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Wojciechowski T. Understanding the Impact of Deviant Peer Association on Dual Systems Model Development: Testing the Moderating Role of ADHD. J Nerv Ment Dis 2024; 212:96-103. [PMID: 37983371 DOI: 10.1097/nmd.0000000000001743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
ABSTRACT Recent research has indicated that deviant peers may play a role in cognitive development. This is particularly the case for the dual systems model, a key framework for understanding engagement in antisocial behavior during adolescence and emerging adulthood. However, limited research has examined how preexisting mental health concerns may moderate these relationships. This study used the Pathways to Desistance data to examine attention deficit hyperactivity disorder (ADHD) as a moderator of the relationships between deviant peer association and dual systems model constructs. Generalized estimating equations were used to test these relationships. Results indicated that deviant peer association and the presence of ADHD both predicted increased sensation-seeking and lower impulse control. ADHD significantly moderated the relationship between deviant peer association and impulse control, indicating a weaker impact of deviant peer association on impulse control among participants with ADHD. No significant interaction was observed for the relationship between deviant peer association and sensation-seeking.
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Egeland J, Lund O, Kowalik-Gran I, Aarlien AK, Söderlund GBW. Effects of auditory white noise stimulation on sustained attention and response time variability. Front Psychol 2023; 14:1301771. [PMID: 38144987 PMCID: PMC10748431 DOI: 10.3389/fpsyg.2023.1301771] [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: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction "The moderate brain arousal model" claims that white noise improves attention by optimizing brain arousal. We analyze Conners' Continuous Performance Test-3 (CCPT-3) performance, expecting to find reduced reaction time variability with noise mediated by decrease under long event-rates and in later parts of the test, indicating that noise reverse fall in phasic and tonic arousal. Methods Sixty-five children with high or lower ADHD-symptoms from a child psychiatric unit, succeeded to complete the CCPT-3 with and without white noise. Results Noise reduced overall variability, improved performance in later parts of the test, and reduced response variability under the longest event rate particularly in the high symptoms group. No overall change in omissions and commissions, but the high symptoms group made fewer omissions during noise compared the low symptom group. Discussion The study indicates an arousal effect of noise but should be replicated with other noise variants and amplitudes to improve effect and compliance.
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Affiliation(s)
- Jens Egeland
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Olaf Lund
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
| | - Iwona Kowalik-Gran
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
| | | | - Göran B. W. Söderlund
- Faculty of Teacher Education Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
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Bozkurt A, Balta S. The effect of methylphenidate on pain perception thresholds in children with attention deficit hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2023; 17:118. [PMID: 37833816 PMCID: PMC10576289 DOI: 10.1186/s13034-023-00667-y] [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: 07/24/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Pain perception is important in children with attention deficit hyperactivity disorder (ADHD) since they are more likely to experience painful events due to increased accident rates. The aim of this study is to contribute to the literature concerning the relationship between ADHD diagnosis, methylphenidate (MPH) therapy, and pain thresholds, since findings regarding the change in pain perception in children with ADHD are scarce and inconsistent. METHODS Children aged 8-13 years constituted both the ADHD group (n = 82) and the healthy controls (n = 41). The ADHD group was divided into two subgroups, ADHD without MPH (not treated pharmacologically) and ADHD with MPH (treated pharmacologically for at least three-months). The Conners' Parent Rating Scale-Revised: Short Form was employed to assess ADHD, a visual analog scale was applied to evaluate chronic pain severity, and a manual pressure algometer was used to assess pain thresholds. RESULT Children with ADHD had lower pain thresholds than the healthy controls (P < 0.05). However, lower regional pain thresholds were observed in the ADHD group without MPH compared to both the healthy control and ADHD with MPH groups. Although pain thresholds in the ADHD with MPH group were regionally lower than in the healthy controls, low pain thresholds were found in fewer regions compared to the ADHD without MPH group. CONCLUSIONS Children with ADHD are more sensitive to pain sensation, and MPH may help normalize these individuals' pain experiences by raising pain thresholds. Families and clinicians must be aware of situations that may cause pain in children with ADHD. In addition, these children's low threshold for pain may lead them to experience it more intensely.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Turkey.
| | - Selin Balta
- Department of Pain Medicine, University of Health Sciences, Konya, Turkey
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Uddin H, Hasan MK. Family resilience and neighborhood factors affect the association between digital media use and mental health among children: does sleep mediate the association? Eur J Pediatr 2023:10.1007/s00431-023-04898-1. [PMID: 36922452 PMCID: PMC10257603 DOI: 10.1007/s00431-023-04898-1] [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: 07/02/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
The associations between digital media use and mental well-being among children and adolescents have been inconclusive. We examined (i) the associations between digital media use and mental health outcomes, anxiety, depression, and ADHD, (ii) whether family resilience and neighborhood factors attenuate the associations, and (iii) whether sleep mediates these associations. We used the National Survey of Children's Health data from 2019 to 2020. A total of 45,989 children's (6-17 years) data were analyzed in this study. Multivariate logistic regression was used to assess the associations between digital media use and anxiety, depression, and ADHD. Path models and Paramed command in STATA were used to test the role of sleep as a mediator of these associations. The prevalence of heavy digital media users (who spent 4 or more hours per day) among the analytic sample was 30.52%, whereas anxiety was 13.81%, depression was 5.93%, and ADHD was 12.41%. Children in the heavy media user group had 63% increased odds of anxiety (95% CI: 1.32-2.01) and 99% increased odds of depression (95% CI: 1.35-2.94) after adjusting for sociodemographic factors, compared to the children in light media user group (who spent < 2 h per day), and these relations were significant at 0.01 level. However, family resilience and community factors significantly attenuated the effect of digital media use on anxiety and depression. Sleep did not mediate the associations between digital media use and anxiety or depression. Conclusions: Family resilience and neighborhood factors protect against the harmful effects of digital media use. Further research is needed to examine the relationships of media contents, the presence of electronic devices in bedrooms, and sleep quality with mental health. What is Known: • Spending long hours on digital media may adversely affect children and adolescents' health and development. However, the mediating role of sleep in the association between digital media use and mental health outcomes is inconclusive. What is New: • Digital media use has detrimental effects on anxiety and depression. However, family resilience and neighborhood factors attenuated the association. The study highlights the importance of positive family functioning and neighborhood conditions reducing the harmful effects of digital media use.
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Affiliation(s)
- Helal Uddin
- Department of Global Public Health, Karolinska Institutet, Solna, 17177, Sweden. .,Department of Sociology, East West University, Dhaka, 1212, Bangladesh. .,Unit for Research in Emergency and Disaster, Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, 33006, Spain.
| | - Md Khalid Hasan
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka 1000, Dhaka, Bangladesh.
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Halbe E, Kolf F, Heger AS, Hüpen P, Bergmann M, Aslan B, Harrison BJ, Davey CG, Philipsen A, Lux S. Altered interaction of physiological activity and behavior affects risky decision-making in ADHD. Front Hum Neurosci 2023; 17:1147329. [PMID: 37151896 PMCID: PMC10157058 DOI: 10.3389/fnhum.2023.1147329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Adult attention-deficit/hyperactivity disorder (ADHD) is often associated with risky decision-making behavior. However, current research studies are often limited by the ability to adequately reflect daily behavior in a laboratory setting. Over the lifespan impairments in cognitive functions appear to improve, whereas affective functions become more severe. We assume that risk behavior in ADHD arises predominantly from deficits in affective processes. This study will therefore aim to investigate whether a dysfunction in affective pathways causes an abnormal risky decision-making (DM) behavior in adult ADHD. Methods Twenty-eight participants with ADHD and twenty-eight healthy controls completed a battery of questionnaires regarding clinical symptoms, self-assessment of behavior and emotional competence. Furthermore, skin conductance responses were measured during the performance in a modified version of the Balloon Analogue Risk Task. A linear mixed-effects model analysis was used to analyze emotional arousal prior to a decision and after feedback display. Results Results showed higher emotional arousal in ADHD participants before decision-making (β = -0.12, SE = 0.05, t = -2.63, p < 0.001) and after feedback display (β = -0.14, SE = 0.05, t = -2.66, p = 0.008). Although risky behavior was greater in HC than in ADHD, we found a significant interaction effect of group and anticipatory skin conductance responses regarding the response behavior (β = 107.17, SE = 41.91, t = 2.56, p = 0.011). Post hoc analyses revealed a positive correlation between anticipatory skin conductance responses and reaction time in HC, whereas this correlation was negative in ADHD. Self-assessment results were in line with the objective measurements. Conclusion We found altered changes in physiological activity during a risky decision-making task. The results confirm the assumption of an aberrant relationship between bodily response and risky behavior in adult ADHD. However, further research is needed with respect to age and gender when considering physiological activities.
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Affiliation(s)
- Eva Halbe
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- *Correspondence: Eva Halbe,
| | - Fabian Kolf
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Alina Sophie Heger
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA–Translational Brain Medicine, Aachen, Germany
| | - Moritz Bergmann
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Behrem Aslan
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Ben J. Harrison
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | | | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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Pershin I, Candrian G, Münger M, Baschera GM, Rostami M, Eich D, Müller A. Vigilance described by the time-on-task effect in EEG activity during a cued Go/NoGo task. Int J Psychophysiol 2023; 183:92-102. [PMID: 36455720 DOI: 10.1016/j.ijpsycho.2022.11.015] [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: 09/15/2022] [Revised: 11/19/2022] [Accepted: 11/25/2022] [Indexed: 11/30/2022]
Abstract
Vigilance refers to the ability to maintain attention and to remain alert to stimuli in prolonged and monotonous tasks. Vigilance decrement describes the decline in performance in the course of such sustained attention tasks. Time-related alterations in attention have been found to be associated with changes in EEG. We investigated these time-on-task effects on the basis of changes in the conventional EEG spectral bands with the aim of finding a compound measure of vigilance. 148 healthy adults performed a cued Go/NoGo task that lasted approximately 21 min. Behavioural performance was examined by comparing the number of errors in the first and last quarters of the task using paired t-test. EEG data were epoched per trial, and time-on-task effects were modelled by using multiple linear regression, with frequency spectra band power values as independent variables and trial number as the dependent variable. Behavioural performance decreased in terms of omission errors only. Performance of the models, expressed by predicted R-squared, was between 0.10 and 0.27, depending on the particular task condition. The time-on-task EEG spectral changes were characterized by broad changes in the alpha and frontal changes in the beta and gamma bands. We were able to identify a set of EEG spectral features that predict time-on-task. Our output is considered to be a measure of vigilance, reflecting the allocation of mental resources for the maintenance of attention.
