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Schulz SE, Luszawski M, Hannah KE, Stevenson RA. Sensory Gating in Neurodevelopmental Disorders: A Scoping Review. Res Child Adolesc Psychopathol 2023; 51:1005-1019. [PMID: 37014483 DOI: 10.1007/s10802-023-01058-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/05/2023]
Abstract
This review aimed to explore the current understanding of sensory gating in neurodevelopmental disorders as a possible transdiagnostic mechanism. We applied methods according to the Joanna Briggs Institute Manual for Evidence Synthesis, following the population, concept, and context scoping review eligibility criteria. Using a comprehensive search strategy in five relevant research databases (Medline, EMBASE, CINAHL, PsychInfo, and Scopus), we searched for relevant peer-reviewed, primary research articles and unpublished data. Two independent reviewers screened the titles and abstracts, full-texts, and completed data extraction. We identified a total of 81 relevant articles and used descriptive analyses to summarize the characteristics and outcomes of all identified studies. Literature regarding sensory gating was most common in autistic populations with relatively fewer studies examining attention-deficit/hyperactivity disorder, tic disorders, and childhood-onset fluency disorder (COFD). The methods to assess sensory gating varied widely both within and between groups and included measures such as habituation, prepulse inhibition, affect-modulated inhibition, medication and other intervention trials. Most consistently, when participants complete questionnaires about their sensory experiences, those who have neurodevelopmental disorders report differences in their sensory gating. Affect-modulated inhibition appears to be discrepant between samples with and without neurodevelopmental disorder diagnoses. Habituation was the most commonly reported phenomenon and many differences in habituation have been found in autistic individuals and individuals with tic disorders whereas concerns with inhibition seemed more common in COFD. Overall, the evidence is inconsistent within and between disorders suggesting there is still much to learn about sensory gating in neurodevelopmental disorders.
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Affiliation(s)
- Samantha E Schulz
- Department of Psychology, University of Western Ontario, London, Canada
- Brain and Mind Institute, University of Western Ontario, London, Canada
- Western Institute for Neuroscience, University of Western Ontario, London, ON, Canada
| | - Michelle Luszawski
- Department of Psychology, University of Western Ontario, London, Canada
- Brain and Mind Institute, University of Western Ontario, London, Canada
- Western Institute for Neuroscience, University of Western Ontario, London, ON, Canada
| | - Kara E Hannah
- Department of Psychology, University of Western Ontario, London, Canada
- Brain and Mind Institute, University of Western Ontario, London, Canada
- Western Institute for Neuroscience, University of Western Ontario, London, ON, Canada
| | - Ryan A Stevenson
- Department of Psychology, University of Western Ontario, London, Canada.
- Brain and Mind Institute, University of Western Ontario, London, Canada.
- Western Institute for Neuroscience, University of Western Ontario, London, ON, Canada.
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Rafi H, Murray R, Delavari F, Perroud N, Vuilleumier P, Debbané M, Piguet C. Neural Basis of Internal Attention in Adults with Pure and Comorbid ADHD. J Atten Disord 2023; 27:423-436. [PMID: 36635890 DOI: 10.1177/10870547221147546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine whether putatively atypical neuronal activity during internal attention in ADHD yields insights into processes underlying emotion dysregulation. METHODS We used a word processing paradigm to assess neural activations in adults with ADHD (N = 46) compared to controls (N = 43). We measured effects of valence, applied partial-least squares correlation analysis to assess multivariate brainbehavior relationships and ran subgroup analyses to isolate results driven by pure ADHD (N = 18). RESULTS During internal attention, ADHD, compared to controls, have (1) increased activation in the right angular gyrus (rAG), which appears driven by pure, not comorbid, ADHD and (2) diminished activation in the insula and fronto-striatal circuitry. Diminished activations were driven by negatively-valenced internal attention and negatively correlated with increased affective lability within the ADHD group. CONCLUSION Internal attention in ADHD is associated with increased rAG activation, possibly reflecting difficulty converging external and internal information, and diminished activation within emotion regulation circuitry.
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Affiliation(s)
| | - Ryan Murray
- University of Geneva, Switzerland
- University of Geneva, Campus Biotech, Switzerland
| | - Farnaz Delavari
- University of Geneva, Switzerland
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | | | | | - Martin Debbané
- University of Geneva, Switzerland
- University College London, UK
| | - Camille Piguet
- University of Geneva, Switzerland
- University Hospitals of Geneva, Switzerland
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Developmental Coordination Disorder (DCD): Relevance for clinical psychologists in Europe. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e4165. [PMID: 36397944 PMCID: PMC9667416 DOI: 10.32872/cpe.4165] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/04/2022] [Indexed: 12/20/2022] Open
Abstract
Background Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder primarily characterized by fine and gross motor coordination difficulties. Yet, many aspects remain unclear regarding the clinical presentation of secondary symptoms and their implications for Clinical Psychology. Therefore, the purpose of this review is to provide an update about the current understanding of DCD for clinical psychologists and psychotherapists across Europe, particularly based on new insights stemming from the last decade of research. Method We provide a narrative review of articles published in the last decade on the topic of DCD, and relevant aspects to clinical psychologist, including lesser known aspects of DCD (e.g., executive functions, psychological consequences, and adult DCD). Results DCD is a highly prevalent, disruptive, and complex disorder, which should be investigated further in many areas (e.g., co-occurrence to ADHD). Existing evidence points toward a key role of executive functioning difficulties at all ages. Most patients report secondary psychological problems, but little headway has been made in examining the effectiveness of psychotherapy for DCD. Conclusions Insights and remaining research gaps are discussed. It is critical for psychologists and clinical researchers to raise awareness for DCD, take note of the growing literature, and foster continued interdisciplinary approaches to research and treatment of DCD. Awareness about Developmental Coordination Disorder (DCD) is low among some European Psychologists. Growing knowledge about DCD should be disseminated among psychotherapists.
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Nastou E, Ocklenburg S, Hoogman M, Papadatou-Pastou M. Handedness in ADHD: Meta-Analyses. Neuropsychol Rev 2022; 32:877-892. [PMID: 35064524 DOI: 10.1007/s11065-021-09530-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/11/2021] [Indexed: 01/02/2023]
Abstract
Meta-analyses have shown that several neurodevelopmental and psychiatric disorders, such as autism spectrum disorder and schizophrenia, are associated with a higher prevalence of atypical (left-, non-right-, or mixed-) handedness. One neurodevelopmental disorder for which this association is unclear is attention deficit hyperactivity disorder (ADHD). Here, some empirical studies have found evidence for a higher prevalence of atypical handedness in individuals with ADHD compared to neurotypical individuals. However, other studies failed to establish such an association. Therefore, meta-analytic integration is critical to estimate whether or not there is an association between handedness and ADHD. We report the results of three meta-analyses (left-, mixed-, and non-right-handedness) comparing handedness in individuals with ADHD to controls (typically developing individuals). The results show evidence of a trend towards elevated levels of atypical handedness when it comes to differences in left- and mixed-handedness (p = 0.09 and p = 0.07, respectively), but do show clear evidence of elevated levels of non-right-handedness between individuals with ADHD and controls (p = 0.02). These findings are discussed in the context of the hypothesis that ADHD is a disorder in which mostly right-hemispheric brain networks are affected. Since right-handedness represents a dominance of the left motor cortex for fine motor behavior, such as writing, as well as a left-hemispheric dominance for language functions, and about 90% of individuals are right-handers, this hypothesis might explain why there is not stronger evidence for an association of left-handedness with ADHD. We suggest that the mechanisms involved in the pathogenesis of ADHD might show an overlap with the mechanisms involved in handedness strength, but not handedness direction.
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Affiliation(s)
- Evgenia Nastou
- Department of Primary Education, National and Kapodistrian University of Athens, 13A Navarinou Street, 10680, Athens, Greece
| | | | | | - Marietta Papadatou-Pastou
- Department of Primary Education, National and Kapodistrian University of Athens, 13A Navarinou Street, 10680, Athens, Greece. .,Biomedical Research Foundation, Academy of Athens, Athens, Greece.
