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Gao Z, Duberg K, Warren SL, Zheng L, Hinshaw SP, Menon V, Cai W. Reduced temporal and spatial stability of neural activity patterns predict cognitive control deficits in children with ADHD. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.29.596493. [PMID: 38854066 PMCID: PMC11160739 DOI: 10.1101/2024.05.29.596493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
This study explores the neural underpinnings of cognitive control deficits in ADHD, focusing on overlooked aspects of trial-level variability of neural coding. We employed a novel computational approach to neural decoding on a single-trial basis alongside a cued stop-signal task which allowed us to distinctly probe both proactive and reactive cognitive control. Typically developing (TD) children exhibited stable neural response patterns for efficient proactive and reactive dual control mechanisms. However, neural coding was compromised in children with ADHD. Children with ADHD showed increased temporal variability and diminished spatial stability in neural responses in salience and frontal-parietal network regions, indicating disrupted neural coding during both proactive and reactive control. Moreover, this variability correlated with fluctuating task performance and with more severe symptoms of ADHD. These findings underscore the significance of modeling single-trial variability and representational similarity in understanding distinct components of cognitive control in ADHD, highlighting new perspectives on neurocognitive dysfunction in psychiatric disorders.
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Affiliation(s)
- Zhiyao Gao
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine Duberg
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Stacie L Warren
- Department of Psychology, University of Texas, Dallas, TX, USA
| | - Li Zheng
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Stephen P. Hinshaw
- Department of Psychology, University of California, Berkeley
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco
| | - Vinod Menon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA, USA
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Maternal & Child Health Research Institute, Stanford, CA, USA
| | - Weidong Cai
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA, USA
- Maternal & Child Health Research Institute, Stanford, CA, USA
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Ouyang G, Wang S, Liu M, Zhang M, Zhou C. Multilevel and multifaceted brain response features in spiking, ERP and ERD: experimental observation and simultaneous generation in a neuronal network model with excitation-inhibition balance. Cogn Neurodyn 2023; 17:1417-1431. [PMID: 37969943 PMCID: PMC10640466 DOI: 10.1007/s11571-022-09889-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/26/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
Brain as a dynamic system responds to stimulations with specific patterns affected by its inherent ongoing dynamics. The patterns are manifested across different levels of organization-from spiking activity of neurons to collective oscillations in local field potential (LFP) and electroencephalogram (EEG). The multilevel and multifaceted response activities show patterns seemingly distinct and non-comparable from each other, but they should be coherently related because they are generated from the same underlying neural dynamic system. A coherent understanding of the interrelationships between different levels/aspects of activity features is important for understanding the complex brain functions. Here, based on analysis of data from human EEG, monkey LFP and neuronal spiking, we demonstrated that the brain response activities from different levels of neural system are highly coherent: the external stimulus simultaneously generated event-related potentials, event-related desynchronization, and variation in neuronal spiking activities that precisely match with each other in the temporal unfolding. Based on a biologically plausible but generic network of conductance-based integrate-and-fire excitatory and inhibitory neurons with dense connections, we showed that the multiple key features can be simultaneously produced at critical dynamical regimes supported by excitation-inhibition (E-I) balance. The elucidation of the inherent coherency of various neural response activities and demonstration of a simple dynamical neural circuit system having the ability to simultaneously produce multiple features suggest the plausibility of understanding high-level brain function and cognition from elementary and generic neuronal dynamics. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-022-09889-w.
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Affiliation(s)
- Guang Ouyang
- Faculty of Education, The University of Hong Kong, Pok Fu Lam, Hong Kong China
| | - Shengjun Wang
- Department of Physics, Shaanxi Normal University, Xi’an, 710119 China
| | - Mianxin Liu
- Department of Physics, Centre for Nonlinear Studies and Beijing-Hong Kong-Singapore Joint Centre for Nonlinear and Complex Systems (Hong Kong), Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong China
| | - Mingsha Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
| | - Changsong Zhou
- Department of Physics, Centre for Nonlinear Studies and Beijing-Hong Kong-Singapore Joint Centre for Nonlinear and Complex Systems (Hong Kong), Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong China
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Einziger T, Devor T, Ben-Shachar MS, Arazi A, Dinstein I, Klein C, Auerbach JG, Berger A. Increased neural variability in adolescents with ADHD symptomatology: Evidence from a single-trial EEG study. Cortex 2023; 167:25-40. [PMID: 37517356 DOI: 10.1016/j.cortex.2023.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/17/2023] [Accepted: 06/09/2023] [Indexed: 08/01/2023]
Abstract
Increased intrasubject variability of reaction time (RT) refers to inconsistency in an individual's speed of responding to a task. This increased variability has been suggested as a fundamental feature of attention deficit hyperactivity disorder (ADHD), however, its neural sources are still unclear. In this study, we aimed to examine whether such inconsistency at the behavioral level would be accompanied by inconsistency at the neural level; and whether different types of neural and behavioral variability would be related to ADHD symptomatology. We recorded electroencephalogram (EEG) data from 62 adolescents, who were part of a prospective longitudinal study on the development of ADHD. We examined trial-by-trial neural variability in response to visual stimuli in two cognitive tasks. Adolescents with high ADHD symptomatology exhibited an increased neural variability before the presentation of the stimulus, but when presented with a visual stimulus, this variability decreased to a level that was similar to that exhibited by participants with low ADHD symptomatology. In contrast with our prediction, neural variability was unrelated to the magnitude of behavioral variability. Our findings suggest that adolescents with higher symptoms are characterized by increased neural variability before the stimulation, which might reflect a difficulty in alertness to the forthcoming stimulus; but this increased neural variability does not seem to account for their RT variability.
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Affiliation(s)
- Tzlil Einziger
- Ruppin Academic Center, Department of Behavioral Sciences, Emek Hefer, Israel.
| | - Tali Devor
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mattan S Ben-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ayelet Arazi
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Ilan Dinstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel; National Autism Research Center of Israel, Beer Sheva, Israel
| | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Germany; Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Germany; 2(nd) Department of Psychiatry, National and Kapodistrian University of Athens, Greece
| | - Judith G Auerbach
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Andrea Berger
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Arnett AB, Gourdet G, Peisch V, Spaulding K, Ferrara E, Li V. The role of single trial variability in event related potentials in children with attention deficit hyperactivity disorder. Clin Neurophysiol 2023; 149:1-8. [PMID: 36841009 PMCID: PMC10101921 DOI: 10.1016/j.clinph.2023.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/21/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Children with attention deficit hyperactivity disorder (ADHD) show attenuated mean P3 component amplitudes compared to typically developing (TD) children. This finding may be the result of individual differences in P3 amplitudes, P3 latencies, and/or greater single trial variability (STV) in amplitude or latency, suggesting neural "noise." METHODS Event related potentials (ERPs) from 75 children with ADHD and 29 TD children were recorded with electroencephalography (EEG). Caregivers provided ratings on child ADHD symptoms. Single-trial ERP amplitudes and latencies were extracted from the P3 component time window during a visual oddball task. Additionally, we computed individual-centered and trial-centered P3 amplitudes to account for inter-individual and inter-trial variability in the timing of the P3 peak. RESULTS In line with prior research, greater ADHD symptom severity was associated with reduced mean P3 amplitude. This correlation was no longer significant after correcting for inter-trial differences in P3 latency. In contrast, greater ADHD symptom severity was associated with reduced STV in P3 amplitude. CONCLUSIONS Our results suggest that attenuated average P3 amplitude in ADHD samples is due to a consistent reduction in strength of the neurophysiological signal at the single trial level, as well as increased inter-trial variability in the timing of P3 peak amplitudes. The traditional method of extracting P3 amplitudes based on a single time window for all trials may not adequately capture variability in P3 latencies associated with ADHD. SIGNIFICANCE Inter- and intra-individual differences in brain signatures should be considered in models of neurobiological differences in neurodevelopmental samples.
