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Shojaei B, Naeim M, Kazemi Z, Taheri M, Imannezhad S, Mohammadi Y. Reducing symptoms of attention deficit/hyperactivity disorder (ADHD) in elementary students: the effectiveness of neurofeedback. Ann Med Surg (Lond) 2024; 86:2651-2656. [PMID: 38694339 PMCID: PMC11060259 DOI: 10.1097/ms9.0000000000001861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/14/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction and importance This research was conducted to investigate the effectiveness of neurofeedback on the symptoms of hyperactivity and attention deficit in primary school students with attention deficit/hyperactivity disorder (ADHD) disorder. Case presentation The present study utilized a randomized clinical trial with pre-test and post-test measurements and included a control group. The research population included all primary school students with ADHD in 2023; 50 of these children were selected as the experimental group based on the accessible sampling method, and 50 were also included in the control group. Neurofeedback treatment sessions for the experimental group were 30 sessions. Research data were collected in three stages: pre-test and post-test, using a questionnaire based on the Conners rating scale from parents. SPSS-25 analyzed the data. Clinical discussion The results showed that neurofeedback is associated with significant effectiveness in the symptoms of attention deficit disorder and hyperactivity of students (P<0.05). Conclusion Based on the findings of this research, it can be said that neurofeedback treatment is effective in reducing attention deficit and hyperactivity symptoms of students with ADHD disorder. It is suggested to widely use neurofeedback to reduce the symptoms of attention deficit and hyperactivity disorder.
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Affiliation(s)
- Behnaz Shojaei
- Department of Midwifery, Faculty of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman
| | - Mahdi Naeim
- Department of Research, Psychology and Counselling Organization, Tehran
| | - Zahra Kazemi
- Department of Research, Psychology and Counselling Organization, Tehran
| | - Mostafa Taheri
- Department of Critical Care and Emergency Nursing, Zanjan Nursing and Midwifery School, Zanjan University of Medical Sciences, Zanjan
| | - Shima Imannezhad
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad
| | - Yasaman Mohammadi
- School of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran
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2
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Bullard CC, Roberts DK, Tatsuki MO, Sullivan MA, Kofler MJ, Alderson RM. Social functioning in children with ADHD: an examination of inhibition, self-control, and working memory as potential mediators. Child Neuropsychol 2024:1-23. [PMID: 38269494 PMCID: PMC11269528 DOI: 10.1080/09297049.2024.2304375] [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: 04/18/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) experience a host of social problems, in addition to significant impairments in behavioral inhibition, working memory, and self-control. Behavioral inhibition and working memory difficulties have been linked with social functioning deficits, but to date, most studies have examined these neurocognitive problems either in isolation or as an aggregate measure in relation to social problems, and none has considered the role of self-control. Thus, it remains unclear whether all of these executive functions are linked with social problems or if the link can be more parsimoniously explained by construct overlap. Fifty-eight children with ADHD and 63 typically developing (TD) children completed tests assessing self-control, behavioral inhibition, and working memory; parents and teachers rated children's social functioning. Examination of potential indirect effects with the bootstrapping procedure indicated that working memory mediated the relation between group membership (ADHD, TD) and child social functioning based on teacher but not parent ratings. Behavioral inhibition and self-control did not have direct relations with either parent- or teacher-rated social functioning. These findings point to important differences regarding how executive functioning difficulties manifest at school compared to home, as well as the specific executive function components that predict ADHD-related social difficulties.
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Affiliation(s)
| | - Delanie K. Roberts
- Oklahoma State University, Department of Psychology
- Children’s Hospital of Los Angeles
| | - Miho O. Tatsuki
- Oklahoma State University, Department of Psychology
- Florida State University, Department of Psychology
| | | | | | - R. Matt Alderson
- Oklahoma State University, Department of Psychology
- Posthumous author
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3
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Konrad JD, Marrus N, Lohse KR, Thuet KM, Lang CE. Associations Between Coordination and Wearable Sensor Variables Vary by Recording Context but Not Assessment Type. J Mot Behav 2024; 56:339-355. [PMID: 38189355 PMCID: PMC10957306 DOI: 10.1080/00222895.2023.2300969] [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] [Received: 06/07/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
Motor coordination is an important driver of development and improved coordination assessments could facilitate better screening, diagnosis, and intervention for children at risk of developmental disorders. Wearable sensors could provide data that enhance the characterization of coordination and the clinical utility of that data may vary depending on how sensor variables from different recording contexts relate to coordination. We used wearable sensors at the wrists to capture upper-limb movement in 85 children aged 6-12. Sensor variables were extracted from two recording contexts. Structured recordings occurred in the lab during a unilateral throwing task. Unstructured recordings occurred during free-living activity. The objective was to determine the influence of recording context (unstructured versus structured) and assessment type (direct vs. indirect) on the association between sensor variables and coordination. The greatest associations were between six sensor variables from the structured context and the direct measure of coordination. Worse coordination scores were associated with upper-limb movements that had higher peak magnitudes, greater variance, and less smoothness. The associations were consistent across both arms, even though the structured task was unilateral. This finding suggests that wearable sensors could be paired with a simple, structured task to yield clinically informative variables that relate to motor coordination.
