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Prat R, Puig-Ribera A, Pagerols M, Español-Martín G, Rivas C, Autet A, Tàpies P, Martín AC, Casas M, Bosch R. Patterns of Physical Activity of Adolescents With ADHD in the School Context: A Cross-Sectional Study for Clinical Practice. J Atten Disord 2024; 28:1210-1224. [PMID: 38622866 DOI: 10.1177/10870547241246688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To describe the daily Physical Activity (PA) patterns of adolescents with Attention-deficit/hyperactivity disorder (ADHD), to analyze the differences in terms of PA patterns between adolescents with ADHD and those without ADHD, and to study the factors associated with achieving the daily PA recommendations. METHODS The sample was composed of 778 adolescents who provided complete information on their PA patterns through the Physical Activity Questionnaire for Adolescents (PAQ-A). Of these, 97 had ADHD according to DSM-5 criteria. RESULTS The results show that being a girl or being of foreign origin and having ADHD have an impact on the achievement of the recommended amount of daily PA. CONCLUSIONS When promoting PA in adolescents with ADHD within the school environment, it is necessary to consider different domains and specific contexts of a school day, paying special attention to girls and adolescents with ADHD of immigrant origin.
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Affiliation(s)
- Raquel Prat
- Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- University of Vic-Central University of Catalonia, IRIS-CC, Vic, Spain
| | - Anna Puig-Ribera
- University of Vic-Central University of Catalonia, IRIS-CC, Vic, Spain
| | - Mireia Pagerols
- Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Universitat de Barcelona, Spain
| | | | - Cristina Rivas
- Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | | | - Pere Tàpies
- Consorci Hospitalari de Vic, Catalunya, Spain
| | | | - Miquel Casas
- Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Rosa Bosch
- Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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Li C, Delgado-Gómez D, Sujar A, Wang P, Martin-Moratinos M, Bella-Fernández M, Masó-Besga AE, Peñuelas-Calvo I, Ardoy-Cuadros J, Hernández-Liebo P, Blasco-Fontecilla H. Assessment of ADHD Subtypes Using Motion Tracking Recognition Based on Stroop Color-Word Tests. Sensors (Basel) 2024; 24:323. [PMID: 38257416 PMCID: PMC10818498 DOI: 10.3390/s24020323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder known for its significant heterogeneity and varied symptom presentation. Describing the different subtypes as predominantly inattentive (ADHD-I), combined (ADHD-C), and hyperactive-impulsive (ADHD-H) relies primarily on clinical observations, which can be subjective. To address the need for more objective diagnostic methods, this pilot study implemented a Microsoft Kinect-based Stroop Color-Word Test (KSWCT) with the objective of investigating the potential differences in executive function and motor control between different subtypes in a group of children and adolescents with ADHD. A series of linear mixture modeling were used to encompass the performance accuracy, reaction times, and extraneous movements during the tests. Our findings suggested that age plays a critical role, and older subjects showed improvements in KSWCT performance; however, no significant divergence in activity level between the subtypes (ADHD-I and ADHD-H/C) was established. Patients with ADHD-H/C showed tendencies toward deficits in motor planning and executive control, exhibited by shorter reaction times for incorrect responses and more difficulty suppressing erroneous responses. This study provides preliminary evidence of unique executive characteristics among ADHD subtypes, advances our understanding of the heterogeneity of the disorder, and lays the foundation for the development of refined and objective diagnostic tools for ADHD.