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Affiliation(s)
- Anne B Arnett
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA; Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Gaelle Gourdet
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Virginia Peisch
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Katherine Spaulding
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Erica Ferrara
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Vivian Li
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
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Ji H, Wu S, Won J, Weng S, Lee S, Seo S, Park JJ. The Effects of Exergame on Attention in Children with Attention Deficit Hyperactivity Disorder (Preprint). JMIR Serious Games 2022; 11:e40438. [PMID: 37159253 DOI: 10.2196/40438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Despite growing evidence showing the effects of exercise and cognitive trainings on enhancing attention, little is known about the combined effects of exergame on attention in children with attention deficit/hyperactivity disorder (ADHD). Exergame, a form of exercise using a video game, has both cognitive stimulation and physical activity components and has been shown to improve cognitive function in children. OBJECTIVE The purpose of this study was to investigate the effect of exergaming on attention and to compare the effect induced by exergaming with the effect of aerobic exercise on attention in children with ADHD. METHODS In all, 30 children with ADHD, aged 8-12 years, were randomly divided into an exergaming group (EXG; n=16) or a bicycle exercise group (BEG; n=14). Before and after the 4-week intervention, the Frankfurter Aufmerksamkeits-Inventar (FAIR; Frankfurt Attention Inventory) test was administrated, and event-related potentials during the Go/No-go task was measured to assess attention. RESULTS After intervention, both the EXG and BEG had significantly increased selective attention and continuous attention (all P<.001), as well as self-control on the FAIR test (EXG: P=.02 and BEG: P=.005). Similarly, both the EXG and BEG had significantly reduced response time on the Go/No-go test (all P<.001). For the Go response, the N2 amplitude (frontocentral maximal negativity) was significantly increased in Fz (midfrontal line) in the EXG (P=.003) but was not changed in the BEG (P=.97). Importantly, the N2 amplitude in Fz was significantly greater in the EXG compared to the BEG (Go: P=.001 and No-go: P=.008). CONCLUSIONS Exergaming has the comparable effects to bicycle exercise to enhance attention in children with ADHD, suggesting that exergaming can be used as an alternative treatment for children with ADHD. TRIAL REGISTRATION Clinical Research Information Service KCT0008239; https://tinyurl.com/57e4jtnb.
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Affiliation(s)
- HongQing Ji
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Shanshan Wu
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - Shiyang Weng
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
| | - Sujin Lee
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Sangmin Seo
- Busan Children's Mind Clinic, Busan, Republic of Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
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Ganin IP, Kaplan AY. Study of the human brain potentials variability effects in P300 based brain–computer interface. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2022. [DOI: 10.24075/brsmu.2022.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The P300-based brain–computer interfaces (P300 BCI) allow the user to select commands by focusing on them. The technology involves electroencephalographic (EEG) representation of the event-related potentials (ERP) that arise in response to repetitive external stimulation. Conventional procedures for ERP extraction and analysis imply that identical stimuli produce identical responses. However, the floating onset of EEG reactions is a known neurophysiological phenomenon. A failure to account for this source of variability may considerably skew the output and undermine the overall accuracy of the interface. This study aimed to analyze the effects of ERP variability in EEG reactions in order to minimize their influence on P300 BCI command classification accuracy. Healthy subjects aged 21–22 years (n = 12) were presented with a modified P300 BCI matrix moving with specified parameters within the working area. The results strongly support the inherent significance of ERP variability in P300 BCI environments. The correction of peak latencies in single EEG reactions provided a 1.5–2 fold increase in ERP amplitude with a concomitant enhancement of classification accuracy (from 71–78% to 92–95%, p < 0.0005). These effects were particularly pronounced in attention-demanding tasks with the highest matrix velocities. The findings underscore the importance of accounting for ERP variability in advanced BCI systems.
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Affiliation(s)
- IP Ganin
- Lomonosov Moscow State University, Moscow, Russia
| | - AYa Kaplan
- Lomonosov Moscow State University, Moscow, Russia
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7
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Liang J, Zhou C. Criticality enhances the multilevel reliability of stimulus responses in cortical neural networks. PLoS Comput Biol 2022; 18:e1009848. [PMID: 35100254 PMCID: PMC8830719 DOI: 10.1371/journal.pcbi.1009848] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 02/10/2022] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
Cortical neural networks exhibit high internal variability in spontaneous dynamic activities and they can robustly and reliably respond to external stimuli with multilevel features–from microscopic irregular spiking of neurons to macroscopic oscillatory local field potential. A comprehensive study integrating these multilevel features in spontaneous and stimulus–evoked dynamics with seemingly distinct mechanisms is still lacking. Here, we study the stimulus–response dynamics of biologically plausible excitation–inhibition (E–I) balanced networks. We confirm that networks around critical synchronous transition states can maintain strong internal variability but are sensitive to external stimuli. In this dynamical region, applying a stimulus to the network can reduce the trial-to-trial variability and shift the network oscillatory frequency while preserving the dynamical criticality. These multilevel features widely observed in different experiments cannot simultaneously occur in non-critical dynamical states. Furthermore, the dynamical mechanisms underlying these multilevel features are revealed using a semi-analytical mean-field theory that derives the macroscopic network field equations from the microscopic neuronal networks, enabling the analysis by nonlinear dynamics theory and linear noise approximation. The generic dynamical principle revealed here contributes to a more integrative understanding of neural systems and brain functions and incorporates multimodal and multilevel experimental observations. The E–I balanced neural network in combination with the effective mean-field theory can serve as a mechanistic modeling framework to study the multilevel neural dynamics underlying neural information and cognitive processes. The complexity and variability of brain dynamical activity range from neuronal spiking and neural avalanches to oscillatory local field potentials of local neural circuits in both spontaneous and stimulus-evoked states. Such multilevel variable brain dynamics are functionally and behaviorally relevant and are principal components of the underlying circuit organization. To more comprehensively clarify their neural mechanisms, we use a bottom-up approach to study the stimulus–response dynamics of neural circuits. Our model assumes the following key biologically plausible components: excitation–inhibition (E–I) neuronal interaction and chemical synaptic coupling. We show that the circuits with E–I balance have a special dynamic sub-region, the critical region. Circuits around this region could account for the emergence of multilevel brain response patterns, both ongoing and stimulus-induced, observed in different experiments, including the reduction of trial-to-trial variability, effective modulation of gamma frequency, and preservation of criticality in the presence of a stimulus. We further analyze the corresponding nonlinear dynamical principles using a novel and highly generalizable semi-analytical mean-field theory. Our computational and theoretical studies explain the cross-level brain dynamical organization of spontaneous and evoked states in a more integrative manner.
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Affiliation(s)
- Junhao Liang
- Department of Physics, Centre for Nonlinear Studies and Beijing-Hong Kong-Singapore Joint Centre for Nonlinear and Complex Systems (Hong Kong), Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
- Centre for Integrative Neuroscience, Eberhard Karls University of Tübingen, Tübingen, Germany
- Department for Sensory and Sensorimotor Systems, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Changsong Zhou
- Department of Physics, Centre for Nonlinear Studies and Beijing-Hong Kong-Singapore Joint Centre for Nonlinear and Complex Systems (Hong Kong), Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
- Department of Physics, Zhejiang University, Hangzhou, China
- * E-mail:
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Mihaylova MS, Bocheva NB, Stefanova MD, Genova BZ, Totev TT, Racheva KI, Shtereva KA, Staykova SN. Visual noise effect on reading in three developmental disorders: ASD, ADHD, and DD. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221106119. [PMID: 36382080 PMCID: PMC9620686 DOI: 10.1177/23969415221106119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS Developmental disorders such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and Developmental Dyslexia (DD) are reported to have more visual problems, oral language difficulties, and diminished reading skills in addition to their different diagnostic features. Moreover, these conditions also have increased internal noise and probably an impaired ability of external noise filtering. The aim of the present study was to compare the reading performance of these groups in the presence of external visual noise which disrupts the automatic reading processes through the degradation of letters. METHODS Sixty-four children and adolescents in four groups, ASD, ADHD, DD, and TD, participated in the study. Two types of stimuli were used - unrelated words and pseudowords. The noise was generated by exchanging a fixed number of pixels between the black symbols and the white background distorting the letters. The task of the participants was to read aloud the words or pseudowords. The reading time for a single letter string, word or pseudoword, was calculated, and the proportion of errors was assessed in order to describe the reading performance. RESULTS The results obtained showed that the reading of unrelated words and pseudowords differs in the separate groups of participants and is affected differently by the added visual noise. In the no-noise condition, the group with TD had the shortest time for reading words and short pseudowords, followed by the group with ASD, while their reading of long pseudowords was slightly slower than that of the ASD group. The noise increase evoked variations in the reading of groups with ASD and ADHD, which differed from the no-noise condition and the control group with TD. The lowest proportion of errors was observed in readers with TD. The reading performance of the DD group was the worst at all noise levels, with the most prolonged reading time and the highest proportion of errors. At the highest noise level, the participants from all groups read the words and pseudowords with similar reading speed and accuracy. CONCLUSIONS In reading words and pseudowords, the ASD, ADHD, and DD groups show difficulties specific for each disorder revealed in a prolonged reading time and a higher proportion of errors. The dissimilarity in reading abilities of the groups with different development is most evident when the accuracy and reading speed are linked together. IMPLICATIONS The use of noise that degrades the letter structure in the present study allowed us to separate the groups with ASD, ADHD, and DD and disclose specifics in the reading process of each disorder. Error type analysis may provide a basis to improve the educational strategies by appropriately structuring the learning process of children with TD, ASD, ADHD, and DD.
