A motor presetting study in hyperactive, learning disabled and control children

Do hyperactive children have motor organization and/or execution deficits?

Hyperactive children have been described as motorically clumsy. To explore the validity of this assertion, an experiment using the additive factor method was designed to examine motor organization and execution in hyperactive children. Four groups of boys aged 7 to 8 years took part in the study: (1) a pure hyperactive (HA) group, N=20; (2) a pure conduct-disordered (CD) group, N=18; (3) a mixed hyperactive/conduct-disordered (HA+CD) group, N=12; (4) a normal (N) control group, N=22. While the small sample size precluded a definitive conclusion, the results indicated that neither HA nor CD children showed any motor organization or execution deficit in a simple sequential key-tapping task. Given previous findings indicating that hyperactive children show deficits in more complex motor coordination skills, the generalizability of our negative results needs to be examined on other more complex tasks.

Methylphenidate does not modify the impact of response frequency or stimulus sequence on performance and event-related potentials of children with attention deficit hyperactivity disorder

Twenty-six children with attention deficit/hyperactivity disorder (ADHD) participated in a double-blind trial consisting of 2 consecutive weeks each of placebo and methylphenidate (M = 26.92 mg/day = 0.78 mg/kg/day). As expected, stimulant therapy resulted in moderate weight loss, increased somatic complaints, and teacher and parent reports of reduced inattentiveness, aggression, and oppositionality. In both phases of the trial, patients were tested in a choice reaction time task assessing two aspects of the task that presumably affect response selection: response frequency (ratio of targets/nontargets = 25/75 vs. 50/50) and stimulus sequence (alternations vs. repetitions). Both manipulations yielded expected results on performance and event-related potentials (ERPs). Stimulant treatment increased accuracy and speed among younger children and curtailed variability of reaction time for the sample as a whole. However, methylphenidate did not affect ERPs. In combination, the results imply that the enhancement of performance by methylphenidate does not involve the demands of response selection examined in this study.

A quantitative cytochrome oxidase mapping study, cross-regional and neurobehavioural correlations in the anterior forebrain of an animal model of Attention Deficit Hyperactivity Disorder

The aim of this study was to trace by molecular imaging techniques the neural substrates of attention deficit hyperactivity disorder (ADHD) using the spontaneously hypertensive rat (SHR) as animal model. Adult SHR and Wistar-Kyoto (WKY) controls were used throughout this study. In experiment 1, naive male SHR and WKY were used, whereas in experiment 2 SHR and WKY rats of both genders were trained on a multiple fixed interval (FI (120 s for water, 5-min extinction)) paradigm and sacrificed 6 months later. In both experiments coronal sections of the anterior forebrain were processed for quantitative cytochrome oxidase (COase) histochemistry by the method of Gonzalez-Lima. Optical density values were transformed into actual enzyme activity units by using tissue-calibrated standards. In experiment 1, non-trained male rats of the SHR line showed lower COase activity in the medial and lateral prefrontal cortices, compared with WKY controls. In experiment 2, there was a line x treatment interaction effect in the pole of the nucleus accumbens (ACB). Regional correlative analyses revealed that: (i) under basal conditions, SHR are more synchronized than WKY rats in the COase level of different brain regions; and (ii) the training desynchronizes COase activity in the WKY, further synchronizes it and increases the cross-talk between hemispheres in male SHR only. Neurobehavioral covariations between behavioural scores and metabolic capacity in the medial and lateral prefrontal/frontal cortices, the caudate-putamen complex (CPU), the pole, core, and shell of the accumbal complex (ACB), and the ventral pallidum (VP), indicated that, in the WKY rats, the frequency of lever pressing covaried positively with the COase activity in the CPU, whereas in the SHR covaried with both medial and lateral prefrontal/frontal cortices. The bursts of activity during the 1-1.33-s segment was positively correlated, in the WKY rats only, with the core and shell of the ACB, and with the VP. Finally, the correlative profiles showed significant gender differences with effects in male SHR only. Thus, the results lend support to the involvement of the cortico-striato-pallidal system in ADHD.