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Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
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Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
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Management of anxiety disorders in children with attention-deficit hyperactivity disorder: a narrative review. Int Clin Psychopharmacol 2021; 36:1-11. [PMID: 33086253 DOI: 10.1097/yic.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Anxiety disorders are common comorbidities of attention deficit/hyperactivity disorder (ADHD) and conversely, ADHD is prevalent among anxious youths. A variety of treatments, both psychopharmacological and nonpsychopharmacological, are used to manage combined ADHD/anxiety disorder. This article aims to review the literature on the treatment of ADHD with comorbid anxiety disorders, and make evidence-based recommendations for clinical practice. In most cases, when ADHD is the primary condition, stimulants are the first-line of treatment, frequently resulting not only in improvement in ADHD symptoms but also alleviating the symptoms of the comorbid anxiety disorder. Stimulant treatment is relatively safe and well-tolerated in ADHD with comorbid anxiety disorder. When the stimulant administration does not attenuate the severity of the comorbid anxiety disorder, a treatment that targets specifically the anxiety disorder should be added. This recommendation, however, might be challenged by the impressive efficacy of atomoxetine for both the ADHD and anxiety disorder symptoms. Adjunctive cognitive-behavior therapy for anxiety disorder symptoms is strongly recommended and is considered superior to medication alone. Other options include adding pharmacological treatment for the anxiety symptoms. In moderate and severe cases of comorbid Ads, selective serotonin reuptake inhibitors can be added to the stimulants, with the required caution.
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The Neurofunctional Basis of Affective Startle Modulation in Humans: Evidence From Combined Facial Electromyography and Functional Magnetic Resonance Imaging. Biol Psychiatry 2020; 87:548-558. [PMID: 31547934 DOI: 10.1016/j.biopsych.2019.07.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/15/2019] [Accepted: 07/25/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND The startle eye-blink is the cross-species translational tool to study defensive behavior in affective neuroscience with relevance to a broad range of neuropsychiatric conditions. It makes use of the startle reflex, a defensive response elicited by an immediate, unexpected sensory event, which is potentiated when evoked during threat and inhibited during safety. In contrast to skin conductance responses or pupil dilation, modulation of the startle reflex is valence specific. Rodent models implicate a modulatory pathway centering on the brainstem (i.e., nucleus reticularis pontis caudalis) and the centromedial amygdala as key hubs for flexibly integrating valence information into differential startle magnitude. Technical advances now allow for the investigation of this pathway using combined facial electromyography and functional magnetic resonance imaging in humans. METHODS We employed a multimethodological approach combining trial-by-trial facial eye-blink startle electromyography and brainstem- and amygdala-specific functional magnetic resonance imaging in humans. Validating the robustness and reproducibility of our findings, we provide evidence from two different paradigms (fear-potentiated startle, affect-modulated startle) in two independent studies (N = 43 and N = 55). RESULTS We provide key evidence for a conserved neural pathway for acoustic startle modulation between humans and rodents. Furthermore, we provide the crucial direct link between electromyography startle eye-blink magnitude and neural response strength. Finally, we demonstrate a dissociation between arousal-specific amygdala responding and triggered valence-specific amygdala responding. CONCLUSIONS We provide neurobiologically based evidence for the strong translational value of startle responding and argue that startle-evoked amygdala responding and its affective modulation may hold promise as an important novel tool for affective neuroscience and its clinical translation.
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Boecker L, Pauli P. Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems. Neurosci Biobehav Rev 2019; 103:230-266. [PMID: 31129237 DOI: 10.1016/j.neubiorev.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/12/2019] [Accepted: 05/18/2019] [Indexed: 02/06/2023]
Abstract
Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.
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Affiliation(s)
- Lea Boecker
- Department of Economic Psychology, Social Psychology & Experimental Methods, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Marcusstraße 9-11, 97070 Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany
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Shang CY, Sheng C, Yang LK, Chou TL, Gau SSF. Differential brain activations in adult attention-deficit/ hyperactivity disorder subtypes: a counting Stroop functional MRI study. Brain Imaging Behav 2019; 12:882-890. [PMID: 28699075 DOI: 10.1007/s11682-017-9749-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although previous functional neuroimaging studies have found abnormal brain activations in individuals with attention deficit hyperactivity disorder (ADHD), little was known about distinct brain dysfunctions across different ADHD subtypes. The objective of the present study was to investigate the abnormal brain activations associated with two ADHD subtypes, predominantly inattentive (ADHD-PI) and combined (ADHD-C) subtypes. Twenty-five adults with ADHD-PI, 25 with ADHD-C, and 30 healthy controls (HC) participated in this study. The brain function of the participants were assessed by using the counting Stroop task inside the scanner and the Conners' Continuous Performance Test (CCPT) outside the scanner. The HC group showed greater activations in the caudate nucleus and inferior frontal gyrus (IFG) than the ADHD-PI and ADHD-C groups. The ADHD-PI group showed greater activations in the superior parietal lobule (SPL) than the ADHD-C group. In all participants with ADHD, we found negative correlations of activation in the left caudate and the left IFG with the standard deviation of the reaction time of the CCPT, and negative correlations of activation in the left SPL with the reaction time changes across different inter-stimulus intervals. Our results demonstrated altered brain activity in the frontostriatal networks of adults with ADHD-PI and the fronto-striato-parietal networks of adults with ADHD-C. Abnormalities in the parietal areas may represent the main difference between the ADHD-PI and ADHD-C subtypes.
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Affiliation(s)
- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chia Sheng
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.,Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tai-Li Chou
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan. .,Department of Psychology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan. .,Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan. .,Department of Psychology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
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Beyer F, Buades-Rotger M, Claes M, Krämer UM. Hit or Run: Exploring Aggressive and Avoidant Reactions to Interpersonal Provocation Using a Novel Fight-or-Escape Paradigm (FOE). Front Behav Neurosci 2017; 11:190. [PMID: 29089875 PMCID: PMC5650963 DOI: 10.3389/fnbeh.2017.00190] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022] Open
Abstract
Interpersonal provocation presents an approach-avoidance conflict to the provoked person: responding aggressively might yield the joy of retribution, whereas withdrawal can provide safety. Experimental aggression studies typically measure only retaliation intensity, neglecting whether individuals want to confront the provocateur at all. To overcome this shortcoming of previous measures, we developed and validated the Fight-or-Escape paradigm (FOE). The FOE is a competitive reaction time (RT) task in which the winner can choose the volume of a sound blast to be directed at his/her opponent. Participants face two ostensible opponents who consistently select either high or low punishments. At the beginning of each trial, subjects are given the chance to avoid the encounter for a limited number of times. In a first experiment (n = 27, all women), we found that fear potentiation (FP) of the startle response was related to lower scores in a composite measure of aggression and avoidance against the provoking opponent. In a second experiment (n = 34, 13 men), we altered the paradigm such that participants faced the opponents in alternating rather than in random order. Participants completed the FOE as well as the Dot-Probe Task (DPT) and the Approach-Avoidance Task (AAT). Subjects with higher approach bias scores in the AAT avoided the provoking opponent less frequently. Hence, individuals with high threat reactivity and low approach motivation displayed more avoidant responses to provocation, whereas participants high in approach motivation were more likely to engage in aggressive interactions when provoked. The FOE is thus a promising laboratory measure of avoidance and aggression.
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Affiliation(s)
- Frederike Beyer
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Macià Buades-Rotger
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Psychology II, University of Lübeck, Lübeck, Germany
| | - Marie Claes
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Ulrike M Krämer
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Psychology II, University of Lübeck, Lübeck, Germany
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Bergado Acosta JR, Schneider M, Fendt M. Intra-accumbal blockade of endocannabinoid CB1 receptors impairs learning but not retention of conditioned relief. Neurobiol Learn Mem 2017. [DOI: 10.1016/j.nlm.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Taskiran C, Karaismailoglu S, Cak Esen HT, Tuzun Z, Erdem A, Balkanci ZD, Dolgun AB, Cengel Kultur SE. Clinical features and subjective/physiological responses to emotional stimuli in the presence of emotion dysregulation in attention-deficit hyperactivity disorder. J Clin Exp Neuropsychol 2017; 40:389-404. [PMID: 28721740 DOI: 10.1080/13803395.2017.1353952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Emotion dysregulation (ED) has long been recognized in clinical descriptions of attention-deficit hyperactivity disorder (ADHD), but a renewed interest in ED has advanced research on the overlap between the two entities. Autonomic reactivity (AR) is a neurobiological correlate of emotion regulation; however, the association between ADHD and AR remains unclear. Our aim was to explore the clinical differences, AR, and subjective emotional responses to visual emotional stimuli in ADHD children with and without ED. METHOD School-aged ADHD children with (n = 28) and without (n = 20) ED, according to the definition of deficiency in emotional self-regulation (DESR), and healthy controls (n = 22) were interviewed by using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime version (K-SADS-PL) to screen frequent psychopathologies for these ages. All subjects were evaluated with Child Behavior Checklist 6-18 (CBCL), the Strengths and Difficulties Questionnaire (SDQ), the McMaster Family Assessment Device (FAD), the School-Age Temperament Inventory (SATI), and Conners' Parent Rating Scale (CPRS-48), which were completed by parents. To evaluate emotional responses, the International Affective Picture System (IAPS) and the subjective and physiological responses (electrodermal activity and heart rate reactivity) to selected pictures were examined. RESULTS Regarding clinically distinctive features, the ADHD+ED group differed from the ADHD-ED and the control groups in terms of having higher temperamental negative reactivity, more oppositional/conduct problems, and lower prosocial behaviors. In the AR measures, children in the ADHD+ED group rated unpleasant stimuli as more negative, but they still had lower heart rate reactivity (HRR) than the ADHD-ED and control groups; moreover, unlike the two other groups, the ADHD+ED group showed no differences in HRR between different emotional stimuli. CONCLUSION The presented findings are unique in terms of their ability to clinically and physiologically differentiate between ADHD children with and without ED.
