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Cundari M, Vestberg S, Gustafsson P, Gorcenco S, Rasmussen A. Neurocognitive and cerebellar function in ADHD, autism and spinocerebellar ataxia. Front Syst Neurosci 2023; 17:1168666. [PMID: 37415926 PMCID: PMC10321758 DOI: 10.3389/fnsys.2023.1168666] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
The cerebellum plays a major role in balance, motor control and sensorimotor integration, but also in cognition, language, and emotional regulation. Several neuropsychiatric disorders such as attention deficit-hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as neurological diseases such as spinocerebellar ataxia type 3 (SCA3) are associated with differences in cerebellar function. Morphological abnormalities in different cerebellar subregions produce distinct behavioral symptoms related to the functional disruption of specific cerebro-cerebellar circuits. The specific contribution of the cerebellum to typical development may therefore involve the optimization of the structure and function of cerebro-cerebellar circuits underlying skill acquisition in multiple domains. Here, we review cerebellar structural and functional differences between healthy and patients with ADHD, ASD, and SCA3, and explore how disruption of cerebellar networks affects the neurocognitive functions in these conditions. We discuss how cerebellar computations contribute to performance on cognitive and motor tasks and how cerebellar signals are interfaced with signals from other brain regions during normal and dysfunctional behavior. We conclude that the cerebellum plays a role in many cognitive functions. Still, more clinical studies with the support of neuroimaging are needed to clarify the cerebellum's role in normal and dysfunctional behavior and cognitive functioning.
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Affiliation(s)
- Maurizio Cundari
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
- Unit of Neuropsychiatry, Hospital of Helsingborg, Helsingborg, Sweden
- Unit of Neurology, Hospital of Helsingborg, Helsingborg, Sweden
| | - Susanna Vestberg
- Department of Psychology, Faculty of Social Science, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden
| | - Sorina Gorcenco
- Department for Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Rasmussen
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
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Nejati V. Reading mind from the eyes in individuals with attention deficit-hyperactivity disorder (ADHD): A meta-analysis. Expert Rev Neurother 2022; 22:889-896. [PMID: 36420829 DOI: 10.1080/14737175.2022.2151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Individuals with ADHD struggle with social impairments. The present study aimed to find out the inconsistent results of theory of mind skill in individuals with ADHD. METHODS The current meta-analysis reviewed 17 empirical studies that compared theory of mind in individuals with and without ADHD based on reading mind from the eyes test (RMET). RESULTS Finding from 1620 participants with ADHD and 1249 healthy controls showed a significant impairment in theory of mind in individuals with ADHD (Hedges' g = 0.66). Moderator analyses indicated that the impaired theory of mind was not affected by age and gender. CONCLUSION These findings describe impaired theory of mind in individuals with ADHD and provide an insight to pay attention to theory of mind in respective clinical assessments and treatments.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411 Tehran, Iran
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Mohamed SMH, Butzbach M, Fuermaier ABM, Weisbrod M, Aschenbrenner S, Tucha L, Tucha O. Basic and complex cognitive functions in Adult ADHD. PLoS One 2021; 16:e0256228. [PMID: 34473722 PMCID: PMC8412315 DOI: 10.1371/journal.pone.0256228] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.
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Affiliation(s)
- Saleh M. H. Mohamed
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- * E-mail:
| | - Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - Anselm B. M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
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Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
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Tatar ZB, Cansız A. Executive function deficits contribute to poor theory of mind abilities in adults with ADHD. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:244-251. [PMID: 32186409 DOI: 10.1080/23279095.2020.1736074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Studies exploring the theory of mind (ToM) in adults with Attention/Deficit Hyperactivity Disorder (ADHD), have tended to result in mixed findings. The contribution of neuropsychologic functions to ToM has not been investigated yet in adults with ADHD. The aim of this study was to investigate ToM abilities and the role of attention and executive functions in ToM of adults with ADHD.Methods: This study was conducted in Bakirkoy Training and Research Hospital. Forty adults with ADHD and 40 healthy controls were administered a sociodemographic data form, and scales. Both groups were also assessed by Reading Mind From the Eyes Test (RMET), Trail Making Test (TMT) Part A-B and Continuous Performance Test (CPT).Results: ToM was significantly impaired in adults with ADHD relative to controls (23.50 ± 3.44 and 26.25 ± 1.67, t(77) = 4.543, p = 0.003). Adults with ADHD performed worse on TMT Part B (76.02 ± 51.47 and 46.39 ± 18.33 seconds, t(78) = -3.429, p < 0.001), and CPT than the controls (46.20 ± 8.09 and 52.00 ± 3.56, t(78) = 4.145, p < 0.001). A significant regression equation was found: F (1,38) = 6.494, β = -0.382, p < 0.05 with an R² of 0.146.Conclusion: Our findings suggest that adults with ADHD demonstrated social cognition difficulties and executive function deficits contributed to poor ToM abilities in ADHD.