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Affiliation(s)
- Jeffrey D Konrad
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Keith R Lohse
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, USA
| | - Kayla M Thuet
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, USA
| | - Catherine E Lang
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, USA
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, USA
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4
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Zhao Y, Zhong Y, Chen W, Chang S, Cao Q, Wang Y, Yang L. Ocular and neural genes jointly regulate the visuospatial working memory in ADHD children. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2023; 19:14. [PMID: 37658396 PMCID: PMC10472596 DOI: 10.1186/s12993-023-00216-9] [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: 04/23/2023] [Accepted: 08/16/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Working memory (WM) deficits have frequently been linked to attention deficit hyperactivity disorder (ADHD). Despite previous studies suggested its high heritability, its genetic basis, especially in ADHD, remains unclear. The current study aimed to comprehensively explore the genetic basis of visual-spatial working memory (VSWM) in ADHD using wide-ranging genetic analyses. METHODS The current study recruited a cohort consisted of 802 ADHD individuals, all met DSM-IV ADHD diagnostic criteria. VSWM was assessed by Rey-Osterrieth complex figure test (RCFT), which is a widely used psychological test include four memory indexes: detail delayed (DD), structure delayed (SD), structure immediate (SI), detail immediate (DI). Genetic analyses were conducted at the single nucleotide polymorphism (SNP), gene, pathway, polygenic and protein network levels. Polygenic Risk Scores (PRS) were based on summary statistics of various psychiatric disorders, including ADHD, autism spectrum disorder (ASD), major depressive disorder (MDD), schizophrenia (SCZ), obsessive compulsive disorders (OCD), and substance use disorder (SUD). RESULTS Analyses at the single-marker level did not yield significant results (5E-08). However, the potential signals with P values less than E-05 and their mapped genes suggested the regulation of VSWM involved both ocular and neural system related genes, moreover, ADHD-related genes were also involved. The gene-based analysis found RAB11FIP1, whose encoded protein modulates several neurodevelopment processes and visual system, as significantly associated with DD scores (P = 1.96E-06, Padj = 0.036). Candidate pathway enrichment analyses (N = 53) found that forebrain neuron fate commitment significantly enriched in DD (P = 4.78E-04, Padj = 0.025), and dopamine transport enriched in SD (P = 5.90E-04, Padj = 0.031). We also observed a significant negative relationship between DD scores and ADHD PRS scores (P = 0.0025, Empirical P = 0.048). CONCLUSIONS Our results emphasized the joint contribution of ocular and neural genes in regulating VSWM. The study reveals a shared genetic basis between ADHD and VSWM, with GWAS indicating the involvement of ADHD-related genes in VSWM. Additionally, the PRS analysis identifies a significant relationship between ADHD-PRS and DD scores. Overall, our findings shed light on the genetic basis of VSWM deficits in ADHD, and may have important implications for future research and clinical practice.
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Affiliation(s)
- Yilu Zhao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yuanxin Zhong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Wei Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Suhua Chang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Qingjiu Cao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yufeng Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Li Yang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital), NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan Bei Road, Beijing, 100191, China.
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5
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Nejati V, Derakhshan Z, Mohtasham A. The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD). Asian J Psychiatr 2023; 81:103469. [PMID: 36669291 DOI: 10.1016/j.ajp.2023.103469] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
This study aimed to evaluate the effect of working memory training on executive functions and behavioral symptoms in children with ADHD. Thirty children with ADHD were randomly assigned to active control or Active Memory Intervention (AMIN) group. Executive functions and rating scales were used for assessment in three baseline, post-intervention, and 1-month follow-up sessions. The results show AMIN improves working memory and inhibitory control as well as ameliorates ADHD symptoms at home and school. Working memory training is beneficial and transferable intervention in children with ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran.