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Affiliation(s)
- Candan Taskiran
- a Department of Child and Adolescent Psychiatry , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Serkan Karaismailoglu
- b Department of Physiology , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Halime Tuna Cak Esen
- a Department of Child and Adolescent Psychiatry , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Zeynep Tuzun
- c Division of Adolescent Medicine, Department of Pediatrics , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Aysen Erdem
- b Department of Physiology , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Zeynep Dicle Balkanci
- b Department of Physiology , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Anil Barak Dolgun
- d Department of Biostatistics , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
| | - Sadriye Ebru Cengel Kultur
- a Department of Child and Adolescent Psychiatry , Hacettepe University Faculty of Medicine , Sıhhiye , Ankara , Turkey
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Hoogman M, Bralten J, Hibar DP, Mennes M, Zwiers MP, Schweren LSJ, van Hulzen KJE, Medland SE, Shumskaya E, Jahanshad N, Zeeuw PD, Szekely E, Sudre G, Wolfers T, Onnink AMH, Dammers JT, Mostert JC, Vives-Gilabert Y, Kohls G, Oberwelland E, Seitz J, Schulte-Rüther M, Ambrosino S, Doyle AE, Høvik MF, Dramsdahl M, Tamm L, van Erp TGM, Dale A, Schork A, Conzelmann A, Zierhut K, Baur R, McCarthy H, Yoncheva YN, Cubillo A, Chantiluke K, Mehta MA, Paloyelis Y, Hohmann S, Baumeister S, Bramati I, Mattos P, Tovar-Moll F, Douglas P, Banaschewski T, Brandeis D, Kuntsi J, Asherson P, Rubia K, Kelly C, Martino AD, Milham MP, Castellanos FX, Frodl T, Zentis M, Lesch KP, Reif A, Pauli P, Jernigan TL, Haavik J, Plessen KJ, Lundervold AJ, Hugdahl K, Seidman LJ, Biederman J, Rommelse N, Heslenfeld DJ, Hartman CA, Hoekstra PJ, Oosterlaan J, Polier GV, Konrad K, Vilarroya O, Ramos-Quiroga JA, Soliva JC, Durston S, Buitelaar JK, Faraone SV, Shaw P, Thompson PM, Franke B. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry 2017; 4:310-319. [PMID: 28219628 PMCID: PMC5933934 DOI: 10.1016/s2215-0366(17)30049-4] [Citation(s) in RCA: 446] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/04/2017] [Accepted: 01/09/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Neuroimaging studies have shown structural alterations in several brain regions in children and adults with attention deficit hyperactivity disorder (ADHD). Through the formation of the international ENIGMA ADHD Working Group, we aimed to address weaknesses of previous imaging studies and meta-analyses, namely inadequate sample size and methodological heterogeneity. We aimed to investigate whether there are structural differences in children and adults with ADHD compared with those without this diagnosis. METHODS In this cross-sectional mega-analysis, we used the data from the international ENIGMA Working Group collaboration, which in the present analysis was frozen at Feb 8, 2015. Individual sites analysed structural T1-weighted MRI brain scans with harmonised protocols of individuals with ADHD compared with those who do not have this diagnosis. Our primary outcome was to assess case-control differences in subcortical structures and intracranial volume through pooling of all individual data from all cohorts in this collaboration. For this analysis, p values were significant at the false discovery rate corrected threshold of p=0·0156. FINDINGS Our sample comprised 1713 participants with ADHD and 1529 controls from 23 sites with a median age of 14 years (range 4-63 years). The volumes of the accumbens (Cohen's d=-0·15), amygdala (d=-0·19), caudate (d=-0·11), hippocampus (d=-0·11), putamen (d=-0·14), and intracranial volume (d=-0·10) were smaller in individuals with ADHD compared with controls in the mega-analysis. There was no difference in volume size in the pallidum (p=0·95) and thalamus (p=0·39) between people with ADHD and controls. Exploratory lifespan modelling suggested a delay of maturation and a delay of degeneration, as effect sizes were highest in most subgroups of children (<15 years) versus adults (>21 years): in the accumbens (Cohen's d=-0·19 vs -0·10), amygdala (d=-0·18 vs -0·14), caudate (d=-0·13 vs -0·07), hippocampus (d=-0·12 vs -0·06), putamen (d=-0·18 vs -0·08), and intracranial volume (d=-0·14 vs 0·01). There was no difference between children and adults for the pallidum (p=0·79) or thalamus (p=0·89). Case-control differences in adults were non-significant (all p>0·03). Psychostimulant medication use (all p>0·15) or symptom scores (all p>0·02) did not influence results, nor did the presence of comorbid psychiatric disorders (all p>0·5). INTERPRETATION With the largest dataset to date, we add new knowledge about bilateral amygdala, accumbens, and hippocampus reductions in ADHD. We extend the brain maturation delay theory for ADHD to include subcortical structures and refute medication effects on brain volume suggested by earlier meta-analyses. Lifespan analyses suggest that, in the absence of well powered longitudinal studies, the ENIGMA cross-sectional sample across six decades of ages provides a means to generate hypotheses about lifespan trajectories in brain phenotypes. FUNDING National Institutes of Health.