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Affiliation(s)
- Milena Slavcheva Mihaylova
- Milena Slavcheva Mihaylova, Institute of
Neurobiology, Bulgarian Academy of Sciences, 23 Academic Georgi Bonchev Street,
Sofia 1113, Bulgaria.
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Fietsam AC, Tucker JR, Kamath MS, Huang-Pollock C, Wang Z, Neely KA. Manual dexterity and strength and in young adults with and without Attention-Deficit/Hyperactivity Disorder (ADHD). Neurosci Lett 2022; 766:136349. [PMID: 34785312 PMCID: PMC9578534 DOI: 10.1016/j.neulet.2021.136349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/03/2023]
Abstract
Manual motor deficits are common in children with attention deficit/hyperactivity disorder (ADHD); however, it is unclear whether these impairments persist into adulthood. The aim of this study was to examine manual dexterity and strength in young adults with ADHD aged 18-25 years. Sixty-one individuals with confirmed ADHD and 56 adults without ADHD completed Purdue Pegboard tasks for manual dexterity and maximal hand- and pinch-grip tests for strength. In the Purdue Pegboard task, participants placed pins using the right, left, and both-hands, respectively. In addition, participants built assemblies using pins, washers, and collars with alternating hand movements. The results demonstrated that women without ADHD out-performed the other three groups in the right-hand, bimanual, and assembly PPB tasks. Both maximal hand strength tests demonstrated that men were stronger than women, but no differences were observed between adults with and without ADHD. The current findings suggest that adults with ADHD may have deficits in manual dexterity and tasks requiring bimanual coordination.
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Affiliation(s)
| | | | | | | | - Zheng Wang
- Department of Applied Physiology and Kinesiology, University of Florida, FL, United States
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10
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Schulze M, Aslan B, Stöcker T, Stirnberg R, Lux S, Philipsen A. Disentangling early versus late audiovisual integration in adult ADHD: a combined behavioural and resting-state connectivity study. J Psychiatry Neurosci 2021; 46:E528-E537. [PMID: 34548387 PMCID: PMC8526154 DOI: 10.1503/jpn.210017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Studies investigating sensory processing in attention-deficit/hyperactivity disorder (ADHD) have shown altered visual and auditory processing. However, evidence is lacking for audiovisual interplay - namely, multisensory integration. As well, neuronal dysregulation at rest (e.g., aberrant within- or between-network functional connectivity) may account for difficulties with integration across the senses in ADHD. We investigated whether sensory processing was altered at the multimodal level in adult ADHD and included resting-state functional connectivity to illustrate a possible overlap between deficient network connectivity and the ability to integrate stimuli. METHODS We tested 25 patients with ADHD and 24 healthy controls using 2 illusionary paradigms: the sound-induced flash illusion and the McGurk illusion. We applied the Mann-Whitney U test to assess statistical differences between groups. We acquired resting-state functional MRIs on a 3.0 T Siemens magnetic resonance scanner, using a highly accelerated 3-dimensional echo planar imaging sequence. RESULTS For the sound-induced flash illusion, susceptibility and reaction time were not different between the 2 groups. For the McGurk illusion, susceptibility was significantly lower for patients with ADHD, and reaction times were significantly longer. At a neuronal level, resting-state functional connectivity in the ADHD group was more highly regulated in polymodal regions that play a role in binding unimodal sensory inputs from different modalities and enabling sensory-to-cognition integration. LIMITATIONS We did not explicitly screen for autism spectrum disorder, which has high rates of comorbidity with ADHD and also involves impairments in multisensory integration. Although the patients were carefully screened by our outpatient department, we could not rule out the possibility of autism spectrum disorder in some participants. CONCLUSION Unimodal hypersensitivity seems to have no influence on the integration of basal stimuli, but it might have negative consequences for the multisensory integration of complex stimuli. This finding was supported by observations of higher resting-state functional connectivity between unimodal sensory areas and polymodal multisensory integration convergence zones for complex stimuli.
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Affiliation(s)
- Marcel Schulze
- From the Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany (Schulze, Aslan, Lux, Philipsen); Biopsychology and Cognitive Neuroscience, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany (Schulze); the German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany (Stöcker, Stirnberg); and the Department of Physics and Astronomy, University of Bonn, Bonn, Germany (Stöcker)
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Nobukawa S, Wagatsuma N, Nishimura H, Doho H, Takahashi T. An Approach for Stabilizing Abnormal Neural Activity in ADHD Using Chaotic Resonance. Front Comput Neurosci 2021; 15:726641. [PMID: 34539367 PMCID: PMC8442914 DOI: 10.3389/fncom.2021.726641] [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] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022] Open
Abstract
Reduced integrity of neural pathways from frontal to sensory cortices has been suggested as a potential neurobiological basis of attention-deficit hyperactivity disorder. Neurofeedback has been widely applied to enhance reduced neural pathways in attention-deficit hyperactivity disorder by repeated training on a daily temporal scale. Clinical and model-based studies have demonstrated that fluctuations in neural activity underpin sustained attention deficits in attention-deficit hyperactivity disorder. These aberrant neural fluctuations may be caused by the chaos–chaos intermittency state in frontal-sensory neural systems. Therefore, shifting the neural state from an aberrant chaos–chaos intermittency state to a normal stable state with an optimal external sensory stimulus, termed chaotic resonance, may be applied in neurofeedback for attention-deficit hyperactivity disorder. In this study, we applied a neurofeedback method based on chaotic resonance induced by “reduced region of orbit” feedback signals in the Baghdadi model for attention-deficit hyperactivity disorder. We evaluated the stabilizing effect of reduced region of orbit feedback and its robustness against noise from errors in estimation of neural activity. The effect of chaotic resonance successfully shifted the abnormal chaos-chaos intermittency of neural activity to the intended stable activity. Additionally, evaluation of the influence of noise due to measurement errors revealed that the efficiency of chaotic resonance induced by reduced region of orbit feedback signals was maintained over a range of certain noise strengths. In conclusion, applying chaotic resonance induced by reduced region of orbit feedback signals to neurofeedback methods may provide a promising treatment option for attention-deficit hyperactivity disorder.
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Affiliation(s)
- Sou Nobukawa
- Department of Computer Science, Chiba Institute of Technology, Chiba, Japan
| | - Nobuhiko Wagatsuma
- Department of Information Science, Faculty of Science, Toho University, Chiba, Japan
| | - Haruhiko Nishimura
- Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan
| | - Hirotaka Doho
- Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan.,Faculty of Education, Teacher Training Division, Kochi University, Kochi, Japan
| | - Tetsuya Takahashi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan.,Department of Neuropsychiatry, University of Fukui, Fukui, Japan.,Uozu Shinkei Sanatorium, Uozu, Japan
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12
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ADHD symptoms map onto noise-driven structure-function decoupling between hub and peripheral brain regions. Mol Psychiatry 2021; 26:4036-4045. [PMID: 31666679 DOI: 10.1038/s41380-019-0554-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/18/2019] [Accepted: 08/19/2019] [Indexed: 12/11/2022]
Abstract
Adults with childhood-onset attention-deficit hyperactivity disorder (ADHD) show altered whole-brain connectivity. However, the relationship between structural and functional brain abnormalities, the implications for the development of life-long debilitating symptoms, and the underlying mechanisms remain uncharted. We recruited a unique sample of 80 medication-naive adults with a clinical diagnosis of childhood-onset ADHD without psychiatric comorbidities, and 123 age-, sex-, and intelligence-matched healthy controls. Structural and functional connectivity matrices were derived from diffusion spectrum imaging and multi-echo resting-state functional MRI data. Hub, feeder, and local connections were defined using diffusion data. Individual-level measures of structural connectivity and structure-function coupling were used to contrast groups and link behavior to brain abnormalities. Computational modeling was used to test possible neural mechanisms underpinning observed group differences in the structure-function coupling. Structural connectivity did not significantly differ between groups but, relative to controls, ADHD showed a reduction in structure-function coupling in feeder connections linking hubs with peripheral regions. This abnormality involved connections linking fronto-parietal control systems with sensory networks. Crucially, lower structure-function coupling was associated with higher ADHD symptoms. Results from our computational model further suggest that the observed structure-function decoupling in ADHD is driven by heterogeneity in neural noise variability across brain regions. By highlighting a neural cause of a clinically meaningful breakdown in the structure-function relationship, our work provides novel information on the nature of chronic ADHD. The current results encourage future work assessing the genetic and neurobiological underpinnings of neural noise in ADHD, particularly in brain regions encompassed by fronto-parietal systems.