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Affiliation(s)
- Chao Li
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28903 Getafe, Spain
| | - Aaron Sujar
- School of Computer Engineering, University Rey Juan Carlos, 28933 Madrid, Spain
| | - Ping Wang
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - Marina Martin-Moratinos
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - Marcos Bella-Fernández
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
- Department of Psychology, Comillas Pontifical University, 28015 Madrid, Spain
- Department of Psychology, Autonomous University of Madrid, 28029 Madrid, Spain
| | | | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, University Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Juan Ardoy-Cuadros
- Health Sciences College, Rey Juan Carlos University, 28933 Madrid, Spain
| | - Paula Hernández-Liebo
- Department of Psychiatry, Marqués de Valdecilla University Hospital, University of Cantabria, 39008 Santander, Spain
| | - Hilario Blasco-Fontecilla
- Center of Biomedical Network Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- UNIR-ITEI & Health Sciences School, International University of La Rioja, 26006 Logroño, Spain
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Seppä S, Halt AH, Nordström T, Hurtig T. Effects of Symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) on Academic Performance and Educational Attainment. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01598-7. [PMID: 37658240 DOI: 10.1007/s10578-023-01598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/03/2023]
Abstract
The aim of this longitudinal population-based cohort study was to examine the effects of ADHD and ODD symptoms in adolescence on academic performance at age 16, and on educational attainment by the age of 32. The population studied here was the Northern Finland Birth Cohort 1986 (NFBC1986). The participants were classified into four groups: those with symptoms of ADHD, ODD, ADHD + ODD, and a control group. Early academic performance at the age of 16 years was based on the Joint Application Register for Secondary Education, and eventual educational attainment was derived from the registers of Statistics Finland and included information recorded up to 2018. Although symptoms of pure ODD had a negative effect on academic performance at school relative to the control group, this effect was weaker than that of pure ADHD symptoms. The ADHD + ODD group, both males and females, had the greatest deficits of all in educational attainment in adulthood and failed to progress to an institution of higher education as often as the control group. Symptoms of ODD in adolescent females predicted educational attainment in adulthood that extended no further than the compulsory comprehensive school level. The results remained statistically significant after adjustment for the educational level of the parents of the subjects, family type, and any psychiatric disorders (other than ADHD or ODD). The findings provide valuable information on the pervasive effects of co-occurring symptoms of ADHD and ODD that persist into adulthood.
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Affiliation(s)
- Sampo Seppä
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Anu-Helmi Halt
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Tanja Nordström
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Tuula Hurtig
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Clinic of Child Psychiatry, Oulu University Hospital, University of Oulu, Oulu, Finland
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Basharpoor S, Zakibakhsh Mohammadi N, Heidari F, Azarkolah A, Vicario CM, Salehinejad MA. Emotional working memory training improves cognitive inhibitory abilities in individuals with borderline personality trait: A randomized parallel-group trial. J Affect Disord 2022; 319:181-188. [PMID: 36155238 DOI: 10.1016/j.jad.2022.09.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive inhibition impairment is one of the causes of impulsive behaviors in individuals with borderline personality disorder (BPD). This study aimed to investigate the effect of emotional working memory training (EWMT) on cognitive inhibition in individuals with a clinically significant borderline personality trait. METHODS In a randomized, parallel-group trial, 40 individuals with borderline personality trait, were selected out of 1000 screened individuals and were randomly assigned to the experimental (N = 20) and waiting-list control (N = 20) groups based on the score on the Borderline Personality Scale and the follow-up Structured Clinical Interview for DSM-IV Personality Disorders. The experimental group underwent 10 sessions of EWMT and the control group did not receive any intervention (waiting list). Participants completed the Stroop Color and Word Test (SCWT) and Go/No-Go task Before and after the intervention. RESULTS EWMT significantly reduced reaction time of incongruent trials in the SCWT and commission errors in the Go/No-Go task after the intervention only in the experimental group. Furthermore, the interference score in SCWT and commission error rate at the post-intervention time were significantly lower for the experimental vs the waitlist group. LIMITATIONS The single-blind design and absence of follow-up measures. CONCLUSIONS EWMT can improve cognitive inhibition in individuals with borderline personality trait and could be used for therapeutic purposes of impulsivity behavior in BPD.
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Affiliation(s)
- Sajjad Basharpoor
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Nasim Zakibakhsh Mohammadi
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Fazeleh Heidari
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Anita Azarkolah
- Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Carmelo M Vicario
- Department of Cognitive Science, University of Messina, Messina, Italy
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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Korchia T, Boyer L, Deneuville M, Etchecopar-Etchart D, Lancon C, Fond G. ADHD prevalence in patients with hypersexuality and paraphilic disorders: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 272:1413-1420. [PMID: 35551451 DOI: 10.1007/s00406-022-01421-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
Hypersexuality and paraphilic disorders have been associated with increased ADHD in several studies. To determine the prevalence of ADHD in hypersexuality and paraphilic disorders. Three databases (Medline, Web of Science and Google Scholar) were explored. Using random effects models, we calculated the pooled estimate of ADHD prevalence. The leave-1-out method and subgroup analyses were carried out to identify sources of heterogeneity. Seven studies from three countries (N = 730 patients with hypersexuality) were included (including five US studies). The overall estimate of the prevalence of ADHD in patients with hypersexuality or paraphilic disorders was 22.6% (95% interval: 17-29.4) with high heterogeneity (I2 = 63%). No publication bias was observed according to Egger's test. We found no significant difference in ADHD prevalence between the following subgroups: hypersexuality vs. paraphilic disorders, studies exploring the history of childhood ADHD vs. adult ADHD, US studies vs. others. The French study was a source of heterogeneity with a much lower rate than others (4.5%) but did not significantly change the prevalence estimate. Removing this study increases the prevalence to 25%. We found no association between the year of publication and ADHD prevalence. ADHD is much more frequent in populations with hypersexuality or paraphilic disorders compared to the general population. It should be systematically screened. The subgroup analyses were not sufficient to identify all sources of heterogeneity, other sources should be explored in further studies.