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Affiliation(s)
- Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Derrek P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Maarten Mennes
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Marcel P Zwiers
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Lizanne S J Schweren
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kimm J E van Hulzen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Elena Shumskaya
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Patrick de Zeeuw
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eszter Szekely
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA
| | - Gustavo Sudre
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Alberdingk M H Onnink
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Janneke T Dammers
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Jeanette C Mostert
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Yolanda Vives-Gilabert
- Asociación para la Innovación en Análisis, Gestión y Procesamiento de Datos Científicos y Tecnológicos, Barcelona, Spain
| | - Gregor Kohls
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Eileen Oberwelland
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany; JARA Translational Brain Medicine, Research Center Juelich, Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany
| | - Martin Schulte-Rüther
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany; JARA Translational Brain Medicine, Research Center Juelich, Aachen, Germany
| | - Sara Ambrosino
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Alysa E Doyle
- Department of Psychiatry and Center for Human Genetics Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Stanley Center for Psychiatric Research at the Broad Institute, Cambridge, MA, USA
| | - Marie F Høvik
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Leanne Tamm
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Anders Dale
- Departments of Neurosciences and Radiology, University of California, San Diego, San Diego, CA, USA; UCSD Center for Translational Imaging and Precision Medicine, San Diego, CA, USA
| | - Andrew Schork
- Department of Cognitive Science, UC San Diego, La Jolla, CA, USA
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Kathrin Zierhut
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany; Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Ramona Baur
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Hazel McCarthy
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Yuliya N Yoncheva
- The Child Study Center at NYU Langone Medical Center, New York, NY, USA
| | - Ana Cubillo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kaylita Chantiluke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ivanei Bramati
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Paulo Mattos
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Tovar-Moll
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Morphological Sciences Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pamela Douglas
- Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Centre Zurich, University of Zurich, Zurich, Switzerland; ETH Zurich, Zurich, Switzerland
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clare Kelly
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland; The Child Study Center at NYU Langone Medical Center, New York, NY, USA; Trinity College Institute of Neuroscience, Dublin, Ireland
| | | | - Michael P Milham
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA; Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Francisco X Castellanos
- The Child Study Center at NYU Langone Medical Center, New York, NY, USA; Division of Child and Adolescent Psychiatric Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Thomas Frodl
- Department of Psychiatry, University of Dublin, Trinity College Dublin, Dublin, Ireland; Department of Psychiatry and Psychotherapy, University Hospital, Otto-von-Guericke-University, Magdeburg, Germany
| | - Mariam Zentis
- Department of Psychiatry and Psychotherapy, University Hospital, Otto-von-Guericke-University, Magdeburg, Germany
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany; Department of Translational Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Paul Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Terry L Jernigan
- Departments of Cognitive Science, Psychiatry, Radiology, and Center for Human Development, University of California, San Diego, CA, USA
| | - Jan Haavik
- KG Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph Biederman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | - Nanda Rommelse
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry, Nijmegen, Netherlands
| | - Dirk J Heslenfeld
- Department of Cognitive Psychology, VU University Amsterdam, Amsterdam, Netherlands; Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Georg von Polier
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, University Hospital Aachen, Aachen, Germany
| | - Oscar Vilarroya
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Fundació IMIM, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain
| | - Joan Carles Soliva
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sarah Durston
- NICHE-lab, Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry, Nijmegen, Netherlands
| | - Stephen V Faraone
- KG Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, National Human Genome Research Institute, Bethesda, MD, USA; National Institute of Mental Health, Bethesda, MD, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, USA
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
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Conzelmann A, Woidich E, Mucha RF, Weyers P, Müller M, Lesch KP, Jacob CP, Pauli P. Methylphenidate and emotional-motivational processing in attention-deficit/hyperactivity disorder. J Neural Transm (Vienna) 2016; 123:971-9. [PMID: 26852138 DOI: 10.1007/s00702-016-1512-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/20/2016] [Indexed: 01/01/2023]
Abstract
In line with the assumption that emotional-motivational deficits are one core dysfunction in ADHD, in one of our previous studies we observed a reduced reactivity towards pleasant pictures in adult ADHD patients as compared to controls. This was indicated by a lack of attenuation of the startle reflex specifically during pleasant pictures in ADHD patients. The first choice medical agents in ADHD, methylphenidate (MPH), is discussed to normalize these dysfunctions. However, experimental evidence in the sense of double-blind placebo-controlled study designs is lacking. Therefore, we investigated 61 adult ADHD patients twice, one time with placebo and one time with MPH with the same experimental design as in our study previously and assessed emotion processing during the presentation of pleasant, neutral and unpleasant pictures. We obtained startle reflex data as well as valence and arousal ratings in association with the pictures. As previously shown, ADHD patients showed a diminished startle attenuation during pleasant pictures while startle potentiation during unpleasant pictures was normal. Valence and arousal ratings unsuspiciously increased with increasing pleasantness and arousal of the pictures, respectively. There were no significant influences of MPH. The study replicates that ADHD patients show a reduced reactivity towards pleasant stimuli. MPH did not normalize this dysfunction. Possibly, MPH only influences emotions during more complex behavioural tasks that involve executive functions in adults with ADHD. Our results emphasize the importance for the use of double-blind placebo-controlled designs in psychopharmacological research.
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Affiliation(s)
- Annette Conzelmann
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany. .,Department of Child and Adolescent Psychiatry, University of Tübingen, Tübingen, Germany.
| | - Eva Woidich
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Ronald F Mucha
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Peter Weyers
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Mathias Müller
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Klaus-Peter Lesch
- Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Christian P Jacob
- Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany.
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Connectivity Analysis and Feature Classification in Attention Deficit Hyperactivity Disorder Sub-Types: A Task Functional Magnetic Resonance Imaging Study. Brain Topogr 2015; 29:429-39. [PMID: 26602102 DOI: 10.1007/s10548-015-0463-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/16/2015] [Indexed: 12/28/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a pervasive neuropsychiatric disorder. Patients with different ADHD subtypes show different behaviors under different stimuli and thus might require differential approaches to treatment. This study explores connectivity differences between ADHD subtypes and attempts to classify these subtypes based on neuroimaging features. A total of 34 patients (13 ADHD-IA and 21 ADHD-C subtypes) underwent functional magnetic resonance imaging (fMRI) with six task paradigms. Connectivity differences between ADHD subtypes were assessed for the whole brain in each task paradigm. Connectivity measures of the identified regions were used as features for the support vector machine classifier to distinguish between ADHD subtypes. The effectiveness of connectivity measures of the regions were tested by predicting ADHD-related Diagnostic and Statistical Manual of Mental Disorders (DSM) scores. Significant connectivity differences between ADHD subtypes were identified mainly in the frontal, cingulate, and parietal cortices and partially in the temporal, occipital cortices and cerebellum. Classifier accuracy for distinguishing between ADHD subtypes was 91.18 % for both gambling punishment and emotion task paradigms. Linear prediction under the two task paradigms showed significant correlation with DSM hyperactive/impulsive score. Our study identified important brain regions from connectivity analysis based on an fMRI paradigm using gambling punishment and emotion task paradigms. The regions and associated connectivity measures could serve as features to distinguish between ADHD subtypes.
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Cañadas E, Lupiáñez J, Kawakami K, Niedenthal PM, Rodríguez-Bailón R. Perceiving emotions: Cueing social categorization processes and attentional control through facial expressions. Cogn Emot 2015. [PMID: 26197208 DOI: 10.1080/02699931.2015.1052781] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Individuals spontaneously categorise other people on the basis of their gender, ethnicity and age. But what about the emotions they express? In two studies we tested the hypothesis that facial expressions are similar to other social categories in that they can function as contextual cues to control attention. In Experiment 1 we associated expressions of anger and happiness with specific proportions of congruent/incongruent flanker trials. We also created consistent and inconsistent category members within each of these two general contexts. The results demonstrated that participants exhibited a larger congruency effect when presented with faces in the emotional group associated with a high proportion of congruent trials. Notably, this effect transferred to inconsistent members of the group. In Experiment 2 we replicated the effects with faces depicting true and false smiles. Together these findings provide consistent evidence that individuals spontaneously utilise emotions to categorise others and that such categories determine the allocation of attentional control.
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Affiliation(s)
- Elena Cañadas
- a Department of Experimental Psychology , University of Granada , Granada , Spain
| | - Juan Lupiáñez
- a Department of Experimental Psychology , University of Granada , Granada , Spain
| | - Kerry Kawakami
- b Department of Psychology , York University , Toronto , ON , Canada
| | - Paula M Niedenthal
- c Laboratory of Cognitive and Social Psychology , Blaise Pascal University , Clermont-Ferrand , France
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Reimherr FW, Marchant BK, Gift TE, Steans TA, Wender PH. Types of adult attention-deficit hyperactivity disorder (ADHD): baseline characteristics, initial response, and long-term response to treatment with methylphenidate. ACTA ACUST UNITED AC 2015; 7:115-28. [PMID: 25987323 DOI: 10.1007/s12402-015-0176-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/01/2015] [Indexed: 02/01/2023]
Abstract
Much recent research describes the importance of emotional symptoms in ADHD. While there is no accepted system for including emotionality in diagnosing ADHD, the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) provides a tool to facilitate this. It assesses a range of adult ADHD symptoms which load on two factors: inattentive and emotional dysregulation. The consistently high inattentive factor was used to define significant elevation on the more variable emotional dysregulation factor (which contains four WRAADDS domains: hyperactivity/restlessness, temper, affective lability, and emotional over-reactivity) allowing the definition of two ADHD diagnostic types. We compared these two types on a broad range of adult subject characteristics, including response to methylphenidate (MPH) treatment assessed during two clinical trials. Marked impairment in three of the four emotional domains reflected a symptom severity level equivalent to that of the inattentive factor. 59 % met this threshold, defining them as ADHD emotion dysregulation presentation, as opposed to 41 % with ADHD inattentive presentation. Cluster analysis validated these groups by generating similar clusters with 85 % agreement regarding membership. ADHD emotional dysregulation presentation subjects showed more childhood ADHD symptoms, adult symptoms of oppositional defiant disorder, and evidence of personality disorder. Both types showed similar improvement during the double-blind MPH arm of the trials and during a 6-month open-label phase. Based on the presence of symptoms of emotional dysregulation, ADHD in adults can be conceptualized as two types. Impairment and comorbidity in adults with ADHD are largely concentrated in ADHD emotional dysregulation presentation patients.
