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Xing J, Wei R, Wang H, Hua Z, Tang X, Yi L, Li X, Liu J. Symptoms of ADHD and Autism Spectrum Disorder Interactively Predict Children's Verbal Fluency. J Atten Disord 2024; 28:1092-1104. [PMID: 38353406 DOI: 10.1177/10870547241232081] [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: 04/14/2024]
Abstract
OBJECTIVE Verbal fluency, the capacity to generate words from a designated category, predicts myriad cognitive and life outcomes. The study investigated verbal fluency in children with ADHD, autism spectrum disorder (ASD), and comorbid ADHD and ASD, to understand how ADHD- and ASD-related symptoms individually and jointly predict verbal fluency, and the underlying linguistic and cognitive substrates. METHOD Thirty-three school-aged children with ADHD, 27 with ASD, 25 with comorbid ADHD and ASD, and 39 with typical development, were assessed for ADHD and ASD symptoms and completed a semantic verbal fluency task. RESULTS Findings indicated that ADHD and ASD symptoms, especially ADHD hyperactivity-impulsivity symptoms and language-related ASD symptoms, interactively predicted verbal fluency across diagnostic groups. CONCLUSION The study implicated the potential cognitive and linguistic mechanisms underlying verbal fluency differences in ADHD and/or ASD, and clinical practices on enhancing verbal fluency in these clinical groups.
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Affiliation(s)
| | - Ran Wei
- Peking University, Beijing, China
| | - Hui Wang
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | | | - Xinzhou Tang
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Li Yi
- Peking University, Beijing, China
| | - Xue Li
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Liu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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2
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Oberman LM, Benussi A. Transcranial Magnetic Stimulation Across the Lifespan: Impact of Developmental and Degenerative Processes. Biol Psychiatry 2024; 95:581-591. [PMID: 37517703 PMCID: PMC10823041 DOI: 10.1016/j.biopsych.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
Transcranial magnetic stimulation (TMS) has emerged as a pivotal noninvasive technique for investigating cortical excitability and plasticity across the lifespan, offering valuable insights into neurodevelopmental and neurodegenerative processes. In this review, we explore the impact of TMS applications on our understanding of normal development, healthy aging, neurodevelopmental disorders, and adult-onset neurodegenerative diseases. By presenting key developmental milestones and age-related changes in TMS measures, we provide a foundation for understanding the maturation of neurotransmitter systems and the trajectory of cognitive functions throughout the lifespan. Building on this foundation, the paper delves into the pathophysiology of neurodevelopmental disorders, including autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette syndrome, and adolescent depression. Highlighting recent findings on altered neurotransmitter circuits and dysfunctional cortical plasticity, we underscore the potential of TMS as a valuable tool for unraveling underlying mechanisms and informing future therapeutic interventions. We also review the emerging role of TMS in investigating and treating the most common adult-onset neurodegenerative disorders and late-onset depression. By outlining the therapeutic applications of noninvasive brain stimulation techniques in these disorders, we discuss the growing body of evidence supporting their use as therapeutic tools for symptom management and potentially slowing disease progression. The insights gained from TMS studies have advanced our understanding of the underlying mechanisms in both healthy and disease states, ultimately informing the development of more targeted diagnostic and therapeutic strategies for a wide range of neuropsychiatric conditions.
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Affiliation(s)
- Lindsay M Oberman
- National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, Maryland
| | - Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
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3
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Ferguson C, Hobson C, Hedge C, Waters C, Anning K, van Goozen S. Disentangling the relationships between motor control and cognitive control in young children with symptoms of ADHD. Child Neuropsychol 2024; 30:289-314. [PMID: 36946244 DOI: 10.1080/09297049.2023.2190965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
Children with ADHD experience difficulties with motor and cognitive control. However, the relationships between these symptoms are poorly understood. As a step toward improving treatment, this study investigated associations between specific aspects of motor control and cognitive control in children with varying levels of hyperactive-impulsive symptoms. A heterogeneous sample of 255 children of 4 to 10 years of age (median = 6.50, MAD = 1.36) completed a battery of tests probing motor generation, visuomotor fluency, visuomotor flexibility, cognitive inhibition, verbal and visuospatial working memory, and cognitive flexibility. Their caregivers were interviewed regarding their hyperactive-impulsive symptoms. 25.9% of the main sample met diagnostic criteria for ADHD. Multiple linear regression analysis was used to determine whether specific aspects of motor control were associated with specific aspects of cognitive control, and whether any associations were moderated by hyperactive-impulsive symptoms. Additionally, cognitive modeling (the drift diffusion model approximated with EZ-DM) was used to understand performance on a cognitive inhibition task. Visuomotor fluency was significantly associated with cognitive inhibition. Visuomotor flexibility was significantly associated with cognitive flexibility. There were no significant moderation effects. Cognitive modeling was inconclusive. In conclusion, the ability to fluently perform visually guided continuous movement is linked with the ability to inhibit the effects of distracting information. The ability to spontaneously use visual information to flexibly alter motor responses is related to the ability to cognitively shift from one frame of mind to another. These relationships appear to be quantitatively and qualitatively similar across the childhood hyperactive-impulsive continuum as rated by parents.
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Affiliation(s)
- Cameron Ferguson
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Community Neurological Rehabilitation Service, Aneurin Bevan University Health Board, NHS Wales, Newport, United Kingdom
| | - Christopher Hobson
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Craig Hedge
- School of Psychology, Aston University, Aston, United Kingdom
| | - Cerith Waters
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Kate Anning
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
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Li C, Delgado-Gómez D, Sujar A, Wang P, Martin-Moratinos M, Bella-Fernández M, Masó-Besga AE, Peñuelas-Calvo I, Ardoy-Cuadros J, Hernández-Liebo P, Blasco-Fontecilla H. Assessment of ADHD Subtypes Using Motion Tracking Recognition Based on Stroop Color-Word Tests. SENSORS (BASEL, SWITZERLAND) 2024; 24:323. [PMID: 38257416 PMCID: PMC10818498 DOI: 10.3390/s24020323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder known for its significant heterogeneity and varied symptom presentation. Describing the different subtypes as predominantly inattentive (ADHD-I), combined (ADHD-C), and hyperactive-impulsive (ADHD-H) relies primarily on clinical observations, which can be subjective. To address the need for more objective diagnostic methods, this pilot study implemented a Microsoft Kinect-based Stroop Color-Word Test (KSWCT) with the objective of investigating the potential differences in executive function and motor control between different subtypes in a group of children and adolescents with ADHD. A series of linear mixture modeling were used to encompass the performance accuracy, reaction times, and extraneous movements during the tests. Our findings suggested that age plays a critical role, and older subjects showed improvements in KSWCT performance; however, no significant divergence in activity level between the subtypes (ADHD-I and ADHD-H/C) was established. Patients with ADHD-H/C showed tendencies toward deficits in motor planning and executive control, exhibited by shorter reaction times for incorrect responses and more difficulty suppressing erroneous responses. This study provides preliminary evidence of unique executive characteristics among ADHD subtypes, advances our understanding of the heterogeneity of the disorder, and lays the foundation for the development of refined and objective diagnostic tools for ADHD.