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Affiliation(s)
- Théo Korchia
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Laurent Boyer
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Manon Deneuville
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Damien Etchecopar-Etchart
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Christophe Lancon
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Guillaume Fond
- Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS - Health Service Research and Quality of Life Center, Hôpitaux Universitaires de Marseille, 27 Boulevard Jean Moulin, 13005, Marseille, France.
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François-sévigny J, Pilon M, Gauthier L. Differences in Parents and Teachers’ Perceptions of Behavior Manifested by Gifted Children with ADHD Compared to Gifted Children without ADHD and Non-Gifted Children with ADHD Using the Conners 3 Scale. Brain Sci 2022; 12:1571. [DOI: 10.3390/brainsci12111571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
The potential for the misdiagnosis of giftedness as attention deficit/hyperactivity disorder (ADHD) has been well documented, as has the clinical diagnostic profile of individuals with both giftedness and ADHD. This study aimed to examine parents’ and teachers’ responses to the Conners 3 behavioral rating scale of gifted students with ADHD compared to gifted students without ADHD and non-gifted students with ADHD. Ninety-two children aged 6 to 12 years were included in the study. On the basis of clinical assessments utilizing the K-SADS, the WISC-V, and other neurocognitive tests, the students were split into three groups: gifted/ADHD (n = 35), ADHD (n = 35), and gifted (n = 22). The results revealed that mothers’, fathers’, and teachers’ responses to the Conners 3 rating scale distinguished well between the gifted group and the other two groups, but not between the gifted/ADHD and ADHD groups. The learning difficulties observed by teachers was the most significant element that distinguished gifted/ADHD students from non-gifted ADHD students. Other results indicated that mothers and fathers reported more inattention problems in their gifted/ADHD children than teachers. Additionally, mothers tended to observe more learning and executive function problems in their gifted/ADHD children than teachers did. These findings highlight the importance of multiple informants complementing each other in the assessment process for ADHD in a gifted context to counteract the masking effect between giftedness and ADHD.
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7
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Dinçer M, Uğurtaş Gökçe FS, Gül H, Taş Torun Y, Bodur Ş, Cöngöloğlu MA. Is Processing Speed (Gs) related to Hyperactivity (As a Narrow Cognitive Area of Gps): A Dimensional Approach to Heterogeneity of Clinical and WISC-IV Cognitive Profiles in ADHD From RDoC/HiTOP Perspective. J Atten Disord 2022; 26:1747-1761. [PMID: 35579206 DOI: 10.1177/10870547221099963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity. METHOD The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers. RESULTS We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L's DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores. CONCLUSION Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.
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Affiliation(s)
- Mustafa Dinçer
- Mehmet Akif inan Training and Research Hospital, Şanlıurfa, Turkey
| | | | - Hesna Gül
- Gülhane Training and Research Hospital, Ankara, Turkey
| | | | - Şahin Bodur
- Gülhane Training and Research Hospital, Ankara, Turkey
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8
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Bodalski EA, Flory K, Canu WH, Willcutt EG, Hartung CM. ADHD Symptoms and Procrastination in College Students: The Roles of Emotion Dysregulation and Self-Esteem. J Psychopathol Behav Assess. [DOI: 10.1007/s10862-022-09996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Hery-Niaussat C, Ossart V, Penigault P, Robert P, Manera V, Gros A. Therapeutic hypnosis in a child with a written language disorder. Am J Clin Hypn 2022; 65:269-280. [PMID: 36197740 DOI: 10.1080/00029157.2022.2108746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Children with Attentional Deficit Hyperactivity Disorder (ADHD) frequently have low self-awareness and attentional deficits on which therapeutic hypnosis can have a positive impact. Here we investigated the contribution of therapeutic hypnosis in the treatment of written language disorders in a child with ADHD. This study is a Single-Case Experimental Design (SCED) using repeated measures. The participant is 11 years old. We assessed reading performance and verbal fluency for four weeks before starting the intervention, as well as during the therapeutic window when four hypnosis sessions were administered over an 8-week timeframe. We assessed written language through a regular and irregular word reading test, a spelling choice test, a phonological analysis test, and a fast serial naming test pre- and post-intervention. We assessed attention and self-esteem pre- and post-intervention. The patient's scores on text reading improved during the intervention compared to the baseline (p = .028). Reading fluency improved, but the pre-post comparison did not reach statistical significance. A progression in scores and response times in phonological tests was observed, with the participant moving from pathological scores in the pre-intervention to normative scores in the post-intervention. Attention and self-esteem significantly improved after the treatment (p = .031, and p = .002 respectively). These results indicate that hypnosis-based therapy might be beneficial to children with specific written language disorders. If these results are confirmed in future studies, therapeutic hypnosis may become part of the recommendations for treatment of ADHD.
