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Ćirović M, Jeličić L, Maksimović S, Fatić S, Marisavljević M, Bošković Matić T, Subotić M. EEG Correlates of Cognitive Functions in a Child with ASD and White Matter Signal Abnormalities: A Case Report with Two-and-a-Half-Year Follow-Up. Diagnostics (Basel) 2023; 13:2878. [PMID: 37761245 PMCID: PMC10529253 DOI: 10.3390/diagnostics13182878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
This research aimed to examine the EEG correlates of different stimuli processing instances in a child with ASD and white matter signal abnormalities and to investigate their relationship to the results of behavioral tests. The prospective case study reports two and a half years of follow-up data from a child aged 38 to 66 months. Cognitive, speech-language, sensory, and EEG correlates of auditory-verbal and auditory-visual-verbal information processing were recorded during five test periods, and their mutual interrelation was analyzed. EEG findings revealed no functional theta frequency range redistribution in the frontal regions favoring the left hemisphere during speech processing. The results pointed to a positive linear trend in the relative theta frequency range and a negative linear trend in the relative alpha frequency range when listening to and watching the cartoon. There was a statistically significant correlation between EEG signals and behavioral test results. Based on the obtained results, it may be concluded that EEG signals and their association with the results of behavioral tests should be evaluated with certain restraints considering the characteristics of the stimuli during EEG recording.
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Affiliation(s)
- Milica Ćirović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Slavica Maksimović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Saška Fatić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Maša Marisavljević
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Tatjana Bošković Matić
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- Clinic of Neurology, University Clinical Centre of Kragujevac, 34000 Kragujevac, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (M.Ć.); (S.M.); (S.F.); (M.M.); (M.S.)
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Caldani S, Acquaviva E, Moscoso A, Landman B, Michel A, Delorme R, Bucci MP. Motor Capabilities in Children with ADHD Are Improved after Brief Visuopostural Training. Neurol Int 2023; 15:792-803. [PMID: 37489356 PMCID: PMC10366723 DOI: 10.3390/neurolint15030050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
Children with ADHD show poor motor control. The aim of the present study was to test whether children with ADHD improved their motor performances (oculomotor as well as posture) after a short visuopostural training period. Two groups (G1 trained and G2 non-trained), each comprising 15 children with ADHD matched in IQ (intelligence quotient), sex, and age, participated in the study. Eye movements and postural sway were measured before (T1) and after (T2) 10 min of visuopostural training for the trained group and after 10 min of resting for the non-trained group. Training consisted of a visual search task performed while the child was standing on an unstable platform. At T1, oculomotor and postural abilities were statistically similar for both groups of children with ADHD (trained and non-trained). At T2, significant improvements in both oculomotor and postural capabilities were observed for the trained group but not for the non-trained group. These findings suggest that a short visuopostural training period could help children with ADHD to learn how to focus their visual attention in order to improve motor performance. Visuopostural training could allow a better integration of sensory inputs via central mechanisms, leading to improvement in both oculomotor and postural control. Further studies on a larger number of children with ADHD will be needed to confirm these findings and explore the eventual possible persistence of the training effect.
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Affiliation(s)
- Simona Caldani
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Ana Moscoso
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Alexandre Michel
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
- Paris University, 75005 Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, 75015 Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
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Abdulghani A, Poghosyan M, Mehren A, Philipsen A, Anderzhanova E. Neuroplasticity to autophagy cross-talk in a therapeutic effect of physical exercises and irisin in ADHD. Front Mol Neurosci 2023; 15:997054. [PMID: 36776770 PMCID: PMC9909442 DOI: 10.3389/fnmol.2022.997054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Adaptive neuroplasticity is a pivotal mechanism for healthy brain development and maintenance, as well as its restoration in disease- and age-associated decline. Management of mental disorders such as attention deficit hyperactivity disorder (ADHD) needs interventions stimulating adaptive neuroplasticity, beyond conventional psychopharmacological treatments. Physical exercises are proposed for the management of ADHD, and also depression and aging because of evoked brain neuroplasticity. Recent progress in understanding the mechanisms of muscle-brain cross-talk pinpoints the role of the myokine irisin in the mediation of pro-cognitive and antidepressant activity of physical exercises. In this review, we discuss how irisin, which is released in the periphery as well as derived from brain cells, may interact with the mechanisms of cellular autophagy to provide protein recycling and regulation of brain-derived neurotrophic factor (BDNF) signaling via glia-mediated control of BDNF maturation, and, therefore, support neuroplasticity. We propose that the neuroplasticity associated with physical exercises is mediated in part by irisin-triggered autophagy. Since the recent findings give objectives to consider autophagy-stimulating intervention as a prerequisite for successful therapy of psychiatric disorders, irisin appears as a prototypic molecule that can activate autophagy with therapeutic goals.
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Affiliation(s)
- Alhasan Abdulghani
- C. and O. Vogt Institute for Brain Research, Medical Faculty and University Hospital Düsseldorf, Henrich Heine University, Düsseldorf, Düsseldorf, Germany,*Correspondence: Alhasan Abdulghani,
| | - Mikayel Poghosyan
- Institute for Biology-Neurobiology, Freie University of Berlin, Berlin, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Elmira Anderzhanova
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Luo X, Lin X, Ide JS, Luo X, Zhang Y, Xu J, Wang L, Chen Y, Cheng W, Zheng J, Wang Z, Yu T, Taximaimaiti R, Jing X, Wang X, Cao Y, Tan Y, Li CSR. Male-specific, replicable and functional roles of genetic variants and cerebral gray matter volumes in ADHD: a gene-wide association study across KTN1 and a region-wide functional validation across brain. Child Adolesc Psychiatry Ment Health 2023; 17:4. [PMID: 36609385 PMCID: PMC9824933 DOI: 10.1186/s13034-022-00536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with reduction of cortical and subcortical gray matter volumes (GMVs). The kinectin 1 gene (KTN1) has recently been reported to significantly regulate GMVs and ADHD risk. In this study, we aimed to identify sex-specific, replicable risk KTN1 alleles for ADHD and to explore their regulatory effects on mRNA expression and cortical and subcortical GMVs. We examined a total of 1020 KTN1 SNPs in one discovery sample (ABCD cohort: 5573 males and 5082 females) and three independent replication European samples (Samples #1 and #2 each with 802/122 and 472/141 male/female offspring with ADHD; and Sample #3 with 14,154/4945 ADHD and 17,948/16,246 healthy males/females) to identify replicable associations within each sex. We examined the regulatory effects of ADHD-risk alleles on the KTN1 mRNA expression in two European brain cohorts (n = 348), total intracranial volume (TIV) in 46 European cohorts (n = 18,713) and the ABCD cohort, as well as the GMVs of seven subcortical structures in 50 European cohorts (n = 38,258) and of 118 cortical and subcortical regions in the ABCD cohort. We found that four KTN1 variants significantly regulated the risk of ADHD with the same direction of effect in males across discovery and replication samples (0.003 ≤ p ≤ 0.041), but none in females. All four ADHD-risk alleles significantly decreased KTN1 mRNA expression in all brain regions examined (1.2 × 10-5 ≤ p ≤ 0.039). The ADHD-risk alleles significantly increased basal ganglia (2.8 × 10-22 ≤ p ≤ 0.040) and hippocampus (p = 0.010) GMVs but reduced amygdala GMV (p = 0.030) and TIV (0.010 < p ≤ 0.013). The ADHD-risk alleles also significantly reduced some cortical (right superior temporal pole, right rectus) and cerebellar but increased other cortical (0.007 ≤ p ≤ 0.050) GMVs. To conclude, we identified a set of replicable and functional risk KTN1 alleles for ADHD, specifically in males. KTN1 may play a critical role in the pathogenesis of ADHD, and the reduction of specific cortical and subcortical, including amygdalar but not basal ganglia or hippocampal, GMVs may serve as a neural marker of the genetic effects.