| | - Zahra Derakhshan
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran
| | - Ahdiyeh Mohtasham
- Department of Psychology, Shahid Beheshti University, Po box: 1983969411, Tehran, Islamic Republic of Iran
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Gender differences in smartphone addiction and depression among Korean adolescents: Focusing on the internal mechanisms of attention deficit and self-control. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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7
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Campez M, Raiker JS, Little K, Altszuler AR, Merrill BM, Macphee FL, Gnagy EM, Greiner AR, Musser ED, Coles EK, Pelham WE. An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD. Exp Clin Psychopharmacol 2022; 30:209-219. [PMID: 33475395 PMCID: PMC8406432 DOI: 10.1037/pha0000446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) consistently exhibit a stronger preference for immediate rewards than for larger rewards available following a delay on tasks measuring choice impulsivity (CI). Despite this, however, there remains a dearth of studies examining the impact of stimulant treatment on CI as well as associated higher order (e.g., working memory [WM]) and perceptual (e.g., time perception) cognitive processes. The present study examines the effect of osmotic release oral system methylphenidate (OROS-MPH) on CI, WM and time perception processes as well as the relation among these processes before and after taking a regimen of OROS-MPH. Thirty-five children (aged 7-12 years) with a diagnosis of ADHD participating in a concurrent stimulant medication study were recruited to complete computerized assessments of CI, WM, and time perception. Children completed the assessments after administration of a placebo as well as their lowest effective dose of OROS-MPH following a 2-week titration period. The results from one-sample t-tests indicated that OROS-MPH improves both CI and WM in youth with ADHD but does not impact time perception. Further, results revealed no significant association among the various indices of cognitive performance while taking placebo or OROS-MPH. Overall, the findings suggest that while OROS-MPH improves both CI and WM in youth with ADHD, improvements in CI as a result of OROS-MPH are unlikely to be associated with the improvements in WM given the lack of association among the two. Future studies should consider alternate cognitive, emotional, and motivational mechanisms that may account for the impact of OROS-MPH on CI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Mileini Campez
- Florida International University, Center for Children and Families
| | - Joseph S. Raiker
- Florida International University, Center for Children and Families
| | | | - Amy R. Altszuler
- Florida International University, Center for Children and Families
| | | | - Fiona L. Macphee
- Florida International University, Center for Children and Families
| | | | | | - Erica D. Musser
- Florida International University, Center for Children and Families
| | - Erika K. Coles
- Florida International University, Center for Children and Families
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8
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Rosenbaum J, Ceyte H, Hamon I, Deforge H, Hascoët AMJ, Caudron S, Hascoët JM. Influence of body mobility on attention networks in school-aged prematurely born children: A controlled trial. Front Pediatr 2022; 10:928541. [PMID: 36160773 PMCID: PMC9492848 DOI: 10.3389/fped.2022.928541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022] Open
Abstract
School-aged prematurely born children (PC) have a higher risk of academic difficulties, which may be partly explained by attention difficulties. It has been suggested that children's attentional performance might be influenced by their body posture and spontaneous body motion. The aim of this study (ClinicalTrials.gov - NCT03125447) was to test the influence of three body mobility conditions on the three functions of attention (alertness, orienting, and executive control) among school-aged PC vs. term-born children (TC). Notably, 21 PC and 21 TC performed the Attention Network Test for Children in three body mobility conditions, namely, sitting and standing imposed fixed postures and a free-to-move condition. The children's median reaction times were compared between trials (1) with and without alerting cues, (2) with valid and invalid orienting cues, and (3) with and without distracting information, to calculate the performance of alertness, orienting, and executive control, respectively. Results showed that with distracting information, PC exhibited significantly slower responses in the standing-still posture than in the sitting-still posture (1,077 ± 240 vs. 1,175 ± 273 ms, p < 0.05), but not TC. No difference was observed with the free-to-move condition. PC and TC did not significantly differ in alertness or orienting, regardless of body mobility condition. These data suggest that PC must use executive resources to stand still and maintain position, which impairs their performance during executive tasks. We speculate that these results may be related to less developed postural control and motor inhibition in PC.
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Affiliation(s)
- Joëlle Rosenbaum
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France
| | - Hadrien Ceyte
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France.,Aix-Marseille University, CNRS, ISM, Marseille, France
| | - Isabelle Hamon
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France.,CHRU, Maternité Régionale, Nancy, France
| | - Hélène Deforge
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France.,CHRU, Maternité Régionale, Nancy, France
| | - Alexandre M J Hascoët
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France.,CHRU, Maternité Régionale, Nancy, France
| | - Sébastien Caudron
- CNRS, LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Jean-Michel Hascoët
- Développement, Adaptation et Handicap Laboratory (DevAH), Université de Lorraine, Nancy, France.,CHRU, Maternité Régionale, Nancy, France
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9
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Rosenbaum J, Hascoët JM, Hamon I, Petel A, Caudron S, Ceyte H. Body Mobility and Attention Networks in 6- to 7-Year-Old Children. Front Psychol 2021; 12:743504. [PMID: 34777134 PMCID: PMC8579035 DOI: 10.3389/fpsyg.2021.743504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022] Open
Abstract
Learning in 6- to 7-year-old children is strongly influenced by three functions of attention: alertness, orienting, and executive control. These functions share a close relationship with body mobility, such as the posture adopted or a request to stay still during tasks. The aim of this study (ClinicalTrials.gov) was to analyze the influence of body posture (standing versus sitting) and the influence of these imposed postures compared to a free body mobility on attention functions in 6- to 7-year-old children. Twenty-one children (11 girls) with a mean age of 6.7±0.6years performed the Attention Network Test for Children in three-body mobility conditions: sitting still, standing still, and free to move. Three attentional scores were calculated which would separately reflect performance of alertness, orienting, and executive control. Overall, no difference in alertness performance was found between the three bodily mobility conditions. In addition, our results suggest a general poor orienting performance in children, whatever the body mobility condition, which might be related to their young age. Finally, children improved their executive control performance when they stood still, probably due to an improvement in arousal and mental state.