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Affiliation(s)
- Célia Hery-Niaussat
- Faculté de Médecine de Nice, Nice, France.,Institut Claude Pompidou, Université Côte d'Azur, Nice, France
| | | | - Philippe Penigault
- Département Universitaire d'Enseignement et de Formation en Orthophonie de Paris, Faculté de Médecine Pitié-Salpêtrière, Paris VI, France
| | - Philippe Robert
- Faculté de Médecine de Nice, Nice, France.,Institut Claude Pompidou, Université Côte d'Azur, Nice, France
| | - Valeria Manera
- Faculté de Médecine de Nice, Nice, France.,Institut Claude Pompidou, Université Côte d'Azur, Nice, France
| | - Auriane Gros
- Faculté de Médecine de Nice, Nice, France.,Institut Claude Pompidou, Université Côte d'Azur, Nice, France
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Salehinejad MA, Vosough Y, Nejati V. The Impact of Bilateral Anodal tDCS over Left and Right DLPFC on Executive Functions in Children with ADHD. Brain Sci 2022; 12:brainsci12081098. [PMID: 36009161 PMCID: PMC9406177 DOI: 10.3390/brainsci12081098] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is increasingly used for therapeutic purposes in attention-deficit hyperactivity disorder (ADHD). The dorsolateral prefrontal cortex (DLPFC) is the most targeted region of tDCS studies in ADHD. There is limited knowledge and mixed results about the relevance of left or right DLPFCs in ADHD’s cognitive deficits. No study so far has investigated the impact of the increased excitability of both left and right DLPFC with anodal tDCS on cognitive deficits in ADHD. Here, we explored the impact of online bilateral anodal left and right DLPFC tDCS on executive dysfunction in children with ADHD. Twenty-two children with ADHD (mean age ± SD =8.86 ± 1.80) received bilateral anodal online tDCS over the left and right DLPFC (1.5 mA, 15 min) in two separate sessions in active and sham states. They underwent a battery of four neuropsychological tasks of executive functions during stimulation that measured working memory, cognitive flexibility, response inhibition, and executive control. Bilateral anodal left and right DLPFC tDCS did not improve performance on working memory, cognitive flexibility, and response inhibition. Executive control was, however, partially improved for those who received active tDCS first. The upregulation of bilateral DLPFC tDCS with anodal polarity does not improve executive dysfunction in children with ADHD. The unilateral modulation of DLPFC with anodal tDCS may be more beneficial to cognitive deficits in ADHD in light of previous works targeting only left and/or right DLPFC.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, 44139 Dortmund, Germany
| | - Younes Vosough
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran 1983969411, Iran
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran 1983969411, Iran
- Correspondence:
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11
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Salvat H, Mohammadi MN, Molavi P, Mostafavi SA, Rostami R, Salehinejad MA. Nutrient intake, dietary patterns, and anthropometric variables of children with ADHD in comparison to healthy controls: a case-control study. BMC Pediatr 2022; 22:70. [PMID: 35093041 PMCID: PMC8800296 DOI: 10.1186/s12887-022-03123-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor health behaviors and variables are recently more documented in attention-deficit hyperactivity disorder (ADHD) lifestyle which might be relevant to the pathophysiology of this disorder. The objective of this case-control study was to assess the nutrient intake, dietary patterns, and anthropometric variables in children with ADHD compared to normal peers. METHOD One hundred children diagnosed with ADHD were included and compared to 100 healthy, sex-matched normal children as the control group. Anthropometric indices, macronutrients, and micronutrients were measured and compared in both groups. RESULTS ADHD children were significantly consuming more simple sugars, tea, ready-made meals but less protein, vitamin B1, vitamin B2, vitamin C, zinc and calcium compared to the control group. The body mass index (BMI) and waist circumference of children with ADHD were significantly higher and were related to the severity and type of the disease. CONCLUSION Unhealthy eating behavior is more frequent in children with ADHD, compared to normal children which might warrant lifestyle intervention in this disorder.