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Affiliation(s)
- Fred W Reimherr
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84103, USA
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Raz S, Dan O. Altered event-related potentials in adults with ADHD during emotional faces processing. Clin Neurophysiol 2015; 126:514-23. [DOI: 10.1016/j.clinph.2014.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 06/01/2014] [Accepted: 06/03/2014] [Indexed: 12/21/2022]
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EEG theta/beta ratio as a potential biomarker for attentional control and resilience against deleterious effects of stress on attention. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2015; 14:782-91. [PMID: 24379166 DOI: 10.3758/s13415-013-0238-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anxious stress compromises cognitive executive performance. This occurs, for instance, in cognitive performance anxiety (CPA), in which anxiety about one's cognitive performance causes that performance to actually deteriorate (e.g., test anxiety). This is thought to result from a prefrontal cortically (PFC) mediated failure of top-down attentional control over stress-induced automatic processing of threat-related information. In addition, stress-induced increased catecholamine influx into the PFC may directly compromise attentional function. Previous research has suggested that the ratio between resting state electroencephalographic (EEG) low- and high-frequency power (the theta/beta ratio) is related to trait attentional control, which might moderate these effects of stress on attentional function. The goals of the present study were to test the novel prediction that theta/beta ratio moderates the deleterious effects of CPA-like anxious stress on state attentional control and to replicate a previous finding that the theta/beta ratio is related to self-reported trait attentional control. After recording of baseline frontal EEG signals, 77 participants performed a stress induction or a control procedure. Trait attentional control was assessed with the Attentional Control Scale, whereas stress-induced changes in attentional control and anxiety were measured with self-report visual analogue scales. The hypothesized moderating influence of theta/beta ratio on the effects of stress on state attentional control was confirmed. Theta/beta ratio explained 28% of the variance in stress-induced deterioration of self-reported attentional control. The negative relationship between theta/beta ratio and trait attentional control was replicated (r = -.33). The theta/beta ratio reflects, likely prefrontally mediated, attentional control, and should be a useful biomarker for the study of CPA and other anxiety-cognition interactions.
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Tye C, Battaglia M, Bertoletti E, Ashwood KL, Azadi B, Asherson P, Bolton P, McLoughlin G. Altered neurophysiological responses to emotional faces discriminate children with ASD, ADHD and ASD+ADHD. Biol Psychol 2014; 103:125-34. [DOI: 10.1016/j.biopsycho.2014.08.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 08/04/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
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Elovainio M, Raaska H, Sinkkonen J, Mäkipää S, Lapinleimu H. Associations between attachment-related symptoms and later psychological problems among international adoptees: Results from the FinAdo study. Scand J Psychol 2014; 56:53-61. [DOI: 10.1111/sjop.12174] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/02/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Marko Elovainio
- National Institute for Health and Welfare; Helsinki Finland
- Institute for Behavioural Siences; University of Helsinki; Finland
| | - Hanna Raaska
- University of Helsinki; Helsinki University Hospital; Finland
| | | | | | - Helena Lapinleimu
- Department of Pediatrics; Turku University Hospital and University of Turku; Finland
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Abstract
The aim of this study was to assess the response of social phobia (SP) symptoms to methylphenidate (MPH) treatment in children with attention deficit hyperactivity disorder (ADHD). Twenty-one ADHD patients with SP, aged between 8 and 18 years, received 12 weeks of MPH treatment. The severity of SP symptoms were assessed by the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA), and the severity of ADHD symptoms was assessed by the ADHD Rating Scale at baseline and at endpoint. MPH treatment was associated with a significant decrease in the ADHD Rating Scale scores (P<0.0001) and in the total LSAS-CA scores (P=0.013), as well as the school-related items of LSAS-CA (P=0.011). A significant correlation was found between the reductions in ADHD score and total LSAS-CA score (P=0.038), especially in school-related SP. The improvement in ADHD symptoms because of MPH treatment correlates with a parallel improvement in SP. MPH treatment appears to be safe and effective in ADHD/SP children.
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Gong J, Yuan J, Wang S, Shi L, Cui X, Luo X. Feedback-related negativity in children with two subtypes of attention deficit hyperactivity disorder. PLoS One 2014; 9:e99570. [PMID: 24932610 PMCID: PMC4059686 DOI: 10.1371/journal.pone.0099570] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 05/15/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The current model of ADHD suggests abnormal reward and punishment sensitivity, although differences in ADHD subgroups are unclear. This study aimed to investigate the effect of feedback valence (reward or punishment) and punishment magnitude (small or large) on Feedback-Related Negativity (FRN) and Late Positive Potential (LPP) in two subtypes of ADHD (ADHD-C and ADHD-I) compared to typically developing children (TD) during a children's gambling task. METHODS Children with ADHD-C (n = 16), children with ADHD-I (n = 15) and typically developing children (n = 15) performed a children's gambling task under three feedback conditions: large losses, small losses and gains. FRN and LPP components in brain potentials were recorded and analyzed. RESULTS In TD children and children with ADHD-C, large loss feedback evoked more negative FRN amplitudes than small loss feedback, suggesting that brain sensitivity to the punishment and its magnitude is not impaired in children with ADHD-C. In contrast to these two groups, the FRN effect was absent in children with ADHD-I. The LPP amplitudes were larger in children with ADHD-C in comparison with those with ADHD-I, regardless of feedback valence and magnitude. CONCLUSION Children with ADHD-C exhibit intact brain sensitivity to punishment similar to TD children. In contrast, children with ADHD-I are significantly impaired in neural sensitivity to the feedback stimuli and in particular, to punishment, compared to TD and ADHD-C children. Thus, FRN, rather than LPP, is a reliable index of the difference in reward and punishment sensitivity across different ADHD-subcategories.
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Affiliation(s)
- Jingbo Gong
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China
- Traditional Chinese Medicine University of Hunan, Changsha, Hunan, PR China
| | - Jiajin Yuan
- School of Psychology, Southwest University, Chongqing, China
| | - Suhong Wang
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China
- Department of Neuroscience, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Lijuan Shi
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China
| | - Xilong Cui
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China
| | - Xuerong Luo
- Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China
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Gerber B, Yarali A, Diegelmann S, Wotjak CT, Pauli P, Fendt M. Pain-relief learning in flies, rats, and man: basic research and applied perspectives. Learn Mem 2014; 21:232-52. [PMID: 24643725 PMCID: PMC3966540 DOI: 10.1101/lm.032995.113] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Memories relating to a painful, negative event are adaptive and can be stored for a lifetime to support preemptive avoidance, escape, or attack behavior. However, under unfavorable circumstances such memories can become overwhelmingly powerful. They may trigger excessively negative psychological states and uncontrollable avoidance of locations, objects, or social interactions. It is therefore obvious that any process to counteract such effects will be of value. In this context, we stress from a basic-research perspective that painful, negative events are "Janus-faced" in the sense that there are actually two aspects about them that are worth remembering: What made them happen and what made them cease. We review published findings from fruit flies, rats, and man showing that both aspects, respectively related to the onset and the offset of the negative event, induce distinct and oppositely valenced memories: Stimuli experienced before an electric shock acquire negative valence as they signal upcoming punishment, whereas stimuli experienced after an electric shock acquire positive valence because of their association with the relieving cessation of pain. We discuss how memories for such punishment- and relief-learning are organized, how this organization fits into the threat-imminence model of defensive behavior, and what perspectives these considerations offer for applied psychology in the context of trauma, panic, and nonsuicidal self-injury.