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13
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Barth B, Rohe T, Deppermann S, Fallgatter AJ, Ehlis AC. Neural oscillatory responses to performance monitoring differ between high- and low-impulsive individuals, but are unaffected by TMS. Hum Brain Mapp 2021; 42:2416-2433. [PMID: 33605509 PMCID: PMC8090766 DOI: 10.1002/hbm.25376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 12/17/2022] Open
Abstract
Higher impulsivity may arise from neurophysiological deficits of cognitive control in the prefrontal cortex. Cognitive control can be assessed by time‐frequency decompositions of electrophysiological data. We aimed to clarify neuroelectric mechanisms of performance monitoring in connection with impulsiveness during a modified Eriksen flanker task in high‐ (n = 24) and low‐impulsive subjects (n = 21) and whether these are modulated by double‐blind, sham‐controlled intermittent theta burst stimulation (iTBS). We found a larger error‐specific peri‐response beta power decrease over fronto‐central sites in high‐impulsive compared to low‐impulsive participants, presumably indexing less effective motor execution processes. Lower parieto‐occipital theta intertrial phase coherence (ITPC) preceding correct responses predicted higher reaction time (RT) and higher RT variability, potentially reflecting efficacy of cognitive control or general attention. Single‐trial preresponse theta phase clustering was coupled to RT in correct trials (weighted ITPC), reflecting oscillatory dynamics that predict trial‐specific behavior. iTBS did not modulate behavior or EEG time‐frequency power. Performance monitoring was associated with time‐frequency patterns reflecting cognitive control (parieto‐occipital theta ITPC, theta weighted ITPC) as well as differential action planning/execution processes linked to trait impulsivity (frontal low beta power). Beyond that, results suggest no stimulation effect related to response‐locked time‐frequency dynamics with the current stimulation protocol. Neural oscillatory responses to performance monitoring differ between high‐ and low‐impulsive individuals, but are unaffected by iTBS.
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Affiliation(s)
- Beatrix Barth
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Tim Rohe
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,Department of Psychology, Friedrich-Alexander University Erlangen-Nuernberg, Erlangen, Germany
| | - Saskia Deppermann
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Andreas Jochen Fallgatter
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
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14
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Stern T, Crutcher EH, McCarthy JM, Ali MA, Issachar G, Geva AB, Peremen Z, Schaaf CP. Brain Network Analysis of EEG Recordings Can Be Used to Assess Cognitive Function in Teenagers With 15q13.3 Microdeletion Syndrome. Front Neurosci 2021; 15:622329. [PMID: 33584189 PMCID: PMC7876406 DOI: 10.3389/fnins.2021.622329] [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] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/04/2021] [Indexed: 11/26/2022] Open
Abstract
15q13.3 microdeletion syndrome causes a spectrum of cognitive disorders, including intellectual disability and autism. We assessed the ability of the EEG analysis algorithm Brain Network Analysis (BNA) to measure cognitive function in 15q13.3 deletion patients, and to differentiate between patient and control groups. EEG data was collected from 10 individuals with 15q13.3 microdeletion syndrome (14–18 years of age), as well as 30 age-matched healthy controls, as the subjects responded to Auditory Oddball (AOB) and Go/NoGo cognitive tasks. It was determined that BNA can be used to evaluate cognitive function in 15q13.3 microdeletion patients. This analysis also significantly differentiates between patient and control groups using 5 scores, all of which are produced from ERP peaks related to late cortical components that represent higher cognitive functions of attention allocation and response inhibition (P < 0.05).
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Affiliation(s)
| | - Emeline H Crutcher
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - John M McCarthy
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | - May A Ali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States
| | | | | | | | - Christian P Schaaf
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, United States.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, United States.,Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
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15
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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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16
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Hilger K, Sassenhagen J, Kühnhausen J, Reuter M, Schwarz U, Gawrilow C, Fiebach CJ. Neurophysiological markers of ADHD symptoms in typically-developing children. Sci Rep 2020; 10:22460. [PMID: 33384437 PMCID: PMC7775445 DOI: 10.1038/s41598-020-80562-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms of inattention, impulsivity, and hyperactivity. Neurophysiological correlates of ADHD include changes in the P3 component of event-related brain potentials (ERPs). Motivated by recent advances towards a more dimensional understanding of ADHD, we investigate whether ADHD-related ERP markers relate to continuous variations in attention and executive functioning also in typically-developing children. ERPs were measured while 31 school children (9-11 years) completed an adapted version of the Continuous Performance Task that additionally to inhibitory processes also isolates effects of physical stimulus salience. Children with higher levels of parent-reported ADHD symptoms did not differ in task performance, but exhibited smaller P3 amplitudes related to stimulus salience. Furthermore, ADHD symptoms were associated with the variability of neural responses over time: Children with higher levels of ADHD symptoms demonstrated lower variability in inhibition- and salience-related P3 amplitudes. No effects were observed for ERP latencies and the salience-related N2. By demonstrating that ADHD-associated neurophysiological mechanisms of inhibition and salience processing covary with attention and executive functioning in a children community sample, our study provides neurophysiological support for dimensional models of ADHD. Also, temporal variability in event-related potentials is highlighted as additional indicator of ADHD requiring further investigation.
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Affiliation(s)
- Kirsten Hilger
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany. .,Department of Psychology I, University Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany. .,IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.
| | - Jona Sassenhagen
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Kühnhausen
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,LEAD Graduate School and Research Network, Eberhard Karls University Tübingen, Tübingen, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, University Hospital Tübingen, Tübingen, Germany
| | - Merle Reuter
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Ulrike Schwarz
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Caterina Gawrilow
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Christian J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.,IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
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17
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Bozhilova N, Kuntsi J, Rubia K, Michelini G, Asherson P. Electrophysiological modulation of sensory and attentional processes during mind wandering in attention-deficit/hyperactivity disorder. NEUROIMAGE-CLINICAL 2020; 29:102547. [PMID: 33444949 PMCID: PMC7808945 DOI: 10.1016/j.nicl.2020.102547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 12/03/2022]
Abstract
Adults with ADHD relative to controls reported lower P1 during high demands on sustained attention. Adults with ADHD also showed lower P1 during task focus, but not during mind wandering than controls. Increased mind wandering frequency in ADHD might account for these between-group effects.
We recently reported increased mind wandering (MW) frequency in adults with attention-deficit/hyperactivity disorder (ADHD) relative to controls during high demands on sustained attention, reflecting deficient context regulation of MW. Studies on community samples previously linked context regulation of MW with attenuation in brain sensory processes, reflecting perceptual decoupling, and attentional processes during MW compared to task focus. However, the association between deficient context regulation of MW and these neural processes has not been studied in ADHD. We addressed this question by comparing adults with ADHD (N = 23) and controls (N = 25) on event-related potentials of early sensory processes (P1) and attention allocation (P3) during tasks manipulating cognitive demands (high vs low) on working memory and sustained attention, and during periods of MW and task focus measured through experience-sampling. Compared to controls, adults with ADHD showed reduced P1 during high sustained attention demands, as well as reduced P3 during high working memory demands. These group differences were no longer significant after adding MW frequency as a covariate. Across tasks, adults with ADHD showed no differences from controls on the P1 during MW episodes, but attenuated P1 during task focus. P3 was reduced in adults with ADHD compared to controls during MW, but not during task focus during the sustained attention task. These findings converge to indicate that impairments in early sensory processing in individuals with ADHD seem parallel to increased MW frequency and might reflect inefficient adjustments from periods of MW to task focus.