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Affiliation(s)
- Ilia Pershin
- Brain and Trauma Foundation Grisons, Chur, Switzerland.
| | - Gian Candrian
- Brain and Trauma Foundation Grisons, Chur, Switzerland
| | - Marionna Münger
- Brain and Trauma Foundation Grisons, Chur, Switzerland; University of Zurich, Zurich, Switzerland
| | | | - Maryam Rostami
- Brain and Trauma Foundation Grisons, Chur, Switzerland; University of Tehran, Tehran, Iran
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Idrees I, Bellato A, Cortese S, Groom MJ. The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 144:104968. [PMID: 36427764 DOI: 10.1016/j.neubiorev.2022.104968] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
We carried out a systematic review and meta-analysis to investigate the effects of stimulant and non-stimulant medications on autonomic functioning in people with ADHD (PROSPERO: CRD42020212439). We searched (9th August 2021) PsycInfo, MEDLINE, EMBASE, Web of Science and The Cochrane Library, for randomised and non-randomised studies reporting indices of autonomic activity, (electrodermal, pupillometry and cardiac), pre- and post-medication exposure in people meeting DSM/ICD criteria for ADHD. In the narrative syntheses, we included 5 electrodermal studies, 1 pupillometry study and 57 studies investigating heart rate and blood pressure. In the meta-analyses, 29 studies were included on blood pressure and 32 on heart rate. Administration of stimulants, and to a lesser degree, non-stimulants increased heart rate and blood pressure in people with ADHD. Similarly, an upregulation of arousal, reflected in increased electrodermal activity and pupil diameter was observed following stimulant use. Yet, the methodological diversity of studies presented in this review reinforces the need for more standardised and rigorous research to fully understand the relationship between arousal, medication, and behaviour in ADHD.
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Affiliation(s)
- Iman Idrees
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK.
| | - Alessio Bellato
- School of Psychology, University of Nottingham Malaysia, Malaysia
| | - Samuele Cortese
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK; Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
| | - Madeleine J Groom
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
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One-year-later spontaneous EEG features predict visual exploratory human phenotypes. Commun Biol 2022; 5:1361. [PMID: 36509841 PMCID: PMC9744741 DOI: 10.1038/s42003-022-04294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
During visual exploration, eye movements are controlled by multiple stimulus- and goal-driven factors. We recently showed that the dynamics of eye movements -how/when the eye move- during natural scenes' free viewing were similar across individuals and identified two viewing styles: static and dynamic, characterized respectively by longer or shorter fixations. Interestingly, these styles could be revealed at rest, in the absence of any visual stimulus. This result supports a role of intrinsic activity in eye movement dynamics. Here we hypothesize that these two viewing styles correspond to different spontaneous patterns of brain activity. One year after the behavioural experiments, static and dynamic viewers were called back to the lab to record high density EEG activity during eyes open and eyes closed. Static viewers show higher cortical inhibition, slower individual alpha frequency peak, and longer memory of alpha oscillations. The opposite holds for dynamic viewers. We conclude that some properties of spontaneous activity predict exploratory eye movement dynamics during free viewing.
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Viglione A, Sagona G, Carrara F, Amato G, Totaro V, Lupori L, Putignano E, Pizzorusso T, Mazziotti R. Behavioral impulsivity is associated with pupillary alterations and hyperactivity in CDKL5 mutant mice. Hum Mol Genet 2022; 31:4107-4120. [PMID: 35861639 DOI: 10.1093/hmg/ddac164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 11/14/2022] Open
Abstract
Cyclin-dependent kinase-like 5 (Cdkl5) deficiency disorder (CDD) is a severe neurodevelopmental condition caused by mutations in the X-linked Cdkl5 gene. CDD is characterized by early-onset seizures in the first month of life, intellectual disability, motor and social impairment. No effective treatment is currently available and medical management is only symptomatic and supportive. Recently, mouse models of Cdkl5 disorder have demonstrated that mice lacking Cdkl5 exhibit autism-like phenotypes, hyperactivity and dysregulations of the arousal system, suggesting the possibility to use these features as translational biomarkers. In this study, we tested Cdkl5 male and female mutant mice in an appetitive operant conditioning chamber to assess cognitive and motor abilities, and performed pupillometry to assess the integrity of the arousal system. Then, we evaluated the performance of artificial intelligence models to classify the genotype of the animals from the behavioral and physiological phenotype. The behavioral results show that CDD mice display impulsivity, together with low levels of cognitive flexibility and perseverative behaviors. We assessed arousal levels by simultaneously recording pupil size and locomotor activity. Pupillometry reveals in CDD mice a smaller pupil size and an impaired response to unexpected stimuli associated with hyperlocomotion, demonstrating a global defect in arousal modulation. Finally, machine learning reveals that both behavioral and pupillometry parameters can be considered good predictors of CDD. Since early diagnosis is essential to evaluate treatment outcomes and pupillary measures can be performed easily, we proposed the monitoring of pupil size as a promising biomarker for CDD.
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Affiliation(s)
- Aurelia Viglione
- BIO@SNS Lab, Scuola Normale Superiore, via Moruzzi 1, 56124 Pisa, Italy
| | - Giulia Sagona
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, viale del Tirreno 331, 56128 Pisa, Italy
| | - Fabio Carrara
- ISTI-Istituto di Scienza e Tecnologia dell'Informazione, National Research Council, via Moruzzi 1, 56124 Pisa, Italy
| | - Giuseppe Amato
- ISTI-Istituto di Scienza e Tecnologia dell'Informazione, National Research Council, via Moruzzi 1, 56124 Pisa, Italy
| | - Valentino Totaro
- BIO@SNS Lab, Scuola Normale Superiore, via Moruzzi 1, 56124 Pisa, Italy
| | - Leonardo Lupori
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, viale del Tirreno 331, 56128 Pisa, Italy
| | - Elena Putignano
- Institute of Neuroscience, National Research Council, via Moruzzi 1, 56124 Pisa, Italy
| | - Tommaso Pizzorusso
- BIO@SNS Lab, Scuola Normale Superiore, via Moruzzi 1, 56124 Pisa, Italy.,Institute of Neuroscience, National Research Council, via Moruzzi 1, 56124 Pisa, Italy
| | - Raffaele Mazziotti
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, viale del Tirreno 331, 56128 Pisa, Italy
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Lin HY. The Effects of White Noise on Attentional Performance and On-Task Behaviors in Preschoolers with ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15391. [PMID: 36430109 PMCID: PMC9692615 DOI: 10.3390/ijerph192215391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/14/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Several models have tentatively associated improving attention-deficit/hyperactivity disorder (ADHD) symptoms with arousal and external environmental stimulation. In order to further clarify the relationships between ADHD symptoms, arousal, and external stimulation, this study focused on exploring the "simultaneous" effects of white noise on intrinsic attentional performance and extrinsic on-task behaviors in preschoolers with and without ADHD. By using the computerized task (K-CPT 2), 104 preschoolers, including 52 ADHD children and 52 typically developing (TD) children, were tested and analyzed for their intrinsic attention (such as detectability, omission errors, commission errors, and reaction time). Simultaneously, these preschoolers' external on-task behaviors were recorded for analysis through systematic observation. This study showed that white noise could effectively improve attention performance, including enhancing the ability to differentiate non-targets from targets and decreasing omission errors. It could also reduce the extrinsic hyperactive behaviors of preschoolers with ADHD. The findings of this study highlighted that white noise stimulation is a beneficial non-pharmacological treatment for preschoolers with ADHD. In contrast, for TD preschoolers, the results of this study showed that the external white noise stimuli were not only unhelpful but also a burden.
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Affiliation(s)
- Hung-Yu Lin
- Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung 41354, Taiwan
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11
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Zhang Y, Chen L, Jiang X, Bőthe B. Investigating the Associations of ADHD Symptoms, Impulsivity, Physical Exercise, and Problematic Pornography Use in a Chinese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15221. [PMID: 36429937 PMCID: PMC9691194 DOI: 10.3390/ijerph192215221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
Investigating the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and impulsivity will benefit our understanding of the concept of problematic pornography use (PPU), and revealing predisposing and malleable moderators of PPU will be beneficial for its prevention and intervention. The current study not only aimed to observe these relationships, but also explored the potential moderating role of physical exercise in the general population. A total of 600 Chinese adults (Mage = 32.31, SDage = 12.40, 39.8% women) were recruited and completed an online survey. The results showed that participants with regular exercise scored lower than those without exercise on ADHD, impulsivity, and PPU (all ps < 0.001). Using latent moderated structural equations (LMS), the findings revealed that the relationship between ADHD symptoms and PPU was mediated by impulsivity, and physical exercise moderated this relationship (B = -0.14, p = 0.048). Specifically, when individuals' physical exercise was higher than 0.84 standard deviations above the mean, the positive predictive effect of impulsivity on PPU was not significant. These findings indicate the important role of impulsivity in the relationship between ADHD and PPU, and physical exercise could be a meaningful component of interventions among individuals experiencing PPU.
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Affiliation(s)
- Ying Zhang
- Department of Physical Education, Fuzhou University, Fuzhou 350108, China
| | - Lijun Chen
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China
| | - Xiaoliu Jiang
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fuzhou 350108, China
| | - Beáta Bőthe
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada
- Département de Psychologie, Université de Montréal, Montréal, QC H3T 1J4, Canada
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12
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Muacevic A, Adler JR. Increased Screen Time as a Cause of Declining Physical, Psychological Health, and Sleep Patterns: A Literary Review. Cureus 2022; 14:e30051. [PMID: 36381869 PMCID: PMC9638701 DOI: 10.7759/cureus.30051] [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: 08/28/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Dependency on digital devices resulting in an ever-increasing daily screen time has subsequently also been the cause of several adverse effects on physical and mental or psychological health. Constant exposure to devices like smartphones, personal computers, and television can severely affect mental health- increase stress and anxiety, for example, and cause various sleep issues in both children as well as adults. Risk factors for obesity and cardiovascular disorders, including hypertension, poor regulation of stress, low HDL cholesterol, and insulin resistance are among the physical health repercussions we see. The psychological health effects comprise suicidal tendencies and symptoms of depression which are associated with digital device dependency, screen-time-induced poor sleep quality, and content-influenced negativity. Oftentimes it can cause the induction of a state of hyper-arousal, increase stress hormones, desynchronize the body clock or the circadian cycle, alter brain chemistry and create a drag on mental energy and development. With a focus on brain development in children and detrimental effects in both adults and children, this research article goes on to explore the various aspects of screen addiction and excessive screen exposure.
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Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use. SUSTAINABILITY 2022. [DOI: 10.3390/su14148845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.
