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Inci Izmir SB, Aktan ZD, Ercan ES. The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder. J Atten Disord 2024; 28:1555-1576. [PMID: 39092505 DOI: 10.1177/10870547241267379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVE The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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Becker SP, Martinez AC, Wiggs KK, Langberg JM, Smith ZR. Multi-method examination of cognitive disengagement syndrome and ADHD inattentive symptoms in relation to early adolescents' academic functioning. Eur Child Adolesc Psychiatry 2024; 33:2189-2201. [PMID: 37804421 DOI: 10.1007/s00787-023-02311-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo, is a set of symptoms characterized by excessive daydreaming, mental fogginess, and slowed behavior/thinking. Studies examining the association between CDS and academic functioning have reported mixed findings and have relied upon limited measures of CDS, broad ratings of academic impairment, and/or focused only on elementary-aged children. The current study examined the relationship between CDS and academic functioning in adolescents using a comprehensive, multi-informant, multi-method design. Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD) recruited in the fall of their 8th grade. Above and beyond ADHD inattentive symptoms, CDS symptoms were related to poorer homework performance, lower math fluency, and lower daily academic motivation across multiple informants, and teacher-reported CDS symptoms were related to lower grades. Findings were not moderated by ADHD diagnosis, suggesting that associations between CDS and academic outcomes do not differ for adolescents with and without ADHD. Findings demonstrate that CDS symptoms are uniquely associated with daily academic difficulties as well as global indices of academic performance. These findings have implications for assessing and monitoring CDS symptoms in interventions aiming to improve the academic functioning in adolescents with and without ADHD.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Andrew C Martinez
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH, USA
| | - Kelsey K Wiggs
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH, USA
| | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA
| | - Zoe R Smith
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
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Fredrick JW, Becker SP. Personality Traits in Relation to Cognitive Disengagement Syndrome and ADHD Inattention in Two Samples of Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:460-472. [PMID: 38407137 PMCID: PMC11192613 DOI: 10.1080/15374416.2024.2316707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Cognitive disengagement syndrome (CDS; previously referred to as sluggish cognitive tempo) is a set of behaviors, including excessive mind-wandering, mental fogginess, and hypoactivity, that are separate from ADHD inattentive (ADHD-IN) symptoms and linked to functional outcomes. However, CDS and ADHD-IN symptoms are strongly associated, and our understanding of whether personality correlates are similarly or differentially linked to CDS and ADHD-IN is limited. The objective of the current study was to examine personality correlates of CDS and ADHD-IN symptoms across two independent samples of school-aged youth. METHOD Study 1 included 207 school-aged children (ages 7-11; 63% male; 87.9% White) with or without teacher-reported elevations in CDS. Study 2 included 263 school-aged children (ages 8-12; 58% male; 75.3% White) with the full range of CDS symptomatology. Parents and teachers completed ratings of ADHD-IN and CDS, and parents also reported on their child's personality dimensions. RESULTS Across two samples and controlling for demographic characteristics as well as ADHD-IN symptoms and other personality traits, higher levels of FFFS-fear/shyness were uniquely associated with higher levels of parent- and teacher-reported CDS symptoms. In most models, lower levels of BAS-drive were also uniquely associated with higher levels of CDS. In contrast, when controlling for demographic characteristics and CDS symptoms, higher levels of BAS-impulsivity/fun-seeking were uniquely associated with higher levels of parent- and teacher-reported ADHD-IN symptoms. DISCUSSION The findings provide the clearest evidence to date that personality dimensions are differentially associated with ADHD-IN and CDS symptoms in children, further underscoring CDS as a distinct construct from ADHD-IN.
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Affiliation(s)
- Joseph W. Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Khalid E, VanLandingham HB, Basurto KS, Nili AN, Gonzalez C, Guilfoyle JL, Ovsiew GP, Durkin NM, Ulrich DM, Resch ZJ, Pliskin NH, Soble JR, Cerny BM. Exploring Subfactors of Adult Cognitive Disengagement Syndrome and Impact on Neuropsychological Performance. J Atten Disord 2024; 28:957-969. [PMID: 38178579 DOI: 10.1177/10870547231218945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE This study investigated subfactors of cognitive disengagement syndrome (CDS; previously referred as sluggish cognitive tempo) among adults referred for neuropsychological evaluation of attentiondeficit/hyperactivity disorder (ADHD). METHOD Retrospective analyses of data from 164 outpatient neuropsychological evaluations examined associations between CDS subfactors and self-reported psychological symptoms and cognitive performance. RESULTS Factor analysis produced two distinct but positively correlated constructs: "Cognitive Complaints'' and "Lethargy." Both correlated positively with symptom reports (rs = 0.26-0.57). Cognitive Complaints correlated negatively with working memory, processing speed, and executive functioning performance (rs = -0.21 to -0.37), whereas Lethargy correlated negatively only with processing speed and executive functioning performance (rs = -0.26 to -0.42). Both predicted depression symptoms, but only Cognitive Complaints predicted inattention symptoms. Both subfactors demonstrated modest to nonsignificant associations with cognitive performance after accounting for estimated premorbid intelligence and inattention. CONCLUSION Findings indicate a bidimensional conceptualization of CDS, with differential associations between its constituent subfactors, reported symptoms, and cognitive performance.