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Affiliation(s)
- Natali Bozhilova
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College University London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Giorgia Michelini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom; Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, United States
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
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18
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Visual statistical learning and integration of perceptual priors are intact in attention deficit hyperactivity disorder. PLoS One 2020; 15:e0243100. [PMID: 33332378 PMCID: PMC7746270 DOI: 10.1371/journal.pone.0243100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background Deficits in visual statistical learning and predictive processing could in principle explain the key characteristics of inattention and distractibility in attention deficit hyperactivity disorder (ADHD). Specifically, from a Bayesian perspective, ADHD may be associated with flatter likelihoods (increased sensory processing noise), and/or difficulties in generating or using predictions. To our knowledge, such hypotheses have never been directly tested. Methods We here test these hypotheses by evaluating whether adults diagnosed with ADHD (n = 17) differed from a control group (n = 30) in implicitly learning and using low-level perceptual priors to guide sensory processing. We used a visual statistical learning task in which participants had to estimate the direction of a cloud of coherently moving dots. Unbeknown to the participants, two of the directions were more frequently presented than the others, creating an implicit bias (prior) towards those directions. This task had previously revealed differences in other neurodevelopmental disorders, such as autistic spectrum disorder and schizophrenia. Results We found that both groups acquired the prior expectation for the most frequent directions and that these expectations substantially influenced task performance. Overall, there were no group differences in how much the priors influenced performance. However, subtle group differences were found in the influence of the prior over time. Conclusion Our findings suggest that the symptoms of inattention and hyperactivity in ADHD do not stem from broad difficulties in developing and/or using low-level perceptual priors.
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19
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The relationship between sensory processing sensitivity and attention deficit hyperactivity disorder traits: A spectrum approach. Psychiatry Res 2020; 293:113477. [PMID: 33198048 DOI: 10.1016/j.psychres.2020.113477] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
The aim of the present study was to examine the relationship between sensory processing sensitivity (SPS) and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in adults. The Highly Sensitive Person Scale (HSPS) scale and the Adult ADHD Self-Report Scale (ASRS) were administered to a non-clinical group of 274 participants recruited from a university volunteers list. We found a highly significant positive correlation between number of self-reported ADHD traits and sensory sensitivity. Furthermore, ADHD traits and age were predictors of SPS and exploratory factor analysis revealed a factor that combined ADHD traits and items from the HSPS. The psychometric properties of the HSPS were also examined supporting the unidimensional nature of the concept. To our knowledge, this is the first study to identify a positive relationship between HSPS and ADHD traits in the general population. Our results further support recent findings suggesting abnormal sensory processing in ADHD.
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20
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Guo J, Luo X, Li B, Chang Q, Sun L, Song Y. Abnormal modulation of theta oscillations in children with attention-deficit/hyperactivity disorder. NEUROIMAGE-CLINICAL 2020; 27:102314. [PMID: 32615476 PMCID: PMC7330615 DOI: 10.1016/j.nicl.2020.102314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/26/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
We study frontal theta ERS and posterior theta lateralization in ADHD children. ADHD children show increased frontal theta ERS and posterior theta lateralization. Midfrontal theta ERS connects with right posterior theta modulation in ADHD children. Right posterior theta modulation is linked with RT variability in ADHD children.
Previous studies have found that theta activities exhibit posterior lateralized modulation as well as midfrontal event-related synchronization (ERS) during covert visual attention in adults. The present study investigated whether these theta modulations existed in children and whether they were associated with attentional problems in attention-deficit/hyperactivity disorder (ADHD). Electroencephalography signals were recorded from typically developing (TD) children and children with ADHD (TD: n = 24; ADHD: n = 22) while they performed a cued covert visual attention task. The participants responded to a target following a cue designed as human eyes that gazed to the left or right visual field (70% validity). Compared with the TD children, the children with ADHD showed increased midfrontal theta ERS and significant posterior theta lateralization in response to the cues. More importantly, we found that the stronger posterior theta lateralization in the right hemisphere exhibited a positive trial-based correlation with the larger midfrontal theta ERS and predicted lower RT variability at the trial level in the children with ADHD. We suggest that ADHD may be associated with some enhanced systems in the frontal and posterior areas via theta oscillations, which may be involved in the compensatory maturation for their attention deficits in childhood, thereby promoting the stability of behavioral responses.
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Affiliation(s)
- Jialiang Guo
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiangsheng Luo
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Bingkun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Qinyuan Chang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
| | - Yan Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.
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21
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Seernani D, Ioannou C, Damania K, Spindler K, Hill H, Foulsham T, Smyrnis N, Bender S, Fleischhaker C, Biscaldi M, Ebner-Priemer U, Klein C. Studying global processing in autism and attention-deficit/hyperactivity disorder with gaze movements: The example of a copying task. PLoS One 2020; 15:e0224186. [PMID: 32497045 PMCID: PMC7272031 DOI: 10.1371/journal.pone.0224186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
Recent discussions in the literature, along with the revision of the Diagnostic and Statistical Manual (DSM) (American Psychiatric Association 2013), suggest aetiological commonalities between the highly comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Addressing this discussion requires studying these disorders together by comparing constructs typical to each of them. In the present study, we investigate global processing, known to be difficult for participants with ASD, and Intra-Subject Variability (ISV), known to be consistently increased in participants with ADHD, in groups, aged 10–13 years, with ADHD (n = 25), ASD without comorbid ADHD (ASD-) (n = 13) and ASD with ADHD (ASD+) (n = 18) in comparison with a typically developing group (n = 22). A Copying task, typically requiring global processing and in this case particularly designed using equally complex stimuli to also measure ISV across trials, was selected. Oculomotor measures in this task proved to be particularly sensitive to group differences. While increased ISV was not observed in the present task in participants with ADHD, both ASD groups looked longer on the figure to be drawn, indicating that global processing takes longer in ASD. However, the ASD+ group fixated on the figure only between drawing movements, whereas the ASD- group did this throughout the drawing process. The present study provides evidence towards ASD and ADHD being separate, not-overlapping, disorders. Since the pure ASD- group was affected more by central coherence problems than the ASD+ group, it may suggest that neuropsychological constructs interact differently in different clinical groups and sub-groups.
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Affiliation(s)
- D. Seernani
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - C. Ioannou
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - K. Damania
- Independent Researcher, Seattle, Washington, United States of America
| | - K. Spindler
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - H. Hill
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - T. Foulsham
- Department of Psychology, University of Essex, Colchester, England, United Kingdom
| | - N. Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - S. Bender
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Köln, Germany
| | - C. Fleischhaker
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - M. Biscaldi
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - U. Ebner-Priemer
- Institute of Sports and Sports Sciences, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - C. Klein
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Freiburg, Freiburg, Germany
- Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Köln, Germany
- * E-mail:
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22
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23
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Intact Stimulus-Response Conflict Processing in ADHD-Multilevel Evidence and Theoretical Implications. J Clin Med 2020; 9:jcm9010234. [PMID: 31952353 PMCID: PMC7019707 DOI: 10.3390/jcm9010234] [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: 12/18/2019] [Revised: 01/03/2020] [Accepted: 01/11/2020] [Indexed: 01/31/2023] Open
Abstract
Attention-deficit-hyperactivity disorder (ADHD) is closely associated with deficits in cognitive control. It seems, however, that the degree of deficits strongly depends on the examined subprocess, with the resolution of stimulus–stimulus conflicts being particularly difficult for patients with ADHD. The picture is far less clear regarding stimulus–response conflicts. The current study provides multi-level behavioural and neurophysiological data on this type of conflict monitoring in children with ADHD compared to healthy controls. To account for the potentially strong effects of intra-individual variability, electroencephalogram (EEG) signal decomposition methods were used to analyze the data. Crucially, none of the analyses (behavioural, event-related potentials, or decomposed EEG data) show any differences between the ADHD group and the control group. Bayes statistical analysis confirmed the high likelihood of the null hypothesis being true in all cases. Thus, the data provide multi-level evidence showing that conflict monitoring processes are indeed partly intact in ADHD, even when eliminating possible biasing factors such as intra-individual variability. While stimulus–stimulus conflict processing has been shown to be consistently dysfunctional in ADHD, the resolution of stimulus–response conflicts is not deficient in this patient group. In comparison to other studies, the results provide novel theoretical insights into the nature of conflict control deficits in childhood ADHD.
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24
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Adamou M, Fullen T, Jones SL. EEG for Diagnosis of Adult ADHD: A Systematic Review With Narrative Analysis. Front Psychiatry 2020; 11:871. [PMID: 33192633 PMCID: PMC7477352 DOI: 10.3389/fpsyt.2020.00871] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/10/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder is a common neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity and or impulsivity. Since the development of the concept, a reliable biomarker to aid diagnosis has been sought. One potential method is the use of electroencephalogram to measure neuronal activity. The aim of this review is to provide an up to date synthesis of the literature surrounding the potential use of electroencephalogram for diagnosis of attention deficit hyperactivity disorder in adulthood. METHODS A search of PsycINFO, PubMed, and EMBASE was undertaken in February 2019 for peer-reviewed articles exploring electroencephalogram patterns in adults (18 years with no upper limit) diagnosed with attention deficit hyperactivity disorder. RESULTS Differences in electroencephalogram activity are potentially unique to adult attention deficit hyperactivity disorder populations. Strongest support was derived for elevated levels of both absolute and relative theta power, alongside the observation that alpha activity is able to typically differentiate between adult attention deficit hyperactivity disorder and normative populations. CONCLUSIONS Electroencephalogram can have a use in clinical settings to aid adult attention deficit hyperactivity disorder diagnosis, but areas of inconsistency are apparent.