Inhibitory dysfunction in hyperactive boys

Recent evidence suggests that the main deficit in childhood hyperactivity is in frontal lobe-mediated self-regulative functions such as inhibitory control. Hyperactives have consistently been shown to perform poorly on the stop task, which is a laboratory measurement of inhibitory control. This study was aimed at extending knowledge about inhibitory processes involved in the hyperactive's performance on this task. For this purpose, the performance of 11 pervasive hyperactives was compared to the performance of normal children on two stop tasks which differed from each other in the contingency of timing of the stop signal. In Stop1 stop signals were internally related, i.e. presented at time intervals after onset of the response stimulus, whereas in Stop2 stop signals were externally related, i.e. presented at time intervals related to the subject's own go-process. Both tasks were modifications of the classical stop task in modality of the stop signal visual instead of auditory and in event rate, which was half-shortened. The aim of this study was: (a) to replicate the findings of deficient inhibitory functions in hyperactive children in the stop task in spite of modifications in modality and event rate; and (b) to elucidate (dis)similarities of stopping processes or of group differences in these stopping processes triggered by stop delays related either to external or to internal processes. Hyperactive children were less efficient than controls in inhibiting their motor response in both versions of the stop task. independent of whether the stop signals were externally or internally related. Furthermore, the go-process of the hyperactives was more variable and erratic in both tasks. Thus, the results strengthen the effectiveness of stop tasks in distinguishing hyperactive from normal children.

Neuroelectric mapping reveals precursor of stop failures in children with attention deficits

Children with attention deficit disorders (ADD) may have specific problems with response inhibition in the STOP task. This task requires that subjects stop responses to a primary task if a second signal follows. However, it is unclear whether these problems reflect an impairment of the stopping process per se, whether they are related to reduced frontal lobe activation and whether they are confined to severe and pervasive forms of ADD. In 11 ADD and nine control children, 32 channel event-related EEG potentials (ERPs) were recorded in a STOP and a delayed GO task. Mapping revealed that both tasks evoked a similar sequence of neuroelectric microstates, i.e. of time segments with stable map topography. Adaptive segmentation identified the transition between these microstates. Reliable group differences were found in several microstates and in both tasks despite matched performance. In the GO task, ADD children had topographically altered P2/N2 microstates and attenuated P300-type microstates. In the STOP task, a topographically altered N1 microstate which coincided with the onset of the stop signal preceded the stop failures of ADD children. The timing of this microstate is too early to reflect deficits in actual stop signal processing and instead suggests altered initial orienting of attention to the primary signal in ADD children. Imaging with low resolution tomography (LORETA) during this microstate to stop failures indicated mainly posterior activation for both groups and increased rather than reduced frontal activation in ADD children. For a later microstate (P550), LORETA indicated strong frontal activation after successful stopping, but no group differences. The results suggest that information processing of ADD children deviates during activation of posterior mechanisms which may be related to the orienting of attention and which precedes and partly determines inhibitory control problems in ADD.

Differential expression of transcription factors in the accumbens of an animal model of ADHD

Transcription factors have been used as neuronal markers in the nucleus accumbens (ACB) of male juvenile spontaneously hypertensive rats (SHR), an animal model of attention-deficit hyperactivity disorder (ADHD), to trace putative neural substrates. In SHR, immunocytochemistry and PC-assisted image analysis showed lower expression of pan-fos, c-fos, zif/268 in the shell, and the c-fos and zif/268 in the core, with an increased level of Jun-B in the core. The differential lower basal expression of transcription factors in the ACB of an animal model of ADHD implies a reduced number of modules and might represent a neural substrate of the attention deficits seen in SHR and children with ADHD at low motivational levels.

Changing a response set in normal development and in ADHD children with and without tics

The current study was designed to provide a rigorous investigation of the locus of task-inappropriate (impulsive) responding in ADHD children with and without tics. For this purpose we used a variant of Sternberg's (1969) response bias task. The task measures a set of mental operations, namely, preparing a planned response, carrying out or stopping a planned response, and preparing to execute an alternative response. In the first study, we determined the effect of age in a normal sample. As expected, task performance improved as a function of age. Younger children had problems changing a response set. In the second experiment, we compared ADHD children with and without tics with normal children. Unexpectedly, the noticeable task inefficiency of the patient groups was not related to (a) a hasty scan of the display, (b) an inability to change response set, or (c) a speed-accuracy trade-off. Implications for and a discussion about the response inhibition hypothesis in ADHD are discussed.