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Affiliation(s)
| | - Jean-Michel Hascoët
- Université de Lorraine, DevAH, Nancy, France
- Université de Lorraine, CHRU, Maternité Régionale, Département de Néonatologie, Nancy, France
| | - Isabelle Hamon
- Université de Lorraine, DevAH, Nancy, France
- Université de Lorraine, CHRU, Maternité Régionale, Département de Néonatologie, Nancy, France
| | | | - Sébastien Caudron
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
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10
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Burley DT, Anning KL, van Goozen SHM. The association between hyperactive behaviour and cognitive inhibition impairments in young children. Child Neuropsychol 2021; 28:302-317. [PMID: 34505554 DOI: 10.1080/09297049.2021.1976128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hyperactivity is one of the core features of attention-deficit hyperactivity disorder (ADHD), and yet there is evidence that hyperactive behavior in children with ADHD is not ubiquitous and could be a compensatory response to high cognitive demands. No research has yet objectively measured hyperactive behavior in young children who are demonstrating early signs of ADHD or examined the role of emotional state on hyperactivity levels.The current study measured motor activity using actigraphy during baseline, cognitive inhibition (Flanker task), and emotion arousing (Impossibly Perfect Circles task) conditions in 95 children aged 4-7 years old with developmental difficulties, including emerging symptoms of ADHD. We examined the relationship between objectively recorded activity, parent-rated hyperactivity problems, using the Strengths and Difficulties Questionnaire (SDQ), and cognitive inhibition task performance.Parent ratings of hyperactivity (but not inattention) symptoms were positively related to recorded hyperactivity, and this relationship was specific to activity measured during the cognitive inhibition task. Impaired cognitive inhibition performance was related to increased measured movement and this association was strongest in children who were rated as having the highest levels of hyperactive behavior.These findings confirm theoretically predicted associations between objectively recorded hyperactivity and impaired executive functioning and support the notion that hyperactivity in children emerges in response to high cognitive demands. The results encourage further investigation into the role of hyperactivity as a transdiagnostic dimension that can explain variation within and between different types of diagnostic classifications.
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Affiliation(s)
| | - Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK
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11
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Tarle SJ, Alderson RM, Arrington EF, Roberts DK. Emotion Regulation and Children With Attention-Deficit/Hyperactivity Disorder: The Effect of Varying Phonological Working Memory Demands. J Atten Disord 2021; 25:851-864. [PMID: 31319729 DOI: 10.1177/1087054719864636] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Findings from extant studies of the relationship between ADHD-related emotion regulation and working memory deficits have been equivocal, and their correlational designs preclude inferences about the functional relationship between working memory demands and emotion regulation. This study aimed to experimentally examine the functional relationship between varying working memory demands and ADHD-related emotion regulation deficits. Method: Overt emotion regulation behaviors were coded while children with and without ADHD completed experimental tasks that manipulated low and high working memory demands. Results: Compared with typically developing children, children with ADHD exhibited large-magnitude overall emotion expression deficits, disproportionately greater self-criticism during high working memory conditions, and disproportionately greater positive emotion expression during low working memory demand conditions. Conclusion: These findings suggest that working memory demands are functionally related to emotion regulation deficits exhibited by children with ADHD and may explicate variability of emotion regulation difficulties related to environmental demands.
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12
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Irwin LN, Groves NB, Soto EF, Kofler MJ. Is There a Functional Relation Between Set Shifting and Hyperactivity in Children with Attention-Deficit/Hyperactivity Disorder (ADHD)? J Int Neuropsychol Soc 2020; 26:1019-1027. [PMID: 32456747 PMCID: PMC7658020 DOI: 10.1017/s1355617720000545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Replicated evidence indicates that children with attention-deficit/hyperactivity disorder (ADHD) show disproportionate increases in hyperactivity/physical movement when their underdeveloped executive functions are taxed. However, our understanding of hyperactivity's relation with set shifting is limited, which is surprising given set shifting's importance as the third core executive function alongside working memory and inhibition. The aim of this study was to experimentally examine the effect of imposing set shifting and inhibition demands on objectively measured activity level in children with and without ADHD. METHOD The current study used a validated experimental manipulation to differentially evoke set shifting, inhibition, and general cognitive demands in a carefully phenotyped sample of children aged 8-13 years with ADHD (n = 43) and without ADHD (n = 34). Activity level was sampled during each task using multiple, high-precision actigraphs; total hyperactivity scores (THS) were calculated. RESULTS Results of the 2 × 5 Bayesian ANOVA for hyperactivity revealed strong support for a main effect of task (BF10 = 1.79 × 1018, p < .001, ω2 = .20), such that children upregulated their physical movement in response to general cognitive demands and set shifting demands specifically, but not in response to increased inhibition demands. Importantly, however, this manipulation did not disproportionally increase hyperactivity in ADHD as demonstrated by significant evidence against the task × group interaction (BF01 = 18.21, p = .48, ω2 = .002). CONCLUSIONS Inhibition demands do not cause children to upregulate their physical activity. Set shifting produces reliable increases in children's physical movement/hyperactivity over and above the effects of general cognitive demands but cannot specifically explain hyperactivity in children with ADHD.