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Affiliation(s)
- Chao Li
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - David Delgado-Gómez
- Department of Statistics, University Carlos III of Madrid, 28903 Getafe, Spain
| | - Aaron Sujar
- School of Computer Engineering, University Rey Juan Carlos, 28933 Madrid, Spain
| | - Ping Wang
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - Marina Martin-Moratinos
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
| | - Marcos Bella-Fernández
- Department of Psychiatry, Puerta de Hierro University Hospital, 28222 Majadahonda, Spain
- Department of Psychology, Comillas Pontifical University, 28015 Madrid, Spain
- Department of Psychology, Autonomous University of Madrid, 28029 Madrid, Spain
| | | | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, University Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Juan Ardoy-Cuadros
- Health Sciences College, Rey Juan Carlos University, 28933 Madrid, Spain
| | - Paula Hernández-Liebo
- Department of Psychiatry, Marqués de Valdecilla University Hospital, University of Cantabria, 39008 Santander, Spain
| | - Hilario Blasco-Fontecilla
- Center of Biomedical Network Research on Mental Health (CIBERSAM), 28029 Madrid, Spain
- UNIR-ITEI & Health Sciences School, International University of La Rioja, 26006 Logroño, Spain
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Johns‐Mead R, Vijayakumar N, Mulraney M, Melvin G, Youssef G, Sciberras E, Anderson VA, Nicholson JM, Efron D, Hazel P, Silk TJ. Categorical and dimensional approaches to the developmental relationship between ADHD and irritability. J Child Psychol Psychiatry 2023; 64:1422-1431. [PMID: 37170636 PMCID: PMC10952727 DOI: 10.1111/jcpp.13818] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and irritability commonly co-occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co-occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability. METHODS A community sample of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow-up after 18-months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity-impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability. RESULTS Irritability was significantly higher among the ADHD group than controls; however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive-impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability; however, baseline irritability did not significantly predict change in ADHD symptoms. CONCLUSIONS ADHD symptoms-particularly hyperactive-impulsive symptoms-predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain-specific measures provides additional insight into this relationship.
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Affiliation(s)
- Rania Johns‐Mead
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
| | - Nandita Vijayakumar
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
| | - Melissa Mulraney
- Institute for Social NeuroscienceISN PsychologyIvanhoeVic.Australia
| | - Glenn Melvin
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
| | - George Youssef
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
- Murdoch Children's Research InstituteMelbourneVic.Australia
| | - Vicki A. Anderson
- Murdoch Children's Research InstituteMelbourneVic.Australia
- The Royal Children's HospitalMelbourneVic.Australia
- Department of PaediatricsUniversity of MelbourneMelbourneVic.Australia
| | | | - Daryl Efron
- Murdoch Children's Research InstituteMelbourneVic.Australia
- The Royal Children's HospitalMelbourneVic.Australia
- Department of PaediatricsUniversity of MelbourneMelbourneVic.Australia
| | - Philip Hazel
- Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
| | - Tim J. Silk
- Centre for Social and Early Emotional Development (SEED) and School of PsychologyDeakin UniversityGeelongVic.Australia
- Murdoch Children's Research InstituteMelbourneVic.Australia
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Godfrey-Harris M, Shaw SCK. The experiences of medical students with ADHD: A phenomenological study. PLoS One 2023; 18:e0290513. [PMID: 37607167 PMCID: PMC10443849 DOI: 10.1371/journal.pone.0290513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
Attention Deficit/Hyperactivity 'Disorder' (ADHD) is a form of neurodivergence, characterised by lifelong differences in attention, impulsivity, and hyperactivity. University students with ADHD underachieve academically and tend to have lower levels of self-esteem. Medical schools have an obligation to minimise barriers for students with ADHD. Understanding the experiences of medical students with ADHD is vital to promote inclusive approaches. Our exploratory research question was: "What are the experiences of medical students with ADHD?" This was an interpretive phenomenological study. Loosely structured interviews were conducted with participants (medical students with ADHD) over Zoom. Subsequent transcripts were analysed using interpretive phenomenological analysis. Six people participated. Our analysis identified the following themes: Identity and diagnosis; ADHD profile; system issues; conflict, competition and compensation; improving the experience. Participants reported experiences of bullying and isolation at medical school, perpetrated by doctors and peers, as well as feelings of alienation when unable to conform on placement and in exams. From this, participants adopted survival strategies, such as masking, to avoid being ostracised. All recognised their ADHD status when their mental health deteriorated during their medical studies. Of those who disclosed their diagnosis, none were offered personalised support. Participants feared disclosure, largely due to weaponised professionalism and the effects of toxic competitiveness in medicine. They yearned for a sense of belonging. Participants reported strengths associated with ADHD such as empathy and working well under pressure, which are highly desirable aptitudes for doctors. This study has highlighted areas where medical schools can be instrumental in cultivating an environment where medical students with ADHD can thrive, not just survive. This may take the form of peer support groups, alongside reasonable adjustments throughout medical school-particularly for Objective Structured Clinical Examinations, for example. Enabling these students to thrive may help to prevent early burnout and subsequent attrition from medicine.
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Bunford N, Hámori G, Nemoda Z, Angyal N, Fiáth R, Sebők-Welker TÉ, Pászthy B, Ulbert I, Réthelyi JM. The domain-variant indirect association between electrophysiological response to reward and ADHD presentations is moderated by dopaminergic polymorphisms. Compr Psychiatry 2023; 124:152389. [PMID: 37104986 DOI: 10.1016/j.comppsych.2023.152389] [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] [Received: 11/09/2022] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Understanding the etiopathogenesis of attention-deficit/hyperactivity disorder (ADHD) may necessitate decomposition of the heterogeneous clinical phenotype into more homogeneous intermediate phenotypes. Reinforcement sensitivity is a promising candidate, but the exact nature of the ADHD-reward relation - including how, for whom, and to which ADHD dimensions atypicalities in reward processing are relevant - is equivocal. METHODS Aims were to examine, in a carefully phenotyped sample of adolescents (N = 305; Mage = 15.30 years, SD = 1.07; 39.7% girls), whether functional dopaminergic polymorphisms implicated in both reward processing and ADHD (1) are differentially associated with event-related potentials (ERPs) of reward anticipation at distinct levels of ADHD risk (nno risk = 174, nat-risk = 131, ndiagnosed = 83); and (2) moderate the indirect effect of dispositional affectivity on the association between ERPs and ADHD domains. RESULTS In adolescents at-risk for or with ADHD, carrying a hypodopaminergic allele was associated with enhanced ERPs of attention allocation to cue and attenuated ERPs of anticipatory attention to feedback. No associations were observed in adolescents not at-risk for or without ADHD. Controlling for age and sex, both the negative indirect effect of positive affectivity (PA) on the association between ERPs and inattention and the positive indirect effect of PA on the association between ERPs and hyperactivity/impulsivity were supported only for those with high activity dopamine transporter (DAT) alleles. CONCLUSIONS Reward and affective processing are promising intermediate phenotypes relevant to disentangling ADHD developmental pathways. Consistent with developmental multifinality, through the successive effects of reward anticipation and positive affectivity, functional dopaminergic variants may confer protection against inattention or risk for hyperactivity/impulsivity.
