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Lee U, Oh KS, Shin YC, Jeon SW, Cho SJ, Kim J, Kim ES, Lee MY, Moon S, Kim EJ, Shin D. Association between intra-individual variability and prefrontal cortex activity measured by functional Near Infrared Spectroscopy (fNIRS) in children with ADHD. Child Neuropsychol 2024:1-10. [PMID: 38781441 DOI: 10.1080/09297049.2024.2357380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
This study uses fNIRS to determine whether there is a difference in the relationship between intra-individual variability and frontal lobe activity between ADHD patients and typically developing children. A total of 28 subjects (14 in ADHD patient group and 14 in control group) participated in this study. The subjects were tested for K-SADS and intelligence, and then the frontal lobe activity of the subjects was measured by continuous performance test, using functional near-infrared spectroscopy (NIRSIT). Processing speed index was significantly lower in the ADHD patient group than in the control group (p = .04). The CPT test results showed a positive correlation in the activity of the right dorsolateral prefrontal region in the patient group, but not at a statistically significant level. In the control group, activity showed a significant level of negative correlation with commission and hit reaction time standard deviation (p = .023; p = .063 respectively). In contrary to ADHD patient group, activation of the right dorsolateral prefrontal area was significantly correlated with reduction of intra-individual variability. This result showing that the relationship between activation of the right dorsolateral prefrontal area of the ADHD patient group and intra-individual variability shows a different pattern from typically developing children.
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Affiliation(s)
- Ung Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kang-Seob Oh
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Junhyung Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Soo Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Suhyeon Moon
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Eun-Ji Kim
- Department of Psychiatry, Todak Clinic, Seoul, Republic of Korea
| | - Dongwon Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Navarro-Soria I, Rico-Juan JR, Juárez-Ruiz de Mier R, Lavigne-Cervan R. Prediction of attention deficit hyperactivity disorder based on explainable artificial intelligence. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-14. [PMID: 38593762 DOI: 10.1080/21622965.2024.2336019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Accurate assessment of Attention Deficit Hyperactivity Disorder (ADHD) is crucial for the effective treatment of affected individuals. Traditionally, psychometric tests such as the WISC-IV have been utilized to gather evidence and identify patterns or factors contributing to ADHD diagnosis. However, in recent years, the use of machine learning (ML) models in conjunction with post-hoc eXplainable Artificial Intelligence (XAI) techniques has improved our ability to make precise predictions and provide transparent explanations. The objective of this study is twofold: firstly, to predict the likelihood of an individual receiving an ADHD diagnosis using ML algorithms, and secondly, to offer interpretable insights into the decision-making process of the ML model. The dataset under scrutiny comprises 694 cases collected over the past decade in Spain, including information on age, gender, and WISC-IV test scores. The outcome variable is the professional diagnosis. Diverse ML algorithms representing various learning styles were rigorously evaluated through a stratified 10-fold cross-validation, with performance assessed using key metrics, including accuracy, area under the receiver operating characteristic curve, sensitivity, and specificity. Models were compared using both the full set of initial features and a well-suited wrapper-type feature selection algorithm (Boruta). Following the identification of the most suitable model, Shapley additive values were computed to assign weights to each predictor based on their additive contribution to the outcome and to elucidate the predictions. Strikingly, a reduced set of 8 out of the initial 20 variables produced results comparable to using the full feature set. Among the ML models tested, the Random Forest algorithm outperformed others on most metrics (ACC = 0.90, AUC = 0.94, Sensitivity = 0.91, Specificity = 0.92). Notably, the principal predictors, ranked by importance, included GAI - CPI, WMI, CPI, PSI, VCI, WMI - PSI, PRI, and LN. Individual case examples exhibit variations in predictions depending on unique characteristics, including instances of false positives and negatives. Our ML model adeptly predicted ADHD diagnoses in 90% of cases, with potential for further enhancement by expanding our database. Furthermore, the use of XAI techniques enables the elucidation of salient factors in individual cases, thereby aiding inexperienced professionals in the diagnostic process and facilitating comparison with expert assessments. It is important to note that this tool is designed to support the ADHD diagnostic process, where the medical professional always has the final say in decision-making.
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Affiliation(s)
- Ignasi Navarro-Soria
- Department of Developmental and Educational Psychology, University of Alicante, San Vicente, Spain
| | - Juan Ramón Rico-Juan
- Department of Software and Computing Systems, University of Alicante, San Vicente, Spain
| | | | - Rocío Lavigne-Cervan
- Department of Developmental and Educational Psychology, University of Malaga, Malaga, Spain
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3
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Moore AR, Olson M. Sense of time is slower following exhaustive cycling exercise. PSYCHOLOGICAL RESEARCH 2024; 88:826-836. [PMID: 38200373 DOI: 10.1007/s00426-023-01914-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024]
Abstract
Subjective perception of time is altered during vigorous exercise. This could be due in part to the fatigue associated with physical activity at high intensities. The aim of this study was to determine the effect of fatigue, specifically, on subjective time perception. Twenty-six healthy, untrained subjects (17 men/9 women; age = 26.0 ± 4.3 years;V ˙ O 2 peak = 38.13 ± 5.62 mL/kg/min) completed a maximal aerobic exercise test on a cycle ergometer. Time perception was assessed before (PRE) and after (POST) the exercise test using a time production task wherein subjects started a stopwatch and stopped it once they believed a designated time period had passed. This time produced with the stopwatch was the estimate of the target time that was compared to the target time interval. Relative error of the timing task was significantly higher for POST (0.112 ± 0.260) than for PRE (0.028 ± 0.173), p = .032, η2 = .178. Subjects produced ~ 8.4% more time than the target intervals when fatigued, which is indicative of a slower sense of time perception. A shift in attentional focus from timing to the sensations associated with fatigue is a possible factor to explain this result. Future studies which investigate the effects of exercise on time perception should consider the impact of fatigue experienced during exercise.