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Hong N, Kim JJ, Kwon JH, Eom H, Kim E. Effect of Distractors on Sustained Attention and Hyperactivity in Youth With Attention Deficit Hyperactivity Disorder Using a Mobile Virtual Reality School Program. J Atten Disord 2022; 26:358-369. [PMID: 33430697 DOI: 10.1177/1087054720986229] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examined whether distractors in virtual reality (VR) environment affected the attention and hyperactivity in children and adolescents with ADHD. METHOD A total of 40 students (21 ADHD, 19 controls) aged between 9 and 17 years participated in this study. A rapid visual information processing task utilizing VR (VR-RVP) was performed under two conditions (no-distractor and distractor condition). Task performance and head movement during each condition were compared, and additional analyses were conducted after grouping participants into two developmental stages. RESULTS Children with ADHD performed comparably to the controls under the distractor condition, but had poorer performance under the no-distractor condition. They displayed more head movement under the distractor condition than in the no-distractor condition. CONCLUSION VR is possibly a useful tool for investigating the effect of distractors on individuals with ADHD, and children with ADHD are more vulnerable to a low-level stimulation situation than normal children in VR.
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Affiliation(s)
- Narae Hong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Joon-Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Eunjoo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Republic of Korea
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15
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Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition associated with impaired function and increased risk of poor outcomes in children, young people and adults with the condition. Currently approved pharmacological treatments for ADHD include a range of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, guanfacine, clonidine) medications. All have been shown to be effective in treating the symptoms of ADHD and improving other functional outcomes including quality of life, academic performance, rates of accidents and injuries, and do not appear to be associated with significant adverse outcomes or side effects. In this chapter, we review medications for ADHD by summarising the mechanisms of action of each of the two main classes of compounds (stimulants and nonstimulants), the formulations of the most commonly prescribed medications within each class, their efficacy in treating ADHD symptoms and other outcomes, and other factors that influence treatment decisions including side effects and tolerability, comorbidities and medical history. We conclude with a summary of the treatment decisions made by clinicians and suggest some next steps for research. Further research is needed to understand the mechanisms of action of these medications and how exactly they improve symptoms, and to examine their effects on commonly occurring comorbidities.
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Affiliation(s)
- Madeleine J Groom
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK.
| | - Samuele Cortese
- Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, Nottingham, UK
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16
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Ziegler M, Kaiser A, Igel C, Geissler J, Mechler K, Holz NE, Becker K, Döpfner M, Romanos M, Brandeis D, Hohmann S, Millenet S, Banaschewski T. Actigraphy-Derived Sleep Profiles of Children with and without Attention-Deficit/Hyperactivity Disorder (ADHD) over Two Weeks-Comparison, Precursor Symptoms, and the Chronotype. Brain Sci 2021; 11:brainsci11121564. [PMID: 34942866 PMCID: PMC8699578 DOI: 10.3390/brainsci11121564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Although sleep problems are common in children with ADHD, their extent, preceding risk factors, and the association between neurocognitive performance and neurobiological processes in sleep and ADHD, are still largely unknown. We examined sleep variables in school-aged children with ADHD, addressing their intra-individual variability (IIV) and considering potential precursor symptoms as well as the chronotype. Additionally, in a subgroup of our sample, we investigated associations with neurobehavioral functioning (n = 44). A total of 57 children (6-12 years) with (n = 24) and without ADHD (n = 33) were recruited in one center of the large ESCAlife study to wear actigraphs for two weeks. Actigraphy-derived dependent variables, including IIV, were analyzed using linear mixed models in order to find differences between the groups. A stepwise regression model was used to investigate neuropsychological function. Overall, children with ADHD showed longer sleep onset latency (SOL), higher IIV in SOL, more movements during sleep, lower sleep efficiency, and a slightly larger sleep deficit on school days compared with free days. No group differences were observed for chronotype or sleep onset time. Sleep problems in infancy predicted later SOL and the total number of movements during sleep in children with and without ADHD. No additional effect of sleep problems, beyond ADHD symptom severity, on neuropsychological functioning was found. This study highlights the importance of screening children with ADHD for current and early childhood sleep disturbances in order to prevent long-term sleep problems and offer individualized treatments. Future studies with larger sample sizes should examine possible biological markers to improve our understanding of the underlying mechanisms.
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Affiliation(s)
- Mirjam Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Correspondence: ; Tel.: +49-(0)-621-1703-4911
| | - Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Christine Igel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Julia Geissler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, University of Würzburg, 97080 Würzburg, Germany; (J.G.); (M.R.)
| | - Konstantin Mechler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Nathalie E. Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, 6525 EN Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, 6525 EN Nijmegen, The Netherlands
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg and University Hospital Marburg, 35039 Marburg, Germany;
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, 35032 Marburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany;
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, University of Würzburg, 97080 Würzburg, Germany; (J.G.); (M.R.)
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, 8032 Zürich, Switzerland
- Center for Integrative Human Physiology, University of Zürich, 8057 Zürich, Switzerland
- Neuroscience Center Zürich, Swiss Federal Institute of Technology, University of Zürich, 8057 Zürich, Switzerland
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany; (A.K.); (C.I.); (K.M.); (N.E.H.); (D.B.); (S.H.); (S.M.); (T.B.)
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17
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Bellato A, Arora I, Kochhar P, Ropar D, Hollis C, Groom MJ. Heart Rate Variability in Children and Adolescents with Autism, ADHD and Co-occurring Autism and ADHD, During Passive and Active Experimental Conditions. J Autism Dev Disord 2021; 52:4679-4691. [PMID: 34716841 PMCID: PMC9556357 DOI: 10.1007/s10803-021-05244-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 12/22/2022]
Abstract
Despite overlaps in clinical symptomatology, autism and ADHD may be associated with opposite autonomic arousal profiles which might partly explain altered cognitive and global functioning. We investigated autonomic arousal in 106 children/adolescents with autism, ADHD, co-occurring autism/ADHD, and neurotypical controls. Heart rate variability was recorded during resting-state, a 'passive' auditory oddball task and an 'active' response conflict task. Autistic children showed hyper-arousal during the active task, while those with ADHD showed hypo-arousal during resting-state and the passive task. Irrespective of diagnosis, children characterised by hyper-arousal showed more severe autistic symptomatology, increased anxiety and reduced global functioning than those displaying hypo-arousal, suggesting the importance of considering individual autonomic arousal profiles for differential diagnosis of autism/ADHD and when developing personalised interventions.
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Affiliation(s)
- Alessio Bellato
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Iti Arora
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Puja Kochhar
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.,Child and Adolescent Mental Health Services (CAMHS), Derbyshire Healthcare NHS Foundation Trust, Temple House, Mill Hill Lane, Derby, DE23 6SA, UK
| | - Danielle Ropar
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Chris Hollis
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Medtech Co-operative, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.,NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Madeleine J Groom
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK. .,NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
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18
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Gagnon K, Labrosse M, Gingras MA, Godbout R. Sleep Instability Correlates with Attentional Impairment in Boys with Attention Deficit Hyperactivity Disorder. Brain Sci 2021; 11:1425. [PMID: 34827422 PMCID: PMC8615536 DOI: 10.3390/brainsci11111425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Theoretical models of sleep and attention deficit hyperactivity disorder (ADHD) suggest that symptoms of ADHD are associated with daytime sleepiness, but it has received little support. The present study aimed at testing an alternative model involving the association of attentional instability with sleep instability, i.e., sleep stage transitions and arousals. Twelve ADHD and 15 healthy control (HC) boys aged between 8 and 12 years old underwent polysomnography recording and attentional testing. The microarousal index, the number of awakenings, and the number of stage shifts between stages 1, 2, 3, 4 and REM sleep throughout the night were computed as sleep stability parameters. Attentional functioning was assessed using the Continuous Performance Test-II. We found significantly higher sleep instability in ADHD compared to HC. Sleep arousals and stage transitions (micro arousal index, stage 4/3 and 2/4 transitions) in ADHD significantly correlated with lower attentional scores. No association whatsoever was found between sleep instability and attentional functioning in HC. The results show that sleep instability is associated with lower attentional performance in boys with ADHD, but not in HC. This could be compatible with a model according to which attention and sleep stability share a common neural substrate in ADHD.
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Affiliation(s)
- Katia Gagnon
- Sleep Laboratory and Clinic, Hôpital en Santé mentale Rivière-des-Prairies, Montréal, QC H1E 1A4, Canada; (K.G.); (M.L.); (M.-A.G.)
- Department of Psychiatry, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mélanie Labrosse
- Sleep Laboratory and Clinic, Hôpital en Santé mentale Rivière-des-Prairies, Montréal, QC H1E 1A4, Canada; (K.G.); (M.L.); (M.-A.G.)
| | - Marc-André Gingras
- Sleep Laboratory and Clinic, Hôpital en Santé mentale Rivière-des-Prairies, Montréal, QC H1E 1A4, Canada; (K.G.); (M.L.); (M.-A.G.)
| | - Roger Godbout
- Sleep Laboratory and Clinic, Hôpital en Santé mentale Rivière-des-Prairies, Montréal, QC H1E 1A4, Canada; (K.G.); (M.L.); (M.-A.G.)
- Department of Psychiatry, Université de Montréal, Montréal, QC H3T 1J4, Canada
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19
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Jawinski P, Markett S, Sander C, Huang J, Ulke C, Hegerl U, Hensch T. The Big Five Personality Traits and Brain Arousal in the Resting State. Brain Sci 2021; 11:brainsci11101272. [PMID: 34679337 DOI: 10.3390/brainsci11101272/s1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 05/25/2023] Open
Abstract
Based on Eysenck's biopsychological trait theory, brain arousal has long been considered to explain individual differences in human personality. Yet, results from empirical studies remained inconclusive. However, most published results have been derived from small samples and, despite inherent limitations, EEG alpha power has usually served as an exclusive indicator for brain arousal. To overcome these problems, we here selected N = 468 individuals of the LIFE-Adult cohort and investigated the associations between the Big Five personality traits and brain arousal by using the validated EEG- and EOG-based analysis tool VIGALL. Our analyses revealed that participants who reported higher levels of extraversion and openness to experience, respectively, exhibited lower levels of brain arousal in the resting state. Bayesian and frequentist analysis results were especially convincing for openness to experience. Among the lower-order personality traits, we obtained the strongest evidence for neuroticism facet 'impulsivity' and reduced brain arousal. In line with this, both impulsivity and openness have previously been conceptualized as aspects of extraversion. We regard our findings as well in line with the postulations of Eysenck and consistent with the recently proposed 'arousal regulation model'. Our results also agree with meta-analytically derived effect sizes in the field of individual differences research, highlighting the need for large (collaborative) studies.
