Associations between cognitive performance and sigma power during sleep in children with attention-deficit/hyperactivity disorder, healthy children, and healthy adults

Temporal Alpha Dissimilarity of ADHD Brain Network in Comparison With CPT and CATA

Attention deficit hyperactivity disorder (ADHD) is a chronic neurological and psychiatric disorder that affects children during their development. To find neural patterns for ADHD and provide subjective features as decision references to assist specialists and physicians. Many studies have been devoted to investigating the neural dynamics of the brain through resting-state or continuous performance tests (CPT) with EEG or functional magnetic resonance imaging (fMRI). The present study used coherence, which is one of the functional connectivity (FC) methods, to analyze the neural patterns of children and adolescents (8-16 years old) under CPT and continuous auditory test of attention (CATA) task. In the meantime, electroencephalography (EEG) oscillations were recorded by a wireless brain-computer interface (BCI). 72 children were enrolled, of which 53 participants were diagnosed with ADHD and 19 presented to be typical developing (TD). The experimental results exhibited a higher difference in alpha and theta bands between the TD group and the ADHD group. While the differences between the TD group and the ADHD group in all four frequency domains were greater than under CPT conditions. Statistically significant differences ( [Formula: see text]) were observed between the ADHD and TD groups in the alpha rhythm during the CATA task in the short-range of coherence. For the temporal lobe FC during the CATA task, the TD group exhibited statistically significantly FC ( [Formula: see text]) in the alpha rhythm compared to the ADHD group. These findings offering new possibilities for more techniques and diagnostic methods in finding more ADHD features. The differences in alpha and beta frequencies were more pronounced in the ADHD group during the CPT task compared to the CATA task. Additionally, the disparities in brain activity were more evident across delta, theta, alpha and beta frequency domains when the task given was a CATA as opposed to a CPT. The findings presented the underlying mechanisms of the FC differences between children and adolescents with ADHD. Moreover, these findings should extend to use machine learning approaches to assist the ADHD classification and diagnosis.

Neurocognitive Effects of Sleep Disruption in Children and Adolescents

A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.

The Associations between the Homeostatic and Circadian Sleep Processes and the Neurobehavioral Functioning (NBF) of Individuals with ADHD-A Systematic Review

The objective of the present review was to systematically examine associations between perturbations of the homeostatic or circadian sleep processes and the neurobehavioral functioning (NBF) of individuals with ADHD. Electronic databases were searched for articles published between December 2013 and March 2023. Studies were included if they used objective measures of NBF, used objective or subjective measures of sleep, and focused on individuals with ADHD. Ten studies met these inclusion criteria. Of these, eight studies found perturbations in the interplay between NBF and Process S or Process C, and three studies did not. The quality of the studies was degraded because they failed to address key factors that affect the sleep processes and by the presence of methodological weaknesses. Our review suggests that homeostatic and circadian sleep processes are associated with NBF in individuals with ADHD. However, to confirm the validity of this conclusion, future studies should examine or control for confounders and utilize experimental designs that allow causality to be inferred.

Relation between sleep disorders and attention deficit disorder with hyperactivity in children and adolescents: A systematic review

BACKGROUND

Sleep problems have a high recurrence in children and adolescents with attention deficit disorder with hyperactivity (ADHD) experience high rates of sleep problems.

OBJECTIVE

Understand the relationship between sleep disorders and ADHD symptoms.

METHODS AND PROCEDURES

A systematic review was performed using electronic databases, including PubMed, Cochrane Library, Scopus, Lilacs, and Psychology Database (ProQuest) systems. The quality of each article was assessed using a 5-criteria checklist, measuring relevant dimensions.

OUTCOMES AND RESULTS

The review analyzed fifteen articles, were included that raised the realizations among sleep problems in the population of children with ADHD, obtaining a total of 1645 children and adolescents with ADHD that were compared with typical development groups. The articles selected for this systematic review of observational design have a high quality.

CONCLUSIONS AND IMPLICATIONS

Children and adolescents with ADHD have sleep problems, which may exacerbate or be the cause of the ADHD clinic, affecting the quality of life of children and their families. Early inquiry and a timely approach can contribute to reducing the severity of ADHD symptoms.

Evidence for Three Subgroups of Female FMR1 Premutation Carriers Defined by Distinct Neuropsychiatric Features: A Pilot Study

Over 200 Cytosine-guanine-guanine (CGG) trinucleotide repeats in the 5' untranslated region of the Fragile X mental retardation 1 (FMR1) gene results in a "full mutation," clinically Fragile X Syndrome (FXS), whereas 55 - 200 repeats result in a "premutation." FMR1 premutation carriers (PMC) are at an increased risk for a range of psychiatric, neurocognitive, and physical conditions. Few studies have examined the variable expression of neuropsychiatric features in female PMCs, and whether heterogeneous presentation among female PMCs may reflect differential presentation of features in unique subgroups. In the current pilot study, we examined 41 female PMCs (ages 17-78 years) and 15 age-, sex-, and IQ-matched typically developing controls (TDC) across a battery of self-report, eye tracking, expressive language, neurocognitive, and resting state EEG measures to determine the feasibility of identifying discrete clusters. Secondly, we sought to identify the key features that distinguished these clusters of female PMCs. We found a three cluster solution using k-means clustering. Cluster 1 represented a psychiatric feature group (27% of our sample); cluster 2 represented a group with executive dysfunction and elevated high frequency neural oscillatory activity (32%); and cluster 3 represented a relatively unaffected group (41%). Our findings indicate the feasibility of using a data-driven approach to identify naturally occurring clusters in female PMCs using a multi-method assessment battery. CGG repeat count and its association with neuropsychiatric features differ across clusters. Together, our findings provide important insight into potential diverging pathophysiological mechanisms and risk factors for each female PMC cluster, which may ultimately help provide novel and individualized targets for treatment options.