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Affiliation(s)
- Andrew R Moore
- Department of Kinesiology, Augusta University, 1120 15th Street, CFH-134, Augusta, GA, 30909, USA.
| | - Maddie Olson
- Department of Physical Therapy, Brenau University, Gainesville, GA, USA
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Conte G, Costanza C, Novelli M, Scarselli V, Arigliani E, Valente F, Baglioni V, Terrinoni A, Chiarotti F, Cardona F. Comorbidities and Disease Duration in Tourette Syndrome: Impact on Cognition and Quality of Life of Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:226. [PMID: 38397337 PMCID: PMC10887127 DOI: 10.3390/children11020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/01/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Cognitive functions represent foundational factors for mental health and quality of life (QoL). In Tourette syndrome (TS), psychiatric comorbidities are common and have been inconsistently reported to affect the cognition and QoL of patients, while the role of tic disorder duration has not been yet explored. METHODS To examine how comorbidities and TS duration may influence cognition and QoL, N = 80 children with TS (6-16 years) were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV). Standardized questionnaires were used to assess the presence and severity of TS main comorbidities and QoL. Data were interpreted using linear correlations, regression, and mediation analysis. RESULTS Depression and attention-deficit/hyperactivity disorder (ADHD) symptoms accounted for poorer cognitive performance. Anxiety oppositely predicted better cognitive performance, while no significant role for obsessive compulsive disorder (OCD) was observed. Disease duration was associated with lower total IQ, verbal reasoning, and working memory abilities. Depression, anxiety, and TS duration also deeply influenced QoL measures. CONCLUSIONS TS common comorbidities have a differential impact on the cognitive abilities of children and adolescents, which translates into a complex influence on their perceived QoL. A longer clinical history of tics was related to worse cognitive outcomes, which prompts further consideration of disease duration in both clinical and research settings involving children and adolescents.
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Affiliation(s)
- Giulia Conte
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Carola Costanza
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, 90128 Palermo, Italy;
| | - Maria Novelli
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Veronica Scarselli
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Elena Arigliani
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Francesca Valente
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Valentina Baglioni
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Arianna Terrinoni
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
| | - Flavia Chiarotti
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Francesco Cardona
- Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (M.N.); (V.S.); (E.A.); (F.V.); (V.B.); (A.T.)
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5
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Moradi N, Rajabi S, Mansouri Nejad A. The effect of neurofeedback training combined with computer cognitive games on the time perception, attention, and working memory in children with ADHD. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:24-36. [PMID: 36002025 DOI: 10.1080/21622965.2022.2112679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the effect of neurofeedback (NF) based on quantitative electroencephalography (QEEG) and SmartMind game on the time perception, attention, and working memory of children with Attention Deficit/Hyperactivity Disorder (ADHD) through an experimental design. METHOD Using a purposive sampling method, 32 male students diagnosed with ADHD were selected and then randomly assigned to an experimental group and a control group. The experimental group received the treatment (NF + SmartMind) for 30 weekly sessions. Children's performances on a time perception test, a Continuous Performance Test (CPT), and a Wechsler working memory test (WISC) were examined before and after the intervention. RESULTS A significant difference was observed between the mean scores of the pretest and post-test for the experimental group, implying that NF training improved short-time perception and long-time perception attention in CPT test: omission error component, Correct Response component, and working memory: Visual forward component. However, the treatment did not have a significant effect on the commission error component (CPT), working memory in terms of the visual reverse, auditory reverse, and auditory forward components. CONCLUSION NF combined with computer cognitive games (CCGs) can improve time perception, attention, and working memory in children with ADHD.
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Affiliation(s)
| | | | - Ali Mansouri Nejad
- Department of English Language Teaching, Farhangian University, Tehran, Iran
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Hinault T, D'Argembeau A, Bowler DM, La Corte V, Desaunay P, Provasi J, Platel H, Tran The J, Charretier L, Giersch A, Droit-Volet S. Time processing in neurological and psychiatric conditions. Neurosci Biobehav Rev 2023; 154:105430. [PMID: 37871780 DOI: 10.1016/j.neubiorev.2023.105430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/25/2023]
Abstract
A central question in understanding cognition and pathology-related cognitive changes is how we process time. However, time processing difficulties across several neurological and psychiatric conditions remain seldom investigated. The aim of this review is to develop a unifying taxonomy of time processing, and a neuropsychological perspective on temporal difficulties. Four main temporal judgments are discussed: duration processing, simultaneity and synchrony, passage of time, and mental time travel. We present an integrated theoretical framework of timing difficulties across psychiatric and neurological conditions based on selected patient populations. This framework provides new mechanistic insights on both (a) the processes involved in each temporal judgement, and (b) temporal difficulties across pathologies. By identifying underlying transdiagnostic time-processing mechanisms, this framework opens fruitful avenues for future research.
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Affiliation(s)
- Thomas Hinault
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032 Caen, France.
| | - Arnaud D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, F.R.S-FNRS, 4000 Liège, Belgium
| | - Dermot M Bowler
- Autism Research Group, City, University of London, EC1V 0HB London, United Kingdom
| | - Valentina La Corte
- Laboratoire Mémoire, Cerveau et Cognition (MC2Lab), UR 7536, Université de Paris cité, 92774 Boulogne-Billancourt, France; Institut Universitaire de France, 75231 Paris, France
| | - Pierre Desaunay
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032 Caen, France; Service de Psychiatrie de l'enfant et de l'adolescent, CHU de Caen, 14000 Caen, France
| | - Joelle Provasi
- CHArt laboratory (Human and Artificial Cognition), EPHE-PSL, 75014 Paris, France
| | - Hervé Platel
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032 Caen, France
| | - Jessica Tran The
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032 Caen, France
| | - Laura Charretier
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032 Caen, France
| | - Anne Giersch
- Cognitive Neuropsychology and Pathophysiology of Schizophrenia Laboratory, National Institute of Health and Medical Research, University of Strasbourg, 67081 Strasbourg, France
| | - Sylvie Droit-Volet
- Université Clermont Auvergne, LAPSCO, CNRS, UMR 6024, 60032 Clermont-Ferrand, France
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Morelli F, Catalano G, Scognamillo I, Balzarotti N, Luparia A, Olivier L, Bertone C, Gori M, Signorini S. Visual Function and Neuropsychological Profiling of Idiopathic Infantile Nystagmus. Brain Sci 2023; 13:1348. [PMID: 37759948 PMCID: PMC10526276 DOI: 10.3390/brainsci13091348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Though considered a benign condition, idiopathic infantile nystagmus (IIN) may be associated with decreased visual acuity and oculo-motor abnormalities, resulting in developmental delays and poor academic performance. Nevertheless, the specific visual function profile of IIN and its possible impact on neuropsychological development have been poorly investigated. To fill this gap, we retrospectively collected the clinical data of 60 children presenting with IIN over a 10-year period (43 male; mean age of 7 years, range of 2 months-17 years, 9 months). The majority of the subjects in our cohort presented with reduced visual acuity for far distances and normal visual acuity for near distances, associated with oculo-motor abnormalities. The overall scores of cognitive and visual-cognitive tests were in the normal range, but revealed peculiar cognitive and visual-cognitive profiles, defined by specific frailties in processing speed and visual-motor integration. The same neuropsychological profiles characterize many neurodevelopmental disorders and may express a transnosographic vulnerability of the dorsal stream. As the first study to explore the neuropsychologic competencies in children with IIN, our study unveils the presence of subclinical frailties that need to be addressed to sustain academic and social inclusion.