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Affiliation(s)
| | | | - Elia F. Soto
- Florida State University, Department of Psychology
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13
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Campez M, Raiker JS, Sarver DE, Friedman LM, Orban SA, Rapport MD. Working Memory Capacity and ADHD Symptoms in Boys: Examining the Heterogeneity of Working Memory Functioning Using Latent Profile Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020; 42:450-463. [PMID: 33343079 PMCID: PMC7747754 DOI: 10.1007/s10862-019-09762-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recent studies demonstrate that working memory (WM) is integral to etiological models of ADHD; however, significant questions persist regarding the relation between WM performance across tasks with varying cognitive demands and ADHD symptoms. The current study incorporates an individual differences approach to WM heterogeneity (i.e., latent profile analysis) to (a) identify differential profiles of WM across the phonological and visuospatial WM subsystems; and (b) characterize differences in symptom presentation among WM profiles. Parent and teacher ratings of child behavior, obtained for boys with (n=51) and without (n=38) a diagnosis of ADHD, were compared across latent classes of visuospatial and phonological WM performance. Latent profile analysis identified three classes of WM functioning: Low WM, Moderate WM, and High WM. Membership in the Low and Moderate WM classes was associated with greater levels of parent- and teacher-rated inattentive and hyperactive symptoms. While 84% of the ADHD group were assigned to the Low and Moderate WM classes, more than a quarter of children without ADHD exhibited Moderate WM limitations. Collectively, these findings extend prior work suggesting that there is substantial heterogeneity in WM functioning in children with and without ADHD and that these differences contribute to the expression of symptoms of inattention and hyperactivity.
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Affiliation(s)
- Mileini Campez
- Department of Psychology, Center for Children &
Families, Florida International University, 11200 SW 8 Street AHC1 140,
Miami, FL 33199 USA
| | - Joseph S. Raiker
- Department of Psychology, Center for Children &
Families, Florida International University, 11200 SW 8 Street AHC1 140,
Miami, FL 33199 USA
| | - Dustin E. Sarver
- Department of Pediatrics, Department of Psychiatry and
Human Behavior, Center for Advancement of Youth, University of Mississippi Medical
Center, 2500 North State Street, Jackson, MS, 39216 USA
| | - Lauren M. Friedman
- Department of Psychiatry, University of California–
San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143 USA
| | - Sarah A. Orban
- Department of Psychology, University of Tampa, 401 W.
Kennedy Boulevard, Tampa, FL 33606 USA
| | - Mark D. Rapport
- Department of Psychology, University of Central Florida,
4111 Pictor Lane, Psychology Bldg 99, Orlando, FL 32816 USA
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14
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Kofler MJ, Singh LJ, Soto EF, Chan ES, Miller CE, Harmon SL, Spiegel JA. Working memory and short-term memory deficits in ADHD: A bifactor modeling approach. Neuropsychology 2020; 34:686-698. [PMID: 32437194 PMCID: PMC7483636 DOI: 10.1037/neu0000641] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) has been associated with large magnitude impairments in working memory, whereas short-term memory deficits, when detected, tend to be less pronounced. However, confidence in these findings is limited due to task impurity combined with methodological and statistical limitations of the current evidence base. Method: A well-characterized, clinically evaluated sample of 172 children ages 8-13 years (M = 10.30, SD = 1.42; 72 girls; 64% White/non-Hispanic) were administered multiple, counterbalanced working memory tests. Bifactor-(s-1) modeling was used to characterize the presence and magnitude of central executive working memory, phonological short-term memory, and visuospatial short-term memory deficits in pediatric ADHD. Results: ADHD status was associated with very large magnitude impairments in central executive working memory that are present in most pediatric cases (d = 1.63-2.03; 75%-81% impaired), and these deficits covaried with ADHD inattentive and hyperactive/impulsive symptom severity based on both parent and teacher report. There was also evidence for a unique, albeit significantly smaller, impairment in visuospatial short-term memory (d = 0.60; 38% impaired); however, visuospatial short-term memory abilities did not covary with ADHD symptom severity. There was no evidence linking ADHD with phonological short-term memory deficits across either the dimensional or categorical analyses. Conclusion: These findings provide strong evidence that ADHD is associated with marked central executive working memory deficits that covary with their behavioral symptom presentation across settings. In contrast, visuospatial short-term memory deficits, when present, are likely epiphenomenal, and the most parsimonious conclusion appears to be that phonological short-term memory is intact in pediatric ADHD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Elia F. Soto
- Florida State University, Department of Psychology
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15
