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Ferguson C, Hobson C, Hedge C, Waters C, Anning K, van Goozen S. Disentangling the relationships between motor control and cognitive control in young children with symptoms of ADHD. Child Neuropsychol 2024; 30:289-314. [PMID: 36946244 DOI: 10.1080/09297049.2023.2190965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
Children with ADHD experience difficulties with motor and cognitive control. However, the relationships between these symptoms are poorly understood. As a step toward improving treatment, this study investigated associations between specific aspects of motor control and cognitive control in children with varying levels of hyperactive-impulsive symptoms. A heterogeneous sample of 255 children of 4 to 10 years of age (median = 6.50, MAD = 1.36) completed a battery of tests probing motor generation, visuomotor fluency, visuomotor flexibility, cognitive inhibition, verbal and visuospatial working memory, and cognitive flexibility. Their caregivers were interviewed regarding their hyperactive-impulsive symptoms. 25.9% of the main sample met diagnostic criteria for ADHD. Multiple linear regression analysis was used to determine whether specific aspects of motor control were associated with specific aspects of cognitive control, and whether any associations were moderated by hyperactive-impulsive symptoms. Additionally, cognitive modeling (the drift diffusion model approximated with EZ-DM) was used to understand performance on a cognitive inhibition task. Visuomotor fluency was significantly associated with cognitive inhibition. Visuomotor flexibility was significantly associated with cognitive flexibility. There were no significant moderation effects. Cognitive modeling was inconclusive. In conclusion, the ability to fluently perform visually guided continuous movement is linked with the ability to inhibit the effects of distracting information. The ability to spontaneously use visual information to flexibly alter motor responses is related to the ability to cognitively shift from one frame of mind to another. These relationships appear to be quantitatively and qualitatively similar across the childhood hyperactive-impulsive continuum as rated by parents.
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Affiliation(s)
- Cameron Ferguson
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Community Neurological Rehabilitation Service, Aneurin Bevan University Health Board, NHS Wales, Newport, United Kingdom
| | - Christopher Hobson
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Craig Hedge
- School of Psychology, Aston University, Aston, United Kingdom
| | - Cerith Waters
- South Wales Doctoral Programme in Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, United Kingdom
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
| | - Kate Anning
- Neurodevelopment Assessment Unit, Cardiff University, Cardiff, United Kingdom
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Zhao YJ, Zhang Y, Wang Q, Manssuer L, Cui H, Ding Q, Sun B, Liu W, Voon V. Evidence Accumulation and Neural Correlates of Uncertainty in Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1058-1065. [PMID: 37343660 PMCID: PMC10555851 DOI: 10.1016/j.bpsc.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Decision making is frequently associated with risk taking under uncertainty. Elevated intolerance of uncertainty is suggested to be a critical feature of obsessive-compulsive disorder (OCD). However, impairments of latent constructs of uncertainty processing and its neural correlates remain unclear in OCD. METHODS In 83 participants (24 OCD patients treated with capsulotomy, 28 OCD control participants, and 31 healthy control participants), we performed magnetic resonance imaging using a card gambling task in which participants made decisions whether to bet or not that the next card would be larger than the current one. A hierarchical drift diffusion model was used to dissociate speed and amount of evidence accumulated before a decisional threshold (i.e., betting or no betting) was reached. RESULTS High uncertainty was characterized by a smaller amount of evidence accumulation (lower thresholds), thus dissociating uncertainty from conflict tasks and highlighting the specificity of this task to test value-based uncertainty. OCD patients exhibited greater caution with poor performance and greater evidence accumulation overall along with slower speed of accumulation, particularly under low uncertainty. Bilateral dorsal anterior cingulate and anterior insula distinguished high- and low-uncertainty decision processes in healthy control participants but not in the OCD groups, indicating impairments in anticipation of differences in outcome variance and salience network activity. There were no behavioral or imaging differences relating to capsulotomy despite improvements in OCD symptoms. CONCLUSIONS Our findings highlight greater impairments particularly in more certain trials in the OCD groups along with impaired neural differentiation of high and low uncertainty and suggest uncertainty processing as a trait cognitive endophenotype rather than a state-specific factor.