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Affiliation(s)
- Federica Morelli
- Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy; (F.M.); (I.S.)
- Developmental Neuro-Ophthalmology Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (A.L.); (L.O.); (S.S.)
| | - Guido Catalano
- Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy; (F.M.); (I.S.)
| | - Ilaria Scognamillo
- Department of Brain and Behavioral Sciences, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy; (F.M.); (I.S.)
| | - Nicolò Balzarotti
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Via Enrico Melen 82, 16100 Genova, Italy; (N.B.); (M.G.)
| | - Antonella Luparia
- Developmental Neuro-Ophthalmology Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (A.L.); (L.O.); (S.S.)
| | - Lucrezia Olivier
- Developmental Neuro-Ophthalmology Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (A.L.); (L.O.); (S.S.)
| | - Chiara Bertone
- Department of Surgical and Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy;
| | - Monica Gori
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Via Enrico Melen 82, 16100 Genova, Italy; (N.B.); (M.G.)
| | - Sabrina Signorini
- Developmental Neuro-Ophthalmology Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; (A.L.); (L.O.); (S.S.)
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Zhou Q, Ye X, Wei C, Wu Y, Ren P, Lin X, Li L, Xiang W, Xiao L. Network Analysis of ADHD Symptoms and Cognitive Profiles in Children. Neuropsychiatr Dis Treat 2023; 19:1207-1219. [PMID: 37223654 PMCID: PMC10202214 DOI: 10.2147/ndt.s409503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose Although many studies have reported the cognitive profiles in attention-deficit/hyperactivity disorder (ADHD), the interactions between ADHD symptoms and the patients' cognitive profiles have not been carefully examined through the network analysis. Here, in this study, we systematically analyzed the ADHD patents' symptoms and cognitive profiles, and identified a set of interactions between ADHD symptoms and cognitive domains using the network approach. Patients and Methods A total of 146 children with ADHD, 6 to 15 years of age, were included in the study. All participants were assessed by the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) test. The patients' ADHD symptoms were evaluated by the Vanderbilt ADHD parent and teacher rating scales. GraphPad Prism 9.1.1 software was used for descriptive statistics and R 4.2.2 was used for network model construction. Results The ADHD children in our sample showed lower scores for full scale intelligence quotient (FSIQ), verbal comprehension index (VCI), processing speed index (PSI) and working memory index (WMI). Among all the ADHD core symptoms and comorbid symptoms, the academic ability, inattention symptoms and mood disorder showed direct interaction with the cognitive domains of WISC-IV. In addition, oppositional defiant of the ADHD comorbid symptoms, and perceptual reasoning of the cognitive domains exhibited the highest strength centrality in the ADHD-Cognition network based on parent ratings. Classroom behaviors of the ADHD functional impairment, and verbal comprehension of the cognitive domains exhibited the highest strength centrality in the network based on teacher ratings. Conclusion We highlighted the importance of considering the interactions between the ADHD symptoms and cognitive properties when designing the intervention plans for the ADHD children.
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Affiliation(s)
- Qionglin Zhou
- Hainan Medical University, Haikou, People’s Republic of China
| | - Xiaoshan Ye
- Hainan Medical University, Haikou, People’s Republic of China
| | - Chongxia Wei
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Yufan Wu
- Hainan Medical University, Haikou, People’s Republic of China
| | - Pengcheng Ren
- Hainan Medical University, Haikou, People’s Republic of China
| | - Xuewei Lin
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Ling Li
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Wei Xiang
- Hainan Medical University, Haikou, People’s Republic of China
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
| | - Le Xiao
- Hainan Medical University, Haikou, People’s Republic of China
- Hainan Women and Children’s Medical Center, Haikou, People’s Republic of China
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9
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Fasano A, Biancardi C, Masi G, Della Vecchia S, Frumento P, Mazzoni A, Falotico E, Faraguna U, Sicca F. Maximum downward slope of sleep slow waves as a potential marker of attention-deficit/hyperactivity disorder clinical phenotypes. J Psychiatr Res 2022; 156:679-689. [PMID: 36399860 DOI: 10.1016/j.jpsychires.2022.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/25/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly heterogeneous diagnostic category, encompassing several endophenotypes and comorbidities, including sleep problems. However, no predictor of clinical long-term trajectories or comorbidity has yet been established. Sleep EEG has been proposed as a potential tool for evaluating the synaptic strength during development, as well as the cortical thickness, which is presumed to be altered in ADHD. We investigated whether the slope of the Slow Waves (SWs), a microstructural parameter of the sleep EEG, was a potential predictive parameter for psychiatric comorbidities and neuropsychological dimensions in ADHD. METHODS 70 children (58 m; 8.76 ± 2.77 y) with ADHD who underwent psychiatric and neurologic evaluations and a standard EEG recording during naps were investigated. After sleep EEG analysis, we grouped the extracted SWs in bins of equal amplitude and then measured the associations, through generalized linear regression, between their maximum downward slopes (MDS) and the individual scores obtained from clinical rating scales. RESULTS The presence of Multiple Anxiety Disorders was positively associated with MDS of medium amplitude SWs in temporo-posterior left areas. The Child Behavior Checklist scores showed negative associations in the same areas for small SWs. The presence of autistic traits was positively associated with MDS of high amplitude SWs in bilateral anterior and temporal left areas. The WISC-IV Processing Speed Index showed negative associations with MDS of small-to-medium SWs in anterior and temporal right areas, while positive associations in posterior and temporal left areas. CONCLUSIONS Consistency of association clusters' localization on the scalp suggests that variations in the local MDS, revealing alterations of local synaptic strength and/or in daytime use of certain cortical circuits, could underlie specific neurodevelopmental trajectories resulting in different ADHD clinical phenotypes.