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Affiliation(s)
- Marios Adamou
- School of Human & Health Sciences, University of Hudderfield, West Yorkshire, United Kingdom
| | - Tim Fullen
- Adult ADHD & Autism Service, South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
| | - Sarah L Jones
- Adult ADHD & Autism Service, South West Yorkshire Partnership NHS Foundation Trust, Wakefield, United Kingdom
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25
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Kovarski K, Malvy J, Khanna RK, Arsène S, Batty M, Latinus M. Reduced visual evoked potential amplitude in autism spectrum disorder, a variability effect? Transl Psychiatry 2019; 9:341. [PMID: 31852886 PMCID: PMC6920480 DOI: 10.1038/s41398-019-0672-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/21/2019] [Accepted: 11/07/2019] [Indexed: 12/27/2022] Open
Abstract
Atypical sensory behaviours represent a core symptom of autism spectrum disorder (ASD). Investigating early visual processing is crucial to deepen our understanding of higher-level processes. Visual evoked potentials (VEPs) to pattern-reversal checkerboards were recorded in ASD children and age-matched controls. Peak analysis of the P100 component and two types of single-trial analyses were carried out. P100 amplitude was reduced in the ASD group, consistent with previous reports. The analysis of the proportion of trials with a positive activity in the latency range of the P100, measuring inter-trial (in)consistency, allowed identifying two subgroups of ASD participants: the first group, as control children, showed a high inter-trial consistency, whereas the other group showed an inter-trial inconsistency. Analysis of median absolute deviation of single-trial P100 (st-P100) latencies revealed an increased latency variability in the ASD group. Both single-trial analyses revealed increased variability in a subset of children with ASD. To control for this variability, VEPs were reconstructed by including only positive trials or trials with homogeneous st-P100 latencies. These control analyses abolished group differences, confirming that the reduced P100 amplitude results from increased inter-trial variability in ASD. This increased variability in ASD supports the neural noise theory. The existence of subgroups in ASD suggests that the neural response variability is not a genuine characteristic of the entire autistic spectrum, but rather characterized subgroups of children. Exploring the relationship between sensory responsiveness and inter-trial variability could provide more precise bioclinical profiles in children with ASD, and complete the functional diagnostic crucial for the development of individualized therapeutical projects.
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Affiliation(s)
- Klara Kovarski
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France. .,CNRS (Integrative Neuroscience and Cognition Center, UMR 8002), Paris, France. .,Université Paris Descartes, Sorbonne Paris Cité, Paris, France. .,Fondation Ophtalmologique A. de Rothschild, Paris, France.
| | - Joëlle Malvy
- 0000 0001 2182 6141grid.12366.30UMR 1253, iBrain, Université de Tours, Inserm, Tours, France ,0000 0004 1765 1600grid.411167.4CHRU de Tours, Centre Universitaire de Pédopsychiatrie, Tours, France
| | - Raoul K. Khanna
- 0000 0001 2182 6141grid.12366.30UMR 1253, iBrain, Université de Tours, Inserm, Tours, France ,0000 0004 1765 1600grid.411167.4CHRU de Tours, Département d’Ophtalmologie, Tours, France
| | - Sophie Arsène
- 0000 0004 1765 1600grid.411167.4CHRU de Tours, Département d’Ophtalmologie, Tours, France
| | - Magali Batty
- 0000 0001 2353 1689grid.11417.32Université de Toulouse, CERPPS, Toulouse, France
| | - Marianne Latinus
- 0000 0001 2182 6141grid.12366.30UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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26
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Magnuson JR, Iarocci G, Doesburg SM, Moreno S. Increased Intra-Subject Variability of Reaction Times and Single-Trial Event-Related Potential Components in Children With Autism Spectrum Disorder. Autism Res 2019; 13:221-229. [PMID: 31566907 DOI: 10.1002/aur.2210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/19/2019] [Accepted: 09/04/2019] [Indexed: 01/30/2023]
Abstract
Autism spectrum disorder (ASD) is an increasingly common neurodevelopmental disorder that affects 1 in 59 children. The cognitive profiles of individuals with ASD are varied, and the neurophysiological underpinnings of these developmental difficulties are unclear. While many studies have focused on overall group differences in the amplitude or latency of event related potential (ERP) responses, recent research suggests that increased intra-subject neural variability may also be a reliable indicator of atypical brain function in ASD. This study aimed to identify behavioral and neural variability responses during an emotional inhibitory control task in children with ASD compared to typically developing (TD) children. Children with ASD showed increased variability in response to both inhibitory and emotional stimuli, evidenced by greater reaction time variability and single-trial ERP variability of N200 and N170 amplitudes and/or latencies compared to TD children. These results suggest that the physiological basis of ASD may be more accurately explained by increased intra-subject variability, in addition to characteristic increases or decreases in the amplitude or latency of neural responses. Autism Res 2020, 13:221-229. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The cognitive functions including memory, attention, executive functions, and perception, of individuals with ASD are varied, and the physiological underpinnings of these profiles are unclear. In this study, children with ASD showed increased intra-subject neural and behavioral variability in response to an emotional inhibitory control task compared to typically developing children. These results suggest that the physiological basis of ASD may also be explained by increased behavioral and neural variability in people with ASD, rather than simply characteristic increases or decreases in averaged brain responses.
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Affiliation(s)
- Justine R Magnuson
- Department of Kinesiology, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sam M Doesburg
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sylvain Moreno
- School of Interactive Arts and Technology, Simon Fraser University, Burnaby, British Columbia, Canada
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27
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Lin ZL, Lin DR, Chen JJ, Li J, Li XY, Wang LS, Liu ZZ, Cao QZ, Chen C, Zhu Y, Chen WR, Liu YZ, Lin HT. Increased prevalence of parent ratings of ADHD symptoms among children with bilateral congenital cataracts. Int J Ophthalmol 2019; 12:1323-1329. [PMID: 31456924 DOI: 10.18240/ijo.2019.08.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/14/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder (ADHD) symptoms among children with bilateral congenital cataracts (CCs). METHODS This cross-sectional study investigated children with bilateral CC aged 3-8y (CC group) using Conners' Parent Rating Scale-48 (CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision (NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children (46.22% vs 20.28%, Pearson's χ 2=20.062; P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5y. Furthermore, male children aged between 6 and 8y showed a higher impulsive/hyperactive score than females of the same age (t=6.083, P<0.001). CONCLUSION Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.
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Affiliation(s)
- Zhuo-Ling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Duo-Ru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing-Jing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Li-Sha Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zhen-Zhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Qian-Zhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
| | - Wei-Rong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Yi-Zhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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28
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Al‐Jawahiri R, Jones M, Milne E. Atypical neural variability in carriers of 16p11.2 copy number variants. Autism Res 2019; 12:1322-1333. [DOI: 10.1002/aur.2166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 06/13/2019] [Indexed: 12/21/2022]
Affiliation(s)
| | - Myles Jones
- Department of PsychologyUniversity of Sheffield Sheffield UK
| | - Elizabeth Milne
- Department of PsychologyUniversity of Sheffield Sheffield UK
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29
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Pertermann M, Bluschke A, Roessner V, Beste C. The Modulation of Neural Noise Underlies the Effectiveness of Methylphenidate Treatment in Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:743-750. [PMID: 31103546 DOI: 10.1016/j.bpsc.2019.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/19/2019] [Accepted: 03/26/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Various lines of research suggest that the stability of neural processes is low in attention-deficit/hyperactivity disorder (ADHD). Considering overarching neural principles, this lack of stability relates to increased levels of neural noise. However, no study has directly examined neural noise in ADHD. Likewise, it is unknown whether the modulation of neural noise reflects a mechanistic link as to why methylphenidate (MPH) is effective in treating impulsivity in ADHD. METHODS We compared neural noise between 29 juvenile patients with ADHD and 32 healthy control subjects and examined the effects of MPH. We examined 1/f neural noise of electroencephalogram data collected while participants performed a response inhibition (Go/NoGo) task. RESULTS Specific during NoGo trials, children with ADHD showed more neural noise than healthy control subjects. This was especially the case with regard to the theta frequency band, which is very closely related to cognitive control. MPH treatment reduced neural noise in ADHD to the level of healthy control subjects. Correlational analyses showed a direct relationship between decreases in neural noise and increases in behavioral performance. Mechanistically, this can be explained by the MPH-induced increase in dopaminergic neurotransmission that enhances the signal-to-noise ratio in neural networks and thus reduces neural noise. CONCLUSIONS This study is the first to demonstrate increased (pink) neural noise in patients with ADHD and its reduction through MPH treatment. The study reveals an important mechanistic link as to why MPH is effective in treating impulsivity in ADHD.