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Affiliation(s)
- Yi-Jie Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China; Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingying Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Qianfeng Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Luis Manssuer
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Hailun Cui
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Qiong Ding
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Clinical Neuroscience Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjuan Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Valerie Voon
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, China; Zhangjiang Fudan International Innovation Center, Shanghai, China; Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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Waxmonsky J, Fosco W, Waschbusch D, Babinski D, Baweja R, Pegg S, Cao V, Shroff D, Kujawa A. The Impact of Irritability and Callous Unemotional Traits on Reward Positivity in Youth with ADHD and Conduct Problems. Res Child Adolesc Psychopathol 2022; 50:1027-1040. [PMID: 35182261 PMCID: PMC9388699 DOI: 10.1007/s10802-022-00901-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) and conduct problems exhibit significant variability in functioning and treatment response that cannot be fully accounted for by differences in symptom severity. Reward responsivity (RR) is a potential transdiagnostic means to account for this variability. Irritability and callous-unemotional (CU) traits moderate associations between both ADHD and conduct problems with multiple realms of functioning. Both are theorized to be associated with RR, but associations in clinical samples are unknown. In 48 youth ages 5-12 with ADHD referred for treatment of conduct problems, we examined RR using a guessing task where participants select a door icon to win and lose money. Analyses focused on the reward positivity (RewP) event-related potential in response to gain and loss feedback, which reliably peaks approximately 300 ms after feedback. Frequentist and Bayesian approaches assessed main effects of ADHD, Conduct Disorder (CD) and non-irritable Oppositional Defiant Disorder (ODD) symptoms with RR, plus interactions between symptoms and affective dimensions (irritability, CU). CD and ODD were hypothesized to be associated with altered RR, with irritability and CU moderating these associations. Across models, a reliable CD x irritability interaction emerged, indicating enhanced RewP when irritability was elevated and CD symptoms were low. CU did not moderate any associations with RR, and little support was found for associations between RR and other symptom domains. As neural response to reward varied with levels of irritability and CD symptoms, RR may hold potential as a clinically-relevant biomarker in youth with ADHD and conduct problems.
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Affiliation(s)
- James Waxmonsky
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA.
| | - Whitney Fosco
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Daniel Waschbusch
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Dara Babinski
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Raman Baweja
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Samantha Pegg
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Vanessa Cao
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Delshad Shroff
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Cardinale EM, Naim R, Haller SP, German R, Botz-Zapp C, Bezek J, Jangraw DC, Brotman MA. Rationale and validation of a novel mobile application probing motor inhibition: Proof of concept of CALM-IT. PLoS One 2021; 16:e0252245. [PMID: 34086728 PMCID: PMC8177631 DOI: 10.1371/journal.pone.0252245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/02/2021] [Indexed: 12/02/2022] Open
Abstract
Identification of behavioral mechanisms underlying psychopathology is essential for the development of novel targeted therapeutics. However, this work relies on rigorous, time-intensive, clinic-based laboratory research, making it difficult to translate research paradigms into tools that can be used by clinicians in the community. The broad adoption of smartphone technology provides a promising opportunity to bridge the gap between the mechanisms identified in the laboratory and the clinical interventions targeting them in the community. The goal of the current study is to develop a developmentally appropriate, engaging, novel mobile application called CALM-IT that probes a narrow biologically informed process, inhibitory control. We aim to leverage the rigorous and robust methods traditionally used in laboratory settings to validate this novel mechanism-driven but easily disseminatable tool that can be used by clinicians to probe inhibitory control in the community. The development of CALM-IT has significant implications for the ability to screen for inhibitory control deficits in the community by both clinicians and researchers. By facilitating assessment of inhibitory control outside of the laboratory setting, researchers could have access to larger and more diverse samples. Additionally, in the clinical setting, CALM-IT represents a novel clinical screening measure that could be used to determine personalized courses of treatment based on the presence of inhibitory control deficits.
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Affiliation(s)
- Elise M. Cardinale
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Reut Naim
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Simone P. Haller
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Ramaris German
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Christian Botz-Zapp
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Jessica Bezek
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
| | - David C. Jangraw
- Department of Electrical and Biomedical Engineering, University of Vermont, Burlington, VT, United States of America
| | - Melissa A. Brotman
- Emotion & Development Branch, National Institute of Mental Health, Bethesda, MD, United States of America
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