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Affiliation(s)
- N Bunford
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary.
| | - Gy Hámori
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Műegyetem rkp. 3., H-1111 Budapest, Hungary
| | - Z Nemoda
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Tűzoltó utca 37-47., H-1094 Budapest, Hungary
| | - N Angyal
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Tűzoltó utca 37-47., H-1094 Budapest, Hungary
| | - R Fiáth
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A., H-1083 Budapest, Hungary
| | - T É Sebők-Welker
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Doctoral School of Mental Health Sciences, Semmelweis University, Balassa u. 6., 1083 Budapest, Hungary
| | - B Pászthy
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay János u. 53-43., H-1083 Budapest, Hungary
| | - I Ulbert
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A., H-1083 Budapest, Hungary
| | - J M Réthelyi
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Balassa u. 6., H-1083 Budapest, Hungary
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Sonuga-Barke EJS, Becker SP, Bölte S, Castellanos FX, Franke B, Newcorn JH, Nigg JT, Rohde LA, Simonoff E. Annual Research Review: Perspectives on progress in ADHD science - from characterization to cause. J Child Psychol Psychiatry 2023; 64:506-532. [PMID: 36220605 PMCID: PMC10023337 DOI: 10.1111/jcpp.13696] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 12/20/2022]
Abstract
The science of attention-deficit/hyperactivity disorder (ADHD) is motivated by a translational goal - the discovery and exploitation of knowledge about the nature of ADHD to the benefit of those individuals whose lives it affects. Over the past fifty years, scientific research has made enormous strides in characterizing the ADHD condition and in understanding its correlates and causes. However, the translation of these scientific insights into clinical benefits has been limited. In this review, we provide a selective and focused survey of the scientific field of ADHD, providing our personal perspectives on what constitutes the scientific consensus, important new leads to be highlighted, and the key outstanding questions to be addressed going forward. We cover two broad domains - clinical characterization and, risk factors, causal processes and neuro-biological pathways. Part one focuses on the developmental course of ADHD, co-occurring characteristics and conditions, and the functional impact of living with ADHD - including impairment, quality of life, and stigma. In part two, we explore genetic and environmental influences and putative mediating brain processes. In the final section, we reflect on the future of the ADHD construct in the light of cross-cutting scientific themes and recent conceptual reformulations that cast ADHD traits as part of a broader spectrum of neurodivergence.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychology, Psychiatry & Neuroscience, King’s College London. UK
- Department of Child & Adolescent Psychiatry, Aarhus University, Denmark
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, United States
| | - Sven Bölte
- Department of Women’s and Children’s Health, Karolinska Institutet, Sweden
- Division of Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Sweden
| | - Francisco Xavier Castellanos
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Joel T. Nigg
- Department of Psychiatry, Oregon Health and Science University, USA
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clinica de Porto Alegre, Federal University of Rio Grande do Sul, Brazil; National Institute of Developmental Psychiatry, Brazil
| | - Emily Simonoff
- School of Academic Psychiatry, Institute of Psychology, Psychiatry & Neuroscience, King’s College London. UK
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Koevoet D, Deschamps PKH, Kenemans JL. Catecholaminergic and cholinergic neuromodulation in autism spectrum disorder: A comparison to attention-deficit hyperactivity disorder. Front Neurosci 2023; 16:1078586. [PMID: 36685234 PMCID: PMC9853424 DOI: 10.3389/fnins.2022.1078586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by social impairments and restricted, repetitive behaviors. Treatment of ASD is notoriously difficult and might benefit from identification of underlying mechanisms that overlap with those disturbed in other developmental disorders, for which treatment options are more obvious. One example of the latter is attention-deficit hyperactivity disorder (ADHD), given the efficacy of especially stimulants in treatment of ADHD. Deficiencies in catecholaminergic systems [dopamine (DA), norepinephrine (NE)] in ADHD are obvious targets for stimulant treatment. Recent findings suggest that dysfunction in catecholaminergic systems may also be a factor in at least a subgroup of ASD. In this review we scrutinize the evidence for catecholaminergic mechanisms underlying ASD symptoms, and also include in this analysis a third classic ascending arousing system, the acetylcholinergic (ACh) network. We complement this with a comprehensive review of DA-, NE-, and ACh-targeted interventions in ASD, and an exploratory search for potential treatment-response predictors (biomarkers) in ASD, genetically or otherwise. Based on this review and analysis we propose that (1) stimulant treatment may be a viable option for an ASD subcategory, possibly defined by genetic subtyping; (2) cerebellar dysfunction is pronounced for a relatively small ADHD subgroup but much more common in ASD and in both cases may point toward NE- or ACh-directed intervention; (3) deficiency of the cortical salience network is sizable in subgroups of both disorders, and biomarkers such as eye blink rate and pupillometric data may predict the efficacy of targeting this underlying deficiency via DA, NE, or ACh in both ASD and ADHD.
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Affiliation(s)
- Damian Koevoet
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands,*Correspondence: Damian Koevoet,
| | - P. K. H. Deschamps
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - J. L. Kenemans
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
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10
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Dinçer M, Uğurtaş Gökçe FS, Gül H, Taş Torun Y, Bodur Ş, Cöngöloğlu MA. Is Processing Speed (Gs) related to Hyperactivity (As a Narrow Cognitive Area of Gps): A Dimensional Approach to Heterogeneity of Clinical and WISC-IV Cognitive Profiles in ADHD From RDoC/HiTOP Perspective. J Atten Disord 2022; 26:1747-1761. [PMID: 35579206 DOI: 10.1177/10870547221099963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity. METHOD The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers. RESULTS We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L's DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores. CONCLUSION Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.
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Affiliation(s)
- Mustafa Dinçer
- Mehmet Akif inan Training and Research Hospital, Şanlıurfa, Turkey
| | | | - Hesna Gül
- Gülhane Training and Research Hospital, Ankara, Turkey
| | | | - Şahin Bodur
- Gülhane Training and Research Hospital, Ankara, Turkey
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Tzang RF, Chang YC. Generalized structural equation modeling: Symptom heterogeneity in attention-deficit/hyperactivity disorder leading to poor treatment efficacy. World J Psychiatry 2022; 12:787-800. [PMID: 35978969 PMCID: PMC9258275 DOI: 10.5498/wjp.v12.i6.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/15/2021] [Accepted: 05/07/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treatment efficacy for attention-deficit/hyperactivity disorder (ADHD) is reported to be poor, possibly due to heterogeneity of ADHD symptoms. Little is known about poor treatment efficacy owing to ADHD heterogeneity.
AIM To use generalized structural equation modeling (GSEM) to show how the heterogeneous nature of hyperactivity/impulsivity (H/I) symptoms in ADHD, irritable oppositional defiant disorder (ODD), and the presentation of aggression in children interferes with treatment responses in ADHD.
