsive disorder, and a range of other mood and anxiety disorders. These comorbid conditions are often the major source of impairment for the affected child. Advances have also been made in understanding the underlying neurobiology of TS using in vivo neuroimaging and neurophysiology techniques. Progress on the genetic front has been less rapid. Proper diagnosis and education (involving the affected child and his or her parents, teachers, and peers) are essential prerequisites to the successful management of children with TS. When necessary, modestly effective antitic medications are available, although intervening to treat the comorbid attention-deficit/hyperactivity disorder and/or obsessive-compulsive disorder is usually the place to start. CONCLUSIONS Prospective longitudinal studies and randomized clinical trials have led to the refinement of several models of pathogenesis and advanced our evidence base regarding treatment options. However, fully explanatory models are needed that would allow for more accurate prognosis and the development of targeted and efficacious treatments.
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Affiliation(s)
- James E Swain
- Drs. Swain, Scahill, Lombroso, King, and Leckman are with the Child Study Center of Yale University, New Haven, CT; and Dr. Scahill is also with the School of Nursing at Yale University..
| | - Lawrence Scahill
- Drs. Swain, Scahill, Lombroso, King, and Leckman are with the Child Study Center of Yale University, New Haven, CT; and Dr. Scahill is also with the School of Nursing at Yale University
| | - Paul J Lombroso
- Drs. Swain, Scahill, Lombroso, King, and Leckman are with the Child Study Center of Yale University, New Haven, CT; and Dr. Scahill is also with the School of Nursing at Yale University
| | - Robert A King
- Drs. Swain, Scahill, Lombroso, King, and Leckman are with the Child Study Center of Yale University, New Haven, CT; and Dr. Scahill is also with the School of Nursing at Yale University
| | - James F Leckman
- Drs. Swain, Scahill, Lombroso, King, and Leckman are with the Child Study Center of Yale University, New Haven, CT; and Dr. Scahill is also with the School of Nursing at Yale University
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Bodnar LE, Prahme MC, Cutting LE, Denckla MB, Mahone EM. Construct Validity of Parent Ratings of Inhibitory Control. Child Neuropsychol 2007; 13:345-62. [PMID: 17564851 DOI: 10.1080/09297040600899867] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Recent literature has emphasized the need to examine executive functions (EF) in children using multiple sources, including both parent rating and performance-based measures. Computerized Go/No-Go tests, including commercially available continuous performance tests (CPTs), represent one of the most commonly used methods of assessing inhibitory control - a variable central to the executive function construct. We examined the relationship between parent ratings of inhibitory control and CPT performance in two mixed clinical samples. Experiment 1 examined 109 children ages 6-18 using the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000) and the Conners' CPT-II (Conners, 2000). In this sample, ratings on the BRIEF Inhibit scale (mean T-score = 62.3) were significantly higher than the CPT-II commissions score (mean T-score = 50.7; p < .0001); and the BRIEF and CPT-II scores were not highly correlated (r = - .12). Experiment 2 examined a sample of 131 children ages 7-18 using the BRIEF and the Tests of Variables of Attention (TOVA; Greenberg, 1996). In this sample, parent ratings on the BRIEF Inhibit scale (mean T-score = 56.8) were similar to TOVA commissions scores (mean T-score = 58.6; p = .33), although still poorly correlated (r = -.02). Factor analyses exploring covariance between BRIEF scales CPT-II variables (Experiment 1) and between BRIEF and TOVA (Experiment 2) yielded similar findings. In both experiments, all eight BRIEF scales loaded on a single factor, with no overlap with either the CPT-II or the TOVA. In mixed outpatient clinical samples, the BRIEF appears to measure different elements of inhibitory control than those assessed by computerized continuous performance tests.