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Affiliation(s)
- Xingguang Luo
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Xiandong Lin
- Laboratory of Radiation Oncology and Radiobiology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuzhou, 350014, China
| | - Jaime S Ide
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Xinqun Luo
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350004, Fujian, China
| | - Yong Zhang
- Tianjin Mental Health Center, Tianjin, 300222, China
| | - Jianying Xu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai, 519000, Guangdong, China
| | - Leilei Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Wenhong Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jianming Zheng
- National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University School of Medicine, Shanghai, 200030, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Ting Yu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Reyisha Taximaimaiti
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiaozhong Jing
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiaoping Wang
- Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Yuping Cao
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center On Mental Disorders, China National Technology Institute On Mental Disorders, Changsha, 410011, Hunan, China.
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical School of Medicine, Beijing, 100096, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
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Romeo RR, Leonard JA, Grotzinger HM, Robinson ST, Takada ME, Mackey AP, Scherer E, Rowe ML, West MR, Gabrieli JDE. Neuroplasticity associated with changes in conversational turn-taking following a family-based intervention. Dev Cogn Neurosci 2021; 49:100967. [PMID: 34052580 PMCID: PMC8175277 DOI: 10.1016/j.dcn.2021.100967] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/18/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022] Open
Abstract
Children's early language environments are associated with linguistic, cognitive, and academic development, as well as concurrent brain structure and function. This study investigated neurodevelopmental mechanisms linking language input to development by measuring neuroplasticity associated with an intervention designed to enhance language environments of families primarily from lower socioeconomic backgrounds. Families of 52 4-to-6 year-old children were randomly assigned to a 9-week, interactive, family-based intervention or no-contact control group. Children completed pre- and post-assessments of verbal and nonverbal cognition (n = 52), structural magnetic resonance imaging (n = 45), and home auditory recordings of language exposure (n = 39). Families who completed the intervention exhibited greater increases in adult-child conversational turns, and changes in turn-taking mediated intervention effects on language and executive functioning measures. Collapsing across groups, turn-taking changes were also positively correlated with cortical thickening in left inferior frontal and supramarginal gyri, the latter of which mediated relationships between changes in turn-taking and children's language development. This is the first study of longitudinal neuroplasticity in response to changes in children's language environments, and findings suggest that conversational turns support language development through cortical growth in language and social processing regions. This has implications for early interventions to enhance children's language environments to support neurocognitive development.
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Affiliation(s)
- Rachel R Romeo
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States.
| | - Julia A Leonard
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States
| | - Hannah M Grotzinger
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States
| | - Sydney T Robinson
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States
| | - Megumi E Takada
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States
| | - Allyson P Mackey
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States
| | - Ethan Scherer
- Center for Education Policy Research, Harvard University, United States
| | - Meredith L Rowe
- Graduate School of Education, Harvard University, United States
| | - Martin R West
- Center for Education Policy Research, Harvard University, United States; Graduate School of Education, Harvard University, United States
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, United States; Center for Education Policy Research, Harvard University, United States; Integrated Learning Initiative, Massachusetts Institute of Technology, United States
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de Oliveira Rosa V, Rosa Franco A, Abrahão Salum Júnior G, Moreira-Maia CR, Wagner F, Simioni A, de Fraga Bassotto C, R Moritz G, Schaffer Aguzzoli C, Buchweitz A, Schmitz M, Rubia K, Paim Rohde LA. Effects of computerized cognitive training as add-on treatment to stimulants in ADHD: a pilot fMRI study. Brain Imaging Behav 2021; 14:1933-1944. [PMID: 31218531 DOI: 10.1007/s11682-019-00137-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The neurofunctional effects of Cognitive training (CT) are poorly understood. Our main objective was to assess fMRI brain activation patterns in children with ADHD who received CT as an add-on treatment to stimulant medication. We included twenty children with ADHD from a clinical trial of stimulant medication and CT (10 in medication + CT and 10 in medication + non-active training). Between-group differences were assessed in performance and in brain activation during 3 fMRI paradigms of working memory (N-back: 0-back, 1-back, 2-back, 3-back), sustained attention (Sustained Attention Task - SAT: 2 s, 5 s and 8 s delays) and inhibitory control (Go/No-Go). We found significant group x time x condition interactions in working memory (WM) and sustained attention on brain activation. In N-back, decreases were observed in the BOLD signal change from baseline to endpoint with increasing WM load in the right insula, right putamen, left thalamus and left pallidum in the CT compared to the non-active group; in SAT - increases in the BOLD signal change from baseline to endpoint with increasing delays were observed in bilateral precuneus, right insula, bilateral associative visual cortex and angular gyrus, right middle temporal, precentral, postcentral, superior frontal and middle frontal gyri in the CT compared to the non-active group. CT in ADHD was associated with changes in activation in task-relevant parietal and striato-limbic regions of sustained attention and working memory. Changes in brain activity may precede behavioral performance modifications in working memory and sustained attention, but not in inhibitory control.
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Affiliation(s)
- Virginia de Oliveira Rosa
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. .,ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil.
| | - Alexandre Rosa Franco
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Giovanni Abrahão Salum Júnior
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Carlos Renato Moreira-Maia
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | - Flávia Wagner
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | - André Simioni
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | - Caroline de Fraga Bassotto
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | - Guilherme R Moritz
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | | | - Augusto Buchweitz
- BraIns, Brain Institute of Rio Grande do Sul, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo Schmitz
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil
| | - Katya Rubia
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Luis Augusto Paim Rohde
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
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Matthys W, Schutter DJLG. Increasing Effectiveness of Cognitive Behavioral Therapy for Conduct Problems in Children and Adolescents: What Can We Learn from Neuroimaging Studies? Clin Child Fam Psychol Rev 2021; 24:484-499. [PMID: 33683495 PMCID: PMC8324588 DOI: 10.1007/s10567-021-00346-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/03/2022]
Abstract
Cognitive behavioral therapy (CBT) is particularly relevant for children from 7 years on and adolescents with clinical levels of conduct problems. CBT provides these children and adolescents with anger regulation and social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Typically, CBT is combined with another psychological treatment such as behavioral parent training in childhood or an intervention targeting multiple systems in adolescence. The effectiveness of CBT, however, is in the small to medium range. The aim of this review is to describe how the effectiveness of CBT may be improved by paying more attention to a series of psychological functions that have been shown to be impaired in neuroimaging studies: (1) anger recognition, (2) the ability to generate situation appropriate solutions to social problems, (3) reinforcement-based decision making, (4) response inhibition, and (5) affective empathy. It is suggested that children and adolescents first become familiar with these psychological functions during group CBT sessions. In individual sessions in which the parents (and/or child care workers in day treatment and residential treatment) and the child or adolescent participate, parents then learn to elicit, support, and reinforce their child’s use of these psychological functions in everyday life (in vivo practice). In these individual sessions, working on the psychological functions is tailored to the individual child’s characteristic impairments of these functions. CBT therapists may also share crucial social-learning topics with teachers with a view to creating learning opportunities for children and adolescents at school.