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Affiliation(s)
- Bertram Gerber
- Leibniz Institut für Neurobiologie (LIN), Abteilung Genetik von Lernen und Gedächtnis, 39118 Magdeburg, Germany
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Maier SJ, Szalkowski A, Kamphausen S, Feige B, Perlov E, Kalisch R, Jacob GA, Philipsen A, Tüscher O, Tebartz van Elst L. Altered cingulate and amygdala response towards threat and safe cues in attention deficit hyperactivity disorder. Psychol Med 2014; 44:85-98. [PMID: 23510549 DOI: 10.1017/s0033291713000469] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Emotional dysregulation is becoming increasingly recognized as an important feature of attention deficit hyperactivity disorder (ADHD). In this study, two experiments were conducted investigating the neural response to either verbally instructed fear (IF) or uninstructed (classically conditioned) fear (UF) using the skin conductance response (SCR) and functional magnetic resonance imaging (fMRI). METHOD In the conditioning phase of the UF experiment (17 ADHD and 17 healthy controls), subjects experienced an unconditioned stimulus (UCS, unpleasant electrodermal stimulation) paired with a former neutral conditioned stimulus (CS+), whereas a control stimulus (CS-) was never paired with the UCS. In the subsequent test phase, only the CS+ and the CS- were presented. In the IF experiment (13 ADHD and 17 healthy controls), subjects were only told that an independently experienced UCS might occur together with the CS+ but not the CS- during testing. No UCS was presented. RESULTS Groups did not detectably differ in SCR or neural responses to UF. In IF, ADHD patients showed a trend-line decreased SCR and significantly decreased activation of the dorsal anterior cingulate cortex (dACC), a region prominently involved in fear responding, to the CS+. This was accompanied by higher amygdala activation to the CS-. CONCLUSIONS During IF, ADHD patients showed deficits in regions centrally involved in fear learning and expression in terms of diminished CS+-related dACC and increased CS--related amygdala signals. This suggests an impaired processing of verbally transmitted aversive information, which is central for conveying fear information in social contexts. This result extends the growing literature on emotional alterations in ADHD.
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Affiliation(s)
- S J Maier
- Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg, Germany
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26
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Conzelmann A, Gerdes ABM, Mucha RF, Weyers P, Lesch KP, Bähne CG, Fallgatter AJ, Renner TJ, Warnke A, Romanos M, Pauli P. Autonomic hypoactivity in boys with attention-deficit/hyperactivity disorder and the influence of methylphenidate. World J Biol Psychiatry 2014; 15:56-65. [PMID: 24410179 DOI: 10.3109/15622975.2013.829584] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES This study investigates an overall autonomic hypoactivity reflecting hypoarousal as important aetiological factor in ADHD at baseline during rest and in response towards stimuli. In addition, effects of methylphenidate (MPH) are examined. We further assessed whether this hypoarousal is a stable characteristic or ameliorated by arousing emotional stimuli. METHODS Boys with ADHD were examined with (n = 35) or without MPH (n = 45) and compared with healthy boys (n = 22) regarding skin conductance level (SCL) during rest and skin conductance responses (SCRs) as well as valence and arousal ratings in response to positive, neutral, and negative pictures. RESULTS ADHD children without MPH were characterized by reduced baseline SCL and overall reduced SCRs. ADHD children with MPH never differed from control children. All groups displayed normal valence and arousal ratings of the stimuli and enhanced SCRs to emotional in comparison to neutral pictures. CONCLUSIONS This is the first study to unravel (1) a general autonomic hypoactivity in ADHD children at baseline and in response to low arousing neutral and highly arousing emotional stimuli, and (2) hints that MPH normalizes this hypoactivity. Results contribute to the understanding of ADHD aetiology and MPH functionality, and are consistent with the cognitive-energetic model of ADHD.
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Affiliation(s)
- Annette Conzelmann
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg , Germany
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Elsässer M, Newark PE, Stieglitz RD. Selbstregulation, Lageorientierung und Aufmerksamkeit bei erwachsenen ADHS-Patienten. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2014. [DOI: 10.1026/1616-3443/a000248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Einleitung: Es wurden Selbststeuerungskompetenzen und der Einfluss der Unaufmerksamkeit auf die Selbststeuerung bei Erwachsenen mit einer Aufmerksamkeits-Defizit/Hyperaktivitätsstörung (ADHS) untersucht. Methode: Erwachsene mit ADHS und gesunde Kontrollen füllten die Kurzversion des Selbststeuerungs-Inventars (SSI-K) und den Fragebogen zur Messung der Handlungskontrolle (HAKEMP 90) aus. Die Beeinträchtigungen der Aufmerksamkeit wurden bei den ADHS-Patienten mittels entsprechenden Subskalen aus dem ADHS-Selbstbeurteilungsbogen (ADHS-SB) und den Conners Adult ADHD Rating Scales (CAARS-R) erfasst. Mittels Kovarianzanalyse wurden Gruppenunterschiede in der Selbststeuerung zwischen ADHS-Patienten und Kontrollpersonen untersucht. Als nächster Schritt wurde der Zusammenhang zwischen Selbststeuerung und Unaufmerksamkeit bei ADHS-Patienten anhand einer einfachen linearen Regression überprüft. Ergebnisse und Schlussfolgerung: Erwachsene mit ADHS zeichnen sich durch eine geringe Selbstmotivation, eine stärkere Hemmung der willentlichen Prozesse in Form von Willenshemmung und Selbsthemmung, sowie einer Disposition zur Lageorientierung aus. Die Beeinträchtigung der Aufmerksamkeit bei der ADHS-Gruppe scheint die Willenshemmung zu begünstigen.
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Parenting stress and externalizing behavior symptoms in children: the impact of emotional reactivity. Child Psychiatry Hum Dev 2013; 44:786-97. [PMID: 23435549 DOI: 10.1007/s10578-013-0371-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study investigated whether the parenting stress-child externalizing behavior link is moderated by children's emotional reactivity, as indexed by skin conductance responses (SCRs). Participants were 61 children aged 9-12 years and their mothers. Mothers completed measures of parenting stress and their children's externalizing symptoms; children also reported on their externalizing behavior. Children's SCRs were assessed during the viewing of standardized pleasant, unpleasant, and neutral pictures. Cluster analysis on SCRs identified two groups, labeled Lower SCRs and Higher SCRs. Regression analyses indicated that among children with lower SCRs, those exposed to increased parenting stress reported more externalizing symptoms, whereas those who experienced low parenting stress reported similar rates of externalizing problems as children with higher SCRs. No effect of parenting stress emerged for children with higher SCRs. Findings suggest that higher parenting stress renders children with lower, as opposed to higher, SCRs to emotional stimuli more vulnerable to externalizing problems.
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Abstract
Short-term trials involving adults with ADHD have shown significant improvements in symptoms with stimulants and atomoxetine; however, data on long-term benefits and risks of these medications, particularly among older persons, have been insufficient.
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30
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Beyer F, Münte TF, Erdmann C, Krämer UM. Emotional reactivity to threat modulates activity in mentalizing network during aggression. Soc Cogn Affect Neurosci 2013; 9:1552-60. [PMID: 23986265 DOI: 10.1093/scan/nst146] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aggression is a common response to provocation, albeit with considerable interindividual differences. In this fMRI study, we investigated emotional reactivity to threat as possible link between provocation and aggression, as well as the neural correlates of this relationship. We hypothesized that emotional reactivity, measured as fear potentiation (FP) of the startle response, would be negatively associated with aggressive behavior and would modulate neural activity during an aggressive interaction. In 30 healthy female participants, FP was measured as the difference between blink amplitudes while watching threatening vs neutral pictures. Participants subsequently engaged in a variant of the Taylor Aggression Paradigm (TAP), while being scanned. During the TAP, participants selected a punishment level for either a highly provoking or a nonprovoking opponent. There was no difference in aggressive behavior between participants high and low in FP. However, we found a negative correlation between FP and the neural provocation effect in several regions of a network previously associated with mentalizing including the medial prefrontal cortex, precuneus and the temporo-parietal junction. Independently of the FP variability, aggressive behavior correlated with the provocation effect on activity in the caudate nucleus. Our results indicate that during a provocative confrontation, high emotional reactivity to threat suppresses recruitment of the mentalizing network.