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Affiliation(s)
- Elmma Khalid
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Hannah B VanLandingham
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Karen S Basurto
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Amanda N Nili
- University of Illinois College of Medicine, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Gonzalez
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Janna L Guilfoyle
- University of Illinois College of Medicine, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nicole M Durkin
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Neil H Pliskin
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Brian M Cerny
- University of Illinois College of Medicine, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
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Chutko LS, Yakovenko EA, Surushkina SY, Anisimova TI, Cherednichenko DV, Didur MD, Chekalova SA. [Clinical and neurophysiological manifestations of sluggish cognitive tempo in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:120-127. [PMID: 38884438 DOI: 10.17116/jnevro2024124051120] [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] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To study the clinical and neurophysiological features of children with low cognitive tempo (NCT), as well as the effectiveness of the drug Pantogam in the treatment of this pathology. MATERIAL AND METHODS A total of 90 children aged 8 to 10 years were examined. Of these, the main study group consisted of 30 children with NCT, the comparison group consisted of 30 children with a combined type of attention deficit hyperactivity disorder ADHD (ADHD-K), the control group consisted of 30 children without neuropsychiatric disorders. The study used clinical, neurophysiological (electroencephalography (EEG)) and parametric methods. The CMAS scale of apparent anxiety (The Children's Form of Manifest Anxiety Scale), the SNAP-IY scale (assessment of the degree of inattention, hyperactivity and impulsivity), the TOVA computer test (the Test of Variables of Attention), the scale «SCT» (Sluggish Cognitive Tempo) for assessing manifestations of low cognitive tempo, the «RAM» technique for quantifying working memory. Pantogam was used to treat patients at a dose of 750 mg per day for 8 weeks. RESULTS Patients with NCT are characterized by more pronounced attention disorders compared with healthy peers and with children with ADHD-K, and they have a decrease in mainly not selective attention, but the overall level of functional activity. Also, the group of children with NCT has an increased level of anxiety compared to the group of children with ADHD. A comparative analysis of the level of impulsivity showed that children with NCT are less characterized by a deficit in inhibition processes. According to the quantitative analysis of the EEG, specific changes in functional activity in the frontal and central regions of the cerebral cortex were revealed (a statistically significant increase in the ratio of absolute theta rhythm to beta1 rhythm, compared with other groups), reflecting insufficient cortical arousal and less focused neural states. When re-evaluating the condition of children with NCT after a course of therapy with Pantogam, an improvement in the form of a decrease in the degree of inattention, the severity of memory impairment and a decrease in reaction time was recorded in 60% of cases. According to quantitative EEG analysis, there was a significant decrease in the ratio of absolute theta rhythm to beta1 rhythm in the central leads of both hemispheres and in the parietal-temporal leads of the left hemisphere, indicating an increase in the level of overall activation of the cerebral cortex after a course of treatment. CONCLUSION Clinical and neurophysiological differences were revealed in patients with NCT and with combined ADHD. It has been shown that the use of Pantogam for the treatment of children with NCT leads not only to a decrease in the main manifestations of this disorder, but also to an improvement in the functional state of the brain.
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Affiliation(s)
- L S Chutko
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - E A Yakovenko
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - S Yu Surushkina
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - T I Anisimova
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - D V Cherednichenko
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - M D Didur
- N. Bechtereva Institute of Human BraIn Russian Academy of Sciences, St. Petersburg, Russia
| | - S A Chekalova
- Research Institute of Hygiene and Health Protection of Children and Adolescents, Moscow, Russia
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Sadeghi-Bahmani D, Parhoon H, Esmaeili M, Parhoon K, Sadeghi Bahmani L, Khazaie H, Becker SP, Burns GL, Brand S. Validation of the Farsi Version of the Adult Concentration Inventory for Assessing Cognitive Disengagement Syndrome. J Clin Med 2023; 12:4607. [PMID: 37510724 PMCID: PMC10380426 DOI: 10.3390/jcm12144607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
The internal and external validity of cognitive disengagement syndrome (CDS) relative to attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated herein with Farsi-speaking adults. A total of 837 Iranian adults assessed throughout the whole country (54.72% women, Mage = 23.85; SD = 7.05; age range = 18 to 58 years; 75% between 18 and 24 years old; reporting higher educational training) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), depression, anxiety, and stress. Seven of the fifteen CDS symptoms showed a good convergent (high loadings on the CDS factor) and discriminant (higher loadings on the CDS factor than the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations with depression than ADHD-IN, whereas ADHD-IN showed stronger first-order and unique associations with ADHD-HI and anxiety than CDS. The first-order and unique associations of CDS and ADHD-IN did not differ in relation to stress. This study is the first to support the validity of the self-report of assessing CDS symptoms with the Adult Concentration Inventory with Farsi-speaking individuals residing in Iran, thus further strengthening the transcultural validity of the CDS, and paving the way for further transcultural research in the field of CDS among adults.