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Affiliation(s)
- Maik Pertermann
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dresden University of Technology, Dresden, Germany.
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30
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Chmielewski W, Bluschke A, Bodmer B, Wolff N, Roessner V, Beste C. Evidence for an altered architecture and a hierarchical modulation of inhibitory control processes in ADHD. Dev Cogn Neurosci 2019; 36:100623. [PMID: 30738306 PMCID: PMC6969218 DOI: 10.1016/j.dcn.2019.100623] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 01/23/2023] Open
Abstract
Inhibitory control deficits are a hallmark in ADHD. Yet, inhibitory control includes a multitude of entities (e.g. ‘inhibition of interferences’ and ‘action inhibition’). Examining the interplay between these kinds of inhibitory control provides insights into the architecture of inhibitory control in ADHD. Combining a Simon task and a Go/Nogo task, we assessed the interplay of ‘inhibition of interferences’ and ‘action inhibition’. This was combined with EEG recordings, EEG data decomposition and source localization. Simon interference effects in Go trials were larger in ADHD. At the neurophysiological level, this insufficient inhibition of interferences in ADHD related to the superior parietal cortex. Simon interference effects were absent in action inhibition (Nogo) trials in ADHD, compared to controls. This was supported by bayesian statistics. The power of effects was higher than 95%. The differential effects between the groups were associated with modulations of neurophysiological response selection processes in the superior frontal gyrus. ADHD is not only associated with deficits in inhibitory control. Rather, the organization and architecture of the inhibitory control system is different in ADHD. Distinguishable inhibitory control processes operate on a hierarchical ‘first come, first serve’ basis and are not integrated in ADHD. This is a new facet of ADHD.
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Affiliation(s)
- Witold Chmielewski
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Benjamin Bodmer
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Nicole Wolff
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
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31
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Newson JJ, Thiagarajan TC. EEG Frequency Bands in Psychiatric Disorders: A Review of Resting State Studies. Front Hum Neurosci 2019; 12:521. [PMID: 30687041 PMCID: PMC6333694 DOI: 10.3389/fnhum.2018.00521] [Citation(s) in RCA: 319] [Impact Index Per Article: 63.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/11/2018] [Indexed: 12/19/2022] Open
Abstract
A significant proportion of the electroencephalography (EEG) literature focuses on differences in historically pre-defined frequency bands in the power spectrum that are typically referred to as alpha, beta, gamma, theta and delta waves. Here, we review 184 EEG studies that report differences in frequency bands in the resting state condition (eyes open and closed) across a spectrum of psychiatric disorders including depression, attention deficit-hyperactivity disorder (ADHD), autism, addiction, bipolar disorder, anxiety, panic disorder, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and schizophrenia to determine patterns across disorders. Aggregating across all reported results we demonstrate that characteristic patterns of power change within specific frequency bands are not necessarily unique to any one disorder but show substantial overlap across disorders as well as variability within disorders. In particular, we show that the most dominant pattern of change, across several disorder types including ADHD, schizophrenia and OCD, is power increases across lower frequencies (delta and theta) and decreases across higher frequencies (alpha, beta and gamma). However, a considerable number of disorders, such as PTSD, addiction and autism show no dominant trend for spectral change in any direction. We report consistency and validation scores across the disorders and conditions showing that the dominant result across all disorders is typically only 2.2 times as likely to occur in the literature as alternate results, and typically with less than 250 study participants when summed across all studies reporting this result. Furthermore, the magnitudes of the results were infrequently reported and were typically small at between 20% and 30% and correlated weakly with symptom severity scores. Finally, we discuss the many methodological challenges and limitations relating to such frequency band analysis across the literature. These results caution any interpretation of results from studies that consider only one disorder in isolation, and for the overall potential of this approach for delivering valuable insights in the field of mental health.
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32
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Lau-Zhu A, Fritz A, McLoughlin G. Overlaps and distinctions between attention deficit/hyperactivity disorder and autism spectrum disorder in young adulthood: Systematic review and guiding framework for EEG-imaging research. Neurosci Biobehav Rev 2019; 96:93-115. [PMID: 30367918 PMCID: PMC6331660 DOI: 10.1016/j.neubiorev.2018.10.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/08/2018] [Accepted: 10/18/2018] [Indexed: 11/20/2022]
Abstract
Attention deficit/hyperactivity disorders (ADHD) and autism spectrum disorders (ASD) frequently co-occur. However, we know little about the neural basis of the overlaps and distinctions between these disorders, particularly in young adulthood - a critical time window for brain plasticity across executive and socioemotional domains. Here, we systematically review 75 articles investigating ADHD and ASD in young adult samples (mean ages 16-26) using cognitive tasks, with neural activity concurrently measured via electroencephalography (EEG) - the most accessible neuroimaging technology. The majority of studies focused on event-related potentials (ERPs), with some beginning to capitalise on oscillatory approaches. Overlapping and specific profiles for ASD and ADHD were found mainly for four neurocognitive domains: attention processing, performance monitoring, face processing and sensory processing. No studies in this age group directly compared both disorders or considered dual diagnosis with both disorders. Moving forward, understanding of ADHD, ASD and their overlap in young adulthood would benefit from an increased focus on cross-disorder comparisons, using similar paradigms and in well-powered samples and longitudinal cohorts.
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Affiliation(s)
- Alex Lau-Zhu
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Anne Fritz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gráinne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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33
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Bluschke A, Friedrich J, Schreiter ML, Roessner V, Beste C. A comparative study on the neurophysiological mechanisms underlying effects of methylphenidate and neurofeedback on inhibitory control in attention deficit hyperactivity disorder. NEUROIMAGE-CLINICAL 2018; 20:1191-1203. [PMID: 30390574 PMCID: PMC6214870 DOI: 10.1016/j.nicl.2018.10.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/09/2018] [Accepted: 10/24/2018] [Indexed: 02/06/2023]
Abstract
In Attention Deficit Hyperactivity Disorder (AD(H)D), treatments using methylphenidate (MPH) and behavioral interventions like neurofeedback (NF) reflect major therapeutic options. These treatments also ameliorate executive dysfunctions in AD(H)D. However, the mechanisms underlying effects of MPH and NF on executive functions in AD(H)D (e.g. the ability to inhibit prepotent responses) are far from understood. It is particularly unclear whether these interventions affect similar or dissociable neural mechanisms and associated functional neuroanatomical structures. This, however, is important when aiming to further improve these treatments. We compared the neurophysiological mechanisms of MPH and theta/beta NF treatments on inhibitory control on the basis of EEG recordings and source localization analyses. The data show that MPH and theta/beta NF both increase the ability to inhibit pre-potent responses to a similar extent. However, the data suggest that MPH and NF target different neurophysiological mechanisms, especially when it comes to functional neuroanatomical structures associated with these effects. Both treatments seem to affect neurophysiological correlates of a ‘braking function’ in medial frontal areas. However, in case of the NF intervention, inferior parietal areas are also involved. This likely reflects the updating and stabilisation of efficient internal representations in order to initiate appropriate actions. No effects were seen in correlates of perceptual and attentional selection processes. Notably, reliable effects were only obtained after accounting for intra-individual variability in the neurophysiological data, which may also explain the diversity of findings in studies on treatment effects in AD(H)D, especially concerning neurofeedback. Neurophysiological mechanisms of methylphenidate (MPH) and neurofeedback (NF) in ADHD are compared. Both treatments improve inhibition, but have different underlying neurophysiological mechanisms. Both treatments affect the neurophysiological correlates of a ‘breaking function’ in medial frontal areas. NF also affects inferior parietal areas and likely the updating of internal representations. Distinctive effects are only seen when accounting for intra-individual variability.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
| | - Julia Friedrich
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Marie Luise Schreiter
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
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34
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Mihali A, Young AG, Adler LA, Halassa MM, Ma WJ. A Low-Level Perceptual Correlate of Behavioral and Clinical Deficits in ADHD. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2018; 2:141-163. [PMID: 30381800 PMCID: PMC6184361 DOI: 10.1162/cpsy_a_00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 07/10/2018] [Indexed: 11/04/2022]
Abstract
In many studies of attention-deficit hyperactivity disorder (ADHD), stimulus encoding and processing (perceptual function) and response selection (executive function) have been intertwined. To dissociate deficits in these functions, we introduced a task that parametrically varied low-level stimulus features (orientation and color) for fine-grained analysis of perceptual function. It also required participants to switch their attention between feature dimensions on a trial-by-trial basis, thus taxing executive processes. Furthermore, we used a response paradigm that captured task-irrelevant motor output (TIMO), reflecting failures to use the correct stimulus-response rule. ADHD participants had substantially higher perceptual variability than controls, especially for orientation, as well as higher TIMO. In both ADHD and controls, TIMO was strongly affected by the switch manipulation. Across participants, the perceptual variability parameter was correlated with TIMO, suggesting that perceptual deficits are associated with executive function deficits. Based on perceptual variability alone, we were able to classify participants into ADHD and controls with a mean accuracy of about 77%. Participants' self-reported General Executive Composite score correlated not only with TIMO but also with the perceptual variability parameter. Our results highlight the role of perceptual deficits in ADHD and the usefulness of computational modeling of behavior in dissociating perceptual from executive processes.