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Affiliation(s)
- Frederike Beyer
- Department of Neurology and Department of Neuroradiology, University of Lübeck, RatzeburgerAllee 160, 23538 Lübeck, Germany
| | - Thomas F Münte
- Department of Neurology and Department of Neuroradiology, University of Lübeck, RatzeburgerAllee 160, 23538 Lübeck, Germany
| | - Christian Erdmann
- Department of Neurology and Department of Neuroradiology, University of Lübeck, RatzeburgerAllee 160, 23538 Lübeck, Germany Department of Neurology and Department of Neuroradiology, University of Lübeck, RatzeburgerAllee 160, 23538 Lübeck, Germany
| | - Ulrike M Krämer
- Department of Neurology and Department of Neuroradiology, University of Lübeck, RatzeburgerAllee 160, 23538 Lübeck, Germany
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Broderick PA, Rosenbaum T. Sex-specific brain deficits in auditory processing in an animal model of cocaine-related schizophrenic disorders. Brain Sci 2013; 3:504-20. [PMID: 24961412 PMCID: PMC4061862 DOI: 10.3390/brainsci3020504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/04/2013] [Accepted: 03/20/2013] [Indexed: 11/16/2022] Open
Abstract
Cocaine is a psychostimulant in the pharmacological class of drugs called Local Anesthetics. Interestingly, cocaine is the only drug in this class that has a chemical formula comprised of a tropane ring and is, moreover, addictive. The correlation between tropane and addiction is well-studied. Another well-studied correlation is that between psychosis induced by cocaine and that psychosis endogenously present in the schizophrenic patient. Indeed, both of these psychoses exhibit much the same behavioral as well as neurochemical properties across species. Therefore, in order to study the link between schizophrenia and cocaine addiction, we used a behavioral paradigm called Acoustic Startle. We used this acoustic startle paradigm in female versus male Sprague-Dawley animals to discriminate possible sex differences in responses to startle. The startle method operates through auditory pathways in brain via a network of sensorimotor gating processes within auditory cortex, cochlear nuclei, inferior and superior colliculi, pontine reticular nuclei, in addition to mesocorticolimbic brain reward and nigrostriatal motor circuitries. This paper is the first to report sex differences to acoustic stimuli in Sprague-Dawley animals (Rattus norvegicus) although such gender responses to acoustic startle have been reported in humans (Swerdlow et al. 1997 [1]). The startle method monitors pre-pulse inhibition (PPI) as a measure of the loss of sensorimotor gating in the brain's neuronal auditory network; auditory deficiencies can lead to sensory overload and subsequently cognitive dysfunction. Cocaine addicts and schizophrenic patients as well as cocaine treated animals are reported to exhibit symptoms of defective PPI (Geyer et al., 2001 [2]). Key findings are: (a) Cocaine significantly reduced PPI in both sexes. (b) Females were significantly more sensitive than males; reduced PPI was greater in females than in males. (c) Physiological saline had no effect on startle in either sex. Thus, the data elucidate gender-specificity to the startle response in animals. Finally, preliminary studies show the effect of cocaine on acoustic startle in tandem with effects on estrous cycle. The data further suggest that hormones may play a role in these sex differences to acoustic startle reported herein.
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Affiliation(s)
- Patricia A Broderick
- Department of Physiology, Pharmacology & Neuroscience, The Sophie Davis School of Biomedical Education, The City College of New York, The City University of New York, New York, NY 10031, USA.
| | - Taylor Rosenbaum
- School of Arts and Sciences, Emory University, Atlanta, GA 30322, USA.
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Abstract
OBJECTIVES Abnormalities in reward processing have been found in adolescents and adults with ADHD using the 'Monetary Incentive Delay' (MID) task. However, ADHD groups in previous studies were heterogeneous regarding ADHD subtype, gender and, in part, drug treatment status. This study sought to compare neural activations in the ventral striatum (VS) and prefrontal regions during reward processing in homogenous ADHD subtype groups and healthy adults, using the MID task. METHODS In total, 24 drug-naïve, right-handed male adults with ADHD (12 subjects with combined type (ADHD-ct) and 12 subjects with predominantly inattentive (ADHD-it) type ADHD), and twelve healthy right-handed male control subjects were included. RESULTS Compared to ADHD-ct and healthy subjects, ADHD-it subjects showed a bilateral ventral striatal deficit during reward anticipation. In contrast, ADHD-ct subjects showed orbitofrontal hyporesponsiveness to reward feedback when compared with ADHD-it and healthy subjects. CONCLUSIONS This is the first fMRI study that delineates dysfunctional and subtype-divergent neural and behavioural reward processing in adults with ADHD.
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Sonuga-Barke EJS, Fairchild G. Neuroeconomics of attention-deficit/hyperactivity disorder: differential influences of medial, dorsal, and ventral prefrontal brain networks on suboptimal decision making? Biol Psychiatry 2012; 72:126-33. [PMID: 22560046 DOI: 10.1016/j.biopsych.2012.04.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/19/2012] [Accepted: 04/05/2012] [Indexed: 12/31/2022]
Abstract
Psychiatric neuroeconomics offers an alternative approach to understanding mental disorders by studying the way disorder-related neurobiological alterations constrain economic agency, as revealed through decisions about choices between future goods. In this article, we apply this perspective to understand suboptimal decision making in attention-deficit/hyperactivity disorder (ADHD) by integrating recent advances in the neuroscience of decision making and studies of the pathophysiology of ADHD. We identify three brain networks as candidates for further study and develop specific hypotheses about how these could be implicated in ADHD. First, we postulate that altered patterns of connectivity within a network linking medial prefrontal cortex and posterior cingulate cortex (i.e., the default mode network) disrupts ordering of utilities, prospection about desired future states, setting of future goals, and implementation of aims. Second, we hypothesize that deficits in dorsal frontostriatal networks, including the dorsolateral prefrontal cortex and dorsal striatum, produce executive dysfunction-mediated impairments in the ability to compare outcome options and make choices. Third, we propose that dopaminergic dysregulation in a ventral frontostriatal network encompassing the orbitofrontal cortex, ventral striatum, and amygdala disrupts processing of cues of future utility, evaluation of experienced outcomes (feedback), and learning of associations between cues and outcomes. Finally, we extend this perspective to consider three contemporary themes in ADHD research.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Institute for Disorders of Impulse & Attention, School of Psychology, University of Southampton, Southampton, United Kingdom.
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Wilbertz G, Tebartz van Elst L, Delgado MR, Maier S, Feige B, Philipsen A, Blechert J. Orbitofrontal reward sensitivity and impulsivity in adult attention deficit hyperactivity disorder. Neuroimage 2012; 60:353-61. [DOI: 10.1016/j.neuroimage.2011.12.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 11/25/2011] [Accepted: 12/08/2011] [Indexed: 01/25/2023] Open
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Marx I, Pieper J, Berger C, Hässler F, Herpertz SC. Contextual influence of highly valued rewards and penalties on delay decisions in children with ADHD. J Behav Ther Exp Psychiatry 2011; 42:488-96. [PMID: 21676671 DOI: 10.1016/j.jbtep.2011.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 05/13/2011] [Accepted: 05/17/2011] [Indexed: 11/30/2022]
Abstract
In this study, we examined the influence of both reward and penalty on delay decisions in subjects with ADHD. Eighteen 6- to 13-year-old boys with ADHD (combined or hyperactive-impulsive subtype) along with age- and IQ-matched control participants performed a memory game. If the children were successful at the game, they could choose between a small immediate reward (one white chip in exchange for 5 s of waiting) or a large delayed reward (two white chips in exchange for 60 s of waiting). If they failed, they could choose between a large immediate penalty (two black chips in exchange for 5 s of waiting) or a small delayed penalty (one black chip in exchange for 60 s of waiting). Subsequent to task completion, white chips were exchanged for video time and black chips were exchanged with completion of a written task. All of the participants, regardless of ADHD diagnosis, were motivated to complete the task and chose the delayed alternative most often. We conclude that under highly motivating conditions, children with ADHD are not more delay averse than children from the control group with respect to anticipation of reward and penalty.
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Affiliation(s)
- Ivo Marx
- Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Straße 20, 18147 Rostock, Germany.