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Affiliation(s)
- Walter Matthys
- Department of Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, P.O. Box 80140, 3584 CS, Utrecht, The Netherlands. .,Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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Tymofiyeva O, Gaschler R. Training-Induced Neural Plasticity in Youth: A Systematic Review of Structural and Functional MRI Studies. Front Hum Neurosci 2021; 14:497245. [PMID: 33536885 PMCID: PMC7848153 DOI: 10.3389/fnhum.2020.497245] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 12/01/2020] [Indexed: 01/17/2023] Open
Abstract
Experience-dependent neural plasticity is high in the developing brain, presenting a unique window of opportunity for training. To optimize existing training programs and develop new interventions, it is important to understand what processes take place in the developing brain during training. Here, we systematically review MRI-based evidence of training-induced neural plasticity in children and adolescents. A total of 71 articles were included in the review. Significant changes in brain activation, structure, microstructure, and structural and functional connectivity were reported with different types of trainings in the majority (87%) of the studies. Significant correlation of performance improvement with neural changes was reported in 51% of the studies. Yet, only 48% of the studies had a control condition. Overall, the review supports the hypothesized neural changes with training while at the same time charting empirical and methodological desiderata for future research.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, United States
- Department of Psychology, University of Hagen, Hagen, Germany
| | - Robert Gaschler
- Department of Psychology, University of Hagen, Hagen, Germany
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Weyandt LL, Clarkin CM, Holding EZ, May SE, Marraccini ME, Gudmundsdottir BG, Shepard E, Thompson L. Neuroplasticity in children and adolescents in response to treatment intervention: A systematic review of the literature. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2020. [DOI: 10.1177/2514183x20974231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the present study was to conduct a systematic review of the literature, adhering to PRISMA guidelines, regarding evidence of neuroplasticity in children and adolescents in response to cognitive or sensory-motor interventions. Twenty-eight studies employing seven different types of neuroimaging techniques were included in the review. Findings revealed that significant variability existed across the 28 studies with regard to the clinical populations examined, type of interventions employed, neuroimaging methods, and the type of neuroimaging data included in the studies. Overall, results supported that experience-dependent interventions were associated with neuroplastic changes among children and adolescents in both neurotypical and clinical populations. However, it remains unclear whether these molecular neuroplastic changes, including the degree and direction of those differences, were the direct result of the intervention. Although the findings are encouraging, methodological limitations of the studies limit clinical utility of the results. Future studies are warranted that rigorously define the construct of neuroplasticity, establish consistent protocols across measurement techniques, and have adequate statistical power. Lastly, studies are needed to identify the functional and structural neuroplastic mechanisms that correspond with changes in cognition and behavior in child and adolescent samples.
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Affiliation(s)
- Lisa L Weyandt
- Department of Psychology, Director Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, USA
| | - Christine M Clarkin
- Physical Therapy Department, University of Rhode Island, Kingston, RI, USA
- Interdisciplinary Neuroscience Program, Graduate School, University of Rhode Island, Kingston, RI, USA
| | - Emily Z Holding
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shannon E May
- Interdisciplinary Neuroscience Program, Graduate School, University of Rhode Island, Kingston, RI, USA
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Emily Shepard
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Lauren Thompson
- Interdisciplinary Neuroscience Program, Graduate School, University of Rhode Island, Kingston, RI, USA
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10
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Boon HJ. What do ADHD Neuroimaging Studies Reveal for Teachers, Teacher Educators and Inclusive Education? CHILD & YOUTH CARE FORUM 2020. [DOI: 10.1007/s10566-019-09542-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Palaniyappan L, Hodgson O, Balain V, Iwabuchi S, Gowland P, Liddle P. Structural covariance and cortical reorganisation in schizophrenia: a MRI-based morphometric study. Psychol Med 2019; 49:412-420. [PMID: 29729682 DOI: 10.1017/s0033291718001010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND In patients with schizophrenia, distributed abnormalities are observed in grey matter volume. A recent hypothesis posits that these distributed changes are indicative of a plastic reorganisation process occurring in response to a functional defect in neuronal information transmission. We investigated the structural covariance across various brain regions in early-stage schizophrenia to determine if indeed the observed patterns of volumetric loss conform to a coordinated pattern of structural reorganisation. METHODS Structural magnetic resonance imaging scans were obtained from 40 healthy adults and 41 age, gender and parental socioeconomic status matched patients with schizophrenia. Volumes of grey matter tissue were estimated at the regional level across 90 atlas-based parcellations. Group-level structural covariance was studied using a graph theoretical framework. RESULTS Patients had distributed reduction in grey matter volume, with high degree of localised covariance (clustering) compared with controls. Patients with schizophrenia had reduced centrality of anterior cingulate and insula but increased centrality of the fusiform cortex, compared with controls. Simulating targeted removal of highly central nodes resulted in significant loss of the overall covariance patterns in patients compared with controls. CONCLUSION Regional volumetric deficits in schizophrenia are not a result of random, mutually independent processes. Our observations support the occurrence of a spatially interconnected reorganisation with the systematic de-escalation of conventional 'hub' regions. This raises the question of whether the morphological architecture in schizophrenia is primed for compensatory functions, albeit with a high risk of inefficiency.
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Affiliation(s)
- Lena Palaniyappan
- Robarts Research Institute & The Brain and Mind Institute, University of Western Ontario,London,Ontario,Canada
| | - Olha Hodgson
- Translational Neuroimaging in Mental Health,University of Nottingham,UK
| | - Vijender Balain
- Translational Neuroimaging in Mental Health,University of Nottingham,UK
| | - Sarina Iwabuchi
- Translational Neuroimaging in Mental Health,University of Nottingham,UK
| | - Penny Gowland
- Sir Peter Mansfield Imaging Center,University of Nottingham,Nottingham,UK
| | - Peter Liddle
- Translational Neuroimaging in Mental Health,University of Nottingham,UK
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Izadi-Najafabadi S, Rinat S, Zwicker JG. Rehabilitation-induced brain changes detected through magnetic resonance imaging in children with neurodevelopmental disorders: A systematic review. Int J Dev Neurosci 2018; 73:66-82. [PMID: 30550748 DOI: 10.1016/j.ijdevneu.2018.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/19/2018] [Accepted: 12/07/2018] [Indexed: 01/08/2023] Open
Abstract
AIM The aim of this study was to systematically review evidence about rehabilitation-induced neuroplasticity measured by magnetic resonance imaging (MRI) in children with neurodevelopmental disorders. METHOD The following databases were searched: MEDLINE, EMBASE, CINAHL, and PsycINFO. Two independent reviewers screened articles according to inclusion criteria: (1) peer-review study published in a scientific journal; (2) studies that evaluated a rehabilitation-based intervention; (3) participants aged less than 19 years with a neurodevelopmental disorder; and (4) studies that used at least one MRI modality as an outcome measure. Twenty-seven studies met the criteria for the review and their quality was assessed by two independent reviewers using the Effective Public Health Practice Project Quality Assessment Tool. RESULTS Based on an assessment of bias and overall quality, 11% of the papers were rated as strong; 30% moderate; and 59% weak. Outcomes were categorized into structural connectivity, functional connectivity, cortical activation, and structural volume. Cortical activation and structural connectivity were the most commonly reported measures. Most studies were able to identify brain changes in children with neurodevelopmental disorders after therapy. INTERPRETATIONS Rehabilitation is shown to induce MRI-detectable neuroplastic changes in children with neurodevelopmental disorders. Structural connectivity might need greater intensity and/or duration of intervention to induce change.
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Affiliation(s)
- Sara Izadi-Najafabadi
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Shie Rinat
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Jill G Zwicker
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada; Sunny Hill Health Centre for Children, Vancouver, Canada.
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Quansah E, Ruiz-Rodado V, Grootveld M, Zetterström TSC. Methylphenidate alters monoaminergic and metabolic pathways in the cerebellum of adolescent rats. Eur Neuropsychopharmacol 2018; 28:513-528. [PMID: 29478746 DOI: 10.1016/j.euroneuro.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/01/2018] [Accepted: 02/07/2018] [Indexed: 12/31/2022]
Abstract
Abnormalities in the cerebellar circuitry have been suggested to contribute to some of the symptoms associated with attention deficit hyperactivity disorder (ADHD). The psychostimulant methylphenidate (MPH) is the major drug for treating this condition. Here, the effects of acute (2.0 mg/kg and 5.0 mg/kg) and chronic (2.0 mg/kg, twice daily for 15 days) MPH treatments were investigated in adolescent (35-40 days old) rats on monoaminergic and metabolic markers in the cerebellum. Data acquired indicates that acute MPH treatment (2.0 mg/kg) decreased cerebellar vesicular monoamine transporter (VMAT2) density, while chronic treatment caused an increase. In contrast, protein levels of tyrosine hydroxylase (TH) and the dopamine D1 receptor were not significantly altered by neither acute nor chronic MPH treatment. In addition, while chronic but not acute MPH treatment significantly enhanced dopamine turnover (DOPAC/dopamine) in the cerebellum, levels of dopamine and homovanillic acid (HVA) were not altered. Acute MPH (5.0 mg/kg) significantly modified levels of a range of cerebellar metabolites with similar trends also detected for the lower dose (2.0 mg/kg). In this regard, acute MPH tended to decrease cerebellar metabolites associated with energy consumption and excitatory neurotransmission including glutamate, glutamine, N-acetyl aspartate, and inosine. Conversely, levels of some metabolites associated with inhibitory neurotransmission, including GABA and glycine were reduced by acute (5.0 mg/kg) MPH, together with acetate, aspartate and hypoxanthine. In conclusion, this study demonstrated that MPH alters cerebellar biochemistry, and that this effect depends on both dose and duration of treatment. The therapeutic significance of these results requires further investigation.