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Affiliation(s)
- Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
- Department of Epidemiology & Population Health, Stanford University, Stanford, CA 94305, USA
| | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah 6714414971, Iran;
| | - Maryam Esmaeili
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan 8174673441, Iran;
| | - Kamal Parhoon
- Department of Psychology, Kharazmi University, Tehran 1571914911, Iran;
| | - Laleh Sadeghi Bahmani
- Department of Education and Psychology, Shahid Ashrafi Esfahani University, Isfahan 8179949999, Iran;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714415185, Iran;
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - G. Leonard Burns
- Department of Psychology, Washington State University, Pullman, WA 99164, USA;
| | - Serge Brand
- Center for Affective, Sleep and Stress Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714415185, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1441987566, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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Wiggs KK, Froehlich TE, Becker SP. Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research. CNS Drugs 2023; 37:293-304. [PMID: 37061629 DOI: 10.1007/s40263-023-00999-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/17/2023]
Abstract
Although the study of cognitive disengagement syndrome (CDS; previously called sluggish cognitive tempo) first emerged in the 1980s, very little is known about treating CDS or its impact on evidence-based interventions for attention-deficit/hyperactivity disorder (ADHD) with which it frequently co-occurs. The objective of this leading article was to investigate the existing evidence on medication treatment and CDS, including studies that have examined CDS response to medication and CDS as a moderator of ADHD treatment response. A total of seven studies were identified. At present, the limited existing literature suggests that psychostimulants such as methylphenidate and lisdexamfetamine, as well as atomoxetine, may improve CDS symptoms, although replication and research on related medications is needed. However, there are indications that CDS symptoms may predict a reduced response to methylphenidate in children with ADHD. Although untested, research on the neurobiological, neuropsychological, and behavioral correlates of CDS point to a possible benefit of other ADHD medications (e.g., guanfacine), medications that treat narcolepsy (e.g., modafinil), and medications traditionally used to treat depression and anxiety (e.g., viloxazine, bupropion, fluvoxamine), some of which have also recently been used in ADHD management. The article concludes with recommendations for future research on pharmacologic treatment and CDS.
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Affiliation(s)
- Kelsey K Wiggs
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45206, USA
| | - Tanya E Froehlich
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45206, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Chutko LS, Surushkina SY, Yakovenko EA, Anisimova TI, Cherednichenko DV, Didur MD, Chekalova SA. [Cognitive impairment in children with organic asthenic disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:92-99. [PMID: 37942979 DOI: 10.17116/jnevro202312309292] [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] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To study cognitive impairment and neurophysiological characteristics in children with organic asthenia, as well as the effectiveness of the drug Cogitum in the treatment of this pathology. MATERIAL AND METHODS The main study group included 40 children aged 8 to 10 years with a diagnosis of «Organic asthenic disorder» (F06.6). The control group consisted of 30 children aged 8 to 10 years without manifestations of asthenia. The following research methods were used in the work: the asthenic state scale (ASS) by L.D. Malkova to assess the severity of asthenic syndrome, the S. Lee «SCT» (sluggish cognitive tempo) scale to assess manifestations of low cognitive tempo, the «Random Access Memory» method to quantify working memory, the TOVA (The Test of Variables of Attention) computer test to quantify assessment of attention disorders and impulsivity level, electroencephalogram (routine and spectral analysis) (p<0.05). For the treatment of patients from the study group, the drug Cogitum was used at a dose of 10 ml of a drinking solution per day for 30 days. RESULTS In was shown that children from the study group were characterized by a decrease in working memory (7.8±2.9 vs 14.9±5.4), a statistically significant increase in SCT scores (p<0.05), a significantly greater degree of inattention and impulsivity with a tendency to an increase in the number of errors in the second half of the TOVA test (p<0.05). Comparative analysis of EEG relative power data showed a statistically significant increase in the power of waves in the alpha and theta ranges in the fronto-central leads of both hemispheres in the group of children with organic asthenic disorder (p<0.05). When re-evaluating the condition of children after treatment, a statistically significant decrease in the manifestations of asthenia on the ASS scale was recorded in 77.5% of cases. At the same time, there was a significant improvement in attention, memory, and indicators characterizing a low cognitive pace. The results of an electroencephalographic study after a course of treatment showed a decrease in the relative power of the EEG in the theta and alpha ranges in the anterior sections of the cerebral cortex (p<0.05), which indicates an increase in the level of activation of neocortical structures. CONCLUSION Thus, the use of the drug Cogitum for the treatment of organic asthenic disorder leads not only to a decrease in asthenia and cognitive impairment, but also to an improvement in the functional state of the brain.
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Affiliation(s)
- L S Chutko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - S Yu Surushkina
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - E A Yakovenko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - T I Anisimova
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - D V Cherednichenko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - M D Didur
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - S A Chekalova
- Research Institute of Hygiene and Health of Children and Adolescents Federal State Autonomous Institution «NMIC for Children's Health», Moscow, Russia
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