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Affiliation(s)
- Habibeh Salvat
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehriar Nader Mohammadi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Parviz Molavi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Seyed Ali Mostafavi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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Korfmacher AK, Hirsch O, Chavanon ML, Albrecht B, Christiansen H. Self-management training vs. neurofeedback interventions for attention deficit hyperactivity disorder: Results of a randomized controlled treatment study. Front Psychiatry 2022; 13:969351. [PMID: 36061275 PMCID: PMC9433654 DOI: 10.3389/fpsyt.2022.969351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Neurofeedback (NF) and self-management training (SMT) may be viable treatment options for patients with attention deficit hyperactivity disorder (ADHD) if they alleviate core symptoms, enhance the patients' self-concept and improve their quality of life (QoL). Aim of the current study is evaluating both interventions accordingly and to test whether specific improvements in core symptoms lead to more general improvements in self-concept and QoL. METHODS In a psychotherapeutic outpatient clinic in Germany, a total of N = 139 children with ADHD were screened for eligibility, of which 111 fulfilled inclusion criteria and participated in the study in accordance with the CONSORT 2010 statement. These were randomly assigned to NF vs. SMT interventions. Changes from pre- to post-intervention in core ADHD symptoms relying on parent and teacher reports (CONNERS 3) and objective tests (Qb-Test) as well as self-concept (interview with the children) and QoL assessments (using the KINDL-R self-report) were compared between patients receiving NF or SMT. RESULTS Significant improvements in ADHD symptoms were achieved similarly in both treatment groups, whilst QoL and self-concept improved after SMT only. CONCLUSION This treatment study provides further evidence that SMT and NF may reduce core symptoms, but SMT may also improve patients' self-concept and QoL and may thus in its current form be the favorable treatment option in naturalistic settings. However, several limitations of the current study implicate that further research is required before definitive conclusions and recommendations for clinical practice can be given. CLINICAL TRIAL REGISTRATION [www.clinicaltrials.gov], identifier [NCT01879644].
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Affiliation(s)
- Ann-Kathrin Korfmacher
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, Germany
| | - Mira-Lynn Chavanon
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Björn Albrecht
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
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13
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Aiello S, Vagni D, Cerasa A, Leonardi E, Carrozza C, Famà F, Campisi A, Marino F, Siracusano R, Alquino MA, Mainiero F, Germano E, Tartarisco G, Pioggia G, Gagliano A, Ruta L. Autistic Traits and Empathy in Children With Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder and Co-occurring Attention Deficit Hyperactivity Disorder/Autism Spectrum Disorder. Front Neurosci 2021; 15:734177. [PMID: 34887721 PMCID: PMC8649805 DOI: 10.3389/fnins.2021.734177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) are two of the most represented neurodevelopmental conditions in childhood. The diagnostic shift introduced by the DSM-5, allowing a combined diagnosis of ADHD and ASD, poses different clinical challenges related to diagnostic overshadowing, accuracy of clinical judgment and potential delay in an ASD diagnosis in children presenting with ADHD. Here we tried to disentangle the clinical phenotype and specificity of the two co-occurring conditions in relation to autism traits and empathy, by comparing children with ASD with and without comorbid ADHD with children presenting ADHD only and children with typical development. The child versions of the Autism Quotient (C-AQ) and Empathy Quotient (C-EQ) were administered to a total sample of 198 male children between 6 and 14 years old with age appropriate language skills and normal intelligence. Univariate analysis demonstrated no significant differences in the C-AQ total and subscale scores as well as the C-EQ between children with ASD and children with ASD + ADHD, while children with ADHD alone presented an intermediate phenotype between ASD and TD. Furthermore, a receiver operating characteristic (ROC) analysis was applied to discriminate among the different phenotypes. We found that the C-AQ and C-EQ were accurate at distinguishing with satisfactory reliability between: (a) ASD vs. non- ASD (N-ASD) groups comprising both ADHD and TD children (Area Under the Curve AUC 88% for C-AQ and 81% for C-EQ); (b) ASD and TD (AUC 92% for C-AQ and 95% for C-EQ); (c) ASD and ADHD (AUC 80% for C-AQ and 68% for C-EQ). Our data confirm the reliability of the C-AQ and C-EQ as behavioral markers to differentiate ASD (regardless of comorbid ADHD) from an ADHD condition and TD. Interestingly, in our sample an ADHD condition does not increase the severity of the clinical phenotype in terms of autism traits distribution and empathy, suggesting that the psychological measures detected by the two quantitative instruments are independent of ADHD traits. This evidence will contribute to the translational efforts in developing better tailored treatments and preventive strategies.