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Affiliation(s)
- Emmanuel Quansah
- Leicester School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, The Gateway, Leicester LE1 9BH, UK
| | - Victor Ruiz-Rodado
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Martin Grootveld
- Leicester School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, The Gateway, Leicester LE1 9BH, UK
| | - Tyra S C Zetterström
- Leicester School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, The Gateway, Leicester LE1 9BH, UK.
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Lui S, Zhou XJ, Sweeney JA, Gong Q. Psychoradiology: The Frontier of Neuroimaging in Psychiatry. Radiology 2017; 281:357-372. [PMID: 27755933 DOI: 10.1148/radiol.2016152149] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unlike neurologic conditions, such as brain tumors, dementia, and stroke, the neural mechanisms for all psychiatric disorders remain unclear. A large body of research obtained with structural and functional magnetic resonance imaging, positron emission tomography/single photon emission computed tomography, and optical imaging has demonstrated regional and illness-specific brain changes at the onset of psychiatric disorders and in individuals at risk for such disorders. Many studies have shown that psychiatric medications induce specific measurable changes in brain anatomy and function that are related to clinical outcomes. As a result, a new field of radiology, termed psychoradiology, seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with psychiatric disorders. This article will present the state of the art in this area, as well as perspectives regarding preparations in the field of radiology for its evolution. Furthermore, this article will (a) give an overview of the imaging and analysis methods for psychoradiology; (b) review the most robust and important radiologic findings and their potential clinical value from studies of major psychiatric disorders, such as depression and schizophrenia; and (c) describe the main challenges and future directions in this field. An ongoing and iterative process of developing biologically based nomenclatures with which to delineate psychiatric disorders and translational research to predict and track response to different therapeutic drugs is laying the foundation for a shift in diagnostic practice in psychiatry from a psychologic symptom-based approach to an imaging-based approach over the next generation. This shift will require considerable innovations for the acquisition, analysis, and interpretation of brain images, all of which will undoubtedly require the active involvement of radiologists. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Su Lui
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Xiaohong Joe Zhou
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - John A Sweeney
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Qiyong Gong
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
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Farias AC, Cordeiro ML, Felden EP, Bara TS, Benko CR, Coutinho D, Martins LF, Ferreira RT, McCracken JT. Attention-memory training yields behavioral and academic improvements in children diagnosed with attention-deficit hyperactivity disorder comorbid with a learning disorder. Neuropsychiatr Dis Treat 2017; 13:1761-1769. [PMID: 28740391 PMCID: PMC5507011 DOI: 10.2147/ndt.s136663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Recent studies have suggested that children with attention-deficit hyperactivity disorder (ADHD) may benefit from computerized cognitive training. Therapy implementation is especially complicated when ADHD is associated with learning disorders (LDs). This study tested the efficacy of a computer-based cognitive training program, namely, computerized cognitive training (CCT), in children with ADHD comorbid with an LD (ADHD-LD), with or without psychostimulant medication. MATERIALS AND METHODS After diagnostic evaluations, 27 children with ADHD-LD (8 unmedicated and 19 medicated) participated in CCT, which is intended to improve attention, memory, reasoning, visual processing, and executive functioning. The participants completed 24 1-hour sessions over 3 months. Neuropsychometric and standardized academic test results before and after training were compared to assess treatment efficacy. Shapiro-Wilk normality tests were applied, and subsequent Wilcoxon tests were used to identify significant differences in pre-versus post-training performance. RESULTS After CAT, children diagnosed with ADHD-LD showed 1) improvements in trained skills, measured directly within the software and indirectly by external psychometric tests; 2) improvements in attention, memory, and some executive functioning; 3) improvements in academic performance, particularly in mathematics; and 4) reductions in maladaptive behavioral features. CONCLUSION The present findings suggest that cognitive training programs should be explored further as potential adjunctive therapies to improve outcomes in children with ADHD-LD.
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Affiliation(s)
- Antonio Carlos Farias
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba.,Department of Neuropediatrics, Children's Hospital, Pequeno Príncipe.,School of Medicine, University Positivo, Curitiba, Brazil
| | - Mara L Cordeiro
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, US
| | - Erico Pg Felden
- Center for Health Science Research, Santa Catarina State University, Florianópolis, Brazil
| | - Tiago S Bara
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba
| | - Cássia R Benko
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba
| | - Daniele Coutinho
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba
| | - Leandra F Martins
- Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba
| | - Rosilda Tc Ferreira
- Faculdades Pequeno Príncipe.,Neurosciences Core, Pelé Pequeno Príncipe Research Institute, Curitiba
| | - James T McCracken
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, US
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Cognitive Training in Parkinson's Disease: A Review of Studies from 2000 to 2014. PARKINSONS DISEASE 2016; 2016:9291713. [PMID: 27688923 PMCID: PMC5027302 DOI: 10.1155/2016/9291713] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/03/2016] [Indexed: 01/05/2023]
Abstract
Cognitive deficits are prevalent among patients with Parkinson's disease (PD), in both early and late stages of the disease. These deficits are associated with lower quality of life, loss of independence, and institutionalization. To date, there is no effective pharmacological treatment for the range of cognitive impairments presented in PD. Cognitive training (CT) has been explored as an alternative approach to remediating cognition in PD. In this review we present a detailed summary of 13 studies of CT that have been conducted between 2000 and 2014 and a critical examination of the evidence for the effectiveness and applicability of CT in PD. Although the evidence shows that CT leads to short-term, moderate improvements in some cognitive functions, methodological inconsistencies weaken these results. We discuss several key limitations of the literature to date, propose methods of addressing these questions, and outline the future directions that studies of CT in PD should pursue. Studies need to provide more detail about the cognitive profile of participants, include larger sample sizes, be hypothesis driven, and be clearer about the training interventions and the outcome measures.
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17
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Colom R, Hua X, Martínez K, Burgaleta M, Román FJ, Gunter JL, Carmona S, Jaeggi SM, Thompson PM. Brain structural changes following adaptive cognitive training assessed by Tensor-Based Morphometry (TBM). Neuropsychologia 2016; 91:77-85. [PMID: 27477628 DOI: 10.1016/j.neuropsychologia.2016.07.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 07/11/2016] [Accepted: 07/27/2016] [Indexed: 12/01/2022]
Abstract
Tensor-Based Morphometry (TBM) allows the automatic mapping of brain changes across time building 3D deformation maps. This technique has been applied for tracking brain degeneration in Alzheimer's and other neurodegenerative diseases with high sensitivity and reliability. Here we applied TBM to quantify changes in brain structure after completing a challenging adaptive cognitive training program based on the n-back task. Twenty-six young women completed twenty-four training sessions across twelve weeks and they showed, on average, large cognitive improvements. High-resolution MRI scans were obtained before and after training. The computed longitudinal deformation maps were analyzed for answering three questions: (a) Are there differential brain structural changes in the training group as compared with a matched control group? (b) Are these changes related to performance differences in the training program? (c) Are standardized changes in a set of psychological factors (fluid and crystallized intelligence, working memory, and attention control) measured before and after training, related to structural changes in the brain? Results showed (a) greater structural changes for the training group in the temporal lobe, (b) a negative correlation between these changes and performance across training sessions (the greater the structural change, the lower the cognitive performance improvements), and (c) negligible effects regarding the psychological factors measured before and after training.