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Bagner DM, Williams LB, Geffken GR, Silverstein JH, Storch EA. Type 1 Diabetes in Youth: The Relationship Between Adherence and Executive Functioning. CHILDRENS HEALTH CARE 2007. [DOI: 10.1080/02739610701335001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martino D, Defazio G, Church AJ, Dale RC, Giovannoni G, Robertson MM, Orth M. Antineuronal antibody status and phenotype analysis in Tourette's syndrome. Mov Disord 2007; 22:1424-1429. [PMID: 17516471 DOI: 10.1002/mds.21454] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The Gilles de la Tourette syndrome (GTS) spectrum includes psychiatric comorbidities, mainly obsessive-compulsive disorder (OCD) and attention-deficit-hyperactivity disorder (ADHD). The role of environmental factors, e.g., antineuronal antibodies (ANeA), remains unclear. We compared the clinical features of ANeA-positive and ANeA-negative patients in 53 children and 75 adults with GTS. All diagnoses were made according to DSM-IV-TR criteria. A positive ANeA Western immunoblot showed bands for at least 1 of 3 reported striatal antigens (40, 45, and 60 kDa). Twelve children (23%) and 18 adults (25%) with GTS were ANeA-positive. Disease duration, tic phenomenology and severity, frequency of echo/pali/coprophenomena, self-injurious and aggressive behavior, or frequency of OCD comorbidity did not significantly differ between ANeA-positive and negative patients. Similar findings were obtained analyzing separately the three different antibody reactivities. A comorbid diagnosis of ADHD was significantly less frequent in GTS patients positive for the anti-60 kDa antibody only. Using a multivariate logistic regression model, adjusting for age, gender, and age at disease onset, a comorbid diagnosis of ADHD remained inversely associated with anti-60 kDa antibodies (odds ratio = 0.14; P = 0.002; 95% confidence interval 0.04-0.49). ANeA status does not differentiate a specific phenotype of GTS.
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Affiliation(s)
- Davide Martino
- Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Giovanni Defazio
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Andrew J Church
- Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom
| | - Russell C Dale
- Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom
- Neurosciences Unit, Great Ormond Street Hospital NHS Trust and Institute of Child Health, University College London, Queen Square, London, United Kingdom
| | - Gavin Giovannoni
- Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom
| | - Mary M Robertson
- Department of Mental Health Sciences, University College London, Queen Square, London, United Kingdom
| | - Michael Orth
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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Yoon DY, Gause CD, Leckman JF, Singer HS. Frontal dopaminergic abnormality in Tourette syndrome: a postmortem analysis. J Neurol Sci 2007; 255:50-6. [PMID: 17337006 DOI: 10.1016/j.jns.2007.01.069] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 12/21/2006] [Accepted: 01/23/2007] [Indexed: 10/23/2022]
Abstract
Frontal-subcortical abnormalities have been implicated in the pathophysiology of Tourette syndrome (TS). The goal of this study was to more extensively evaluate a possible underlying neurochemical abnormality in frontal cortex. Postmortem brain tissue from frontal and occipital regions (Brodmann's areas 4, 6, 9, 10, 11, 12, and 17) from three TS patients and three age-and sex-matched controls were analyzed by semiquantitative immunoblotting. Relative densities were measured for a variety of neurochemical markers including dopamine (D1, D2), serotonin (5HT-1A), and alpha-adrenergic (alpha-2A) receptors, the dopamine transporter (DAT), a monoamine terminal marker (vesicular monoamine transporter type 2, VMAT-2), and vesicular docking and release proteins (VAMP-2, synaptotagmin, SNAP-25, syntaxin, synaptophysin). Data from each TS sample, corrected for actin content, was expressed as a percentage value of its control. Results identified consistent increases of DAT and D2 receptor density in five of six frontal regions in all three TS subjects. D1 and alpha-2A receptor density were increased in a few frontal regions. These results support the hypothesis of a dopaminergic dysfunction in the frontal lobe and a likely role in the pathophysiology of TS.
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Affiliation(s)
- Dustin Y Yoon
- Department of Neurology, Johns Hopkins University School of Medicine, Harriett Lane Outpatient Building, 200 N. Wolfe Street, Suite 2158, Baltimore, MD 21205, USA
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Lavoie ME, Thibault G, Stip E, O'Connor KP. Memory and executive functions in adults with Gilles de la Tourette syndrome and chronic tic disorder. Cogn Neuropsychiatry 2007; 12:165-81. [PMID: 17453897 PMCID: PMC3749156 DOI: 10.1080/13546800600826371] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The main aim of the current study was to assess whether adults with either Tourette syndrome (TS) or chronic tic disorder (CTD) show a similar neuropsychological profile. Neuropsychological investigations of tic disorders have been mostly focused on children, mainly because symptoms peak during that period. Little has been carried out on adults, even if a significant proportion of the tic population experience moderate or marked levels of tic frequency throughout adulthood. Still, it is not clear whether neuropsychological performances are affected to the same degree in adults with TS and CTD. METHOD Patients diagnosed with TS were compared with a CTD group and a control group free of psychiatric or neurological diagnosis, comparable in terms of age, gender, and intelligence. All participants completed two tests of memory (Rey-Osterreich Complex Figure, California Verbal Learning Test), one test of motor dexterity (Purdue pegboard), and four tasks of executive function (Stroop, Color Trail Test, Tower of London, Wisconsin Card Sorting Test). RESULTS TS and CTD patients showed nonverbal memory impairments while verbal memory and executive functioning remained intact. Results also indicated that nonverbal memory performances decrease as a function of tic severity. CONCLUSION Both TS and CTD patients present a specific nonverbal deficit whilst the executive and motor functions are relatively intact. The two tic disorder subgroups might be part of a spectrum implicating mainly nonverbal memory.