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Affiliation(s)
- Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Christian Sander
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Christine Ulke
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Ulrich Hegerl
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Frankfurt, 60323 Frankfurt, Germany
| | - Tilman Hensch
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
- Department of Psychology, IU International University of Applied Science, 99084 Erfurt, Germany
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20
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Jawinski P, Markett S, Sander C, Huang J, Ulke C, Hegerl U, Hensch T. The Big Five Personality Traits and Brain Arousal in the Resting State. Brain Sci 2021; 11:brainsci11101272. [PMID: 34679337 PMCID: PMC8533901 DOI: 10.3390/brainsci11101272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/14/2022] Open
Abstract
Based on Eysenck's biopsychological trait theory, brain arousal has long been considered to explain individual differences in human personality. Yet, results from empirical studies remained inconclusive. However, most published results have been derived from small samples and, despite inherent limitations, EEG alpha power has usually served as an exclusive indicator for brain arousal. To overcome these problems, we here selected N = 468 individuals of the LIFE-Adult cohort and investigated the associations between the Big Five personality traits and brain arousal by using the validated EEG- and EOG-based analysis tool VIGALL. Our analyses revealed that participants who reported higher levels of extraversion and openness to experience, respectively, exhibited lower levels of brain arousal in the resting state. Bayesian and frequentist analysis results were especially convincing for openness to experience. Among the lower-order personality traits, we obtained the strongest evidence for neuroticism facet 'impulsivity' and reduced brain arousal. In line with this, both impulsivity and openness have previously been conceptualized as aspects of extraversion. We regard our findings as well in line with the postulations of Eysenck and consistent with the recently proposed 'arousal regulation model'. Our results also agree with meta-analytically derived effect sizes in the field of individual differences research, highlighting the need for large (collaborative) studies.
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Affiliation(s)
- Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany;
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Correspondence: ; Tel.: +49-30-2093-9391
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany;
| | - Christian Sander
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Christine Ulke
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Ulrich Hegerl
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Frankfurt, 60323 Frankfurt, Germany
| | - Tilman Hensch
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Psychology, IU International University of Applied Science, 99084 Erfurt, Germany
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21
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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22
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Robe A, Păsărelu CR, Dobrean A. Exploring autonomic regulation in children with ADHD with and without comorbid anxiety disorder through three systematic levels of cardiac vagal control analysis: Rest, reactivity, and recovery. Psychophysiology 2021; 58:e13850. [PMID: 34046904 DOI: 10.1111/psyp.13850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022]
Abstract
Autonomic nervous system (ANS) dysregulation, characterized by reduced vagally mediated Heart Rate Variability (HRV), has been associated with Attention-Deficit/ Hyperactivity Disorder (ADHD). This study investigated the dynamic vagal modulation of cardiac output in response to shifts in environmental demands in children and adolescents with ADHD, with and without a comorbid anxiety disorder. High-frequency HRV (HF-HRV) measures were obtained from 46 children and adolescents ranging from 6 to 17 (M = 9.38; SD = 2.31) years old, during three successive experimental conditions: a baseline recording followed by a sustained attention task, and a post-task recovery period. Findings support the reliability of the d2 Test, a cancelation test of attention and concentration, to induce parasympathetic withdrawal and extend prior work on "vagal flexibility". Further, these findings suggest a pattern of group differences in ANS functioning in children with ADHD, with and without a comorbid anxiety disorder. Only the ADHD without comorbid anxiety group showed a normative autonomic response to the cognitive challenge (reduced HF-HRV). The participants did not display an adaptive process of restoration following the cognitive challenge; the HRV suppression was prolonged during post-task recovery period, suggesting that ANS responded as if the cognitive stressor was still present. The current paper covers and discusses theoretical implications for the abnormalities in neurophysiological functioning and the different physiological responses in the two ADHD subtypes.
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Affiliation(s)
- Andreea Robe
- Doctoral School "Evidence-based Assessment and Psychological Interventions, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania
| | - Costina-Ruxandra Păsărelu
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania
| | - Anca Dobrean
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania
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23
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Schulz J, Huber F, Schlack R, Hölling H, Ravens-Sieberer U, Meyer T, Poustka L, Rothenberger A, Wang B, Becker A. The Association between Low Blood Pressure and Attention-Deficit Hyperactivity Disorder (ADHD) Observed in Children/Adolescents Does Not Persist into Young Adulthood. A Population-Based Ten-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041864. [PMID: 33672943 PMCID: PMC7918102 DOI: 10.3390/ijerph18041864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/30/2022]
Abstract
Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood and adolescence associated with relevant psychosocial impairments. The basic pathophysiology of ADHD may be related, at least partly, to a deficit in autonomic arousal processes, which not only influence core symptoms of the disorder, but may also lead to blood pressure (BP) deviations due to altered arousal regulation. Objectives: This study examined long-term changes in BP in children and adolescents with ADHD up to young adulthood. Methods: In children and adolescents aged between 7 and 17 years at baseline, we compared BP recordings in subjects with (n = 1219, 11.1%) and without (n = 9741, 88.9%) ADHD over a 10-year follow-up using data from the nationwide German Health Survey for Children and Adolescents (KiGGS). Propensity score matching was used to improve the comparability between children in the ADHD and control groups with now n = 1.190 in each group. Results: The results of these matched samples revealed that study participants with ADHD showed significantly lower systolic BP (107.6 ± 10.7 mmHg vs. 109.5 ± 10.9 mmHg, p < 0.001, Cohen’s d = 0.17) and diastolic BP (64.6 ± 7.5 mmHg vs. 65.8 ± 7.4 mmHg, p < 0.001, Cohen’s d = 0.16) at baseline. In a sensitivity analysis with a smaller (n = 272) and more stringently diagnosed ADHD group, the significant differences remained stable with somewhat higher Cohen’s d; i.e., 0.25 and 0.27, respectively. However, these differences did not persist after 10-year follow-up in a smaller matched longitudinal sub-group (ADHD n = 273; control n = 323), as subjects with and without ADHD had similar levels of systolic (123.4 ± 10.65 vs. 123.78 ± 11.1 mmHg, p = 0.675, Cohen’s d = 0.15) and diastolic BP (71.86 ± 6.84 vs. 71.85 ± 7.06 mmHg, p = 0.992, Cohen’s d = 0.16). Conclusions: At baseline, children and adolescents with ADHD had significantly lower BP (of small effect sizes) compared to the non-ADHD group, whereas this difference was no longer detectable at follow-up ten years later. These developmental alterations in BP from adolescence to early adulthood may reflect changes in the state of autonomic arousal, probably modulating the pathophysiology of ADHD.
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Affiliation(s)
- Jan Schulz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
| | - Franziska Huber
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
| | - Robert Schlack
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit Mental Health, 13353 Berlin, Germany; (R.S.); (H.H.)
| | - Heike Hölling
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit Mental Health, 13353 Berlin, Germany; (R.S.); (H.H.)
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany;
- German Centre for Cardiovascular Research, Partner Site Göttingen, 10115 Berlin, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
| | - Biyao Wang
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
- Department of Clinical, Educational and Health Psychology, University College London, London WC1H 0AP, UK
- Correspondence:
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.S.); (F.H.); (L.P.); (A.R.); (A.B.)
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24
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Berger C, Dück A, Perin F, Wunsch K, Buchmann J, Kölch M, Reis O, Marx I. Brain Arousal as Measured by EEG-Assessment Differs Between Children and Adolescents With Attention-Deficit/Hyperactivity Disorder (ADHD) and Depression. Front Psychiatry 2021; 12:633880. [PMID: 34777030 PMCID: PMC8581225 DOI: 10.3389/fpsyt.2021.633880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 09/23/2021] [Indexed: 11/28/2022] Open
Abstract
Objective: Disturbed regulation of vigilance in the wake state seems to play a key role in the development of mental disorders. It is assumed that hyperactivity in adult ADHD is an attempt to increase a general low vigilance level via external stimulation in order to avoid drowsiness. For depression, the avoidance of stimulation is interpreted as a reaction to a tonic increased vigilance state. Although ADHD is assumed to start during childhood, this vigilance model has been barely tested with children diagnosed for ADHD so far. Methods: Resting-state EEG (8 min) measures from two groups of children diagnosed with either ADHD [N = 76 (16 female, 60 male), age: (mean/SD) 118/33 months] or depression [N = 94 (73 female, 21 male), age: 184/23 months] were analyzed. Using the VIGALL toolbox, EEG patterns of vigilance level, and regulation were derived and compared between both groups. In correlation analysis, the relations between vigilance measures, attentional test performance (alertness and inhibition), and mental health symptoms were analyzed. Results: Children with ADHD differed from children with most prominent depressive symptoms in brain arousal regulation and level, but EEG vigilance was not related to behavior problems and not related to the attentional test performance. Brain arousal was dependent on the age of the participant in the whole sample; younger children showed lower vigilance stages than teenagers; this effect was not present when analyzed separately for each diagnostic group. EEG assessment time and received medication had no effect on the EEG vigilance. Discussion: Although based on a small sample, this explorative research revealed that EEG vigilance level is different between children with ADHD and with depression. Moreover, even the standard procedure of the clinical routine EEG (resting state) can be used to differentiate brain arousal states between participants with ADHD and depression. Because routine EEG is not specialized to vigilance assessment, it may not be sufficiently sensitive to find vigilance-symptomatology associations. Further research should address developmental changes in EEG measurements in children and use bigger samples of participants within the same age range.
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Affiliation(s)
- Christoph Berger
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Alexander Dück
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Felicitas Perin
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Katharina Wunsch
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Johannes Buchmann
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Michael Kölch
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Ivo Marx
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
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25
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Earnest T, Shephard E, Tye C, McEwen F, Woodhouse E, Liang H, Sheerin F, Bolton PF. Actigraph-Measured Movement Correlates of Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Young People with Tuberous Sclerosis Complex (TSC) with and without Intellectual Disability and Autism Spectrum Disorder (ASD). Brain Sci 2020; 10:brainsci10080491. [PMID: 32731531 PMCID: PMC7465488 DOI: 10.3390/brainsci10080491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 02/02/2023] Open
Abstract
Actigraphy, an objective measure of motor activity, reliably indexes increased movement levels in attention-deficit/hyperactivity disorder (ADHD) and may be useful for diagnosis and treatment-monitoring. However, actigraphy has not been examined in complex neurodevelopmental conditions. This study used actigraphy to objectively measure movement levels in individuals with a complex neurodevelopmental genetic disorder, tuberous sclerosis (TSC). Thirty participants with TSC (11–21 years, 20 females, IQ = 35–108) underwent brief (approximately 1 h) daytime actigraph assessment during two settings: movie viewing and cognitive testing. Multiple linear regressions were used to test associations between movement measurements and parent-rated ADHD symptoms. Correlations were used to examine associations between actigraph measures and parent-rated ADHD symptoms and other characteristics of TSC (symptoms of autism spectrum disorder (ASD), intellectual ability (IQ), epilepsy severity, cortical tuber count). Higher movement levels during movies were associated with higher parent-rated ADHD symptoms. Higher ADHD symptoms and actigraph-measured movement levels during movies were positively associated with ASD symptoms and negatively associated with IQ. Inter-individual variability of movement during movies was not associated with parent-rated hyperactivity or IQ but was negatively associated with ASD symptoms. There were no associations with tuber count or epilepsy. Our findings suggest that actigraph-measured movement provides a useful correlate of ADHD in TSC.