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Affiliation(s)
| | - Xue Hua
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, University of Southern California (USC), Marina del Rey, CA, USA
| | - Kenia Martínez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Francisco J Román
- Universidad Autónoma de Madrid, Spain; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, USA
| | | | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Paul M Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging and Informatics, University of Southern California (USC), Marina del Rey, CA, USA
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Stevens MC, Gaynor A, Bessette KL, Pearlson GD. A preliminary study of the effects of working memory training on brain function. Brain Imaging Behav 2016; 10:387-407. [PMID: 26138580 PMCID: PMC4698365 DOI: 10.1007/s11682-015-9416-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Working memory (WM) training improves WM ability in Attention-Deficit/Hyperactivity Disorder (ADHD), but its efficacy for non-cognitive ADHD impairments ADHD has been sharply debated. The purpose of this preliminary study was to characterize WM training-related changes in ADHD brain function and see if they were linked to clinical improvement. We examined 18 adolescents diagnosed with DSM-IV Combined-subtype ADHD before and after 25 sessions of WM training using a frequently employed approach (Cogmed™) using a nonverbal Sternberg WM fMRI task, neuropsychological tests, and participant- and parent-reports of ADHD symptom severity and associated functional impairment. Whole brain SPM8 analyses identified ADHD activation deficits compared to 18 non-ADHD control participants, then tested whether impaired ADHD frontoparietal brain activation would increase following WM training. Post hoc tests examined the relationships between neural changes and neurocognitive or clinical improvements. As predicted, WM training increased WM performance, ADHD clinical functioning, and WM-related ADHD brain activity in several frontal, parietal and temporal lobe regions. Increased left inferior frontal sulcus region activity was seen in all Encoding, Maintenance, and Retrieval Sternberg task phases. ADHD symptom severity improvements were most often positively correlated with activation gains in brain regions known to be engaged for WM-related executive processing; improvement of different symptom types had different neural correlates. The responsiveness of both amodal WM frontoparietal circuits and executive process-specific WM brain regions was altered by WM training. The latter might represent a promising, relatively unexplored treatment target for researchers seeking to optimize clinical response in ongoing ADHD WM training development efforts.
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Affiliation(s)
- Michael C Stevens
- Olin Neuropsychiatry Research Center, The Institute of Living / Hartford Hospital, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA.
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Alexandra Gaynor
- Olin Neuropsychiatry Research Center, The Institute of Living / Hartford Hospital, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA
| | - Katie L Bessette
- Olin Neuropsychiatry Research Center, The Institute of Living / Hartford Hospital, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, The Institute of Living / Hartford Hospital, 200 Retreat Avenue, Whitehall Building, Hartford, CT, 06106, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Liu ZX, Glizer D, Tannock R, Woltering S. EEG alpha power during maintenance of information in working memory in adults with ADHD and its plasticity due to working memory training: A randomized controlled trial. Clin Neurophysiol 2016; 127:1307-1320. [DOI: 10.1016/j.clinph.2015.10.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/15/2015] [Accepted: 10/07/2015] [Indexed: 01/30/2023]
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Bikic A, Leckman JF, Lindschou J, Christensen TØ, Dalsgaard S. Cognitive computer training in children with attention deficit hyperactivity disorder (ADHD) versus no intervention: study protocol for a randomized controlled trial. Trials 2015; 16:480. [PMID: 26499057 PMCID: PMC4619562 DOI: 10.1186/s13063-015-0975-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/24/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by symptoms of inattention and impulsivity and/or hyperactivity and a range of cognitive dysfunctions. Pharmacological treatment may be beneficial; however, many affected individuals continue to have difficulties with cognitive functions despite medical treatment, and up to 30 % do not respond to pharmacological treatment. Inadequate medical compliance and the long-term effects of treatment make it necessary to explore nonpharmacological and supplementary treatments for ADHD. Treatment of cognitive dysfunctions may prove particularly important because of the impact of these dysfunctions on the ability to cope with everyday life. Lately, several trials have shown promising results for cognitive computer training, often referred to as cognitive training, which focuses on particular parts of cognition, mostly on the working memory or attention but with poor generalization of training on other cognitive functions and functional outcome. Children with ADHD have a variety of cognitive dysfunctions, and it is important that cognitive training target multiple cognitive functions. METHODS/DESIGN This multicenter randomized clinical superiority trial aims to investigate the effect of "ACTIVATE™," a computer program designed to improve a range of cognitive skills and ADHD symptoms. A total of 122 children with ADHD, aged 6 to 13 years, will be randomized to an intervention or a control group. The intervention group will be asked to use ACTIVATE™ at home 40 minutes per day, 6 days per week for 8 weeks. Both intervention and control group will receive treatment as usual. Outcome measures will assess cognitive functions, symptoms, and behavioral and functional measures before and after the 8 weeks of training and in a 12- and 24-week follow-up. DISCUSSION Results of this trial will provide useful information on the effectiveness of computer training focusing on several cognitive functions. Cognitive training has the potential to reduce cognitive dysfunctions and to become a new treatment option, which can promote a more normal neural development in young children with ADHD and thus reduce cognitive dysfunctions and symptoms. This could help children with ADHD to perform better in everyday life and school. TRIAL REGISTRATION ClinicalTrials.gov: NCT01752530 , date of registration: 10 December 2012.
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Affiliation(s)
- Aida Bikic
- Institute of Clinical Research, University of Southern Denmark, Winsløwsparken 19, Odense, Denmark.
- Department of Child and Adolescent Mental Health Services, Psychiatric Hospital Region of Southern Denmark, Kresten Phillipsens Vej 15, Aabenraa, Denmark.
- Yale Child Study Centre, Yale University, 230 South Frontage Road, New Haven, USA.
| | - James F Leckman
- Yale Child Study Centre, Yale University, 230 South Frontage Road, New Haven, USA.
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | | | - Søren Dalsgaard
- Department of Economics and Business, National Centre for Register-based Research, Aarhus University, Fuglesangs Allé 4, Aarhus, Denmark.
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Dovis S, Van der Oord S, Wiers RW, Prins PJM. Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. a randomized double-blind placebo controlled trial. PLoS One 2015; 10:e0121651. [PMID: 25844638 PMCID: PMC4386826 DOI: 10.1371/journal.pone.0121651] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 01/17/2015] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Executive functions (EFs) training interventions aimed at ADHD-symptom reduction have yielded mixed results. Generally, these interventions focus on training a single cognitive domain (e.g., working memory [WM], inhibition, or cognitive-flexibility). However, evidence suggests that most children with ADHD show deficits on multiple EFs, and that these EFs are largely related to different brain regions. Therefore, training multiple EFs might be a potentially more effective strategy to reduce EF-related ADHD symptoms. METHODS Eighty-nine children with a clinical diagnosis of ADHD (aged 8-12) were randomized to either a full-active-condition where visuospatial WM, inhibition and cognitive-flexibility were trained, a partially-active-condition where inhibition and cognitive-flexibility were trained and the WM-training task was presented in placebo-mode, or to a full placebo-condition. Short-term and long-term (3-months) effects of this gamified, 25-session, home-based computer-training were evaluated on multiple outcome domains. RESULTS During training compliance was high (only 3% failed to meet compliance criteria). After training, only children in the full-active condition showed improvement on measures of visuospatial short-term-memory (STM) and WM. Inhibitory performance and interference control only improved in the full-active- and the partially-active condition. No Treatment-condition x Time interactions were found for cognitive-flexibility, verbal WM, complex-reasoning, nor for any parent-, teacher-, or child-rated ADHD behaviors, EF-behaviors, motivational behaviors, or general problem behaviors. Nonetheless, almost all measures showed main Time-effects, including the teacher-ratings. CONCLUSIONS Improvements on inhibition and visuospatial STM and WM were specifically related to the type of treatment received. However, transfer to untrained EFs and behaviors was mostly nonspecific (i.e., only interference control improved exclusively in the two EF training conditions). As such, in this multiple EF-training, mainly nonspecific treatment factors - as opposed to the specific effects of training EFs-seem related to far transfer effects found on EF and behavior. TRIAL REGISTRATION trialregister.nl NTR2728. Registry name: improving executive functioning in children with ADHD: training executive functions within the context of a computer game; registry number: NTR2728.