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Kofler MJ, Groves NB, Singh LJ, Soto EF, Chan ES, Irwin LN, Miller CE. Rethinking hyperactivity in pediatric ADHD: Preliminary evidence for a reconceptualization of hyperactivity/impulsivity from the perspective of informant perceptual processes. Psychol Assess 2020; 32:752-767. [PMID: 32478528 PMCID: PMC7394731 DOI: 10.1037/pas0000856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hyperactivity is a core ADHD symptom that has been both positively and negatively associated with cognition and functional outcomes. The reason for these conflicting findings is unclear but may relate to subjective assessments that conflate excess physical movement (hyperactivity) with verbally intrusive/impulsive behaviors. The current study adopted a model-driven, rational-empirical approach to distinguish excess physical movement symptoms from other, auditorily perceived behaviors assessed under the "hyperactivity/impulsivity" umbrella. We then tested this alternative conceptualization's fit, reliability, replicability, convergent/divergent validity via actigraphy, and generalizability across informants (parents, teachers) in a well-characterized, clinically evaluated sample of 132 children ages 8-13 years (M = 10.34, SD = 1.51; 47 girls; 67% White/non-Hispanic). The current DSM hyperactivity/impulsivity item pool can be reliably reclassified by knowledgeable judges into items reflecting excess physical movement (visual hyperactivity) and auditory interruptions (verbal intrusion). This bifactor structure showed evidence for multidimensionality and superior model fit relative to traditional hyperactivity/impulsivity models. The resultant visual hyperactivity factor was reliable, replicable, and showed strong convergent validity evidence via associations with objectively assessed hyperactivity. The verbal intrusion factor also showed evidence for reliability and explained a substantive portion of reliable variance, but demonstrated lower estimated replicability. These findings provide preliminary support for conceptualizing ADHD symptoms from the perspective of their cognitive-perceptual impact on others, as well as differentiating excess physical movement (hyperactivity) from other behaviors assessed under the hyperactivity/impulsivity umbrella. "Verbal intrusion" appears to provide a better explanation than "impulsivity" for the reliable, non-hyperactivity variance assessed by these items, but the current item set appears insufficient for replicable measurement of this construct. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Elia F. Soto
- Florida State University, Department of Psychology
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16
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Wells EL, Groves NB, Day TN, Harmon SL, Soto EF, Miller CE, Kofler MJ. Evidence against emotion inference deficits in children with ADHD. Emotion 2020; 21:665-677. [PMID: 32191096 DOI: 10.1037/emo0000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inconsistent evidence suggests that pediatric attention deficit/hyperactivity disorder (ADHD) may be associated with impairments in the ability to use context clues to infer the emotion states of others. However, the evidence base for these impairments is comprised of data from laboratory-based tests of emotion inference that may be confounded by demands on nonaffective cognitive processes that have been linked with ADHD. The current study builds on our previous study of facial affect recognition to address this limitation and investigate a potential mechanism underlying children's ability to infer emotion state from context clues. To do so, we used a fully crossed, counterbalanced experimental design that systematically manipulated emotion inference and working memory demands in 77 carefully phenotyped children ages 8-13 (Mage = 10.46, SD = 1.54; 66% Caucasian/Non-Hispanic; 42% female) with ADHD (n = 42) and without ADHD (n = 35). Results of Bayesian mixed-model ANOVAs indicated that using context clues to infer the emotion state of others competed for neurocognitive resources with the processes involved in rehearsing/maintaining information within working memory (BF₁₀ = 1.57 × 10¹⁹, d = 0.72). Importantly, there was significant evidence against the critical Group × Condition interaction for response times (BF₀₁ = 4.93), and no significant evidence for this interaction for accuracy (BF₀₁ = 2.40). In other words, children with ADHD do not infer emotions more slowly than children without ADHD (d = 0.13), and their small magnitude impairment in accuracy (d = 0.30) was attributable to their generally less accurate performance on choice-response tasks (i.e., across both emotion and control conditions). Taken together, the evidence indicates that emotion inference abilities are likely unimpaired in pediatric ADHD and that working memory is implicated in the ability to infer emotion from context for all children-not just children with ADHD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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17
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Nejati V. Cognitive rehabilitation in children with attention deficit- hyperactivity disorder: Transferability to untrained cognitive domains and behavior. Asian J Psychiatr 2020; 49:101949. [PMID: 32114377 DOI: 10.1016/j.ajp.2020.101949] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/29/2019] [Accepted: 02/09/2020] [Indexed: 10/25/2022]
Abstract
Transferability of cognitive rehabilitation is a crucial point for efficacy. The purpose of the present study is to determine the transfer effect of cognitive rehabilitation to the untrained cognitive domains and behavior in children with attention deficit- hyperactivity disorder (ADHD). Thirty children with ADHD randomly allocated into two intervention and control groups. The intervention group received cognitive rehabilitation in 12-15 sessions. Analyses indicated that the experimental group shows an improvement in the trained domain. The result found a lack of near transfer to selective attention and inhibitory control with a successful far transfer effect to the risky decision making and delay discounting. Furthermore, the transfer occurred to behavioral symptoms of the intervention group. Attention and working memory training decrease delay discounting and delay discounting. The near transfer is not a prerequisite of far transfer. Cognitive rehabilitation can transfer horizontally to other cognitive domains at the same level and vertically to behaviors in a top-down manner.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Velenjak, PO. Box: 1983969411, Tehran, Iran.