METHODS A total of 231 children and adolescents completed ADHD inattention and H/I tests. ODD scores from the Swanson, Nolan, and Pelham, version IV scale were obtained. The child behavior checklist (CBCL) and parent’s satisfaction questionnaire were completed. The relationships were analyzed by GSEM.
RESULTS GSEM revealed that the chance of ADHD remission was lower in children with a combination of H/I symptoms of ADHD, ODD symptoms, and childhood aggressive behavior. ODD directly mediated ADHD symptom severity. The chance of reaching remission based on H/I symptoms of ADHD was reduced by 13.494% [= exp (2.602)] in children with comorbid ADHD and ODD [odds ratio (OR) = 2.602, 95% confidence interval (CI): 1.832-3.373, P = 0.000] after adjusting for the effects of other factors. Childhood aggression mediated ODD symptom severity. The chance of reaching remission based on ODD symptoms was lowered by 11.000% [= 1 - exp (-0.117)] in children with more severe baseline symptoms of aggression based on the CBCL score at study entry [OR = -0.117, 95%CI: (-0.190)-(-0.044), P = 0.002].
CONCLUSION Mediation through ODD symptoms and aggression may influence treatment effects in ADHD after adjusting for the effects of baseline ADHD symptom severity. More attention could be directed to the early recognition of risks leading to ineffective ADHD treatment, e.g., symptoms of ODD and the presentation of aggressive or delinquent behaviors and thought problems in children with ADHD.
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Affiliation(s)
- Ruu-Fen Tzang
- Department of Child and Adolescent Psychiatry, Mackay Memorial Hospital, Taipei 104, Taiwan
- Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing, and Management, New Taipei City 112, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei City 251, Taiwan
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12
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Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit/Hyperactivity Disorder to Disruptive Mood Dysregulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116648. [PMID: 35682233 PMCID: PMC9179962 DOI: 10.3390/ijerph19116648] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/04/2022]
Abstract
(1) Background: Internet gaming disorder (IGD) in youths likely leads to disruptive mood dysregulation, especially among those with attention-deficit/hyperactivity disorder (ADHD). Whether IGD mediates the pathways leading ADHD to disruptive emotional dysfunction remains unclear. This study aims to elucidate the direct or indirect influence of IGD on ADHD; (2) Method: The Swanson, Nolan, and Pelham Version IV questionnaire was used to evaluate symptoms of ADHD and oppositional defiant disorder, and the Chen gaming disorder scale was used to measure IGD. A psychiatrist diagnosed ADHD, IGD, and disruptive mood dysregulation disorder (DMDD)-like symptoms. Structural equation modeling was applied to evaluate the role of IGD in mediating ADHD progression to disruptive mood dysregulation; (3) Results: Among a total of 102 ADHD youths, 53 (52%) of them with IGD were significantly more likely to have poor interpersonal relationships (p < 0.01) and DMDD-like symptoms (p < 0.01) than ADHD youths without IGD. IGD played a mediating role in increasing the risk of disruptive mood dysregulation in ADHD youths; (4) Conclusions: The findings suggest that IGD mediates ADHD’s progression to disruptive mood dysregulation. Intensive biopsychosocial interventions are warranted for ADHD youths with IGD. More children and adolescents became mood-dysregulated after excessive gaming during the COVID-19 pandemic; this study’s results suggest that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.
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13
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Bernanke J, Luna A, Chang L, Bruno E, Dworkin J, Posner J. Structural brain measures among children with and without ADHD in the Adolescent Brain and Cognitive Development Study cohort: a cross-sectional US population-based study. Lancet Psychiatry 2022; 9:222-231. [PMID: 35143759 DOI: 10.1016/s2215-0366(21)00505-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Structural neuroimaging research has identified a variety of abnormalities in cortical and subcortical structures in children with ADHD. However, studies to date have not employed large, non-referred samples, complete with data on potential confounding variables. Here, we tested for differences in structural MRI measures among children with and without ADHD using data from the Adolescent Brain and Cognitive Development (ABCD) Study, the largest paediatric brain imaging study in the USA. METHODS In this cross-sectional study, we used baseline demographic, clinical, and neuroimaging data from the ABCD Study, which recruited children aged 9-10 years between Sept 1, 2016, and Aug 31, 2018, representative of the sociodemographic features of the US population. ADHD was diagnosed by parent report of symptoms. Neuroimaging data underwent centralised quality control and processing by the ABCD team. Linear mixed effects models were used to estimate Cohen's d values associated with ADHD for 79 brain measures of cortical thickness, cortical area, and subcortical volume. We used a novel simulation strategy to assess the ability to detect significant effects despite potential diagnostic misclassification. FINDINGS Our sample included 10 736 participants (5592 boys, 5139 girls; 5692 White, 2165 Hispanic, 1543 Black, 221 Asian, and 1100 of other race or ethnicity), of whom, 949 met the criteria for ADHD and 9787 did not. In the full model, which included potential confounding variables selected a priori, we found only 11 significant differences across the 79 brain measures after false discovery rate correction, all indicating reductions in brain measures among participants with ADHD. Cohen's d values were small, ranging from -0·11 to -0·06, and were not meaningfully changed by using a more restrictive comparison group or alternative diagnostic methods. Simulations indicated adequate statistical power to detect differences even if there was substantial diagnostic misclassification. INTERPRETATION In a sample representative of the general population, children aged 9-10 years with ADHD differed only modestly on structural brain measures from their unaffected peers. Future studies might need to incorporate other MRI modalities, novel statistical approaches, or alternative diagnostic classifications, particularly for research aimed at developing ADHD diagnostic biomarkers. FUNDING Edwin S Webster Foundation and Duke University, NC, USA.
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Affiliation(s)
- Joel Bernanke
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Alex Luna
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Le Chang
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Elizabeth Bruno
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jordan Dworkin
- New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jonathan Posner
- Department of Psychiatry and Behavioral Health, Duke University, Durham, NC, USA.
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14
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Knez R, Stevanovic D, Fernell E, Gillberg C. Orexin/Hypocretin System Dysfunction in ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). Neuropsychiatr Dis Treat 2022; 18:2683-2702. [PMID: 36411777 PMCID: PMC9675327 DOI: 10.2147/ndt.s358373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) is an umbrella term covering a wide range of neurodevelopmental difficulties and disorders. Thus, ESSENCE includes attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental disorders (NDDs) and difficulties, with a variety of symptoms in cognitive, motor, sensory, social, arousal, regulatory, emotional, and behavioral developmental domains, frequently co-occurring and likely having partly common neurobiological substrates. The ESSENCE concept is a clinical paradigm that promotes organizing NDDs in everyday clinical practice according to their coexistence, symptom dimensions overlapping, and treatment possibilities. Despite increased knowledge regarding NDDs, the neurobiological mechanisms that underlie them and other ESSENCE-related problems, are not well understood. With its wide range of neural circuits and interactions with numerous neurotransmitters, the orexin/hypocretin system (Orx-S) is possibly associated with a variety of neurocognitive, psychobiological, neuroendocrine, and physiological functions and behaviors. Dysfunction of Orx-S has been implicated in various psychiatric and neurological disorders. This article provides an overview of Orx-S dysfunctions' possible involvement in the development, presentation, and maintenance of ESSENCE. We provide a focused review of current research evidence linking orexin neuropeptides with specific clinical NDDs symptoms, mostly in ADHD and ASD, within the Research Domain Criteria (RDoC) framework. We propose that Orx-S dysfunction might have an important role in some of these neurodevelopmental symptom domains, such as arousal, wakefulness, sleep, motor and sensory processing, mood and emotional regulation, fear processing, reward, feeding, attention, executive functions, and sociability. Our perspective is presented from a clinical point of view. Further, more thorough systematic reviews are needed as well as planning of extensive new research into the Orx-S's role in ESSENCE, especially considering RDoC elements.