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Affiliation(s)
- Sebastiaan Dovis
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Addiction, Development, and Psychopathology (Adapt) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Saskia Van der Oord
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Psychology, Leuven University, Leuven, Belgium
| | - Reinout W. Wiers
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Addiction, Development, and Psychopathology (Adapt) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Pier J. M. Prins
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
There has been an increasing interest in and the use of computer-based cognitive training as a treatment of attention-deficit/hyperactivity disorder (ADHD). The authors' review of current evidence, based partly on a stringent meta-analysis of 6 randomized controlled trials (RCTs) published in 2013, and an overview of 8 recently published RCTs highlights the inconsistency of findings between trials and across blinded and nonblinded ADHD measures within trials. Based on this, they conclude that more evidence from well-blinded studies is required before cognitive training can be supported as a frontline treatment of core ADHD symptoms.
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Hsu NS, Novick JM, Jaeggi SM. The development and malleability of executive control abilities. Front Behav Neurosci 2014; 8:221. [PMID: 25071485 PMCID: PMC4092375 DOI: 10.3389/fnbeh.2014.00221] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/01/2014] [Indexed: 12/21/2022] Open
Abstract
Executive control (EC) generally refers to the regulation of mental activity. It plays a crucial role in complex cognition, and EC skills predict high-level abilities including language processing, memory, and problem solving, as well as practically relevant outcomes such as scholastic achievement. EC develops relatively late in ontogeny, and many sub-groups of developmental populations demonstrate an exaggeratedly poor ability to control cognition even alongside the normal protracted growth of EC skills. Given the value of EC to human performance, researchers have sought means to improve it through targeted training; indeed, accumulating evidence suggests that regulatory processes are malleable through experience and practice. Nonetheless, there is a need to understand both whether specific populations might particularly benefit from training, and what cortical mechanisms engage during performance of the tasks used in the training protocols. This contribution has two parts: in Part I, we review EC development and intervention work in select populations. Although promising, the mixed results in this early field make it difficult to draw strong conclusions. To guide future studies, in Part II, we discuss training studies that have included a neuroimaging component – a relatively new enterprise that also has not yet yielded a consistent pattern of results post-training, preventing broad conclusions. We therefore suggest that recent developments in neuroimaging (e.g., multivariate and connectivity approaches) may be useful to advance our understanding of the neural mechanisms underlying the malleability of EC and brain plasticity. In conjunction with behavioral data, these methods may further inform our understanding of the brain–behavior relationship and the extent to which EC is dynamic and malleable, guiding the development of future, targeted interventions to promote executive functioning in both healthy and atypical populations.
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Affiliation(s)
- Nina S Hsu
- Center for Advanced Study of Language, University of Maryland College Park, MD, USA ; Department of Psychology, University of Maryland College Park, MD, USA ; Program in Neuroscience and Cognitive Science, University of Maryland College Park, MD, USA
| | - Jared M Novick
- Center for Advanced Study of Language, University of Maryland College Park, MD, USA ; Program in Neuroscience and Cognitive Science, University of Maryland College Park, MD, USA ; Department of Hearing and Speech Sciences, University of Maryland College Park, MD, USA
| | - Susanne M Jaeggi
- School of Education, University of California, Irvine Irvine, CA, USA
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Stoodley CJ. Distinct regions of the cerebellum show gray matter decreases in autism, ADHD, and developmental dyslexia. Front Syst Neurosci 2014; 8:92. [PMID: 24904314 PMCID: PMC4033133 DOI: 10.3389/fnsys.2014.00092] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 04/30/2014] [Indexed: 01/18/2023] Open
Abstract
Differences in cerebellar structure have been identified in autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and developmental dyslexia. However, it is not clear if different cerebellar regions are involved in each disorder, and thus whether cerebellar anatomical differences reflect a generic developmental vulnerability or disorder-specific characteristics. To clarify this, we conducted an anatomic likelihood estimate (ALE) meta-analysis on voxel-based morphometry (VBM) studies which compared ASD (17 studies), ADHD (10 studies), and dyslexic (10 studies) participants with age-matched typically-developing (TD) controls. A second ALE analysis included studies in which the cerebellum was a region of interest (ROI). There were no regions of significantly increased gray matter (GM) in the cerebellum in ASD, ADHD, or dyslexia. Data from ASD studies revealed reduced GM in the inferior cerebellar vermis (lobule IX), left lobule VIIIB, and right Crus I. In ADHD, significantly decreased GM was found bilaterally in lobule IX, whereas participants with developmental dyslexia showed GM decreases in left lobule VI. There was no overlap between the cerebellar clusters identified in each disorder. We evaluated the functional significance of the regions revealed in both whole-brain and cerebellar ROI ALE analyses using Buckner and colleagues' 7-network functional connectivity map available in the SUIT cerebellar atlas. The cerebellar regions identified in ASD showed functional connectivity with frontoparietal, default mode, somatomotor, and limbic networks; in ADHD, the clusters were part of dorsal and ventral attention networks; and in dyslexia, the clusters involved ventral attention, frontoparietal, and default mode networks. The results suggest that different cerebellar regions are affected in ASD, ADHD, and dyslexia, and these cerebellar regions participate in functional networks that are consistent with the characteristic symptoms of each disorder.
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25
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Cerebellar morphology and the effects of stimulant medications in youths with attention deficit-hyperactivity disorder. Neuropsychopharmacology 2014; 39:718-26. [PMID: 24077064 PMCID: PMC3895250 DOI: 10.1038/npp.2013.257] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/30/2013] [Accepted: 08/21/2013] [Indexed: 11/08/2022]
Abstract
The cerebellum is emerging as a key anatomical structure underlying normal attentional and cognitive control mechanisms. Dysregulation within cerebellar circuits may contribute to the core symptoms of Attention Deficit/Hyperactivity Disorder (ADHD). In the present study we aimed to characterize surface morphological features of the cerebellum in ADHD and healthy comparison youths. Further, we studied the association of cerebellar morphology with the severity of ADHD symptoms and the effects of stimulant treatment. We examined 46 youths with ADHD and 59 comparison youths 8-18 years of age in a cross-sectional, case-control study using magnetic resonance imaging. Measures of cerebellar surface morphology were the primary outcome. Relative to comparison participants, youths with ADHD exhibited smaller regional volumes corresponding to the lateral surface of the left anterior and the right posterior cerebellar hemispheres. Stimulant medication was associated with larger regional volumes over the left cerebellar surface, whereas more severe ADHD symptoms were associated with smaller regional volumes in the vermis. We used optimized measures of morphology to detect alterations in cerebellar anatomy specific to ADHD, dimensions of symptomology, and stimulant treatment. Duration of treatment correlated positively with volumes of specific cerebellar subregions, supporting a model whereby compensatory morphological changes support the effects of stimulant treatment.