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Affiliation(s)
- Zeynep Baran Tatar
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Alparslan Cansız
- Harran University Faculty of Medicine Department of Psychiatry, Sanliurfa, Turkey
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Das D, Vélez JI, Acosta MT, Muenke M, Arcos-Burgos M, Easteal S. Retrospective assessment of childhood ADHD symptoms for diagnosis in adults: validity of a short 8-item version of the Wender-Utah Rating Scale. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2016; 8:215-223. [PMID: 27510231 DOI: 10.1007/s12402-016-0202-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
The Wender-Utah Rating Scale (WURS) is a widely used self-report instrument for retrospective assessment of childhood ADHD. However, many WURS items are not specific to ADHD. Here, we investigated the effect of excluding these items on the performance of the WURS in predicting adult ADHD based on previous diagnosis and current clinically significant symptoms. The study was conducted on a sample of adults (n = 1014; 48 % male) participating in a family-based investigation of ADHD. Participants completed the 61-item WURS questionnaire and the 66-item Conners Adult ADHD Rating Scale. Receiver operating characteristic (ROC) curves were used to compare the performance of the eight-item WURS (WURS-8) and the longer WURS-25 in predicting previous ADHD diagnosis and current clinically significant ADHD symptoms. WURS-8 and WURS-25 have approximately the same power to predict adult ADHD, based on either previous diagnosis or current symptoms (area under the ROC curves >0.8). WURS-8 performs at least as well as the longer WURS-25 in predicting adult ADHD. This 8-item questionnaire is thus a valid instrument and is especially useful for screening for ADHD in large epidemiological samples.
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Affiliation(s)
- Debjani Das
- John Curtin School of Medical Research, The Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia.
| | - Jorge I Vélez
- John Curtin School of Medical Research, The Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia
- Neuroscience Research Group, University of Antioquia, Medellin, Colombia
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Maria T Acosta
- The Jennifer and Daniel Gilbert Neurofibromatosis Institute, Washington, DC, USA
- Center for Neuroscience and Behavioral Medicine at Children's National Medical Center, Washington, DC, USA
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Mauricio Arcos-Burgos
- John Curtin School of Medical Research, The Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia
- Neuroscience Research Group, University of Antioquia, Medellin, Colombia
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Simon Easteal
- John Curtin School of Medical Research, The Australian National University, Building 131, Garran Road, Canberra, ACT, 2601, Australia
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Mowinckel AM, Pedersen ML, Eilertsen E, Biele G. A meta-analysis of decision-making and attention in adults with ADHD. J Atten Disord 2015; 19:355-67. [PMID: 25477020 DOI: 10.1177/1087054714558872] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Deficient reward processing has gained attention as an important aspect of ADHD, but little is known about reward-based decision-making (DM) in adults with ADHD. This article summarizes research on DM in adult ADHD and contextualizes DM deficits by comparing them to attention deficits. METHOD Meta-analytic methods were used to calculate average effect sizes for different DM domains and continuous performance task (CPT) measures. RESULTS None of the 59 included studies (DM: 12 studies; CPT: 43; both: 4) had indications of publication bias. DM and CPT measures showed robust, small to medium effects. Large effect sizes were found for a drift diffusion model analysis of the CPT. CONCLUSION The results support the existence of DM deficits in adults with ADHD, which are of similar magnitude as attention deficits. These findings warrant further examination of DM in adults with ADHD to improve the understanding of underlying neurocognitive mechanisms.