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36
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Ibáñez A, Petroni A, Urquina H, Torrente F, Torralva T, Hurtado E, Guex R, Blenkmann A, Beltrachini L, Muravchik C, Baez S, Cetkovich M, Sigman M, Lischinsky A, Manes F. Cortical deficits of emotional face processing in adults with ADHD: Its relation to social cognition and executive function. Soc Neurosci 2011; 6:464-81. [DOI: 10.1080/17470919.2011.620769] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Conzelmann A, Woidich E, Mucha RF, Weyers P, Jacob CP, Lesch KP, Pauli P. Methylphenidate normalizes emotional processing in adult patients with attention-deficit/hyperactivity disorder: preliminary findings. Brain Res 2011; 1381:159-66. [PMID: 21215727 DOI: 10.1016/j.brainres.2010.12.085] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 12/27/2010] [Accepted: 12/30/2010] [Indexed: 11/30/2022]
Abstract
Emotional-motivational dysfunctions may significantly contribute to symptoms of attention-deficit/hyperactivity disorder (ADHD). Hyperactive-impulsive symptoms and sensation seeking could be the result of a search for reinforcers, and cognitive dysfunctions might be due to a low motivational drive. Emotional-motivational dysfunctions could also explain social dysfunctions in ADHD patients because they may lead to misinterpretations of emotional and social clues. Since methylphenidate (MPH) is the first choice as a pharmacological treatment in ADHD, we examined its influence on dysfunctional emotional processes. 13 adult ADHD patients were examined twice, without and after intake of MPH according to their personal medication regimen. The affect-modulated startle paradigm was used to assess physiological (affect-modulated startle response) and subjective (valence and arousal ratings) responses to pleasant, neutral and unpleasant visual stimuli. Healthy controls displayed affective startle modulation as expected, with startle attenuation and potentiation while watching pleasant and unpleasant pictures, respectively. In contrast, unmedicated ADHD patients displayed deficient responses to pleasant stimuli; no startle attenuation during the exposure to pleasant pictures was observed. However, MPH reinstated a normal affective startle modulation, as indicated by attenuation and potentiation associated with pleasant and unpleasant pictures, respectively. Valence and arousal ratings of patients were not affected by MPH. The data suggest that MPH as first choice treatment in ADHD has a positive impact on emotional processes in adult ADHD patients and points to the clinical relevance of emotional-dysfunctions in ADHD.
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Affiliation(s)
- Annette Conzelmann
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Germany
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Neurobiological and psychophysiological correlates of emotional dysregulation in ADHD patients. ACTA ACUST UNITED AC 2010; 2:233-9. [PMID: 21432610 DOI: 10.1007/s12402-010-0047-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
Abstract
Emotional dysregulation in ADHD patients has become an important issue in recent years. Dysfunctions especially in brain regions related to emotional processing as well as psychophysiological reactions have been reported. This review includes functional MRI, event-related potentials as well as emotion-modulated startle studies in ADHD patients. It reflects a selective review of the authors with no claim of completeness. Changes in the processing of positive stimuli, with reduced brain activity in the amygdala, in the ventral striatum and reduced EEG potentials were found. The relevance of the observed dysregulation in emotional processing and psychophysiological reactions with regard to theoretical constructs of ADHD-specific emotional dysregulation versus comorbidity will be discussed.
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Jyonouchi H. Autism spectrum disorders and allergy: observation from a pediatric allergy/immunology clinic. Expert Rev Clin Immunol 2010; 6:397-411. [PMID: 20441426 DOI: 10.1586/eci.10.18] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IgE-mediated allergic diseases (e.g., allergic rhinoconjunctivitis, atopic asthma and food allergy) are prevalent (up to 30%) in the general population and are increasing in developed countries. In infants and young children, non-IgE-mediated food allergy is also prevalent. In addition to easily recognized organ-specific symptoms, allergic diseases can cause neuropsychiatric symptoms, such as irritability and hyperactivity, in otherwise healthy individuals. This is also likely to occur in children with autism spectrum disorder (ASD). Moreover, the discomfort and pain associated with allergic diseases could aggravate behavioral symptoms in ASD children. Allergic conditions are easily treatable; however, ASD children may be underdiagnosed and/or undertreated for allergic and other common childhood diseases, in part due to their impaired communication skills. Practicing physicians should be aware of the potential impact of allergic diseases on behavioral symptoms and cognitive activity in ASD children. However, they also need to be aware that certain symptoms often attributed to 'allergy' by caregivers may not be immune mediated and should understand that behavioral symptoms can also be affected by many non-IgE-mediated causes.
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Affiliation(s)
- Harumi Jyonouchi
- Pediatrics, University of Medicine and Dentistry of New Jersey (UMDNJ)-New Jersey Medical School (NJMS), 185 South Orange Ave, Newark, NJ 07101, USA.
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Scheres A, Tontsch C, Thoeny AL, Kaczkurkin A. Temporal reward discounting in attention-deficit/hyperactivity disorder: the contribution of symptom domains, reward magnitude, and session length. Biol Psychiatry 2010; 67:641-8. [PMID: 20034616 DOI: 10.1016/j.biopsych.2009.10.033] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 10/28/2009] [Accepted: 10/29/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND Theoretical models have hypothesized that one core problem in attention-deficit/hyperactivity disorder (ADHD) is abnormal reward processing. Temporal reward discounting (decreases in subjective reward value due to prereward delay) is of interest because of its relation with a key symptom of ADHD-impulsivity. This study investigated 1) whether steep temporal reward discounting (TD) is associated with ADHD-combined type (ADHD-C)/symptoms of hyperactivity-impulsivity specifically; 2) the role of reward magnitude in TD in ADHD-C/participants with symptoms of hyperactivity-impulsivity; and 3) whether steep TD in ADHD-C/participants with symptoms of hyperactivity-impulsivity is affected by session length. METHODS Three TD tasks were administered to children and adolescents (aged 6-17) with ADHD-C (n = 25), ADHD-inattentive type (ADHD-I; n = 20), and matched typically developing participants (n = 37). Reward magnitude and session length were varied. RESULTS Steep TD was observed in participants with ADHD-C but not in those with ADHD-I, independent of reward magnitude and session length. Dimensional analyses revealed that steep TD was associated with hyperactivity-impulsivity (transcending the arbitrary cutoff for ADHD subtypes), especially when reward magnitude at the trial level was small. CONCLUSIONS These findings suggest that steep TD in ADHD is best thought of as a correlate of the symptom dimension of hyperactivity/impulsivity. Additionally, steep TD in ADHD is the result of a trade-off between delay and reward magnitude, with all factors contributing to choice preferences. These findings may help refine the delay aversion theory of ADHD, and provide evidence for the notion that unique reward processing is one mechanism associated with symptoms of hyperactivity-impulsivity.
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Affiliation(s)
- Anouk Scheres
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.
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Pauli P, Conzelmann A, Mucha RF, Weyers P, Baehne CG, Fallgatter AJ, Jacob CP, Lesch KP. Affect-modulated startle reflex and dopamine D4 receptor gene variation. Psychophysiology 2010; 47:25-33. [DOI: 10.1111/j.1469-8986.2009.00923.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bijlsma EY, Oosting RS, Olivier B, Groenink L. Disrupted startle modulation in animal models for affective disorders. Behav Brain Res 2009; 208:383-90. [PMID: 20006647 DOI: 10.1016/j.bbr.2009.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Accepted: 12/07/2009] [Indexed: 10/20/2022]
Abstract
Affective startle modulation is used to study emotional reactivity in humans, and blunted affective startle modulation has been reported in depressed patients. To determine whether blunted affective startle modulation is also a common feature in animal models for affective disorders, light-enhanced startle was studied in three models: inescapable foot shock (IFS), repeated restraint stress (RRS) and olfactory bulbectomy (OBX). In addition, prepulse inhibition was studied in these models. Light-enhanced startle was blunted following IFS and OBX and RRS decreased overall startle responding. Prepulse inhibition, however, was unaffected. These findings indicate that induction models for affective disorders may be associated with long term effects on affective startle modulation. The lack of changes in sensory motor gating suggests that these changes can be ascribed to alterations in emotional reactivity. In conclusion, our results indicate that the blunted affective startle modulation seen in animal models for affective disorders may be used to examine the mechanisms underlying altered emotional reactivity.
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Affiliation(s)
- E Y Bijlsma
- Department of Psychopharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
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Herrmann MJ, Schreppel T, Biehl SC, Jacob C, Heine M, Boreatti-Hümmer A, Mühlberger A, Fallgatter AJ. Emotional deficits in adult ADHD patients: an ERP study. Soc Cogn Affect Neurosci 2009; 4:340-5. [PMID: 19713453 DOI: 10.1093/scan/nsp033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examined general deficits in positive stimuli evaluation in adults with Attention Deficit Hyperactivity Disorder (ADHD). We investigated the event-related potentials to positive, negative and neutral pictures in 32 adults with ADHD and 32 control subjects. For this study we measured 21 electrodes placed in accordance with the international 10-20 system and calculated the early posterior negativity (EPN), which physiologically is characterized by more negative values for emotional as compared to neutral stimuli. We found significantly reduced EPN values for the ADHD patients compared to the healthy controls, but only in the positive stimuli condition, without any significant differences in the negative stimuli condition. Our data indicate that ADHD patients show less reactivity to positive visual stimuli which might be relevant in the context of described dysfunctions of the motivational-reward system in ADHD.
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Affiliation(s)
- Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Fuechsleinstr. 15, 97080 Würzburg, Germany.
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