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Kadis DS, Goshulak D, Namasivayam A, Pukonen M, Kroll R, De Nil LF, Pang EW, Lerch JP. Cortical thickness in children receiving intensive therapy for idiopathic apraxia of speech. Brain Topogr 2013; 27:240-7. [PMID: 23974724 PMCID: PMC3921462 DOI: 10.1007/s10548-013-0308-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 08/10/2013] [Indexed: 11/30/2022]
Abstract
Children with idiopathic apraxia experience difficulties planning the movements necessary for intelligible speech. There is increasing evidence that targeted early interventions, such as Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT), can be effective in treating these disorders. In this study, we investigate possible cortical thickness correlates of idiopathic apraxia of speech in childhood, and changes associated with participation in an 8-week block of PROMPT therapy. We found that children with idiopathic apraxia (n = 11), aged 3–6 years, had significantly thicker left supramarginal gyri than a group of typically-developing age-matched controls (n = 11), t(20) = 2.84, p ≤ 0.05. Over the course of therapy, the children with apraxia (n = 9) experienced significant thinning of the left posterior superior temporal gyrus (canonical Wernicke’s area), t(8) = 2.42, p ≤ 0.05. This is the first study to demonstrate experience-dependent structural plasticity in children receiving therapy for speech sound disorders.
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Affiliation(s)
- Darren S Kadis
- Division of Neurology, Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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27
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Raz N, Schmiedek F, Rodrigue KM, Kennedy KM, Lindenberger U, Lövdén M. Differential brain shrinkage over 6 months shows limited association with cognitive practice. Brain Cogn 2013; 82:171-80. [PMID: 23665948 DOI: 10.1016/j.bandc.2013.04.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 11/16/2022]
Abstract
The brain shrinks with age, but the timing of this process and the extent of its malleability are unclear. We measured changes in regional brain volumes in younger (age 20-31) and older (age 65-80) adults twice over a 6 month period, and examined the association between changes in volume, history of hypertension, and cognitive training. Between two MRI scans, 49 participants underwent intensive practice in three cognitive domains for 100 consecutive days, whereas 23 control group members performed no laboratory cognitive tasks. Regional volumes of seven brain structures were measured manually and adjusted for intracranial volume. We observed significant mean shrinkage in the lateral prefrontal cortex, the hippocampus, the caudate nucleus, and the cerebellum, but no reliable mean change of the prefrontal white matter, orbital-frontal cortex, and the primary visual cortex. Individual differences in change were reliable in all regions. History of hypertension was associated with greater cerebellar shrinkage. The cerebellum was the only region in which significantly reduced shrinkage was apparent in the experimental group after completion of cognitive training. Thus, in healthy adults, differential brain shrinkage can be observed in a narrow time window, vascular risk may aggravate it, and intensive cognitive activity may have a limited effect on it.
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Affiliation(s)
- Naftali Raz
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA.
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28
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Current World Literature. Curr Opin Support Palliat Care 2013; 7:116-28. [DOI: 10.1097/spc.0b013e32835e749d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Hoekzema E, Carmona S, Ramos-Quiroga JA, Richarte Fernández V, Picado M, Bosch R, Soliva JC, Rovira M, Vives Y, Bulbena A, Tobeña A, Casas M, Vilarroya O. Laminar thickness alterations in the fronto-parietal cortical mantle of patients with attention-deficit/hyperactivity disorder. PLoS One 2012; 7:e48286. [PMID: 23239964 PMCID: PMC3519773 DOI: 10.1371/journal.pone.0048286] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 09/24/2012] [Indexed: 11/18/2022] Open
Abstract
Although Attention-Deficit/Hyperactivity Disorder (ADHD) was initially regarded as a disorder exclusive to childhood, nowadays its prevalence in adulthood is well established. The development of novel techniques for quantifying the thickness of the cerebral mantle allows the further exploration of the neuroanatomical profiles underlying the child and adult form of the disorder. To examine the cortical mantle in children and adults with ADHD, we applied a vertex-wise analysis of cortical thickness to anatomical brain MRI scans acquired from children with (n = 43) and without ADHD (n = 41), as well as a group of adult neurotypical individuals (n = 31), adult patients with a history of stimulant treatment (n = 31) and medication-naïve adults with ADHD (n = 24). We observed several clusters of reduced laminar cortical thickness in ADHD patients in comparison to neurotypical individuals. These differences were primarily located in the dorsal attention network, including the bilateral inferior and superior parietal cortex and a section of the frontal cortex (centered on the superior frontal and precentral gyrus bilaterally). Further laminar thickness deficits were observed in the bilateral orbitofrontal cortex and medial occipital cortex. The deficits in the cortical surface were especially pronounced in the child sample, while adult patients showed a more typical laminar thickness across the cerebral mantle. These findings show that the neuroanatomical profile of ADHD, especially the childhood form of the disorder, involves robust alterations in the cortical mantle, which are most prominent in brain regions subserving attentional processing.
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Affiliation(s)
- Elseline Hoekzema
- Unitat de Recerca en Neurociència Cognitiva, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain.
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Rothenberger A, Rothenberger LG. Updates on treatment of attention-deficit/hyperactivity disorder: facts, comments, and ethical considerations. Curr Treat Options Neurol 2012; 14:594-607. [PMID: 22968494 PMCID: PMC3501189 DOI: 10.1007/s11940-012-0197-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OPINION STATEMENT Within the last 2 years the bulk of information on evidence based treatments in ADHD was reviewed quite intensively and new empirical studies could be added. This update reports comprehensively about actual and essential facts in the field related to brain development and sensitive periods, predictors of treatment, safety of medication, value of naturalistic studies, new drugs and complementary medicine, behavioral interventions including neurofeedback and psychosocial treatment, treatment of comorbidity, and ethical considerations including preventive aspects. The updated combination of well selected evidence based treatments (ie, pharma plus non-pharma) seems to be clinically and ethically recommended as also suggested by the European and American guidelines on ADHD.
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Affiliation(s)
- Aribert Rothenberger
- Child and Adolescent Psychiatry, University Medicine Göttingen, von-Siebold-Str. 5, 37075, Göttingen, Germany,
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Tamm L, Epstein JN, Peugh JL, Nakonezny PA, Hughes CW. Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD. Dev Cogn Neurosci 2012; 4:16-28. [PMID: 23219490 DOI: 10.1016/j.dcn.2012.11.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 10/01/2012] [Accepted: 11/03/2012] [Indexed: 11/30/2022] Open
Abstract
A pilot randomized clinical trial was conducted to examine the initial efficacy of Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). After a diagnostic and baseline evaluation, school-aged children with ADHD were randomized to receive 16 bi-weekly sessions of Pay Attention! (n=54) or to a waitlist control group (n=51). Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation. Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms, child self-report of ability to focus, and parent ratings of executive functioning. Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency, but no treatment effects were observed on other neuropsychological outcomes. Treatment effects were also not observed for teacher ratings of ADHD. These data add to a growing body of literature supporting effects of cognitive training on attention and behavior, however, additional research is warranted.
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Affiliation(s)
- Leanne Tamm
- CCHMC, 3333 Burnet Avenue, ML 10006, Cincinnati, OH 45229, USA.
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32
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Cortese S, Castellanos FX. Neuroimaging of attention-deficit/hyperactivity disorder: current neuroscience-informed perspectives for clinicians. Curr Psychiatry Rep 2012; 14:568-78. [PMID: 22851201 PMCID: PMC3876939 DOI: 10.1007/s11920-012-0310-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The neuroimaging literature on attention-deficit/hyperactivity disorder (ADHD) is growing rapidly. Here, we provide a critical overview of neuroimaging studies published recently, highlighting perspectives that may be of relevance for clinicians. After a comprehensive search of PubMed, Ovid, Web of Science, and EMBASE, we located 41 pertinent papers published between January 2011 and April 2012, comprising both structural and functional neuroimaging studies. This literature is increasingly contributing to the notion that the pathophysiology of ADHD reflects abnormal interplay among large-scale brain circuits. Moreover, recent studies have begun to reveal the mechanisms of action of pharmacological treatment. Finally, imaging studies with a developmental perspective are revealing the brain correlates of ADHD over the lifespan, complementing clinical observations on the phenotypic continuity and discontinuity of the disorder. However, despite the increasing potential to eventually inform clinical practice, current imaging studies do not have validated applications in day-to-day clinical practice. Although novel analytical techniques are likely to accelerate the pace of translational applications, at the present we advise caution regarding inappropriate commercial misuse of imaging techniques in ADHD.