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Affiliation(s)
- Alessio Fasano
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Carlo Biancardi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
| | - Gabriele Masi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | | | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Egidio Falotico
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ugo Faraguna
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federico Sicca
- Child and Adolescent Epilepsy and Clinical Neurophysiology Departmental Unit, USL Centro Toscana, 59100, Prato, Italy
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10
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Zheng Q, Cheng YY, Sonuga-Barke E, Shum KKM. Do Executive Dysfunction, Delay Aversion, and Time Perception Deficit Predict ADHD Symptoms and Early Academic Performance in Preschoolers. Res Child Adolesc Psychopathol 2022; 50:1381-1397. [PMID: 35689730 PMCID: PMC9187895 DOI: 10.1007/s10802-022-00937-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/19/2022]
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) are commonly observed to have learning difficulties. This study examined how three neuropsychological constructs—executive dysfunction, delay aversion, and time perception—were associated with ADHD symptoms and early academic performance in preschoolers at risk of ADHD. One hundred and thirty-one preschoolers (70 boys, 53%) aged 4 to 6 (M = 5.31 years) were assessed on their ADHD-related behaviors, neuropsychological functioning, word reading, and math abilities at two time points one year apart. Factor analysis indicated that inhibitory and attentional control deficit, delay aversion, and time perception/working memory deficit were three dissociable factors. Among the three factors, inhibitory and attentional control measured at Time 1 was the strongest predictor of ADHD symptoms at both Time 1 and Time 2. Time perception was closely related to working memory, and they predicted word reading and numeration across time most strongly among other neuropsychological constructs. Our findings suggested that inhibitory and attentional control, delay aversion, and time perception are dissociable neuropsychological deficits underlying ADHD symptoms in preschoolers. Poor time perception may serve as a marker for the early identification of preschoolers with potential learning problems, and a possible target of intervention for ADHD.
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Affiliation(s)
- Que Zheng
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Yu Yan Cheng
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Edmund Sonuga-Barke
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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11
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Fabio RA, Andricciola F, Caprì T. Visual-motor attention in children with ADHD: The role of automatic and controlled processes. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 123:104193. [PMID: 35149332 DOI: 10.1016/j.ridd.2022.104193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND there are evidence that children with ADHD exhibit a deficit both in automatic and controlled processes. AIMS the present study aimed to examine the visual-motor attention and the influence of cognitive load through a dual task paradigm in children with ADHD compared with typical developing children (TD). METHODS AND PROCEDURES 113 children with ADHD: 40 with subtype inattentive (ADHD- I group), 16 with subtype hyperactive (ADHD-H group), 57 with subtype combined (ADHD-C group), and 113 TD children (TD group) were recruited. We used a dual-task paradigm in which the primary task was a figure-tracing test whereas the second task was a digit span test. A figure-tracing test was used to evaluate visual motor attention. Based on the length and intersection of the lines, the figures of the primary task were categorized into simple and complex. OUTCOMES AND RESULTS the ADHD groups compared to the TD group showed a worse accuracy of performance in both condition with and without cognitive load. CONCLUSIONS AND IMPLICATIONS The findings were discussed in light of the relationship between automatic and controlled processes involved in the visual-motor attention.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
| | - Federica Andricciola
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
| | - Tindara Caprì
- Department of Life and Health Sciences, Link Campus University, Via del Casale di S. Pio V, 44, 00165, Rome, Italy; Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164, Messina, Italy.
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12
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Auditory time thresholds in the range of milliseconds but not seconds are impaired in ADHD. Sci Rep 2022; 12:1352. [PMID: 35079097 PMCID: PMC8789844 DOI: 10.1038/s41598-022-05425-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Abstract
The literature on time perception in individuals with ADHD is extensive but inconsistent, probably reflecting the use of different tasks and performances indexes. A sample of 40 children/adolescents (20 with ADHD, 20 neurotypical) was engaged in two identical psychophysical tasks measuring auditory time thresholds in the milliseconds (0.25–1 s) and seconds (0.75–3 s) ranges. Results showed a severe impairment in ADHD for milliseconds thresholds (Log10BF = 1.9). The deficit remained strong even when non-verbal IQ was regressed out and correlation with age suggests a developmental delay. In the seconds range, thresholds were indistinguishable between the two groups (Log10BF = − 0.5) and not correlated with milliseconds thresholds. Our results largely confirm previous evidence suggesting partially separate mechanisms for time perception in the ranges of milliseconds and seconds. Moreover, since the evidence suggests that time perception of milliseconds stimuli might load relatively less on cognitive control and working memory, compared to longer durations, the current results are consistent with a pure timing deficit in individuals with ADHD.
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13
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Zheng Q, Wang X, Chiu KY, Shum KKM. Time Perception Deficits in Children and Adolescents with ADHD: A Meta-analysis. J Atten Disord 2022; 26:267-281. [PMID: 33302769 DOI: 10.1177/1087054720978557] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Prior studies have reported time perception impairment in children and adolescents with ADHD but the results were inconsistent. METHOD The current meta-analysis reviews 27 empirical studies published in English after year 2000 that compared time perception competence among children and adolescents with and without ADHD. RESULTS Results from 1620 participants with ADHD and 1249 healthy controls showed significant timing deficits in ADHD. Children/adolescents with ADHD perceived time less accurately (Hedges' g > 0.40), less precisely (Hedges' g = 0.66) and had higher tendency to overestimate time than their healthy counterparts. Moderator analyses indicated that the discrepancy of time perception between groups was not affected by the type of timing tasks nor the modality of stimuli used in the tasks. Nonetheless, results were moderated by age and gender. CONCLUSION These findings may update current understanding of the underlying neuropsychological deficits in ADHD and provide insight for future research in clinical assessments and treatments for ADHD.
