Developmental changes in autonomic emotional response during an executive functional task: A pupillometric study during Wisconsin card sorting test

Impairment of autonomic emotional response for executive function in children with ADHD: A multi-modal fNIRS and pupillometric study during the Wisconsin Card Sorting Test

OBJECTIVE

Children with attention deficit hyperactivity disorder (ADHD) often experience difficulties with emotional control and a consequent inability to perform tasks. To clarify the effects of emotional behavior on cognitive functions, we aimed to determine the association between emotional changes and executive functions in children with ADHD by measuring the pupil diameter changes associated with emotional changes.

PARTICIPANTS AND METHODS

This study included 14 children with ADHD and 10 typically developing children (TDC) aged between 10 and 16 years. During the Wisconsin Card Sorting Test (WCST), which is related to context formation and task switching among executive functions, changes in pupil diameter and frontal oxygenated hemoglobin (oxy-Hb) using functional near-infrared spectroscopy (fNIRS) were recorded simultaneously. Pupil diameter changes during "cognitive shift" and "consecutive correction" were compared between both groups.

RESULTS

During cognitive shift, the pupils of children with ADHD contracted, whereas those of the TDC were mydriatic. During consecutive correction, the pupils of children with ADHD were mydriatic, whereas those of the TDC tended to contract. These results correlated with WCST performance. Moreover, during cognitive shifts, changes in bilateral frontal blood flow were increased in TDC, but not in children with ADHD.

CONCLUSION

The locus coeruleus-norepinephrine (LC-NE) system plays an important role in pupillary diameter response. These results suggest that the LC-NE system may be dysfunctional in children with ADHD, and the system's abnormality may lead to affective abnormalities in such patients, which results in poor performance on WCST (i.e., impaired executive functions).

Examining the roles of cognitive flexibility, emotion recognition, and metacognitions in adult Attention Deficit and Hyperactivity Disorder with predominantly inattentive presentation

The evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher-order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher-order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire-30 (MCQ-30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ-30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.

Different Electrophysiological Responses to Informative Value of Feedback Between Children and Adults

The ability to learn from feedback is important for children's adaptive behavior and school learning. Feedback has two main components, informative value and valence. How to disentangle these two components and what is the developmental neural correlates of using the informative value of feedback is still an open question. In this study, 23 children (7-10 years old) and 19 adults (19-22 years old) were asked to perform a rule induction task, in which they were required to find a rule, based on the informative value of feedback. Behavioral results indicated that the likelihood of correct searching behavior under negative feedback was low for children. Event-related potentials showed that (1) the effect of valence was processed in a wide time window, particularly in the N2 component; (2) the encoding process of the informative value of negative feedback began later for children than for adults; (3) a clear P300 was observed for adults; for children, however, P300 was absent in the frontal region; and (4) children processed the informative value of feedback chiefly in the left sites during the P300 time window, whereas adults did not show this laterality. These results suggested that children were less sensitive to the informative value of negative feedback possibly because of the immature brain.