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Affiliation(s)
- Andra Mihali
- Center for Neural Science, New York University, New York, New York, USA
- Department of Psychology, New York University, New York, New York, USA
| | - Allison G. Young
- Department of Psychiatry, NYU School of Medicine, New York, New York, USA
| | - Lenard A. Adler
- Department of Psychiatry, NYU School of Medicine, New York, New York, USA
| | - Michael M. Halassa
- Department of Brain and Cognitive Science, MIT, Boston, Massachusetts, USA
| | - Wei Ji Ma
- Center for Neural Science, New York University, New York, New York, USA
- Department of Psychology, New York University, New York, New York, USA
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35
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Kupers ER, Wang HX, Amano K, Kay KN, Heeger DJ, Winawer J. A non-invasive, quantitative study of broadband spectral responses in human visual cortex. PLoS One 2018. [PMID: 29529085 PMCID: PMC5846788 DOI: 10.1371/journal.pone.0193107] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Currently, non-invasive methods for studying the human brain do not routinely and reliably measure spike-rate-dependent signals, independent of responses such as hemodynamic coupling (fMRI) and subthreshold neuronal synchrony (oscillations and event-related potentials). In contrast, invasive methods—microelectrode recordings and electrocorticography (ECoG)—have recently measured broadband power elevation in field potentials (~50–200 Hz) as a proxy for locally averaged spike rates. Here, we sought to detect and quantify stimulus-related broadband responses using magnetoencephalography (MEG). Extracranial measurements like MEG and EEG have multiple global noise sources and relatively low signal-to-noise ratios; moreover high frequency artifacts from eye movements can be confounded with stimulus design and mistaken for signals originating from brain activity. For these reasons, we developed an automated denoising technique that helps reveal the broadband signal of interest. Subjects viewed 12-Hz contrast-reversing patterns in the left, right, or bilateral visual field. Sensor time series were separated into evoked (12-Hz amplitude) and broadband components (60–150 Hz). In all subjects, denoised broadband responses were reliably measured in sensors over occipital cortex, even in trials without microsaccades. The broadband pattern was stimulus-dependent, with greater power contralateral to the stimulus. Because we obtain reliable broadband estimates with short experiments (~20 minutes), and with sufficient signal-to-noise to distinguish responses to different stimuli, we conclude that MEG broadband signals, denoised with our method, offer a practical, non-invasive means for characterizing spike-rate-dependent neural activity for addressing scientific questions about human brain function.
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Affiliation(s)
- Eline R. Kupers
- Department of Psychology and Center for Neural Science, New York University, New York, New York, United States of America
- * E-mail:
| | - Helena X. Wang
- Department of Psychology and Center for Neural Science, New York University, New York, New York, United States of America
| | - Kaoru Amano
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, Osaka, Japan
| | - Kendrick N. Kay
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - David J. Heeger
- Department of Psychology and Center for Neural Science, New York University, New York, New York, United States of America
| | - Jonathan Winawer
- Department of Psychology and Center for Neural Science, New York University, New York, New York, United States of America
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36
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The Magnitude of Trial-By-Trial Neural Variability Is Reproducible over Time and across Tasks in Humans. eNeuro 2017; 4:eN-NWR-0292-17. [PMID: 29279861 PMCID: PMC5739532 DOI: 10.1523/eneuro.0292-17.2017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 11/21/2022] Open
Abstract
Numerous studies have shown that neural activity in sensory cortices is remarkably variable over time and across trials even when subjects are presented with an identical repeating stimulus or task. This trial-by-trial neural variability is relatively large in the prestimulus period and considerably smaller (quenched) following stimulus presentation. Previous studies have suggested that the magnitude of neural variability affects behavior such that perceptual performance is better on trials and in individuals where variability quenching is larger. To what degree are neural variability magnitudes of individual subjects flexible or static? Here, we used EEG recordings from adult humans to demonstrate that neural variability magnitudes in visual cortex are remarkably consistent across different tasks and recording sessions. While magnitudes of neural variability differed dramatically across individual subjects, they were surprisingly stable across four tasks with different stimuli, temporal structures, and attentional/cognitive demands as well as across experimental sessions separated by one year. These experiments reveal that, in adults, neural variability magnitudes are mostly solidified individual characteristics that change little with task or time, and are likely to predispose individual subjects to exhibit distinct behavioral capabilities.
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Dockree PM, Barnes JJ, Matthews N, Dean AJ, Abe R, Nandam LS, Kelly SP, Bellgrove MA, O'Connell RG. The Effects of Methylphenidate on the Neural Signatures of Sustained Attention. Biol Psychiatry 2017; 82:687-694. [PMID: 28599833 DOI: 10.1016/j.biopsych.2017.04.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/31/2017] [Accepted: 04/18/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although it is well established that methylphenidate (MPH) enhances sustained attention, the neural mechanisms underpinning this improvement remain unclear. We examined how MPH influenced known electrophysiological precursors of lapsing attention over different time scales. METHODS We measured the impact of MPH, compared with placebo, on behavioral and electrocortical markers while healthy adults (n = 40) performed a continuous monitoring paradigm designed to elicit attentional lapses. RESULTS MPH led to increased rates of target detection, and electrophysiological analyses were conducted to identify the mechanisms underlying these improvements. Lapses of attention were reliably preceded by progressive increases in alpha activity that emerged over periods of several seconds. MPH led to an overall suppression of alpha activity across the entire task but also diminished the frequency of these maladaptive pretarget increases through a reduction of alpha variability. A drug-related linear increase in the amplitude of the frontal P3 event-related component was also observed in the pretarget timeframe (3 or 4 seconds). Furthermore, during immediate target processing, there was a significant increase in the parietal P3 amplitude with MPH, indicative of enhanced perceptual evidence accumulation underpinning target detection. MPH-related enhancements occurred without significant changes to early visual processing (visual P1 and 25-Hz steady-state visual evoked potential). CONCLUSIONS MPH serves to reduce maladaptive electrophysiological precursors of lapsing attention by acting selectively on top-down endogenous mechanisms that support sustained attention and target detection with no significant effect on bottom-up sensory excitability. These findings offer candidate markers to monitor the therapeutic efficacy of psychostimulants or to predict therapeutic responses.
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Affiliation(s)
- Paul M Dockree
- School of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - Jessica J Barnes
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Natasha Matthews
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Angela J Dean
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Rafael Abe
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - L Sanjay Nandam
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Simon P Kelly
- School of Electrical and Electronic Engineering, University College Dublin, Dublin, Ireland
| | - Mark A Bellgrove
- School of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Redmond G O'Connell
- School of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
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David N, Schneider TR, Peiker I, Al-Jawahiri R, Engel AK, Milne E. Variability of cortical oscillation patterns: A possible endophenotype in autism spectrum disorders? Neurosci Biobehav Rev 2016; 71:590-600. [DOI: 10.1016/j.neubiorev.2016.09.031] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 09/27/2016] [Accepted: 09/30/2016] [Indexed: 11/30/2022]
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