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Affiliation(s)
- Tom Earnest
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
- Correspondence:
| | - Elizabeth Shephard
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
| | - Charlotte Tye
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
- Social, Genetic & Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Fiona McEwen
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
- Social, Genetic & Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Emma Woodhouse
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK;
| | - Holan Liang
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
- Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Fintan Sheerin
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
| | - Patrick F. Bolton
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (E.S.); (C.T.); (F.M.); (H.L.); (F.S.); (P.F.B.)
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26
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Bellato A, Arora I, Kochhar P, Hollis C, Groom MJ. Atypical Electrophysiological Indices of Eyes-Open and Eyes-Closed Resting-State in Children and Adolescents with ADHD and Autism. Brain Sci 2020; 10:E272. [PMID: 32370023 PMCID: PMC7288160 DOI: 10.3390/brainsci10050272] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 12/19/2022] Open
Abstract
Investigating electrophysiological measures during resting-state might be useful to investigate brain functioning and responsivity in individuals under diagnostic assessment for attention deficit hyperactivity disorder (ADHD) and autism. EEG was recorded in 43 children with or without ADHD and autism, during a 4-min-long resting-state session which included an eyes-closed and an eyes-open condition. We calculated and analyzed occipital absolute and relative spectral power in the alpha frequency band (8-12 Hz), and alpha reactivity, conceptualized as the difference in alpha power between eyes-closed and eyes-open conditions. Alpha power was increased during eyes-closed compared to eyes-open resting-state. While absolute alpha power was reduced in children with autism, relative alpha power was reduced in children with ADHD, especially during the eyes-closed condition. Reduced relative alpha reactivity was mainly associated with lower IQ and not with ADHD or autism. Atypical brain functioning during resting-state seems differently associated with ADHD and autism, however further studies replicating these results are needed; we therefore suggest involving research groups worldwide by creating a shared and publicly available repository of resting-state EEG data collected in people with different psychological, psychiatric, or neurodevelopmental conditions, including ADHD and autism.
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Affiliation(s)
- Alessio Bellato
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK; (I.A.); (P.K.); (C.H.); (M.J.G.)
| | - Iti Arora
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK; (I.A.); (P.K.); (C.H.); (M.J.G.)
| | - Puja Kochhar
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK; (I.A.); (P.K.); (C.H.); (M.J.G.)
| | - Chris Hollis
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK; (I.A.); (P.K.); (C.H.); (M.J.G.)
- NIHR MindTech Healthcare Technology Co-Operative, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK
| | - Madeleine J. Groom
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham NG7 2TU, UK; (I.A.); (P.K.); (C.H.); (M.J.G.)
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27
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Kiiski H, Bennett M, Rueda-Delgado LM, Farina FR, Knight R, Boyle R, Roddy D, Grogan K, Bramham J, Kelly C, Whelan R. EEG spectral power, but not theta/beta ratio, is a neuromarker for adult ADHD. Eur J Neurosci 2020; 51:2095-2109. [PMID: 31834950 DOI: 10.1111/ejn.14645] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/14/2022]
Abstract
Adults with attention-deficit/hyperactivity disorder (ADHD) have been described as having altered resting-state electroencephalographic (EEG) spectral power and theta/beta ratio (TBR). However, a recent review (Pulini et al. 2018) identified methodological errors in neuroimaging, including EEG, ADHD classification studies. Therefore, the specific EEG neuromarkers of adult ADHD remain to be identified, as do the EEG characteristics that mediate between genes and behaviour (mediational endophenotypes). Resting-state eyes-open and eyes-closed EEG was measured from 38 adults with ADHD, 45 first-degree relatives of people with ADHD and 51 unrelated controls. A machine learning classification analysis using penalized logistic regression (Elastic Net) examined if EEG spectral power (1-45 Hz) and TBR could classify participants into ADHD, first-degree relatives and/or control groups. Random-label permutation was used to quantify any bias in the analysis. Eyes-open absolute and relative EEG power distinguished ADHD from control participants (area under receiver operating characteristic = 0.71-0.77). The best predictors of ADHD status were increased power in delta, theta and low-alpha over centro-parietal regions, and in frontal low-beta and parietal mid-beta. TBR did not successfully classify ADHD status. Elevated eyes-open power in delta, theta, low-alpha and low-beta distinguished first-degree relatives from controls (area under receiver operating characteristic = 0.68-0.72), suggesting that these features may be a mediational endophenotype for adult ADHD. Resting-state EEG spectral power may be a neuromarker and mediational endophenotype of adult ADHD. These results did not support TBR as a diagnostic neuromarker for ADHD. It is possible that TBR is a characteristic of childhood ADHD.
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Affiliation(s)
- Hanni Kiiski
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Marc Bennett
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Medical Research Council- Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Francesca R Farina
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rachel Knight
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rory Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Darren Roddy
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Department of Physiology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Katie Grogan
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Clare Kelly
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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28
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Mangalmurti A, Kistler WD, Quarrie B, Sharp W, Persky S, Shaw P. Using virtual reality to define the mechanisms linking symptoms with cognitive deficits in attention deficit hyperactivity disorder. Sci Rep 2020; 10:529. [PMID: 31953449 PMCID: PMC6969149 DOI: 10.1038/s41598-019-56936-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 12/09/2019] [Indexed: 11/09/2022] Open
Abstract
The mechanisms underpinning attentional deficits are only partially understood. Here we ask if shifts in a child's field of view (FOV) act as a mediator between symptoms of attention deficit hyperactivity disorder (ADHD) and associated cognitive anomalies, particularly in attentional processes. Real time measurement of shifts in FOV were obtained on 85 children (mean age 9.4 (SD 1.9) years; 45 with DSM 5-defined ADHD) as they completed the continuous performance task in a "virtual classroom". We extracted measures reflecting focused and selective attention across the task, along with diffusion modelling of latent cognitive processes of information uptake, response conservativeness and non-decision time. Mediation analyses showed that shifts in FOV partially mediated the relationship between hyperactive impulsive symptoms and both poor focused attention and information uptake. Performance accuracy decreased and shifts in FOV increased during the task, but these changes over time did not differ by symptom severity. Employing virtual reality and mediation analysis, we implicate shifts in FOV as a mechanism linking symptoms of ADHD and deficits in focused attention and in the gathering of information to make decisions. The identification of mediating mechanisms might provide new targets for intervention.
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Affiliation(s)
- Aman Mangalmurti
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States
| | - William D Kistler
- Immersive Virtual Environment Testing Unit, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States
| | - Barrington Quarrie
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States
| | - Wendy Sharp
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States
| | - Susan Persky
- Immersive Virtual Environment Testing Unit, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, NHGRI/NIH, Bethesda, United States.
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29
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Can auditory warning signals normalize eye movements in children with ADHD? Eur Child Adolesc Psychiatry 2020; 29:1635-1644. [PMID: 32008169 PMCID: PMC7641930 DOI: 10.1007/s00787-020-01484-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/27/2020] [Indexed: 12/25/2022]
Abstract
Attenuated baseline arousal has been hypothesized to underlie symptoms of attention deficit/hyperactivity disorder (ADHD). A behavioral signature of reduced baseline arousal is an increased beneficiary effect of warning signals in reaction tasks. This paradoxical effect is believed to be caused by a temporary increase in arousal induced by warning signals. In a preregistered study, we tested the hypothesis that children with high levels of ADHD symptoms would be hyperresponsive to warning signals in a well-established visual attention task (the gap/overlap paradigm). Previous studies using this task have found slower and more variable saccadic reaction times in children with ADHD compared to typically developing children, suggesting that these eye movement metrics are candidate biomarkers. We examined 71 children, of which 1/3 had a diagnosis of ADHD, using both dimensional analyses and group comparisons. Previously reported findings of reduced saccadic latency and increased latency variability were replicated. Importantly, saccadic latency was normalized by auditory warning signals. Analyses of pupil dilation, a physiological index of arousal and locus coeruleus-noradrenergic activity, confirmed that warning signals led to enhanced arousal. Our findings are novel and contribute to our understanding of arousal and attention in ADHD and have implications for treatment and interventions.
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30
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Bellato A, Arora I, Hollis C, Groom MJ. Is autonomic nervous system function atypical in attention deficit hyperactivity disorder (ADHD)? A systematic review of the evidence. Neurosci Biobehav Rev 2020; 108:182-206. [DOI: 10.1016/j.neubiorev.2019.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 12/26/2022]
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31
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Stoppe M, Meyer K, Schlingmann M, Olbrich S, Then Bergh F. Hyperstable arousal regulation in multiple sclerosis. Psychoneuroendocrinology 2019; 110:104417. [PMID: 31546115 DOI: 10.1016/j.psyneuen.2019.104417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is common in multiple sclerosis (MS) patients. Exhaustion of physiological reserves and mental stress are postulated causes, the latter supported by more pronounced hypothalamic-pituitary-adrenal (HPA) axis activation in fatigued patients. Divergent dysregulation of arousal appears to play important roles in depression- (hyperstable arousal) and in cancer-related (unstable arousal) fatigue, where HPA axis is hyperactive or hypoactive, respectively. OBJECTIVE This study assessed arousal regulation in multiple sclerosis patients, explored if fatigue can be physiologically described by altered arousal regulation, and if HPA axis activity corresponds to the type(s) of arousal regulation. METHODS 51 mildly-affected patients with relapsing-remitting MS (86% on disease-modifying treatment) and 20 healthy controls were analysed via Vigilance Algorithm Leipzig and combined dexamethasone/corticotropin releasing hormone test. RESULTS Hyperstable arousal pattern was significantly more frequent in patients than in controls (62.7% vs. 45.0%, p = 0.011). Patients scored higher on all fatigue, but not on sleepiness scales. All patients combined showed mild activation of the hypothalamic-pituitary-adrenal axis (p < 0.05 for post-CRH ACTH and AUC ACTH; cortisol n.s.). While fatigue was numerically more pronounced in both hyperstable and unstable arousal, HPA axis activity was highest in hyperstable and lowest in unstable arousal (p = 0.013 for post-CRH ACTH; p = 0.087 for AUC ACTH; cortisol n.s.). CONCLUSION Frequency of arousal patterns are altered in MS. An association with HPA axis activity was weak, possibly because the present sample was stable on immunotherapy.
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Affiliation(s)
- Muriel Stoppe
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany
| | - Klara Meyer
- Department of Neurology, University of Leipzig, Germany
| | | | | | - Florian Then Bergh
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany.