A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE

Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD.

METHODS

Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD.

RESULTS

148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep.

CONCLUSION

Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.

Sleep EEG microstructure in children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis

Attention deficit hyperactivity disorder (ADHD) is commonly associated with sleep problems, possibly due to shared pathophysiology. Microstructural sleep electroencephalographic (EEG) alterations may likely represent markers of disordered cortical maturation in ADHD, although literature data are still conflicting, deserving further assessment. After having systematically reviewed the literature, we included 11 studies from 598 abstracts, and assessed 23 parameters of cyclic alternating pattern (CAP), four parameters of sleep EEG power and one parameter of sleep graphoelements through 29 meta-analyses and, when possible, univariate meta-regressions. Slow wave activity (SWA) in ADHD was significantly higher in early childhood and lower in late childhood/adolescence compared to controls, with an inversion point at 10 years. Total CAP rate and CAP A1 index in non-rapid eye movement (NREM) stage 2 sleep, and CAP A1 rate in NREM sleep were significantly lower in ADHD patients than controls. SWA and CAP A1 changes are therefore possible markers of altered cortical maturation in ADHD, consistently with the neuropsychological deficits characterizing the disorder, likely fostering earlier detection of at-risk/milder conditions, and more tailored therapeutic interventions.

Characteristics of sleep spindles in school-aged children with attention-deficit/hyperactivity disorder

OBJECTIVE

Attention deficit/hyperactivity disorder (ADHD) is a complex disorder, characterized by different presentations with distinct cognitive and neurobiological characterizations. Here we aimed to investigate whether sleep spindle activity, which has been associated with brain maturation, may be a potential biomarker able to differentiate ADHD presentations in school-aged children (7-11 years).

METHOD

Spindle characteristics were extracted from overnight polysomnography in 74 children (27 ADHD-Inattentive [IQ = 96.04], 25 ADHD-hyperactive/impulsive [IQ = 98.9], and 22 ADHD-combined [IQ = 96.1]). We obtained data of the frontal (Fz) and parietal (Pz) derivations using a validated spindle detection algorithm.

RESULTS

Children with ADHD showed a higher number and density of slow compared to fast spindles which were more frequent in frontal area. No differences were observed among ADHD presentations for any spindle characteristics. Spindle frequency and density increased with age, indicating an age-dependent maturation of different sleep spindles. However, no associations between IQ and spindle characteristics were observed.

CONCLUSIONS

In children with ADHD the spindle characteristics evolve with age but sleep spindle activity does not seem to be a valid biomarker of ADHD phenotypes or general cognitive ability.

Sleep, academic achievement, and cognitive performance in children with attention-deficit hyperactivity disorder: A polysomnographic study

The objective of this study was to examine the influence of parent-reported and polysomnography (PSG)-measured sleep patterns on the academic and cognitive performance of children with attention-deficit hyperactivity disorder (ADHD). We assessed 91 children (18 girls) diagnosed with ADHD aged 7-11 years (29 ADHD-Inattentive, 32 ADHD-Hyperactive/Impulsive, and 31 ADHD-Combined). The Paediatric Sleep Questionnaire (PSQ) and Paediatric Daytime Sleepiness Scale (PDSS) were used to assess subjective sleep quality, as perceived by parents, and objective sleep variables were assessed by PSG. Cognitive performance was evaluated using the Wechsler Intelligence Scale for Children (WISC), and the final average grade of the last school year was used as a measure of academic performance. Academic performance was predicted by the following sleep variables: Sleep time, time in bed, night awakenings, and daytime sleepiness. The best predictors of cognitive performance in children with ADHD were rapid eye movement latency, light sleep, periodic limb movements index (PLMs), awakenings, and daytime sleepiness. In conclusion, sleep parameters are closely associated with the academic and cognitive functioning of children with ADHD.

Neurocognitive Effects of Sleep Disruption in Children and Adolescents

A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.

Acoustic closed-loop stimulation during sleep improves consolidation of reward-related memory information in healthy children but not in children with attention-deficit hyperactivity disorder

Study Objectives

Slow oscillations (SO) during slow-wave sleep foster the consolidation of declarative memory. Children with attention-deficit hyperactivity disorder (ADHD) display deficits in the sleep-associated consolidation of declarative memory, possibly due to an altered function of SO. The present study aimed at enhancing SO activity using closed-looped acoustic stimulation during slow-wave sleep in children with ADHD.

Methods

A total of 29 male children (14 with ADHD; aged 8–12 years) participated in a double-blind, placebo-controlled study trial. Children spent two experimental nights in a sleep lab, one stimulation night and one sham night. A declarative learning task (word-pair learning) with a reward condition was used as a primary outcome. Secondary outcome variables were a procedural memory (serial reaction time) and working memory (WM; n-back) task. Encoding of declarative and procedural memory took place in the evening before sleep. After sleep, the retrieval took place followed by the n-back task.

Results

The stimulation successfully induced SO activity during sleep in children with and without ADHD. After stimulation, only healthy children performed better on high-rewarded memory items (primary outcome). In contrast, there were indications that only children with ADHD benefitted from the stimulation with respect to procedural as well as WM performance (secondary outcome).

Conclusions

We were able to show that the acoustic closed-loop stimulation can be applied to enhance SO activity in children with and without ADHD. Our data indicate that SO activity during sleep interacts with subsequent memory performance (primary outcome: rewarded declarative memory; secondary outcome: procedural and WM) in children with and without ADHD.