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Affiliation(s)
| | | | | | - Guido Biele
- University of Oslo, Norway Norwegian Institute of Public Health, Oslo, Norway
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Das D, Cherbuin N, Easteal S, Anstey KJ. Attention Deficit/Hyperactivity Disorder symptoms and cognitive abilities in the late-life cohort of the PATH through life study. PLoS One 2014; 9:e86552. [PMID: 24489743 PMCID: PMC3904910 DOI: 10.1371/journal.pone.0086552] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022] Open
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is a common neuropsychiatric disorder that has not been well studied in older adults. In this study we examined relationships between ADHD symptoms and cognitive ability and compared them between middle-age (MA; 48-52 years) and older-age (OA; 68-74 years) adults sampled from the same population. ADHD, mood disorder symptoms and cognitive abilities were assessed in a large population-based sample (n = 3443; 50% male). We measured current ADHD symptoms using the adult ADHD Self-Report Scale (ASRS), which we found to have the same underlying structure in both cohorts. Older adults reported significantly lower levels of ADHD symptoms and 2.2% of the OA cohort scored equal or above the ASRS cut-off score of 14 (which has been previously associated with ADHD diagnosis) compared with 6.2% of MA adults. Symptom levels were not significantly different between males and females. Using multi-group structural equation modelling we compared ADHD symptom-cognitive performance relationships between the two age groups. Generally higher ADHD symptoms were associated with poorer cognitive performance in the MA cohort. However, higher levels of inattention symptoms were associated with better verbal ability in both cohorts. Surprisingly, greater hyperactivity was associated with better task-switching abilities in older adults. In the OA cohort ADHD symptom-cognition relationships are indirect, mediated largely through the strong association between depression symptoms and cognition. Our results suggest that ADHD symptoms decrease with age and that their relationships with co-occurring mood disorders and cognitive performance also change. Although symptoms of depression are lower in older adults, they are much stronger predictors of cognitive performance and likely mediate the effect of ADHD symptoms on cognition in this age group. These results highlight the need for age-appropriate diagnosis and treatment of comorbid ADHD and mood disorders.
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Affiliation(s)
- Debjani Das
- John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
- * E-mail:
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Simon Easteal
- John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kaarin J. Anstey
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
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Ko CH, Yen JY, Yen CF, Chen CS, Lin WC, Wang PW, Liu GC. Brain activation deficit in increased-load working memory tasks among adults with ADHD using fMRI. Eur Arch Psychiatry Clin Neurosci 2013; 263:561-73. [PMID: 23645101 DOI: 10.1007/s00406-013-0407-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
Working memory (WM) is impaired among adults with attention-deficit hyperactivity disorder (ADHD). This study aimed to investigate the brain activation deficit for low-level or increased-load WM among adults with ADHD. A total of 20 adults with ADHD and controls were recruited according to diagnostic interviewing by a psychiatrist. Phonological and visual-spatial 2-back and 3-back tasks were performed under functional magnetic resonance scanning. The results demonstrated that both the adults with ADHD and the controls exhibited activation of the fronto-parietal network for WM, and the intensity was greater in the adult ADHD group. The ADHD group had higher brain activation over the bilateral anterior cingulate, left inferior frontal lobe, hippocampus, and supplementary motor area (SMA) for phonological WM than the control group. When the task loading increased from 2-back to 3-back tasks, the adults with ADHD perceived greater difficulty. The control group exhibited increased brain activation over the frontal-parietal network in response to increased phonological WM load. However, the ADHD group showed decreased brain activation over the left precuneus, insula, and SMA. Further analysis demonstrated that the ADHD group exhibited a greater decrease in brain activation over the left fronto-parietal network, including the precuneus, SMA, insula/inferior frontal lobe, and dorsolateral prefrontal cortex, than the control group. These results suggest that adults with ADHD pay more effort to low demanding phonological WM. On the other hand, brain activation of the left fronto-parietal network is impaired when the demands of WM exceed the capacity of adults with ADHD.
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Affiliation(s)
- Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Memory in Early Onset Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder: Similarities and Differences. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:1179-92. [DOI: 10.1007/s10802-012-9631-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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