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Affiliation(s)
- Rajna Knez
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.,School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Dejan Stevanovic
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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15
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Rutter TM, Arnett AB. Temperament Traits Mark Liability for Coexisting Psychiatric Symptoms in Children With Elevated ADHD Symptoms. J Atten Disord 2021; 25:1871-1880. [PMID: 32697164 PMCID: PMC7931648 DOI: 10.1177/1087054720943282] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective: Among children with ADHD, coexisting psychiatric disorders are common and associated with greater impairment and symptom persistence. Given that temperament traits are easily measured, developmentally stable, and variable among youth with ADHD, temperament profiles may be clinically useful for predicting liability for coexisting psychiatric symptoms in this population. Methods: Eighty-three children with ADHD symptoms participated. Caregivers rated their child's surgency, negative emotionality, and effortful control, as well as severity of internalizing and externalizing psychiatric symptoms. Hierarchical linear regressions were conducted to estimate associations between temperament traits and psychiatric symptoms, controlling for severity of ADHD. Results: Temperament ratings explained significant variance in psychiatric symptoms above and beyond ADHD symptoms alone. Symptoms of each coexisting psychiatric disorder was associated with a distinct temperament and ADHD symptom profile. Conclusion: Temperament ratings appear to have clinical utility for predicting coexisting psychiatric symptoms in children with elevated ADHD symptoms.
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Affiliation(s)
- Tara M Rutter
- Seattle Pacific University, WA, USA
- University of Washington, Seattle, USA
| | - Anne B Arnett
- University of Washington, Seattle, USA
- Seattle Children's Hospital, WA, USA
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16
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Raiker JS. Editorial: Instrumental Learning in Children With Attention-Deficit/Hyperactivity Disorder: A Rewarding Review Incentivizing Future Research. J Am Acad Child Adolesc Psychiatry 2021; 60:1342-1344. [PMID: 33992749 DOI: 10.1016/j.jaac.2021.05.002] [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] [Received: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
The mechanisms underlying attention-deficit/hyperactivity disorder (ADHD) continue to elude researchers, hindering efforts to improve diagnosis and treatment of the disorder.1 Notably, mechanisms such as operant conditioning, or instrumental learning, have been surprisingly underemphasized in the ADHD literature. This is curious given that behavioral interventions, which rely on the principles of operant conditioning, are one of only a few well-established interventions for ADHD.2 In this issue of the Journal, Hulsbosch et al.3 sought to answer critical questions regarding instrumental learning in children with ADHD through a systematic review that updates and extends prior reviews.4.
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17
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Children and adolescents with neurodevelopmental disorders show cognitive heterogeneity and require a person-centered approach. Sci Rep 2021; 11:18463. [PMID: 34531454 PMCID: PMC8445997 DOI: 10.1038/s41598-021-97551-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/09/2021] [Indexed: 11/15/2022] Open
Abstract
We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6–15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: “Lower Cognitive Profile” (LCP), “Lower Working Memory” (LWM), “Higher Working Memory” (HWM), “Higher Cognitive Profile” (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.
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18
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Burley DT, Anning KL, van Goozen SHM. The association between hyperactive behaviour and cognitive inhibition impairments in young children. Child Neuropsychol 2021; 28:302-317. [PMID: 34505554 DOI: 10.1080/09297049.2021.1976128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hyperactivity is one of the core features of attention-deficit hyperactivity disorder (ADHD), and yet there is evidence that hyperactive behavior in children with ADHD is not ubiquitous and could be a compensatory response to high cognitive demands. No research has yet objectively measured hyperactive behavior in young children who are demonstrating early signs of ADHD or examined the role of emotional state on hyperactivity levels.The current study measured motor activity using actigraphy during baseline, cognitive inhibition (Flanker task), and emotion arousing (Impossibly Perfect Circles task) conditions in 95 children aged 4-7 years old with developmental difficulties, including emerging symptoms of ADHD. We examined the relationship between objectively recorded activity, parent-rated hyperactivity problems, using the Strengths and Difficulties Questionnaire (SDQ), and cognitive inhibition task performance.Parent ratings of hyperactivity (but not inattention) symptoms were positively related to recorded hyperactivity, and this relationship was specific to activity measured during the cognitive inhibition task. Impaired cognitive inhibition performance was related to increased measured movement and this association was strongest in children who were rated as having the highest levels of hyperactive behavior.These findings confirm theoretically predicted associations between objectively recorded hyperactivity and impaired executive functioning and support the notion that hyperactivity in children emerges in response to high cognitive demands. The results encourage further investigation into the role of hyperactivity as a transdiagnostic dimension that can explain variation within and between different types of diagnostic classifications.
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Affiliation(s)
| | - Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK
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19
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Sonuga-Barke E, Thapar A. The neurodiversity concept: is it helpful for clinicians and scientists? Lancet Psychiatry 2021; 8:559-561. [PMID: 33984295 DOI: 10.1016/s2215-0366(21)00167-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Edmund Sonuga-Barke
- School of Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anita Thapar
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.