The effects of auditory stimulation on the arithmetic performance of children with ADHD and nondisabled children

This study evaluated the impact of extra-task stimulation on the academic task performance of children with attention-deficit/hyperactivity disorder (ADHD). Twenty boys with ADHD and 20 nondisabled boys worked on an arithmetic task during high stimulation (music), low stimulation (speech), and no stimulation (silence). The music "distractors" were individualized for each child, and the arithmetic problems were at each child's ability level. A significant Group x Condition interaction was found for number of correct answers. Specifically, the nondisabled youngsters performed similarly under all three auditory conditions. In contrast, the children with ADHD did significantly better under the music condition than speech or silence conditions. However, a significant Group x Order interaction indicated that arithmetic performance was enhanced only for those children with ADHD who received music as the first condition. The facilitative effects of salient auditory stimulation on the arithmetic performance of the children with ADHD provide some support for the underarousal/optimal stimulation theory of ADHD.

Information processing in patients with early and continuously-treated phenylketonuria

A total of 33 patients with early and continuously-treated phenylketonuria (PKU) between 7 and 16 years of age and 33 matched controls participated in a study examining perceptual, central, and response-related mechanisms of information processing. The specific mechanisms studied were: perceptual filtering, memory search, response selection, response execution, and motor presetting. In addition, groups were compared on mean intelligence level and task oriented behaviour. The performance of the PKU patients practically matched that of the controls on all three tasks, suggesting that PKU patients who are continuously maintained on a well-controlled phenylalanine-restricted diet are not impaired in the elementary mechanisms of information processing. Furthermore, groups did not differ in mean IQ or task-oriented behaviour.

CONCLUSION

These results underline the importance of continued, well-controlled dietary treatment. Further studies are recommended to obtain a more complete evaluation of the potential of PKU patients under these stricter dietary treatment conditions.

Information processing deficits in children with early and continuously treated phenylketonuria?

Thirty-three patients with early and continuously treated classical phenylketonuria (PKU) and 33 controls matched for age, gender, and educational level of both parents, participated in a chronometric study exploring elementary mechanisms of information processing. Subjects performed speeded performance tasks designed to systematically vary the load on perceptual, central, and output-related mechanisms of information processing. A preliminary analysis of the data indicated that the overall performance of patients with early and continuously treated PKU practically matched that of the controls on all three tasks. Although this finding must be interpreted with caution as it is based on only a preliminary analysis of the data, it suggests that PKU patients who are continuously maintained on a well-controlled phenylalanine-restricted diet are not deficient in the elementary mechanisms of processing. Given the more recent findings indicating that young children with early-treated classical PKU have specific cognitive deficits in the executive function skills, despite relatively strict dietary control, the authors suggest that future studies should focus on these higher-order cognitive processes.

Attentional difficulties in hyperactive and conduct-disordered children: a processing deficit

A random population sample of 1479 Chinese boys from Hong Kong was screened and diagnosed in a two-stage epidemiological study. Four groups, age 7-8, were distinguished: (1) a pure hyperactive group (HA), (2) a mixed hyperactive/conduct-disordered group (HA+CD), (3) a pure conduct-disordered group (CD), and (4) a normal control group (N). On a visual search task, only the HA children showed a specific processing deficit in performance. This confirms the diagnostic value of such a deficit for hyperactivity, differentiating it from conduct disorder. The failure to find a similar deficit in the HA+CD group raises questions concerning the clinical identity of these children. Each group showed a performance decrement over time in the visual search task but the decrement did not differ between the four groups. This observation is not congruent with the reports of a short attention span in hyperactive children; explanations of this apparent contradiction are considered.

Observations of hyperactive behaviour during vigilance

A sustained attention deficit implies a deficit originating in the course of a task. A series of studies previously indicated that task inefficiency in hyperactive children is independent of task duration. The present study shows that differences in body activity between hyperactive and control children are also independent of task duration. However, the groups did differ in visual behaviour, i.e. hyperactive children did look away from the task more frequently as time proceeds. This visual behaviour did not interfere with task accuracy. It is argued that the results indicate that hyperactive children may have prevented a further deterioration of task efficiency over time through self stimulation.