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18
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Kejani M, Raeisi Z. The effect of drama therapy on working memory and its components in primary school children with ADHD. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-019-00564-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Wells EL, Day TN, Harmon SL, Groves NB, Kofler MJ. Are emotion recognition abilities intact in pediatric ADHD? Emotion 2019; 19:1192-1205. [PMID: 30475028 PMCID: PMC6535378 DOI: 10.1037/emo0000520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Extant studies suggest that children with attention-deficit/hyperactivity disorder (ADHD) may make more errors and respond more slowly on tasks that require them to identify emotions based on facial affect. It is unclear, however, whether these findings reflect a unique deficit in emotion recognition, or more general difficulty with choice-response tasks (i.e., tasks that require participants to select among a set of competing options). In addition, ADHD is associated with executive dysfunction, but there is inconsistent evidence regarding the extent to which top-down cognitive control is involved in emotion recognition. The current study used a series of four counterbalanced tasks to systematically manipulate emotional content and working memory demands to determine (a) whether children with ADHD exhibit a unique facial affect recognition deficit and (b) the extent to which facial affect recognition is an automatic versus controlled process that depends in part on working memory. Bayesian results from a carefully phenotyped sample of 64 children ages 8 to 13 (M = 10.42, SD = 1.56; 26 girls; 67% Caucasian/non-Hispanic) with ADHD (n = 35) and without ADHD (n = 29) indicated that working memory is involved in children's ability to efficiently infer emotional state from facial affect (BF₁₀= 4.59 × 10¹⁴). Importantly, there was significant evidence against deficits in emotion recognition for children with ADHD. The ADHD/non-ADHD groups were statistically equivalent in terms of recognition accuracy (BF₀₁ = 1.32 × 10⁵⁴, d = -0.18), and the ADHD group's slower recognition speed was parsimoniously explained by difficulty with choice-response tasks rather than unique to emotional stimuli (BF₁₀ = 3.23, d = 0.31). These findings suggest that emotion recognition abilities are intact in children with ADHD, and highlight the need to control for impaired bottom-up (choice-response) and top-down abilities (working memory) when investigating emotional functioning in ADHD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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20
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Bausela-Herreras E. BRIEF-P: analysis of executive functions according to informant / BRIEF-P: análisis de las funciones ejecutivas en función del informante. STUDIES IN PSYCHOLOGY 2018. [DOI: 10.1080/02109395.2018.1507096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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21
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Tarle SJ, Alderson RM, Patros CHG, Arrington EF, Roberts DK. Working memory and behavioral inhibition in children with attention-deficit/hyperactivity disorder (ADHD): an examination of varied central executive demands, construct overlap, and task impurity. Child Neuropsychol 2018; 25:664-687. [DOI: 10.1080/09297049.2018.1519068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Stephanie J. Tarle
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - R. Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | | | - Delanie K. Roberts
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
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22
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Hirjak D, Meyer-Lindenberg A, Fritze S, Sambataro F, Kubera KM, Wolf RC. Motor dysfunction as research domain across bipolar, obsessive-compulsive and neurodevelopmental disorders. Neurosci Biobehav Rev 2018; 95:315-335. [PMID: 30236781 DOI: 10.1016/j.neubiorev.2018.09.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/08/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
Although genuine motor abnormalities (GMA) are frequently found in schizophrenia, they are also considered as an intrinsic feature of bipolar, obsessive-compulsive, and neurodevelopmental disorders with early onset such as autism, ADHD, and Tourette syndrome. Such transnosological observations strongly suggest a common neural pathophysiology. This systematic review highlights the evidence on GMA and their neuroanatomical substrates in bipolar, obsessive-compulsive, and neurodevelopmental disorders. The data lends support for a common pattern contributing to GMA expression in these diseases that seems to be related to cerebello-thalamo-cortical, fronto-parietal, and cortico-subcortical motor circuit dysfunction. The identified studies provide first evidence for a motor network dysfunction as a correlate of early neurodevelopmental deviance prior to clinical symptom expression. There are also first hints for a developmental risk factor model of these mental disorders. An in-depth analysis of motor networks and related patho-(physiological) mechanisms will not only help promoting Research Domain Criteria (RDoC) Motor System construct, but also facilitate the development of novel psychopharmacological models, as well as the identification of neurobiologically plausible target sites for non-invasive brain stimulation.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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23
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Kofler MJ, Spiegel JA, Austin KE, Irwin LN, Soto EF, Sarver DE. Are Episodic Buffer Processes Intact in ADHD? Experimental Evidence and Linkage with Hyperactive Behavior. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:1171-1185. [PMID: 28952051 PMCID: PMC5871530 DOI: 10.1007/s10802-017-0346-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Working memory deficits are present in a substantial proportion of children with ADHD, and converging evidence links these deficits with ADHD-related behavioral and functional impairments. At the same time, working memory is not a unitary construct, and evidence is lacking regarding the role of several components of this system in ADHD. Preclinical behavioral studies are needed to fractionate the multicomponent working memory system, determine which specific subcomponent(s) are impaired in ADHD, and more importantly link these subcomponent(s) with specific ADHD-related behavioral symptoms/functional impairments. The current study reflects one piece of that puzzle, and focuses on the episodic buffer component of working memory. Across multiple testing days, a well-characterized sample of 86 children ages 8-13 (M=10.52, SD=1.54; 34 girls; 64% Caucasian/Non-Hispanic) with ADHD (n=49) and without ADHD (n=37) completed three counterbalanced working memory tests that were identical in all aspects except the key subcomponent process (phonological, visuospatial, episodic buffer). Gross motor movement during these and control tasks were measured using 4 high-precision actigraphs. There was no evidence of group differences in gender, age, SES, or IQ. Bayesian mixed-model ANOVAs indicated that the ADHD group performed significantly worse on all three working memory tests (d=1.17-1.44) and was significantly more hyperactive than controls (d=0.66-1.05) during the visuospatial and episodic buffer tests. In contrast, the ADHD and Non-ADHD groups were equivalent with regard to effects of episodic buffer demands on performance and hyperactive behavior. The most parsimonious conclusion is that the episodic buffer is likely intact in ADHD, and unrelated to ADHD hyperactivity symptoms.