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20
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Fu GH, Chen W, Li HM, Wang YF, Liu L, Qian QJ. A potential association of RNF219-AS1 with ADHD: Evidence from categorical analysis of clinical phenotypes and from quantitative exploration of executive function and white matter microstructure endophenotypes. CNS Neurosci Ther 2021; 27:603-616. [PMID: 33644999 PMCID: PMC8025624 DOI: 10.1111/cns.13629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 01/01/2023] Open
Abstract
Aims Attention‐deficit/hyperactivity disorder (ADHD) is a neuropsychiatric disorder of substantial heritability, yet emerging evidence suggests that key risk variants might reside in the noncoding regions of the genome. Our study explored the association of lncRNAs (long noncoding RNAs) with ADHD as represented at three different phenotypic levels guided by the Research Domain Criteria (RDoC) framework: (i) ADHD caseness and symptom dimension, (ii) executive functions as functional endophenotype, and (iii) potential genetic influence on white matter architecture as brain structural endophenotype. Methods Genotype data of 107 tag single nucleotide polymorphisms (SNP) from 10 candidate lncRNAs were analyzed in 1040 children with ADHD and 630 controls of Chinese Han descent. Executive functions including inhibition and set‐shifting were assessed by STROOP and trail making tests, respectively. Imaging genetic analyses were performed in a subgroup of 33 children with ADHD and 55 controls using fractional anisotropy (FA). Results One SNP rs3908461 polymorphism in RNF219‐AS1 was found to be significantly associated with ADHD caseness: with C‐allele detected as the risk genotype in the allelic model (P = 8.607E‐05) and dominant genotypic model (P = 9.628E‐05). Nominal genotypic effects on inhibition (p = 0.020) and set‐shifting (p = 0.046) were detected. While no direct effect on ADHD core symptoms was detected, mediation analysis suggested that SNP rs3908461 potentially exerted an indirect effect through inhibition function [B = 0.21 (SE = 0.12), 95% CI = 0.02‐0.49]. Imaging genetic analyses detected significant associations between rs3908461 genotypes and FA values in corpus callosum, left superior longitudinal fasciculus, left posterior limb of internal capsule, left posterior thalamic radiate (include optic radiation), and the left anterior corona radiate (PFWE corrected < 0.05). Conclusion Our present study examined the potential roles of lncRNA in genetic etiological of ADHD and provided preliminary evidence in support of the potential RNF219‐AS1 involvement in the pathophysiology of ADHD in line with the RDoC framework.
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Affiliation(s)
- Guang-Hui Fu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, China
| | - Wai Chen
- Mental Health Service, Fiona Stanley Hospital, Perth, Australia.,Graduate School of Education, The University of Western Australia, Perth, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, Australia.,School of Psychology, Murdoch University, Perth, Australia
| | - Hai-Mei Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, China
| | - Qiu-Jin Qian
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, China
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21
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Latent brain state dynamics distinguish behavioral variability, impaired decision-making, and inattention. Mol Psychiatry 2021; 26:4944-4957. [PMID: 33589738 PMCID: PMC8589642 DOI: 10.1038/s41380-021-01022-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 01/07/2021] [Indexed: 12/17/2022]
Abstract
Children with Attention Deficit Hyperactivity Disorder (ADHD) have prominent deficits in sustained attention that manifest as elevated intra-individual response variability and poor decision-making. Influential neurocognitive models have linked attentional fluctuations to aberrant brain dynamics, but these models have not been tested with computationally rigorous procedures. Here we use a Research Domain Criteria approach, drift-diffusion modeling of behavior, and a novel Bayesian Switching Dynamic System unsupervised learning algorithm, with ultrafast temporal resolution (490 ms) whole-brain task-fMRI data, to investigate latent brain state dynamics of salience, frontoparietal, and default mode networks and their relation to response variability, latent decision-making processes, and inattention. Our analyses revealed that occurrence of a task-optimal latent brain state predicted decreased intra-individual response variability and increased evidence accumulation related to decision-making. In contrast, occurrence and dwell time of a non-optimal latent brain state predicted inattention symptoms and furthermore, in a categorical analysis, distinguished children with ADHD from controls. Importantly, functional connectivity between salience and frontoparietal networks predicted rate of evidence accumulation to a decision threshold, whereas functional connectivity between salience and default mode networks predicted inattention. Taken together, our computational modeling reveals dissociable latent brain state features underlying response variability, impaired decision-making, and inattentional symptoms common to ADHD. Our findings provide novel insights into the neurobiology of attention deficits in children.
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22
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Pallanti S, Marras A, Makris N. A Research Domain Criteria Approach to Gambling Disorder and Behavioral Addictions: Decision-Making, Response Inhibition, and the Role of Cannabidiol. Front Psychiatry 2021; 12:634418. [PMID: 34603091 PMCID: PMC8484302 DOI: 10.3389/fpsyt.2021.634418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the "substance-related and addictive disorders," in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of "behavioral" addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of "Positive valence systems," particularly in the "Approach motivation" and "Reward learning" constructs, as well as in the "Cognitive systems," primarily in the "Cognitive control" construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: "Incentive salience," "Negative Emotionality," and "Executive Function." The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
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Affiliation(s)
- Stefano Pallanti
- Institute of Neurosciences, Florence, Italy.,Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY, United States
| | - Anna Marras
- Institute of Neurosciences, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Nikolaos Makris
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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23
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Lundervold AJ, Jensen DA, Haavik J. Insomnia, Alcohol Consumption and ADHD Symptoms in Adults. Front Psychol 2020; 11:1150. [PMID: 32536897 PMCID: PMC7269111 DOI: 10.3389/fpsyg.2020.01150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/05/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Substance use disorders and insomnia are common in the general population, and particularly among adults with attention-deficit/hyperactivity disorder (ADHD). Here we investigated the relationship between insomnia, alcohol consumption and ADHD symptoms. Methods Adults with an ADHD diagnosis (n = 235, 41.3% males) and controls (n = 184, 38% males) completed a questionnaire assessing insomnia (Bergen Insomnia Scale), alcohol consumption (Alcohol Use Disorders Identification Test), and current ADHD symptoms (Adult ADHD Self-report Scale). The majority of the sample (95%) gave additional information about childhood ADHD symptoms (Wender Utah Rating Scale), and information about lifetime occurrence of an internalizing disorder was included as part of background information. Results Compared to controls, the ADHD group reported a higher frequency of insomnia, a higher quantity of consumed alcohol and a higher frequency of internalizing disorders. Current and childhood ADHD symptoms were more severe in those with than without insomnia. Scores on ADHD symptom scales were explained by the presence of insomnia and internalizing disorders, while the contribution from alcohol consumption was restricted to the control group. Discussion The high functional impact of insomnia, alcohol misuse and internalizing disorders is well known. The present study contributed by focusing on their relations to ADHD symptoms, and by showing that strong relations were not restricted to adults with a clinical ADHD diagnosis. By this, the results put a critical light on a categorical delineation between adults with an ADHD diagnosis and population selected controls, and call for further studies including dimensional metrics of ADHD symptoms and co-occurring problems.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Daniel A Jensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Garber J, Bradshaw CP. Developmental Psychopathology and the Research Domain Criteria: Friend or Foe? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 49:341-352. [DOI: 10.1080/15374416.2020.1753205] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Judy Garber
- Department of Psychology and Human Development, Vanderbilt University
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25
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Gomez R, Watson S, Wynen JV, Trawley S, Stavropoulos V, Corr PJ. Reinforcement Sensitivity Theory of Personality Questionnaire: Factor Structure Based on CFA and ESEM, and Associations with ADHD. J Pers Assess 2020; 103:523-534. [PMID: 32496822 DOI: 10.1080/00223891.2020.1769113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Revised reinforcement sensitivity theory (r-RST) of personality is a major neuropsychological theory of motivation, emotion and personality. This paper presents the results of a study examining: (1) the factor structure of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ) using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM); and (2) the relationships of the r-RST constructs in the RST-PQ with attention deficit hyperactivity disorder (ADHD) symptom groups of inattention (IA) and hyperactivity/impulsivity (HI). A total of 572 (Sample 1) and 309 (Sample 2) adults completed the RST-PQ. Participants in Sample 2 also completed a questionnaire measuring ADHD symptoms. Results revealed more support for the ESEM model with six factors than the CFA model. For both the ESEM and CFA models, both IA and HI symptom groups were associated positively with the RST-PQ constructs of behavioral inhibition system (BIS) and behavioral approach system (BAS) Impulsivity, with IA also associated negatively with the BAS-Goal-Drive Persistence. The theoretical implications of these findings for understanding the factor structure of the RST-PQ, and for ADHD (IA and HI) in terms of r-RST, are discussed.