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Affiliation(s)
- Que Zheng
- The University of Hong Kong, Hong Kong
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14
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Walg M, Prior H. Prospective and Retrospective Verbal Time Estimationin Children with ADHD. Adv Cogn Psychol 2021; 17:212-220. [PMID: 38169477 PMCID: PMC10697718 DOI: 10.5709/acp-0330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
There is increasing evidence that timing deficits represent a primary cause of key symptoms in ADHD. However, results in experiments on timing may vary with different methods of assessing timing competencies. The present study directly compared two central paradigms, namely, prospective and retrospective time estimation in children with (n = 30) and without (n = 29) ADHD. In both conditions, durations were estimated considerably longer by children with ADHD. Children with ADHD significantly overestimated the real duration of the task compared to children without ADHD in the retrospective but not in the prospective condition. In general, prospective estimates were more accurate than retrospective ones. The findings corroborate the essential role that timing deficits and a faster internal clock play in ADHD. Furthermore, the results demonstrate the importance of careful differentiation between prospective and retrospective time estimation.
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Affiliation(s)
- Marco Walg
- Sana-Klinikum, Department for Child and Adolescent Psychiatry, Remscheid, Germany
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15
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Weissenberger S, Schonova K, Büttiker P, Fazio R, Vnukova M, Stefano GB, Ptacek R. Time Perception is a Focal Symptom of Attention-Deficit/Hyperactivity Disorder in Adults. Med Sci Monit 2021; 27:e933766. [PMID: 34272353 PMCID: PMC8293837 DOI: 10.12659/msm.933766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is classically associated with symptoms that include inattentiveness, hyperactivity, and impulsivity together with a variety of other observable externalized symptoms. ADHD has also been associated with specific internalized cognitive symptoms, including restlessness and emotional impulsivity. This disorder has been recognized as a lifelong condition and can be recognized by a variety of unique cognitive phenomena. In addition to the frequently ignored affective symptoms exhibited by individuals diagnosed with ADHD, problems with time perception have been noted, although these are considered to be secondary issues. Temporal shifts in cognitive processing, however, may be at the very root of ADHD-related symptoms, given the importance of coordinated signal translation in the construction of behavior. In this review, we consider the evidence that suggests that differences in time perception are a central symptom in adults with ADHD. Some of these differences include the feeling of time moving faster, which causes difficulties in prospective time tasks and inaccuracies in time estimation tasks. We analyze the literature from both neurological and psychological perspectives and include an assessment of tools that can be administered via computer to measure time perception. We also suggest several computer-based methods that might be used to address problems with time perception in both children and adults. We strongly recommend the inclusion of ADHD symptoms associated with time perception in the next revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.
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Affiliation(s)
- Simon Weissenberger
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Katerina Schonova
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Pascal Büttiker
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Raffaele Fazio
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Martina Vnukova
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Radek Ptacek
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
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16
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Krieger V, Amador-Campos JA. Clinical presentations of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents: comparison of neurocognitive performance. Child Neuropsychol 2021; 27:1024-1053. [PMID: 33928840 DOI: 10.1080/09297049.2021.1917530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to compare performance in working memory (WM), processing speed (PRS), and attention measures in children and adolescents with typical development (TD) and with Attention deficit hyperactivity disorder (inattentive [ADHD-I] or combined [ADHD-C]) presentations, and to determine the predictive ability of the measures mentioned to discriminate between ADHD presentations and TD. 260 children and adolescents, 138 with ADHD (70 ADHD-I and 68 ADHD-C) and 122 TD in two age cohorts (8-12 years; 13-16 years), were assessed with WM and PRS indexes of Wechsler Intelligence Scale for Children (WISC-IV) and the d2 attention test. Significant differences between ADHD and TD groups in the WISC-IV GAI scores were found in children but not in adolescents. Children and adolescents with both ADHD presentations performed poorly on the PRS index, while on the WM index only children exhibited difficulties. In the attention test, children with ADHD-C showed more impulsivity and more difficulties for processing speed, concentration and accuracy than ADHD-I and TD. In addition, both ADHD presentations had higher inattention scores than TD. ADHD adolescents performed worse than TD in processing speed, concentration and accuracy. ADHD groups showed more impulsivity and inattention than TD. Digit Span and Symbol Search (WISC-IV) and processing speed and accuracy (d2) successfully classified ADHD and TD in children, but in adolescents, only coding (WISC-IV) and accuracy (d2) successfully classified ADHD presentations and TD. The WISC-IV and d2 yield neuropsychological profiles which reflect age-related cognitive changes and may allow the adaptation of more tailored early interventions for ADHD.