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32
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Ulke C, Rullmann M, Huang J, Luthardt J, Becker GA, Patt M, Meyer PM, Tiepolt S, Hesse S, Sabri O, Strauß M. Adult attention-deficit/hyperactivity disorder is associated with reduced norepinephrine transporter availability in right attention networks: a (S,S)-O-[ 11C]methylreboxetine positron emission tomography study. Transl Psychiatry 2019; 9:301. [PMID: 31732713 PMCID: PMC6858438 DOI: 10.1038/s41398-019-0619-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/12/2019] [Accepted: 10/03/2019] [Indexed: 12/22/2022] Open
Abstract
The norepinephrine transporter (NET) has been suggested to play a critical role in attention-deficit/hyperactivity disorder (ADHD). In this prospective controlled study we tested the a-priori-hypothesis that central NET availability is altered in adult ADHD patients compared to healthy controls. Study participants underwent single positron emission tomography-magnetic resonance imaging (PET-MRI). MRI sequences included high resolution T1-MPRAGE data for regions of interest (ROI) delineation and voxel-based morphometry (VBM) and T2-weighted fluid-attenuated inversion-recovery for detection and exclusion of pathological abnormalities. NET availability was assessed by NET-selective (S,S)-O-[11C]methylreboxetine; regional distribution volume ratios (DVR) were calculated based on individual PET-MRI data co-registration and a multi-linear reference tissue model with two constraints (MRTM2; reference region: occipital cortex). VBM analysis revealed no difference in local distribution of gray matter between the 20 ADHD patients (9 females, age 31.8 ± 7.9 years, 488 ± 8 MBq injected activity) and the 20 age-matched and sex-matched control participants (9 females, age 32.3 ± 7.9 years, 472 ± 72 MBq). In mixed-model repeated-measures analysis with NET availability as dependent and ROI as repeated measure we found a significant main effect group in fronto-parietal-thalamic-cerebellar regions (regions on the right: F1,25 = 12.30, p = .002; regions on the left: F1,41 = 6.80, p = .013) indicating a reduced NET availability in ADHD patients. None of the other investigated brain regions yielded significant differences in NET availability between groups after applying a Benjamini-Hochberg correction at a significance level of 0.05. Overall our findings demonstrate the pathophysiological involvement of NET availability in adult ADHD.
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Affiliation(s)
- Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany.
| | - Michael Rullmann
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Julia Luthardt
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Georg-Alexander Becker
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Philipp M Meyer
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Swen Hesse
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig Medical Center, 04103, Leipzig, Germany
| | - Maria Strauß
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany
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Vulnerability to bipolar disorder is linked to sleep and sleepiness. Transl Psychiatry 2019; 9:294. [PMID: 31712668 PMCID: PMC6848097 DOI: 10.1038/s41398-019-0632-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/01/2019] [Accepted: 10/20/2019] [Indexed: 12/16/2022] Open
Abstract
Sleep impairments are a hallmark of acute bipolar disorder (BD) episodes and are present even in the euthymic state. Studying healthy subjects who are vulnerable to BD can improve our understanding of whether sleep impairment is a predisposing factor. Therefore, we investigated whether vulnerability to BD, dimensionally assessed by the hypomanic personality scale (HPS), is associated with sleep disturbances in healthy subjects. We analyzed participants from a population-based cohort who had completed the HPS and had either a 7-day actigraphy recording or a Pittsburgh sleep quality index (PSQI) assessment. In addition, subjects had to be free of confounding diseases or medications. This resulted in 771 subjects for actigraphy and 1766 for PSQI analyses. We found strong evidence that higher HPS scores are associated with greater intraindividual sleep variability, more disturbed sleep and more daytime sleepiness. In addition, factor analyses revealed that core hypomanic features were especially associated with self-reported sleep impairments. Results support the assumption of disturbed sleep as a possibly predisposing factor for BD and suggest sleep improvement as a potential early prevention target.
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Jawinski P, Kirsten H, Sander C, Spada J, Ulke C, Huang J, Burkhardt R, Scholz M, Hensch T, Hegerl U. Human brain arousal in the resting state: a genome-wide association study. Mol Psychiatry 2019; 24:1599-1609. [PMID: 29703947 DOI: 10.1038/s41380-018-0052-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/22/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
Abstract
Arousal affects cognition, emotion, and behavior and has been implicated in the etiology of psychiatric disorders. Although environmental conditions substantially contribute to the level of arousal, stable interindividual characteristics are well-established and a genetic basis has been suggested. Here we investigated the molecular genetics of brain arousal in the resting state by conducting a genome-wide association study (GWAS). We selected N = 1877 participants from the population-based LIFE-Adult cohort. Participants underwent a 20-min eyes-closed resting state EEG, which was analyzed using the computerized VIGALL 2.1 (Vigilance Algorithm Leipzig). At the SNP-level, GWAS analyses revealed no genome-wide significant locus (p < 5E-8), although seven loci were suggestive (p < 1E-6). The strongest hit was an expression quantitative trait locus (eQTL) of TMEM159 (lead-SNP: rs79472635, p = 5.49E-8). Importantly, at the gene-level, GWAS analyses revealed significant evidence for TMEM159 (p = 0.013, Bonferroni-corrected). By mapping our SNPs to the GWAS results from the Psychiatric Genomics Consortium, we found that all corresponding markers of TMEM159 showed nominally significant associations with Major Depressive Disorder (MDD; 0.006 ≤ p ≤ 0.011). More specifically, variants associated with high arousal levels have previously been linked to an increased risk for MDD. In line with this, the MetaXcan database suggests increased expression levels of TMEM159 in MDD, as well as Autism Spectrum Disorder, and Alzheimer's Disease. Furthermore, our pathway analyses provided evidence for a role of sodium/calcium exchangers in resting state arousal. In conclusion, the present GWAS identifies TMEM159 as a novel candidate gene which may modulate the risk for psychiatric disorders through arousal mechanisms. Our results also encourage the elaboration of the previously reported interrelations between ion-channel modulators, sleep-wake behavior, and psychiatric disorders.
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Affiliation(s)
- Philippe Jawinski
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. .,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany. .,Depression Research Centre, German Depression Foundation, Leipzig, Germany.
| | - Holger Kirsten
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.,Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Christian Sander
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christine Ulke
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ralph Burkhardt
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Markus Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Tilman Hensch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
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Andrillon T, Windt J, Silk T, Drummond SPA, Bellgrove MA, Tsuchiya N. Does the Mind Wander When the Brain Takes a Break? Local Sleep in Wakefulness, Attentional Lapses and Mind-Wandering. Front Neurosci 2019; 13:949. [PMID: 31572112 PMCID: PMC6753166 DOI: 10.3389/fnins.2019.00949] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/22/2019] [Indexed: 01/18/2023] Open
Abstract
Sleep has been classically described as an all-or-nothing global phenomenon. However, recent research strongly suggests that this view requires tempering. Invasive and non-invasive recordings in animals and humans show that neural activity typically associated with sleep can locally occur during wakefulness. Although local sleep is defined neuronally, it has been associated with impaired performance during cognitive tasks. Comparatively, the phenomenology of local sleep (i.e., what it feels like when your brain is partially asleep) has been less explored. Taking into account the literature on the neuronal and behavioral profile of local sleep intrusions in wakefulness, we propose that occurrences of local sleep could represent the neural mechanism underlying many attentional lapses. In particular, we argue that a unique physiological event such as local sleep could account for a diversity of behavioral outcomes from sluggish to impulsive responses. We further propose that local sleep intrusions could impact individuals' subjective experience. Specifically, we propose that the timing and anatomical sources of local sleep intrusions could be responsible for both the behavioral consequences and subjective content of attentional lapses and may underlie the difference between subjective experiences such as mind wandering and mind blanking. Our framework aims to build a parallel between spontaneous experiences in sleep and wakefulness by integrating evidence across neuronal, behavioral and experiential levels. We use the example of attention deficit hyperactivity disorder (ADHD) to illustrate how local sleep could explain complex cognitive profiles which include inattention, impulsivity, mind-wandering and mind-blanking.
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Affiliation(s)
- Thomas Andrillon
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Jennifer Windt
- School of Philosophical, Historical and International Studies, Monash University, Melbourne, VIC, Australia
| | - Tim Silk
- School of Psychology, Deakin University, Melbourne, VIC, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sean P. A. Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Mark A. Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Naotsugu Tsuchiya
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan
- Advanced Telecommunications Research Computational Neuroscience Laboratories, Kyoto, Japan
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Schatz KC, Brown LM, Barrett AR, Roth LC, Grinevich V, Paul MJ. Viral rescue of magnocellular vasopressin cells in adolescent Brattleboro rats ameliorates diabetes insipidus, but not the hypoaroused phenotype. Sci Rep 2019; 9:8243. [PMID: 31160697 PMCID: PMC6546688 DOI: 10.1038/s41598-019-44776-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/23/2019] [Indexed: 12/27/2022] Open
Abstract
Dysregulated arousal often accompanies neurodevelopmental disorders such as attention deficit hyperactivity disorder and autism spectrum disorder. Recently, we have found that adolescent homozygous Brattleboro (Hom) rats, which contain a mutation in the arginine vasopressin (AVP) gene, exhibit lower behavioral arousal than their heterozygous (Het) littermates in the open field test. This hypoaroused phenotype could be due to loss of AVP in magnocellular cells that supply AVP to the peripheral circulation and project to limbic structures or parvocellular cells that regulate the stress axis and other central targets. Alternatively, hypoarousal could be a side effect of diabetes insipidus - polydipsia and polyuria seen in Hom rats due to loss of AVP facilitation of water reabsorption in the kidney. We developed a viral-rescue approach to "cure" magnocellular AVP cells of their Brattleboro mutation. Infusion of a recombinant adeno-associated virus (rAAV) containing a functional Avp gene and promoter (rAAV-AVP) rescued AVP within magnocellular cells and fiber projections of the paraventricular nucleus of the hypothalamus (PVN) of male and female adolescent Hom rats. Furthermore, water intake was markedly reduced, ameliorating the symptoms of diabetes insipidus. In contrast, open field activity was unaffected. These findings indicate that the hyporaoused phenotype of adolescent Hom rats is not due to the loss of AVP function in magnocellular cells or a side effect of diabetes insipidus, but favors the hypothesis that central, parvocellular AVP mechanisms underlie the regulation of arousal during adolescence.