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Affiliation(s)
- Marc E Lavoie
- Centre de Recherche Fernand-Seguin and Hôpital Louis-H. Lafontaine, Département de Psychiatrie, Université de Montréal, Canada.
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Griffiths SY, Sherman EMS, Slick DJ, Lautzenhiser A, Westerveld M, Zaroff CM. The Factor Structure of the CVLT-C in Pediatric Epilepsy. Child Neuropsychol 2007; 12:191-203. [PMID: 16837395 DOI: 10.1080/09297040600681315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The current study used archival data to evaluate the fit of six latent variable models, originally generated by Donders (1999), for the California Verbal Learning Test-Children's Version (CVLT-C; Delis, Kramer, Kaplan, & Ober, 1994) in a large (N = 289) sample of pediatric epilepsy cases presenting at three tertiary treatment centers. Using confirmatory factor analysis, we found that a model including factors of Attention Span, Learning Efficiency, Free Delayed Recall, Cued Delayed Recall, and Inaccurate Recall demonstrated the best relative fit for our data. These findings are consistent with those reported by Donders (1999) in his reanalysis of the CVLT-C standardization sample data, supporting the validity of this factorial model in pediatric epilepsy populations.
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Affiliation(s)
- S Y Griffiths
- Department of Psychology, Simon Fraser University, Vancouver, USA
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Georgiou-Karistianis N, Gardner B, Vardy Y, Evans N, Bradshaw JL, Shapiro K, Sheppard D. Attentional blink in adults with Tourette syndrome. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2007. [DOI: 10.1080/00049530600940240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Nellie Georgiou-Karistianis
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
| | - Betina Gardner
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
| | - Yvette Vardy
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
| | - Natalie Evans
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
| | - John L. Bradshaw
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
| | - Kimron Shapiro
- School of Psychology, University of Wales, Bangor, Gwynedd, Wales, United Kingdom
| | - Dianne Sheppard
- Experimental Neuropsychology Research Unit, Psychology Department, School of Psychology, Monash University, Melbourne, Victoria, Australia
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Verté S, Geurts HM, Roeyers H, Oosterlaan J, Sergeant JA. Executive functioning in children with autism and Tourette syndrome. Dev Psychopathol 2006; 17:415-45. [PMID: 16761552 DOI: 10.1017/s0954579405050200] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The main aims of this study were to investigate if children with high-functioning autism (HFA) and children with Tourette syndrome (TS) can be differentiated in their executive functioning (EF) profile compared to normal controls (NCs) and compared to each other and to investigate whether children with HFA or children with TS and a comorbid group of children with both disorders are distinct conditions in terms of EF, Four groups of children participated in this study: HFA, TS, comorbid HFA + TS, and a NC group. All children were in the age range of 6 to 13 years. The groups were compared on five major domains of EF: inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. Children with HFA scored lower than NC children on all the EFs measured. Children with TS and NC children showed the same EF profile. The HFA group scored lower than the TS group for inhibition of a prepotent response and cognitive flexibility. Children with HFA performed poorer than children with comorbid HFA + TS on all functions, with the exception of inhibiting an ongoing response, interference control, and verbal fluency. Children with TS and children with comorbid HFA + TS could not be differentiated from one another in terms of EF. This study indicates that EF deficits are highly characteristic of children with HFA in comparison to children with TS and NC. The results suggest that for the comparison between HFA and TS groups, it is important to take into account comorbidity. A reevaluation of the EF hypothesis in children with TS is suggested.
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Affiliation(s)
- Sylvie Verté
- Research Group Developmental Disorders, Ghent University, H. Dunantlaan 2, B-9000 Ghent, Belgium.
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