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Affiliation(s)
- Rapson Gomez
- Department of Psychology, School of Health and Life Sciences, Federation University, Australia
| | - Shaun Watson
- Department of Psychology, School of Health and Life Sciences, Federation University, Australia
| | | | - Steven Trawley
- Cairnmillar Institute, Hawthorn East, Victoria, Australia
| | - Vasileios Stavropoulos
- Cairnmillar Institute, Hawthorn East, Victoria, Australia.,Department of Psychology, Victoria University, Footscray, Victoria, Australia
| | - Philip J Corr
- Department of Psychology, City University of London, London, UK
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26
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de la Peña IC, Pan MC, Thai CG, Alisso T. Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Subtype/Presentation: Research Progress and Translational Studies. Brain Sci 2020; 10:brainsci10050292. [PMID: 32422912 PMCID: PMC7287898 DOI: 10.3390/brainsci10050292] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 02/01/2023] Open
Abstract
Research on the predominantly inattentive attention-deficit/hyperactivity disorder (ADHD-PI) subtype/presentation is important given its high prevalence, but paradoxically it is under-recognized and undertreated. The temporal stability of the inattention symptom could impact the high worldwide prevalence of ADHD-PI. Some evidence suggests differences in the nature of attentional deficit in ADHD-PI vs. that in other subtypes. Impairments in neuropsychological, neurocognitive, and social functioning are also evident in ADHD-PI, which could be specific to the subtype (e.g., processing speed, social perception, and skills), or differ from others in severity. Neuroimaging studies have also revealed ADHD-PI-specific neuropathological abnormalities and those that are shared with other subtypes. ADHD-PI is highly comorbid with learning and internalizing (e.g., anxiety and depression) disorders. There is no solid evidence for ADHD-PI-specific genetic etiologies and differential responses of subtypes to ADHD medications. Translational studies have used the Wistar Kyoto/NCrl substrain which requires further characterizations as an ADHD-PI model. Overall, ADHD-PI research has been conducted in the context of the Diagnostic and Statistical Manual, which arguably does not conform to the widely recognized "dimensional" view of ADHD. The Research Domain Criteria has been proposed to provide a novel framework for understanding the nature of neuropsychiatric illnesses and ultimately improve their diagnosis and treatment.
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Affiliation(s)
- Ike C. de la Peña
- Department of Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, Loma Linda, CA 92350, USA; (C.G.T.); (T.A.)
- Correspondence: ; Tel.: +1-909-651-5995; Fax: +1-909-558-0446
| | - Michael C. Pan
- Department of Psychology, Korea University, Seoul 02841, Korea;
- Division of Social Sciences, University of the Philippines Visayas Tacloban College, Tacloban 6500, Philippines
| | - Chau Giang Thai
- Department of Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, Loma Linda, CA 92350, USA; (C.G.T.); (T.A.)
| | - Tamara Alisso
- Department of Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, Loma Linda, CA 92350, USA; (C.G.T.); (T.A.)
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27
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Chang CH, Chang YC, Cheng H, Tzang RF. Treatment Efficacy of Internet Gaming Disorder With Attention Deficit Hyperactivity Disorder and Emotional Dysregulaton. Int J Neuropsychopharmacol 2020; 23:349-355. [PMID: 32047929 PMCID: PMC7311645 DOI: 10.1093/ijnp/pyaa010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/16/2020] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recent youth with Attention Deficit Hyperactivity Disorder (ADHD) noticed emotional dysregulation if they had Internet Gaming Disorder (IGD). This study aims to understand the treatment efficacy of IGD with ADHD and emotional dysregulaton. METHOD A total of 101 ADHD youths were recruited. We used the Chen Internet Addiction Scale and IGD criteria of the diagnotsic statistical manual (DSM)-5 to confirm IGD. The Swanson, Nolan, and Pelham questionnaire Version IV was used for symptoms of ADHD and oppositional defiant disorder. Disruptive mood dysregulation disorder was assessed by psychiatrist. RESULTS There is a new phenomenon that emotional dysregulation has been frequently noticed in severely gaming-addicted ADHD youth. Treatment efficacy of IGD is good when the underlying symptom of ADHD is controlled. Symptom scores of disruptive mood dysregulation (DMDD) were significantly reduced by 71.9%, 74.8%, and 84.4% at week 2, 3, and 4, respectively (P ≤ .001) after adjusting baseline symptom severity. CONCLUSION IGD may strongly arouse emotional dysregulation. Future DSM criteria could consider these gaming-addicted youth as a specific subclass of ADHD.
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Affiliation(s)
- Chuan-Hsin Chang
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Helen Cheng
- Department of Psychiatry, Christian Hospital, Changhua, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan,Mackay Medical Colleges, New Taipei City, Taiwan,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan,Correspondence: Ruu-Fen Tzang, MD, Department of Psychiatry, Mackay Memorial Hospital, Number 92, Sec. 2, Zhong Shan N Road, Taipei 104, Taiwan ()
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28
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Tremblay LK, Hammill C, Ameis SH, Bhaijiwala M, Mabbott DJ, Anagnostou E, Lerch JP, Schachar RJ. Tracking Inhibitory Control in Youth With ADHD: A Multi-Modal Neuroimaging Approach. Front Psychiatry 2020; 11:00831. [PMID: 33329071 PMCID: PMC7710692 DOI: 10.3389/fpsyt.2020.00831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 07/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A decreased ability to inhibit a speeded motor response is a well-studied deficit in Attention Deficit Hyperactivity Disorder (ADHD), and has been proposed as an endophenotype. Inhibitory control has been assessed reliably with the Stop Signal Task (SST) and is associated with prior documented differences in regional brain function using f-MRI. Here, we advance on these findings by examining their structural connectivity and white matter integrity with the goal of identifying a network underlying a core cognitive deficit in ADHD. METHODS Healthy controls (N=16) and youth diagnosed with ADHD (N=60) were recruited through the Province of Ontario Neurodevelopmental Disorders Network (POND) and the Hospital for Sick Children. An f-MRI activation difference map was co-registered with each participant's white matter imaging data, representing the specific network nodes where ADHD youth diverged significantly from controls while performing the SST. Probabilistic tractography was applied from these nodes, and white matter integrity indices such as fractional anisotropy (FA) within the tracts of interest were contrasted between the groups and correlated with SST output measures, including the measure of inhibitory control, the stop signal reaction time (SSRT). RESULTS The tracts that connected the network nodes belonged primarily to the inferior fronto-occipital fasciculus (IFOF) and cingulum. ADHD subjects showed trend differences in FA compared to controls between right inferior frontal gyrus (IFG) and right superior temporal gyrus (P= 0.09), right IFG and right posterior cingulate (P= 0.01), right anterior cingulate to posterior cingulate (p= 0.08), and between left middle temporal gyrus (BA 39) and left posterior cingulate (P=0.02). A trend correlation was found between radial diffusivity within IFG to STG white matter (IFOF) and SSRT. CONCLUSIONS We identified potential white matter tracts related to deficient inhibitory control, elucidating the brain mechanisms of an important cognitive deficit in ADHD. These findings could be integrated into future endophenotypic biomarker studies, incorporating altogether brain structure, function, and behavior for future studies of ADHD and other psychiatric conditions that exhibit this deficit.