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Affiliation(s)
- Samuele Cortese
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA.
| | - F. Xavier Castellanos
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, New York, NY, USA
,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know. Eur J Paediatr Neurol 2012; 16:422-33. [PMID: 22306277 DOI: 10.1016/j.ejpn.2012.01.009] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 12/18/2011] [Accepted: 01/12/2012] [Indexed: 01/07/2023]
Abstract
This review, addressed mainly to clinicians, considers commonly asked questions related to the neuroimaging, neurophysiology, neurochemistry and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD). It provides answers based on the most recent meta-analyses and systematic reviews, as well as additional relevant original studies. Empirical findings from neurobiological research into ADHD reflect a shift in the conceptualisation of this disorder from simple theoretical views of a few isolated dysfunctions to more complex models integrating the heterogeneity of the clinical manifestations of ADHD. Thus, findings from structural and functional neuroimaging suggest the involvement of developmentally abnormal brain networks related to cognition, attention, emotion and sensorimotor functions. Brain functioning alterations are confirmed by neurophysiological findings, showing that individuals with ADHD have elevated theta/beta power ratios, and less pronounced responses and longer latencies of event-related potentials, compared with controls. At a molecular level, alterations in any single neurotransmitter system are unlikely to explain the complexity of ADHD; rather, the disorder has been linked to dysfunctions in several systems, including the dopaminergic, adrenergic, serotoninergic and cholinergic pathways. Genetic studies showing a heritability of ∼60-75% suggest that a plethora of genes, each one with a small but significant effect, interact with environmental factors to increase the susceptibility to ADHD. Currently, findings from neurobiological research do not have a direct application in daily clinical practice, but it is hoped that in the near future they will complement the diagnostic process and contribute to the long-term effective treatment of this impairing condition.
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Rutledge KJ, van den Bos W, McClure SM, Schweitzer JB. Training cognition in ADHD: current findings, borrowed concepts, and future directions. Neurotherapeutics 2012; 9:542-58. [PMID: 22911054 PMCID: PMC3441933 DOI: 10.1007/s13311-012-0134-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
With both its high prevalence and myriad of negative outcomes, Attention-Deficit/Hyperactivity Disorder (ADHD) demands a careful consideration of the efficacy of its treatment options. Although the benefits of medication have a robust empirical background, nonpharmaceutical interventions evoke particular interest, as they are often viewed more favorably by parents. This review pays special attention to the use of working memory and recent cognitive training attempts in ADHD, describing its cognitive, behavioral, and biological effects in relation to current neurological theory of the disorder. While these treatments have demonstrated positive effects on some measures, there are limitations, as studies have failed to demonstrate generalization to critical measures, such as teacher-rated classroom behaviors, and have provided limited but growing evidence of functionally significant improvements in behavior. There is also a clear lack of research on the effects of training on reward systems and self-control. These limitations may be addressed by broadening the scope and procedures of the training and incorporating research concepts from other fields of study. First, it is important to consider the developmental trajectories of brain regions in individuals with the disorder, as they may relate to the effectiveness of cognitive training. Notions from behavioral economics, including delay discounting and framing (i.e., context) manipulations that influence present orientation, also have applications in the study of cognitive training in ADHD. In considering these other domains, we may find new ways to conceptualize and enhance cognitive training in ADHD and, in turn, address current limitations of interventions that fall in this category.
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Affiliation(s)
- Kyle J. Rutledge
- Department of Human and Community Development, University of California, Davis, Davis, CA 95616 USA
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis School of Medicine, Sacramento, CA 95817 USA
| | | | - Samuel M. McClure
- Department of Psychology, Stanford University, Stanford, CA 94305 USA
| | - Julie B. Schweitzer
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis School of Medicine, Sacramento, CA 95817 USA
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Halperin JM, Bédard ACV, Curchack-Lichtin JT. Preventive interventions for ADHD: a neurodevelopmental perspective. Neurotherapeutics 2012; 9:531-41. [PMID: 22692794 PMCID: PMC3441940 DOI: 10.1007/s13311-012-0123-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
It is proposed that the time is ripe for the development of secondary preventive interventions for attention-deficit/hyperactivity disorder (ADHD). By targeting preschool children, a developmental stage during which ADHD symptoms first become evident in most children with the disorder, many of the adverse long-term consequences that typify the trajectory of ADHD may be avoided. A dynamic/interactive model of the biological and environmental factors that contribute to the emergence and persistence of ADHD throughout the lifespan is proposed. Based on this model, it is argued that environmental influences and physical exercise can be used to enhance neural growth and development, which in turn should have an enduring and long-term impact on the trajectory of ADHD. Central to this notion are 2 hypotheses: 1) environmental influences can facilitate structural and functional brain development, and 2) changes in brain structure and function are directly related to ADHD severity over the course of development and the degree to which the disorder persists or remits with time. We present experimental and correlational data supporting the first hypothesis and longitudinal data in individuals with ADHD supporting the second. The case is made for initiating such an intervention during the preschool years, when the brain is likely to be more "plastic" and perhaps susceptible to lasting modifications, and before complicating factors, such as comorbid psychiatric disorders, academic failure, and poor social and family relationships emerge, making successful treatment more difficult. Finally, we review recent studies in young children with ADHD that might fall under the umbrella of secondary prevention.
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Affiliation(s)
- Jeffrey M Halperin
- Department of Psychology, Queens College of the City University of New York, Flushing, New York 11367, USA.
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Gryga M, Taubert M, Dukart J, Vollmann H, Conde V, Sehm B, Villringer A, Ragert P. Bidirectional gray matter changes after complex motor skill learning. Front Syst Neurosci 2012; 6:37. [PMID: 22623914 PMCID: PMC3353266 DOI: 10.3389/fnsys.2012.00037] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 05/02/2012] [Indexed: 11/13/2022] Open
Abstract
Long-term motor skill learning has been consistently shown to result in functional as well as structural changes in the adult human brain. However, the effect of short learning periods on brain structure is not well understood. In the present study, subjects performed a sequential pinch force task (SPFT) for 20 min on 5 consecutive days. Changes in brain structure were evaluated with anatomical magnetic resonance imaging (MRI) scans acquired on the first and last day of motor skill learning. Behaviorally, the SPFT resulted in sequence-specific learning with the trained (right) hand. Structural gray matter (GM) alterations in left M1, right ventral premotor cortex (PMC) and right dorsolateral prefrontal cortex (DLPFC) correlated with performance improvements in the SPFT. More specifically we found that subjects with strong sequence-specific performance improvements in the SPFT also had larger increases in GM volume in the respective brain areas. On the other hand, subjects with small behavioral gains either showed no change or even a decrease in GM volume during the time course of learning. Furthermore, cerebellar GM volume before motor skill learning predicted (A) individual learning-related changes in the SPFT and (B) the amount of structural changes in left M1, right ventral PMC and DLPFC. In summary, we provide novel evidence that short-term motor skill learning is associated with learning-related structural brain alterations. Additionally, we showed that practicing a motor skill is not exclusively accompanied by increased GM volume. Instead, bidirectional structural alterations explained the variability of the individual learning success.
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Affiliation(s)
- Martin Gryga
- Department of Neurology and Clinic for Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, University Hospital Leipzig Leipzig, Germany
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Cortese S, Faraone SV, Sergeant J. Misunderstandings of the genetics and neurobiology of ADHD: moving beyond anachronisms. Am J Med Genet B Neuropsychiatr Genet 2011; 156B:513-6. [PMID: 21618423 DOI: 10.1002/ajmg.b.31207] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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