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Affiliation(s)
- K C Schatz
- Department of Psychology, University at Buffalo, SUNY, Buffalo, 14260, NY, USA.
| | - L M Brown
- Department of Psychology, University at Buffalo, SUNY, Buffalo, 14260, NY, USA
| | - A R Barrett
- Department of Psychology, University at Buffalo, SUNY, Buffalo, 14260, NY, USA
| | - L C Roth
- Department of Molecular Neurobiology, Max Planck Institute for Medical Research, Heidelberg, 69120, Germany
- Letten Centre and GliaLab, Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, 0317, Oslo, Norway
| | - V Grinevich
- Department of Molecular Neurobiology, Max Planck Institute for Medical Research, Heidelberg, 69120, Germany
- Schaller Group on Neuropeptides, German Cancer Research Center, Heidelberg, 69120, Germany
- Department of Neuropeptide Research for Psychiatry, Central Institute of Mental Health, Heidelberg University, Mannheim, 68159, Germany
| | - M J Paul
- Department of Psychology, University at Buffalo, SUNY, Buffalo, 14260, NY, USA
- Neuroscience Program, University at Buffalo, SUNY, Buffalo, 14260, NY, USA
- Evolution, Ecology and Behavior Program, University at Buffalo, SUNY, Buffalo, 14260, NY, USA
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Abstract
Pain is a universal, multidimensional experience with sensory, emotional, cognitive, and social components, which is fundamental to our environmental learning when functioning typically. Understanding pain processing in psychiatric conditions could provide unique insight into the underlying pathophysiology or psychiatric disease, especially given the psychobiological overlap with pain processing pathways. Studying pain in psychiatric conditions is likely to provide important insights, yet, there is a limited understanding beyond the work in depression and anxiety. This is a missed opportunity to describe psychiatric conditions in terms of neurobiological alterations. To examine the research into the pain experiences of these groups and the extent to which a-typicality is present, a systematic review was conducted. An electronic search strategy was developed and conducted in several databases. The current systematic review included 46 studies covering five Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) disorders: autism, attention-deficit hyperactivity disorder (ADHD), schizophrenia, personality disorder, and eating disorders, confirming tentative evidence of altered pain and touch processing. Specifically, hyposensitivity is reported in schizophrenia, personality disorder and eating disorder, hypersensitivity in ADHD, and mixed results for autism. Review of the research highlights a degree of methodological inconsistency in the utilization of comprehensive protocols, the lack of which fails to allow us to understand whether a-typicality is systemic or modality specific.
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Lecei A, van Hulst BM, de Zeeuw P, van der Pluijm M, Rijks Y, Durston S. Can we use neuroimaging data to differentiate between subgroups of children with ADHD symptoms: A proof of concept study using latent class analysis of brain activity. Neuroimage Clin 2018; 21:101601. [PMID: 30497980 PMCID: PMC6412817 DOI: 10.1016/j.nicl.2018.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/25/2018] [Accepted: 11/16/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multiple pathway models of ADHD suggest that multiple, separable biological pathways may lead to symptoms of the disorder. If this is the case, it should be possible to identify subgroups of children with ADHD based on distinct patterns of brain activity. Previous studies have used latent class analysis (LCA) to define subgroups at the behavioral and cognitive level and to then test whether they differ at the neurobiological level. In this proof of concept study, we took a reverse approach. We applied LCA to functional imaging data from two previously published studies to explore whether we could identify subgroups of children with ADHD symptoms at the neurobiological level with a meaningful relation to behavior or neuropsychology. METHODS Fifty-six children with symptoms of ADHD (27 children with ADHD and 29 children with ASD and ADHD symptoms) and 31 typically developing children performed two neuropsychological tasks assessing reward sensitivity and temporal expectancy during functional magnetic resonance imaging. LCA was used to identify subgroups with similar patterns of brain activity separately for children with ADHD-symptoms and typically developing children. Behavioral and neuropsychological differences between subgroups were subsequently investigated. RESULTS For typically developing children, a one-subgroup model gave the most parsimonious fit, whereas for children with ADHD-symptoms a two-subgroup model best fits the data. The first ADHD subgroup (n = 49) showed attenuated brain activity compared to the second subgroup (n = 7) and to typically developing children (n = 31). Notably, the ADHD subgroup with attenuated brain activity showed less behavioral problems in everyday life. CONCLUSIONS In this proof of concept study, we showed that we could identify distinct subgroups of children with ADHD-symptoms based on their brain activity profiles. Generalizability was limited due to the small sample size, but ultimately such neurobiological profiles could improve insight in individual prognosis and treatment options.
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Affiliation(s)
- Aleksandra Lecei
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands.
| | - Branko M van Hulst
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands.
| | - Patrick de Zeeuw
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands
| | - Marieke van der Pluijm
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands
| | - Yvonne Rijks
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, the Netherlands
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Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. ENVIRONMENTAL RESEARCH 2018; 164:149-157. [PMID: 29499467 DOI: 10.1016/j.envres.2018.01.015] [Citation(s) in RCA: 298] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/16/2018] [Indexed: 05/03/2023]
Abstract
UNLABELLED A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior. CONCLUSIONS Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents appears as a major factor which may hamper the formation of sound psychophysiological resilience.
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Affiliation(s)
- Gadi Lissak
- Meuhedet Health Services, Jerusalem, Israel.
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Dekkers TJ, van Bergen NRJ, Jansen BRJ. An Assessment of the Psychometric Properties of the Brief Sensation Seeking Scale for Children. J Pers Assess 2018; 101:446-451. [PMID: 29771144 DOI: 10.1080/00223891.2018.1468336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Sensation seeking is a trait that predicts a wide range of real-life risk behavior, such as substance abuse and gambling problems. Sensation seeking is often assessed with the Sensation Seeking Scale. Several adaptations of this questionnaire have been made, for example, to abbreviate it and to make it suitable for children. However, studies on sensation seeking in children are scarce. The aim of this study was to investigate sensation seeking in children (N = 158, M age = 11.4 years). The Brief Sensation Seeking Scale for Children (BSSS-C) was translated into Dutch and psychometric properties were examined. Internal consistency was high, and the factor structure showed close resemblance with previous research. Test-retest and split-half reliabilities were acceptable, as was convergent validity with self-reported symptoms of psychopathology (attention problems and aggressive behavior). Construct validity was adequate, with more sensation seeking in boys than in girls. No effects of age were found. To sum up, sensation seeking can be measured in children in a valid and reliable way. The correlation of sensation seeking with high-risk behaviors emphasizes the importance of assessment early in development.
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Affiliation(s)
- Tycho J Dekkers
- a Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands.,b De Bascule, Academic Center for Child and Adolescent Psychiatry , Department of Forensic Psychiatry and Complex Behavioral Disorders , Duivendrecht , The Netherlands
| | - Naomi R J van Bergen
- a Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Brenda R J Jansen
- a Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands.,c Yield, Research Institute for Child Development and Education , Amsterdam , The Netherlands.,d Amsterdam Brain and Cognition Centre , Amsterdam , The Netherlands
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Huang J, Ulke C, Sander C, Jawinski P, Spada J, Hegerl U, Hensch T. Impact of brain arousal and time-on-task on autonomic nervous system activity in the wake-sleep transition. BMC Neurosci 2018; 19:18. [PMID: 29642849 PMCID: PMC5896037 DOI: 10.1186/s12868-018-0419-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/27/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) activity has been shown to vary with the state of brain arousal. In a previous study, this association of ANS activity with distinct states of brain arousal was demonstrated using 15-min EEG data, but without directly controlling for possible time-on-task effects. In the current study we examine ANS-activity in fine-graded EEG-vigilance stages (indicating states of brain arousal) during two conditions of a 2-h oddball task while controlling for time-on-task. In addition, we analyze the effect of time-on-task on ANS-activity while holding the level of brain arousal constant. METHODS Heart rate and skin conductance level of healthy participants were recorded during a 2-h EEG with eyes closed under simultaneous presentation of stimuli in an ignored (N = 39) and attended (N = 39) oddball condition. EEG-vigilance stages were classified using the Vigilance Algorithm Leipzig (VIGALL 2.1). The time-on-task effect was tested by dividing the EEG into four 30-min consecutive time blocks. ANS-activity was compared between EEG-vigilance stages across the entire 2 h and within each time block. RESULTS We found a coherent decline of ANS-activity with declining brain arousal states, over the 2-h recording and in most cases within each 30-min block in both conditions. Furthermore, we found a significant time-on-task effect on heart rate, even when arousal was kept constant. It was most pronounced between the first and all subsequent blocks and could have been a consequence of postural change at the beginning of the experiment. CONCLUSION Our findings contribute to the validation of VIGALL 2.1 using ANS parameters in 2-h EEG recording under oddball conditions.
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Affiliation(s)
- Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Philippe Jawinski
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
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Strauß M, Ulke C, Paucke M, Huang J, Mauche N, Sander C, Stark T, Hegerl U. Brain arousal regulation in adults with attention-deficit/hyperactivity disorder (ADHD). Psychiatry Res 2018; 261:102-108. [PMID: 29291475 DOI: 10.1016/j.psychres.2017.12.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022]
Abstract
The main aim of the current study was to test the hypothesis that adult patients with attention-deficit/hyperactivity disorder (ADHD) have less stable brain arousal regulation than healthy controls. We objectively assessed brain arousal regulation using the Vigilance Algorithm Leipzig (VIGALL 2.1) to analyze 15-min resting EEG data of thirty-three ADHD patients and thirty-five matched controls. Based on automatically classified 1-s segments we computed mean EEG-vigilance (indexing arousal level) and arousal stability score (indexing arousal regulation). Adult ADHD patients showed significantly lower arousal levels and significantly less stable brain arousal regulation than controls. Multiple regression analysis indicated that arousal regulation (i.e., arousal stability score) predicted the retrospectively-assessed severity of childhood ADHD symptoms, supporting the trait aspect of brain arousal regulation. Our findings support the arousal regulation model of ADHD, which interprets hyperactivity and sensation seeking as an autoregulatory reaction to an unstable regulation of brain arousal. EEG-based arousal parameters may be candidate biomarkers for adult ADHD.
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Affiliation(s)
- Maria Strauß
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany; Depression Research Center, German Depression Foundation, Leipzig, Germany.
| | - Madlen Paucke
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany
| | - Nicole Mauche
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany; Depression Research Center, German Depression Foundation, Leipzig, Germany
| | - Tetyana Stark
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Leipzig, Germany; Depression Research Center, German Depression Foundation, Leipzig, Germany
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Paucke M, Sander C, Hegerl U, Strauß M. P 150 The correlation of attention and neurophysiological characteristics in attention deficit hyperactivity disorder (ADHD). Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.06.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dohrmann AL, Stengler K, Jahn I, Olbrich S. EEG-arousal regulation as predictor of treatment response in patients suffering from obsessive compulsive disorder. Clin Neurophysiol 2017; 128:1906-1914. [PMID: 28826021 DOI: 10.1016/j.clinph.2017.07.406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/09/2017] [Accepted: 07/15/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Aim of this study was to analyze whether electroencephalogram (EEG)-based CNS-arousal markers differ for patients suffering from obsessive compulsive disorder (OCD) that either respond or do not respond to cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs) or their combination. Further the study aimed to identify specific response-predictors for the different therapy approaches. METHODS CNS-arousal from 51 unmedicated patients during fifteen-minute resting state was assessed using VIGALL (Vigilance Algorithm Leipzig). Clinical Global Impression (CGI) scores were used to assess response or non-response after three to six months following therapy (CBT, n=18; SSRI, n=11 or combination, n=22). Differences between Responders (R) and Non-Responders (NR) were identified using multivariate analysis of covariance (MANCOVA) models. RESULTS MANCOVA revealed that Responders spent significant less time at the highest CNS-arousal stage 0. Further, low amounts of the highest CNS-arousal stages were specifically predictive for a response to a combined treatment approach. CONCLUSIONS The fact that CNS-arousal markers allowed discrimination between Responders and Non-Responders and also between Responders of different treatment arms underlines a possible clinical value of EEG-based markers. SIGNIFICANCE These results encourage further research on EEG-arousal regulation for determining pathophysiological subgroups for treatment response.