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Affiliation(s)
- Lescia K Tremblay
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Christopher Hammill
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute (CAMH), Toronto, ON, Canada
| | - Mehereen Bhaijiwala
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Department of Paediatrics, Holland Bloorview Research Institute, Toronto, ON, Canada
| | - Jason P Lerch
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Russell J Schachar
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
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29
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Jin J, Liu L, Chen W, Gao Q, Li H, Wang Y, Qian Q. The Implicated Roles of Cell Adhesion Molecule 1 ( CADM1) Gene and Altered Prefrontal Neuronal Activity in Attention-Deficit/Hyperactivity Disorder: A "Gene-Brain-Behavior Relationship"? Front Genet 2019; 10:882. [PMID: 31616473 PMCID: PMC6775240 DOI: 10.3389/fgene.2019.00882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 08/21/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Genes related to cell adhesion pathway have been implicated in the genetic architecture of attention-deficit/hyperactivity disorder (ADHD). Cell adhesion molecule 1, encoded by CADM1 gene, is a protein which facilitates cell adhesion, highly expressed in the human prefrontal lobe. This study aimed to evaluate the association of CADM1 genotype with ADHD, executive function, and regional brain functions. Methods: The genotype data of 10-tag single nucleotide polymorphisms of CADM1 for 1,040 children and adolescents with ADHD and 963 controls were used for case–control association analyses. Stroop color–word interference test, Rey–Osterrieth complex figure test, and trail making test were conducted to assess “inhibition,” “working memory,” and “set-shifting,” respectively. A subsample (35 ADHD versus 56 controls) participated in the nested imaging genetic study. Resting-state functional magnetic resonance images were acquired, and the mean amplitude of low-frequency fluctuations (mALFF) were captured. Results: Nominal significant genotypic effect of rs10891819 in “ADHD-alone” subgroup was detected (P = 0.008) with TT genotype as protective. The results did not survive multiple testing correction. No direct genetic effect was found for performance on executive function tasks. In the imaging genetic study for the “ADHD-whole” sample, rs10891819 genotype was significantly associated with altered mALFF in the right superior frontal gyrus (rSFG, peak t = 3.85, corrected P < 0.05). Specifically, the mALFFs in T-allele carriers were consistently higher than GG carriers in ADHD and control groups. Endophenotypic correlation analyses indicated a significant negative correlation between “word interference time” in Stroop (shorter “word interference time” indexing better inhibitory function) and mALFF in the rSFG (r = -0.29, P = 0.006). Finally, mediation analysis confirmed significant indirect effects from “rs10891819 genotype (T-allele carriers)” via “mALFF (rSFG)” to “inhibition (“word interference time”)” (Sobelz = -2.47; B = -2.61, 95% confidence interval -0.48 to -4.72; P = 0.009). Conclusions: Our study offered preliminary evidence to implicate the roles of CADM1 in relation to prefrontal brain activities, inhibition function, and ADHD, indicating a potential “gene–brain–behavior” relationship of the CADM1 gene. Future studies with larger samples may specifically test these hypotheses generated by our exploratory findings.
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Affiliation(s)
- Jiali Jin
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Lu Liu
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Wai Chen
- Centre & Discipline of Child and Adolescent Psychiatry, and Psychotherapy, School of Medicine, Division of Paediatrics and Child Health & Division of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth, WA, Australia.,Complex Attention and Hyperactivity Disorders Service (CAHDS), Specialised Child and Adolescent Mental Health Services of Health in Western Australia, Perth, WA, Australia
| | - Qian Gao
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Haimei Li
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yufeng Wang
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Qiujin Qian
- Department of Child Psychiatry, Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & the Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
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30
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Gilbert DL, Huddleston DA, Wu SW, Pedapati EV, Horn PS, Hirabayashi K, Crocetti D, Wassermann EM, Mostofsky SH. Motor cortex inhibition and modulation in children with ADHD. Neurology 2019; 93:e599-e610. [PMID: 31315973 DOI: 10.1212/wnl.0000000000007899] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Compared to typically developing (TD) peers, children with attention-deficit/hyperactivity disorder (ADHD) consistently demonstrate impaired transcranial magnetic stimulation (TMS)-evoked short interval cortical inhibition (SICI) of motor evoked potentials (MEPs) in resting motor cortex (M1). To determine whether perturbed M1 physiology also reflects clinically relevant behavioral dysfunction, we evaluated M1 physiology during a cognitive control task taxing motor response selection/inhibition. METHODS In this case-control study, behavioral ratings, motor skill (assessed using standardized examination), and left M1 physiology were evaluated in 131 right-handed, 8- to 12-year-old children (66 ADHD: mean 10.5 years, 43 male; 65 TD: mean 10.6 years, 42 male). The primary outcomes were MEP amplitudes and SICI, evaluated during rest and during a modified "racecar" Slater-Hammel stop signal reaction task, with TMS pulses administered 150 ms prior to the target go action and after the dynamic stop cue. RESULTS Go responses were significantly slower (p = 0.01) and more variable (p = 0.002) in ADHD. Children with ADHD showed less M1 SICI at rest (p = 0.02) and during go (p = 0.03) and stop trials (p = 0.02). Rest M1 excitability increased during response inhibition task engagement (p < 0.0001). This Task-Related Up-Modulation (TRUM) was less robust across and within groups, with diminished task upmodulation associated with significantly more severe ADHD behavioral ratings and slower stop signal reaction times. CONCLUSION Children with ADHD show anomalous motor cortex physiology, with deficient SICI across behavioral states and less TRUM from rest to action selection. Associations of these physiologic measures with ADHD symptoms and cognitive control measures support further investigation into biological mechanisms.
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Affiliation(s)
- Donald L Gilbert
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD.
| | - David A Huddleston
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steve W Wu
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ernest V Pedapati
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paul S Horn
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathryn Hirabayashi
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Deanna Crocetti
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eric M Wassermann
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stewart H Mostofsky
- From the Division of Neurology (D.L.G., D.A.H., S.W.W., E.V.P., P.S.H.) and Department of Psychiatry (E.V.P.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Center for Neurodevelopmental and Imaging Research (K.H., D.C., S.H.M.), Kennedy Krieger Institute, Baltimore; Behavioral Neurology Unit (E.M.W.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda; and Departments of Neurology and Psychiatry (S.H.M.), Johns Hopkins University School of Medicine, Baltimore, MD
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