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Affiliation(s)
- Stefania Aiello
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy.,S. Anna Institute, Crotone, Italy.,Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Arcavacata, Italy
| | - Elisa Leonardi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Cristina Carrozza
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Francesca Famà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Agrippina Campisi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Rosamaria Siracusano
- Division of Child Neurology and Psychiatry, Federico II University Hospital Naples, Naples, Italy
| | - Maria Ausilia Alquino
- Division of Child Neurology and Psychiatry, Department of the Adult and Developmental Age Human Pathology, University of Messina, Messina, Italy
| | - Francesco Mainiero
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Eva Germano
- Division of Child Neurology and Psychiatry, Department of the Adult and Developmental Age Human Pathology, University of Messina, Messina, Italy
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Antonella Gagliano
- Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Liliana Ruta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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14
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Ren Y, Fang X, Fang H, Pang G, Cai J, Wang S, Ke X. Predicting the Adult Clinical and Academic Outcomes in Boys With ADHD: A 7- to 10-Year Follow-Up Study in China. Front Pediatr 2021; 9:634633. [PMID: 34408992 PMCID: PMC8367416 DOI: 10.3389/fped.2021.634633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and causes adverse effects on social functioning. The present study aimed to widely investigate the predictors, particularly childhood intelligence quotient (IQ) and family environment factors, on adult clinical and academic outcomes in boys with ADHD. Methods: A total of 101 boys with ADHD in a Chinese Han ADHD cohort were followed up 7-10 years later. Baseline ADHD symptoms were evaluated using the parent version of the ADHD Rating Scale-IV (ADHD-RS-IV) and the Chinese version of the Conners' Parent Rating Scale-Revised (CPRS-48). The intelligence of the child was tested by the China-Wechsler Intelligence Scale for Children (C-WISC), and family function was assessed by the Family Environment Scale-Chinese Edition (FES-CV). Adult ADHD persistence was defined using DSM-IV criteria for ADHD, and academic outcome fell into two categories: higher academic level group (studying in senior middle school or above) and lower academic level group (studying in vocational secondary schools or below). Results: Stepwise multiple logistic regression analysis revealed that the father's character, impulsive-hyperactive index as measured by the CPRS-48, and intellectual-cultural index as measured by the FES-CV independently predicted clinical outcomes in adults, with an AUC of 0.770 (p < 0.001, 95% CI = 0.678-0.863). The corresponding sensitivity and specificity were 0.743 and 0.727, respectively. The father's education level, family economic level, and verbal IQ (VIQ) on the C-WISC independently predicted adult academic outcomes, with an AUC of 0.870 (p < 0.001, 95% CI = 0.796-0.944). The corresponding sensitivity and specificity were 0.813 and 0.783, respectively. Conclusion: Initial ADHD symptom severity and IQ, father's character and education level, and family atmosphere and function affect adult clinical and academic outcomes. Addressing these areas early may help to improve the prognosis of ADHD into adulthood.