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Affiliation(s)
- Anna-Lena Dohrmann
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany.
| | - Katarina Stengler
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany
| | - Ina Jahn
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany
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Edmiston EK, Muscatello RA, Corbett BA. Altered Pre-Ejection Period Response to Social Evaluative Threat in Adolescents with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2017; 36:57-65. [PMID: 29177005 PMCID: PMC5699479 DOI: 10.1016/j.rasd.2017.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The autonomic nervous system (ANS) is involved in regulating social behavior; Autism Spectrum Disorder (ASD) is characterized by alterations in social behavior and reduced physiological response to threat. We hypothesized that adolescents with ASD would show reduced ANS response to social threat. METHODS Eighteen males with ASD and thirteen males with typical development (TD), ages 12 to 17, completed a social threat paradigm while wearing an impedance cardiography apparatus. We calculated pre-ejection period (PEP) and tested for between-group differences in PEP response to social threat. We also conducted correlation analyses between PEP change scores and clinical symptom scales. RESULTS There was an effect of diagnosis on change in PEP from baseline to the onset of social threat (F=7.60, p=0.01), with greater changes in PEP in TD compared to ASD. PEP change score and the Social Communication Questionnaire (r=0.634, p=0.005) and the ADHD Problems Subscale of the Child Behavior Checklist (r=0.568, p=0.014) were correlated. CONCLUSIONS These findings suggest reduced arousal in response to social threat in ASD, with preliminary evidence that reduced sympathetic activation is associated with increased social behavior symptoms.
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Affiliation(s)
- E. Kale Edmiston
- Neuroscience Graduate Program, Vanderbilt University, U-1205 Medical Research Building III, 465 21st Avenue South, Nashville, TN 37232-2050
| | - Rachael A. Muscatello
- Neuroscience Graduate Program, Vanderbilt University, U-1205 Medical Research Building III, 465 21st Avenue South, Nashville, TN 37232-2050
| | - Blythe A. Corbett
- Department of Psychiatry, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203
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Maski K, Steinhart E, Williams D, Scammell T, Flygare J, McCleary K, Gow M. Listening to the Patient Voice in Narcolepsy: Diagnostic Delay, Disease Burden, and Treatment Efficacy. J Clin Sleep Med 2017; 13:419-425. [PMID: 27923434 DOI: 10.5664/jcsm.6494] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/21/2016] [Indexed: 01/15/2023]
Abstract
STUDY OBJECTIVES Describe common symptoms, comorbidities, functional limitations, and treatment responsiveness among patients with narcolepsy. Investigate the effect of pediatric onset of narcolepsy symptoms on time to diagnosis of narcolepsy and presence of comorbid depression. METHODS Cross-sectional survey of 1,699 people in the United States with self-reported diagnosis of narcolepsy. We utilized mixed-methods data analyses to report study findings. RESULTS Most participants reported receiving a diagnosis of narcolepsy more than 1 y after symptom onset. We found that the strongest predictor of this delayed diagnosis was pediatric onset of symptoms (odds ratio = 2.4, p < 0.0005). Depression was the most common comorbidity but we detected no association with pediatric onset of narcolepsy symptoms. Overall, participants reported that fatigue and cognitive difficulties were their most burdensome symptoms in addition to sleepiness and cataplexy. The majority of participants reported residual daytime fatigue and/or sleepiness despite treatment. Most participants reported they could not perform at work or school as well as they would like because of narcolepsy symptoms. CONCLUSIONS This study provides unique insight into the narcolepsy disease experience. The study quantifies the problem of diagnostic delay for narcolepsy patients in the United States and highlights that symptoms are more likely to be missed if they develop before 18 y of age. These results suggest that narcolepsy awareness efforts should be aimed at parents, pediatric health care providers, school professionals, and children/adolescents themselves. Disease burden is high because of problems with fatigue, cognition, and persistence of residual symptoms despite treatment.
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Affiliation(s)
- Kiran Maski
- Harvard Medical School, Boston, MA.,Boston Children's Hospital, Boston, MA
| | | | - David Williams
- Harvard Medical School, Boston, MA.,Boston Children's Hospital, Boston, MA
| | - Thomas Scammell
- Harvard Medical School, Boston, MA.,Beth Israel Deaconess Hospital, Boston, MA
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van Hulst BM, de Zeeuw P, Bos DJ, Rijks Y, Neggers SFW, Durston S. Children with ADHD symptoms show decreased activity in ventral striatum during the anticipation of reward, irrespective of ADHD diagnosis. J Child Psychol Psychiatry 2017; 58:206-214. [PMID: 27678006 DOI: 10.1111/jcpp.12643] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Changes in reward processing are thought to be involved in the etiology of attention-deficit/hyperactivity disorder (ADHD), as well as other developmental disorders. In addition, different forms of therapy for ADHD rely on reinforcement principles. As such, improved understanding of reward processing in ADHD could eventually lead to more effective treatment options. However, differences in reward processing may not be specific to ADHD, but may be a trans-diagnostic feature of disorders that involve ADHD-like symptoms. METHODS In this event-related fMRI study, we used a child-friendly version of the monetary incentive delay task to assess performance and brain activity during reward anticipation. Also, we collected questionnaire data to assess reward sensitivity in daily life. For final analyses, data were available for 27 typically developing children, 24 children with ADHD, and 25 children with an autism spectrum disorder (ASD) and ADHD symptoms. RESULTS We found decreased activity in ventral striatum during anticipation of reward in children with ADHD symptoms, both for children with ADHD as their primary diagnosis and in children with autism spectrum disorder and ADHD symptoms. We found that higher parent-rated sensitivity to reward was associated with greater anticipatory activity in ventral striatum for children with ADHD symptoms. In contrast, there was no relationship between the degree of ADHD symptoms and activity in ventral striatum. CONCLUSIONS We provide evidence of biological and behavioral differences in reward sensitivity in children with ADHD symptoms, regardless of their primary diagnosis. Ultimately, a dimensional brain-behavior model of reward sensitivity in children with symptoms of ADHD may be useful to refine treatment options dependent on reward processing.
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Affiliation(s)
- Branko M van Hulst
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Patrick de Zeeuw
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dienke J Bos
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne Rijks
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sebastiaan F W Neggers
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Huang J, Hensch T, Ulke C, Sander C, Spada J, Jawinski P, Hegerl U. Evoked potentials and behavioral performance during different states of brain arousal. BMC Neurosci 2017; 18:21. [PMID: 28122495 PMCID: PMC5267455 DOI: 10.1186/s12868-017-0340-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/20/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Previous studies compared evoked potentials (EPs) between several sleep stages but only one uniform wake state. However, using electroencephalography (EEG), several arousal states can be distinguished before sleep onset. Recently, the Vigilance Algorithm Leipzig (VIGALL 2.0) has been developed, which automatically attributes one out of seven EEG-vigilance stages to each 1-s EEG segment, ranging from stage 0 (associated with cognitively active wakefulness), to stages A1, A2 and A3 (associated with relaxed wakefulness), to stages B1 and B2/3 (associated with drowsiness) up to stage C (indicating sleep onset). Applying VIGALL, we specified the effects of these finely differentiated EEG-vigilance stages (indicating arousal states) on EPs (P1, N1, P2, N300, MMN and P3) and behavioral performance. Subjects underwent an ignored and attended condition of a 2-h eyes-closed oddball-task. Final analysis included 43 subjects in the ignored and 51 subjects in the attended condition. First, the effect of brain arousal states on EPs and performance parameters were analyzed between EEG-vigilance stages A (i.e. A1, A2 and A3 combined), B1 and B2/3&C (i.e. B2/3 and C combined). Then, in a second step, the effects of the finely differentiated EEG-vigilance stages were further specified. RESULTS Comparing stages A versus B1 versus B2/3&C, a significant effect of EEG-vigilance stages on all behavioral parameters and all EPs, with exception of MMN and P3, was found. By applying VIGALL, a more detailed view of arousal effects on EP and performance was possible, such as the finding that the P2 showed no further significant increase in stages deeper than B1. Stage 0 did not differ from any of the A-stages. Within more fine-graded stages, such as the A-substages, EPs and performance only partially differed. However, these analyses were partly based on small sample sizes and future studies should take effort to get enough epochs of rare stages (such as A3 and C). CONCLUSIONS A clear impact of arousal on EPs and behavioral performance was obtained, which emphasize the necessity to consider arousal effects when interpreting EPs.
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Affiliation(s)
- Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Philippe Jawinski
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
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Sander C, Hensch T, Wittekind DA, Böttger D, Hegerl U. Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research. Neuropsychobiology 2016; 72:195-205. [PMID: 26901462 DOI: 10.1159/000439384] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022]
Abstract
During the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adaption of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and non-pharmacological interventions for these conditions.
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Jawinski P, Sander C, Mauche N, Spada J, Huang J, Schmidt A, Häntzsch M, Burkhardt R, Scholz M, Hegerl U, Hensch T. Brain Arousal Regulation in Carriers of Bipolar Disorder Risk Alleles. Neuropsychobiology 2016; 72:65-73. [PMID: 26509803 DOI: 10.1159/000437438] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/06/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Recent genome-wide association studies identified a number of chromosomal risk loci for bipolar disorder (BD, 'manic-depressive illness'). According to the vigilance regulation model, the regulation of brain arousal (referred to as 'vigilance') when assessed via EEG is an emerging biomarker linked to the pathogenesis of manic and depressive episodes. On this basis, the present study aimed to assess whether carriers of BD risk alleles differ in brain arousal regulation. METHODS Healthy participants of the population-based Leipzig Health Care Study (LIFE) underwent a 20-min eyes-closed resting EEG paradigm. Brain arousal was assessed applying the computer-based Vigilance Algorithm Leipzig (VIGALL). The primary sample (n = 540) was genotyped for ten of the most reliable BD risk variants, of which two qualified for replication (n = 509). RESULTS Primary sample analyses revealed Bonferroni-adjusted significance for rs1006737 in CACNA1C (encoding a calcium channel subunit), with risk allele carriers exhibiting relatively steep brain arousal declines. Further, carriers of two risk alleles of rs472913 at 1p32.1 showed generally lower brain arousal levels for the duration of the resting paradigm. However, both associations failed replication. CONCLUSION Although our initial findings are in line with the vigilance regulation model and convincing in view of the previously reported notable role of ion channelopathies in BD, our results do not provide consistent evidence for a link between BD risk variants and brain arousal regulation. Several between-sample differences may account for this inconsistency. The molecular genetics of brain arousal regulation remain to be clarified.
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Affiliation(s)
- Philippe Jawinski
- LIFE - Leipzig Research Centre for Civilization Diseases, Leipzig, Germany
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