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Affiliation(s)
- Virginia Krieger
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Juan Antonio Amador-Campos
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neuroscience, University of Barcelona (UBneuro), Barcelona, Spain
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17
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Bluschke A, Zink N, Mückschel M, Roessner V, Beste C. A novel approach to intra-individual performance variability in ADHD. Eur Child Adolesc Psychiatry 2021; 30:733-745. [PMID: 32410131 PMCID: PMC8060200 DOI: 10.1007/s00787-020-01555-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 05/01/2020] [Indexed: 11/26/2022]
Abstract
Patients with attention deficit/(hyperactivity) disorder (AD(H)D) show increased intra-individual variability (IIV) in behavioral performance. This likely reflects dopaminergic deficiencies. However, the precise performance profile across time and the pattern of fluctuations within it have not yet been considered, partly due to insufficient methods. Yet, such an analysis may yield important theory-based implications for clinical practice. Thus, in a case-control cross-sectional study, we introduce a new method to investigate performance fluctuations in patients with ADD (n = 76) and ADHD (n = 67) compared to healthy controls (n = 45) in a time estimation task. In addition, we also evaluate the effects of methylphenidate (MPH) treatment on this performance pattern in 29 patients with AD(H)D. Trial-by-trial differences in performance between healthy controls and patients with AD(H)D do not persist continuously over longer time periods. Periods during which no differences in performance between healthy controls and patients occur alternate with periods in which such differences are present. AD(H)D subtype and surprisingly also medication status does not affect this pattern. The presented findings likely reflect (phasic) deficiencies of the dopaminergic system in patients with AD(H)D which are not sufficiently ameliorated by first-line pharmacological treatment. The presented findings carry important clinical and scientific implications.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Nicolas Zink
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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18
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Ünal D, Mustafaoğlu Çiçek N, Çak T, Sakarya G, Artik A, Karaboncuk Y, Özusta Ş, Çengel Kültür E. Comparative analysis of the WISC-IV in a clinical setting: ADHD vs. non-ADHD. Arch Pediatr 2020; 28:16-22. [PMID: 33309122 DOI: 10.1016/j.arcped.2020.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/19/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is a useful tool for revealing differences in cognitive ability. Using the WISC-IV, the study investigated the intelligence profile of Turkish children diagnosed with ADHD and compared their profile with that of a non-ADHD clinical sample. METHOD On the basis of the records of 257 drug-naïve patients (6-12years of age), ADHD (n=154) and non-ADHD (n=103) clinical groups were compared with respect to sociodemographic variables and WISC-IV scores. RESULTS The non-ADHD clinical group had higher full scale, index, and subtest scores, except for their scores in the Comprehension subtest. The scores on Working Memory, Processing Speed Indices, Similarities, and Matrix Reasoning subtests were especially lower in the ADHD group than in the non-ADHD group. The Similarities, Matrix Reasoning, and Digit Span subtests classified 83% of the children as having ADHD and identified 43.7% of the non-ADHD clinical controls. CONCLUSION In our study, we found differences in the WISC-IV profiles of the Turkish patients with ADHD. Moreover, the WISC-IV profile of the non-ADHD clinical group was different than that of the ADHD group. More prospective studies with larger groups of ADHD patients and further evaluations of executive function deficits can help clinicians better understand the differences in WISC-IV profiles.
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Affiliation(s)
- D Ünal
- Hacettepe University Child and Adolescent Psychiatry Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - T Çak
- Hacettepe University Child and Adolescent Psychiatry Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - G Sakarya
- Kocaeli Medical Park Hospital, Kocaeli, Turkey
| | - A Artik
- Kayseri City Hospital, Kocasinan/Kayseri, Turkey
| | - Y Karaboncuk
- Yamaç Karaboncuk, Ferhunde Öktem Mental Health Center, Ankara, Turkey
| | - Ş Özusta
- Hacettepe University Child and Adolescent Psychiatry Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - E Çengel Kültür
- Hacettepe University Child and Adolescent Psychiatry Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
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19
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Molavi P, Nadermohammadi M, Salvat Ghojehbeiglou H, Vicario CM, Nitsche MA, Salehinejad MA. ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference. BMC Psychiatry 2020; 20:502. [PMID: 33046041 PMCID: PMC7549239 DOI: 10.1186/s12888-020-02887-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a major neurodevelopmental disorder with heterogeneous symptoms, subtypes, and cognitive deficits. Cognitive deficits are central to ADHD pathophysiology and one potential source of heterogeneity in ADHD. Subtype-specific cognitive correlates are not, however, well-studied. We explored cognitive correlates of ADHD subtypes based on the Wechsler Intelligence Scale for Children (WISC-IV) scores. We also assessed subtype-specific self-esteem rating in ADHD subtypes and explored its association with cognitive correlates. METHODS One hundred thirty-nine children with ADHD (80.6% boy, 19.4% girl) were categorized into the predominantly "hyperactive (ADHD-H)", "inattentive (ADHD-I)" and "combined (ADHD-C)" subtype based on their symptoms and scores on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and Conners Parent-Rating Scale (CPRS-RS). They were then individually administrated the WISC-IV and completed a self-esteem inventory. Group differences in the WISC-IV indices and their predictability in discriminating ADHD subtypes were analyzed. RESULTS We found a quantitative differentiation of cognitive abilities among ADHD subtypes with "working memory" as the most compromised cognitive domain. ADHD-I had the poorest cognitive profile while ADHD-H scored highest in all cognitive domains. Importantly, cognitive abilities were negatively correlated with inattention and positively correlated with hyperactive symptoms. Moreover, self-esteem ratings were positively correlated with the cognitive domains and were rated differently based on the subtypes. ADHD-H, with the highest cognitive strength, reported the highest level of self-esteem among all subtypes. CONCLUSIONS ADHD subtype-specific symptoms, cognitive deficits, and self-esteem problems should be considered for precise diagnosis and effective and personalized treatment in ADHD in light of further supporting evidence and assessments. Cognitive interventions might be more compatible with and effective in inattentive and combined subtypes of ADHD. Working memory improving-based interventions can benefit all ADHD subtypes. A supportive educational system in school and providing adjunct supportive interventions should be considered for children with ADHD as well.
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Affiliation(s)
- Parviz Molavi
- grid.411426.40000 0004 0611 7226Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehriar Nadermohammadi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Habibeh Salvat Ghojehbeiglou
- grid.411426.40000 0004 0611 7226Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Carmelo M. Vicario
- grid.10438.3e0000 0001 2178 8421Department of Scienze Cognitive della Formazione e degli Studi Culturali, University of Messina, Messina, Italy
| | - Michael A. Nitsche
- grid.419241.b0000 0001 2285 956XDepartment of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany. .,International Graduate School of Neuroscience, Ruhr-University Bochum, Bochum, Germany. .,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.
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Abstract
OBJECTIVE There is limited understanding of the cognitive profiles of Spanish-speaking children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study investigated the cognitive cluster profiles of Puerto Rican Spanish-speaking children with ADHD using the Wechsler Intelligence Scales for Children-Fourth Edition Spanish (WISC-IV Spanish) Index scores and examined the association between cognitive cluster profiles with other potentially relevant factors. METHOD Hierarchical cluster analysis was used to identify WISC-IV clusters in a sample of 165 Puerto Rican children who had a primary diagnosis of ADHD. To examine the validity of the ADHD clusters, analysis of variances and chi-square analyses were conducted to compare the clusters across sociodemographics (e.g., age and education), type of ADHD diagnosis (ADHD subtype, Learning Disorder comorbidity), and academic achievement. RESULTS Clusters were differentiated by level and pattern of performance. A five-cluster solution was identified as optimal that included (C1) multiple cognitive deficits, (C2) processing speed deficits, (C3) generally average performance, (C4) perceptual reasoning strengths, and (C5) working memory deficits. Among the five clusters, the profile with multiple cognitive deficits was characterized by poorer performance on the four WISC-IV Spanish Indexes and was associated with adverse sociodemographic characteristics. CONCLUSIONS Results illustrate that there is substantial heterogeneity in cognitive abilities of Puerto Rican Spanish-speaking children with ADHD, and this heterogeneity is associated with a number of relevant outcomes.