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Affiliation(s)
- Yanling Ren
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.,The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xinyu Fang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Hui Fang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Gaofeng Pang
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jing Cai
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Suhong Wang
- The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiaoyan Ke
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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15
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Lau-Jensen SH, Asschenfeldt B, Evald L, Hjortdal VE. Hyperactivity and Inattention in Young Patients Born With an Atrial Septal or Ventricular Septal Defect. Front Pediatr 2021; 9:786638. [PMID: 34938699 PMCID: PMC8686760 DOI: 10.3389/fped.2021.786638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with congenital heart defects have a well-established risk of neuropsychiatric comorbidities. Inattention and hyperactivity are three to four times more frequent in children with complex congenital heart defects. We have previously shown a higher burden of overall attention deficit/hyperactivity disorder (ADHD) symptoms in adults with simple congenital heart defects as well. However, it is unknown whether the higher burden of ADHD symptoms is mainly driven by hyperactivity, inattention, or both. Methods: The participants [simple congenital heart defect = 80 (26.6 years old), controls = 36 (25.3 years old)] and a close relative for each (n = 107) responded to the long version of the Conners' Adults ADHD Rating Scales questionnaire. Our primary and secondary outcomes are mean T-scores in the ADHD scores and symptom sub-scores. Results: Patients with simple congenital heart defects reported a higher mean T-score at all three DSM-IV ADHD scores (ADHD-combined: 52.8 vs. 44.9, p = 0.007, ADHD-inattention: 55.5 vs. 46.4, p = 0.002, and ADHD-hyperactivity: 49.4 vs. 44.0, p = 0.03) and in all four ADHD symptom sub-scores (inattention/memory problems: 50.3 vs. 44.2, p = 0.001, hyperactivity/restlessness: 49.7 vs. 45.9, p = 0.03, impulsivity/emotional lability: 50.0 vs. 41.3, p = 0.001, and self-esteem problems: 53.8 vs. 46.3, p = 0.003). The results were maintained after the removal of outliers (incongruent responses), albeit the hyperactivity/restlessness ADHD symptom sub-score lost significance. Self- and informant ratings differed significantly on the ADHD-inattention score for the congenital heart defect group, where informants rated the ADHD-inattention scores better than the congenital heart defect patients rated themselves. Conclusions: Patients with a simple congenital heart defect have a higher symptom burden across all ADHD scores and all symptom sub-scores. The higher burden of ADHD is driven by both inattention and hyperactivity symptoms, though the inattention symptoms seem more prominent. Close relatives were less aware of the inattention symptoms than the congenital heart defect patients themselves. Routine screening for ADHD symptoms may be warranted to facilitate adequate help and guidance as these symptoms are easily overlooked. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03871881.
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Affiliation(s)
- Sara Hirani Lau-Jensen
- Department of Cardiothoracic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Benjamin Asschenfeldt
- Department of Clinical Medicine, Aarhus University, Aalborg, Denmark.,Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Evald
- Hammel Neurodelvelopmental Center and University Research Clinic, Hammel, Denmark
| | - Vibeke E Hjortdal
- Department of Cardiothoracic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Aarhus University, Aalborg, Denmark
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Salehinejad MA, Ghanavati E, Rashid MHA, Nitsche MA. Hot and cold executive functions in the brain: A prefrontal-cingular network. Brain Neurosci Adv 2021; 5:23982128211007769. [PMID: 33997292 PMCID: PMC8076773 DOI: 10.1177/23982128211007769] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Executive functions, or cognitive control, are higher-order cognitive functions needed for adaptive goal-directed behaviours and are significantly impaired in majority of neuropsychiatric disorders. Different models and approaches are proposed for describing how executive functions are functionally organised in the brain. One popular and recently proposed organising principle of executive functions is the distinction between hot (i.e. reward or affective-related) versus cold (i.e. purely cognitive) domains of executive functions. The prefrontal cortex is traditionally linked to executive functions, but on the other hand, anterior and posterior cingulate cortices are hugely involved in executive functions as well. In this review, we first define executive functions, their domains, and the appropriate methods for studying them. Second, we discuss how hot and cold executive functions are linked to different areas of the prefrontal cortex. Next, we discuss the association of hot versus cold executive functions with the cingulate cortex, focusing on the anterior and posterior compartments. Finally, we propose a functional model for hot and cold executive function organisation in the brain with a specific focus on the fronto-cingular network. We also discuss clinical implications of hot versus cold cognition in major neuropsychiatric disorders (depression, schizophrenia, anxiety disorders, substance use disorder, attention-deficit hyperactivity disorder, and autism) and attempt to characterise their profile according to the functional dominance or manifest of hot-cold cognition. Our model proposes that the lateral prefrontal cortex along with the dorsal anterior cingulate cortex are more relevant for cold executive functions, while the medial-orbital prefrontal cortex along with the ventral anterior cingulate cortex, and the posterior cingulate cortex are more closely involved in hot executive functions. This functional distinction, however, is not absolute and depends on several factors including task features, context, and the extent to which the measured function relies on cognition and emotion or both.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Md Harun Ar Rashid
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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