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21
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Kramer E, Koo B, Restrepo A, Koyama M, Neuhaus R, Pugh K, Andreotti C, Milham M. Diagnostic Associations of Processing Speed in a Transdiagnostic, Pediatric Sample. Sci Rep 2020; 10:10114. [PMID: 32572148 PMCID: PMC7308370 DOI: 10.1038/s41598-020-66892-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/15/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The present study examines the relationships between processing speed (PS), mental health disorders, and learning disorders. Prior work has tended to explore relationships between PS deficits and specific diagnoses in isolation of one another. Here, we simultaneously investigated PS associations with five diagnoses (i.e., anxiety, autism, ADHD, depressive, specific learning) in a large-scale, transdiagnostic, community self-referred sample. METHOD 843 children, ages 8-16 were included from the Healthy Brain Network (HBN) Biobank. Principal component analysis (PCA) was employed to create a composite measure of four PS tasks, referred to as PC1. Intraclass correlation coefficient (ICC) between the four PS measures, as well as PC1, were calculated to assess reliability. RESULTS ICCs were moderate between WISC-V tasks (0.663), and relatively modest between NIH Toolbox Pattern Comparison and other PS scales (0.14-0.27). Regression analyses revealed specific significant relationships between PS and reading and math disabilities, ADHD-inattentive presentation (ADHD-I), and ADHD-combined presentation (ADHD-C). After accounting for inattention, the present study did not find a significant relationship with Autism Spectrum Disorder. DISCUSSION Our examination of PS in a large, transdiagnostic sample suggested more specific associations with ADHD and learning disorders than the literature currently suggests. Implications for understanding how PS interacts with a highly heterogeneous childhood sample are discussed.
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Affiliation(s)
- Eliza Kramer
- Healthy Brain Network, Child Mind Institute, New York, New York, USA
| | - Bonhwang Koo
- Center for the Developing Brain, Child Mind Institute, New York, New York, USA
| | - Anita Restrepo
- Healthy Brain Network, Child Mind Institute, New York, New York, USA
| | | | - Rebecca Neuhaus
- Healthy Brain Network, Child Mind Institute, New York, New York, USA
| | | | | | - Michael Milham
- Center for the Developing Brain, Child Mind Institute, New York, New York, USA.
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA.
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Donati G, Dumontheil I, Meaburn EL. Genome-Wide Association Study of Latent Cognitive Measures in Adolescence: Genetic Overlap With Intelligence and Education. MIND, BRAIN AND EDUCATION : THE OFFICIAL JOURNAL OF THE INTERNATIONAL MIND, BRAIN, AND EDUCATION SOCIETY 2019; 13:224-233. [PMID: 31598132 PMCID: PMC6771723 DOI: 10.1111/mbe.12198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/14/2019] [Accepted: 04/09/2019] [Indexed: 05/03/2023]
Abstract
Individual differences in executive functions (EF) are heritable and predictive of academic attainment (AA). However, little is known about genetic contributions to EFs or their genetic relationship with AA and intelligence. We conducted genome-wide association analyses for processing speed (PS) and the latent EF measures of working memory (WM) and inhibitory control (IC) in 4,611 adolescents from the Avon Longitudinal Study of Parents and Children. While no loci reached genome-wide significance, common genetic variants explained 30% of the variance in WM and 19% in PS. In contrast, we failed to find common genetic contributions to IC. Finally, we examined shared genetic effects between EFs and general intelligence, AA and ADHD. We identified significant genetic correlations between WM, intelligence, and AA. A more specific pattern was observed for PS, with modest genetic overlap with intelligence. Together these findings highlight diversity in the genetic contributions to specific cognitive functions and their genetic relationship with educational and psychiatric outcomes.
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Affiliation(s)
- Georgina Donati
- Centre for Brain & Cognitive DevelopmentBirkbeck, University of London
| | - Iroise Dumontheil
- Centre for Brain & Cognitive DevelopmentBirkbeck, University of London
| | - Emma L. Meaburn
- Centre for Brain & Cognitive DevelopmentBirkbeck, University of London
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Deep Learning Based on Event-Related EEG Differentiates Children with ADHD from Healthy Controls. J Clin Med 2019; 8:jcm8071055. [PMID: 31330961 PMCID: PMC6679086 DOI: 10.3390/jcm8071055] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/17/2019] [Indexed: 01/16/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neuropsychiatric disorders in childhood and adolescence and its diagnosis is based on clinical interviews, symptom questionnaires, and neuropsychological testing. Much research effort has been undertaken to evaluate the usefulness of neurophysiological (EEG) data to aid this diagnostic process. In the current study, we applied deep learning methods on event-related EEG data to examine whether it is possible to distinguish ADHD patients from healthy controls using purely neurophysiological measures. The same was done to distinguish between ADHD subtypes. The results show that the applied deep learning model (“EEGNet”) was able to distinguish between both ADHD subtypes and healthy controls with an accuracy of up to 83%. However, a significant fraction of individuals could not be classified correctly. It is shown that neurophysiological processes indicating attentional selection associated with superior parietal cortical areas were the most important for that. Using the applied deep learning method, it was not possible to distinguish ADHD subtypes from each other. This is the first study showing that deep learning methods applied to EEG data are able to dissociate between ADHD patients and healthy controls. The results show that the applied method reflects a promising means to support clinical diagnosis in ADHD. However, more work needs to be done to increase the reliability of the taken approach.
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Tobia V, Bonifacci P, Bernabini L, Marzocchi GM. Teachers, not parents, are able to predict time processing skills in preschoolers. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2019; 37:519-534. [PMID: 31264234 DOI: 10.1111/bjdp.12294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/30/2019] [Indexed: 11/30/2022]
Abstract
Time processing difficulties are associated with developmental disorders. Questionnaires for assessing children's sense of time are available from primary school, but we lack valid proxy-report tools for younger children, who are not able to complete self-reports. This study aimed to assess the criterion validity of a questionnaire investigating preschoolers' sense of time from the points of view of their parents and teachers. One hundred seventy preschoolers were included in the sample. Their parents and teachers completed the Sense of Time Questionnaire, and the children were administered time reproduction and time discrimination tasks, both concurrently and 7 months later. The assessment of preschoolers' sense of time reported by teachers, but not by parents, predicted the children's time processing skills both concurrently and longitudinally. The teacher version of the Sense of Time Questionnaire constitutes a valid instrument for assessing and predicting preschoolers' time processing skills and can be used for clinical and research purposes STATEMENT OF CONTRIBUTION: What is already known on this subject? Time processing difficulties are associated with developmental disorders such as ADHD and dyscalculia. Early assessment of time processing skills is important for clinical (e.g., screening) and research purposes. We do not have valid questionnaires for assessing sense of time in young children. What the present study adds? The sense of time ability reported by teachers predicts preschoolers' time processing skills. The sense of time ability reported by parents does not predicts preschoolers' time processing skills. The Sense of Time Questionnaire is a valid instrument for investigating time processing skills of 4-6 aged children.
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Affiliation(s)
- Valentina Tobia
- Department of Psychology, Vita-Salute San Raffaele University, Milan, Italy
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Ptacek R, Weissenberger S, Braaten E, Klicperova-Baker M, Goetz M, Raboch J, Vnukova M, Stefano GB. Clinical Implications of the Perception of Time in Attention Deficit Hyperactivity Disorder (ADHD): A Review. Med Sci Monit 2019; 25:3918-3924. [PMID: 31129679 PMCID: PMC6556068 DOI: 10.12659/msm.914225] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder that can affect many areas of the daily life of individuals and is associated with poor health outcomes and with debilitating deficits in executive function. Recently, increasing numbers of research studies have begun to investigate the associations between neural and behavioral manifestations of ADHD. This review summarizes recent research on the perception of time in ADHD and proposes that this symptom is a possible diagnostic characteristic. Controlled studies on time perception have compared individuals with ADHD with typically developing controls (TDCs) and have used methods that include the Zimbardo Time Perspective Inventory (ZTPI). Practical approaches to time perception and its evaluation have shown that individuals with ADHD have difficulties in time estimation and discrimination activities as well as having the feeling that time is passing by without them being able to complete tasks accurately and well. Although ADHD has been associated with neurologic abnormalities in the mesolimbic and dopaminergic systems, recent studies have found that when individuals with ADHD are treated medically, their perception of time tends to normalize. The relationship between ADHD and the perception of time requires greater attention. Further studies on time perception in ADHD with other abnormalities, including executive function, might be approaches that refine the classification and diagnosis of ADHD and should include studies on its varied presentation in different age groups.
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Affiliation(s)
- Radek Ptacek
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Simon Weissenberger
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Ellen Braaten
- Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program and Clay Center for Young Healthy Minds, Massachusetts General Hospital, Boston, MA, USA
| | | | - Michal Goetz
- Department of Paediatric Psychiatry, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Jiri Raboch
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Martina Vnukova
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
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Vadnais SA, Kibby MY, Jagger-Rickels AC. Which neuropsychological functions predict various processing speed components in children with and without attention-deficit/hyperactivity disorder? Dev Neuropsychol 2018; 43:403-418. [PMID: 29718727 DOI: 10.1080/87565641.2018.1469135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We identified statistical predictors of four processing speed (PS) components in a sample of 151 children with and without attention-deficit/hyperactivity disorder (ADHD). Performance on perceptual speed was predicted by visual attention/short-term memory, whereas incidental learning/psychomotor speed was predicted by verbal working memory. Rapid naming was predictive of each PS component assessed, and inhibition predicted all but one task, suggesting a shared need to identify/retrieve stimuli rapidly and inhibit incorrect responding across PS components. Hence, we found both shared and unique predictors of perceptual, cognitive, and output speed, suggesting more specific terminology should be used in future research on PS in ADHD.
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Affiliation(s)
- Sarah A Vadnais
- a Department of Psychology , Southern Illinois University , Carbondale , IL , USA
| | - Michelle Y Kibby
- a Department of Psychology , Southern Illinois University , Carbondale , IL , USA
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Bluschke A, Schuster J, Roessner V, Beste C. Neurophysiological mechanisms of interval timing dissociate inattentive and combined ADHD subtypes. Sci Rep 2018; 8:2033. [PMID: 29391481 PMCID: PMC5794858 DOI: 10.1038/s41598-018-20484-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/19/2018] [Indexed: 01/26/2023] Open
Abstract
It is far from conclusive what distinguishes the inattentive (ADD) and the combined (ADHD-C) subtype of ADHD on the neuronal level. Theoretical considerations suggest that especially interval timing processes may dissociate these subtypes from each other. Combining high-density EEG recordings with source localization analyses, we examine whether there are ADHD-subtype specific modulations of neurophysiological processes subserving interval timing in matched groups of ADD (n = 16), ADHD-C (n = 16) and controls (n = 16). Patients with ADD and ADHD-C show deficits in interval timing, which was correlated with the degree of inattention in ADD patients. Compared to healthy controls, patients with ADHD-C display a somewhat weaker, yet consistent response preparation process (contingent negative variation, CNV). In patients with ADD, the early CNV is interrupted, indicating an oscillatory disruption of the interval timing process. This is associated with activations in the supplemental motor areas and the middle frontal gyrus. Patients with ADD display adequate feedback learning mechanisms (feedback-related negativity, FRN), which is not the case in patients with ADHD-C. The results suggest that altered pacemaker-accumulation processes in medial frontal structures distinguish the ADD from the ADHD-C subtype. Particularly in patients with ADD phasic interruptions of preparatory neurophysiological processes are evident, making this a possible diagnostic feature.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany.
| | - Jacqueline Schuster
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany.,Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
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