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Affiliation(s)
- Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Jamie A Spiegel
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Kristin E Austin
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Lauren N Irwin
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Elia F Soto
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Dustin E Sarver
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, USA
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24
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Hyun GJ, Park JW, Kim JH, Min KJ, Lee YS, Kim SM, Han DH. Visuospatial working memory assessment using a digital tablet in adolescents with attention deficit hyperactivity disorder. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 157:137-143. [PMID: 29477422 DOI: 10.1016/j.cmpb.2018.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/13/2018] [Accepted: 01/24/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder hypothesized to involve impaired visuospatial working memory (VSWM). However, there are few studies utilizing neuropsychological tests to measure VSWM in ADHD adolescents. The Rey-Osterrieth complex figure test (ROCF) is commonly used as a neuropsychological test to assess visuospatial working memory for individuals with ADHD. We assessed working memory using the ROCF test on a digital Galaxy tablet with the technically new Gaussian filter method. METHODS Thirty adolescents with ADHD and 30 healthy control adolescents were recruited for participation in the current study. All adolescents were assessed with K-WISC-IV, Children's depression inventory, and the Korean ADHD rating scale. All adolescents were asked to copy the ROCF from paper onto a Galaxy tablet screen using a wireless pen. RESULTS There was a significant difference in representative value of the deviation of the original images from template images (R-value) in copy and delayed recall between ADHD adolescents and healthy adolescents. There was no significant difference in R-value of immediate recall between ADHD adolescents and healthy adolescents. In all adolescents (ADHD and healthy) and ADHD adolescents, the R-value of copy was negatively correlated with visuospatial index and working memory index, and the R-value of delayed recall was negatively correlated with WMI. The R-value of copy and delayed recall was positively correlated with K-ARS in all adolescents and ADHD adolescents. CONCLUSIONS ADHD adolescents showed differences in the R-values of copy and delayed recall in the digital ROCF version compared to healthy adolescents. The digital ROCF assessment tool can represent different patterns of visuospatial working memory abilities in ADHD adolescents compared to healthy adolescents.
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Affiliation(s)
- Gi Jung Hyun
- Department of Psychiatry, Chung Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea.
| | - Jin Wan Park
- School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
| | - Jin Hee Kim
- School of Advanced Imaging Science, Multimedia, and Film at Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
| | - Kyoung Joon Min
- Department of Psychiatry, Chung Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Young Sik Lee
- Department of Psychiatry, Chung Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea.
| | - Sun Mi Kim
- Department of Psychiatry, Chung Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Republic of Korea.
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25
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Cao P, Xing J, Cao Y, Cheng Q, Sun X, Kang Q, Dai L, Zhou X, Song Z. Clinical effects of repetitive transcranial magnetic stimulation combined with atomoxetine in the treatment of attention-deficit hyperactivity disorder. Neuropsychiatr Dis Treat 2018; 14:3231-3240. [PMID: 30538481 PMCID: PMC6263241 DOI: 10.2147/ndt.s182527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with atomoxetine (ATX) in the treatment of attention-deficit hyperactivity disorder (ADHD). METHODS Sixty-four patients with newly diagnosed ADHD were enrolled from January 2016 to October 2017 from Psychological Centre for Adolescents and Children at 102th Hospital of People's Liberation Army of China. These patients were randomly assigned to three groups according to treatment method: the rTMS group, the ATX group, and the rTMS+ ATX group. Before treatment and 6 weeks after treatment, clinical symptoms and executive functions of ADHD patients were evaluated with the Swanson, Nolan, and Pelham, Version IV (SNAP-IV) Questionnaire, continuous performance test, three subtests (arithmetic, digit span, and coding) of Wechsler Intelligence Scale for Children, as well as Iowa Gambling Tasks (IGT). The effects of treatment were compared among three groups. RESULTS After 6 weeks of treatment, the scores of all factors in the SNAP-IV questionnaire were lower than those before treatment in the three groups; the scores of three subtests of Wechsler Intelligence Scale for Children, continuous performance test, and IGT were also significantly higher than those before treatment. The rTMS+ ATX group had a better improvement in attention deficits and hyperactivity impulse on the SNAP-IV questionnaire compared with the other groups, and also had a higher efficacy on cold and hot executive functions such as arithmetic, forward numbers, coding, and IGT. In addition, the ATX group performed better than the rTMS group in coding and IGT. CONCLUSION rTMS, ATX, and the combination therapy are effective in improving core symptoms and executive function in patients with ADHD. The combined treatment has significant therapeutic advantages over the single treatment groups. Compared with rTMS, the drug therapy has a better improvement in coding and IGT.
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Affiliation(s)
- Pengfei Cao
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China, .,Department of Political Affairs, College of Politics, National Defense University of People's Liberation Army of China, Beijing, China
| | - Jun Xing
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Yin Cao
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Qi Cheng
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xiaojing Sun
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Qi Kang
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Libin Dai
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
| | - Xianju Zhou
- Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China,
| | - Zixiang Song
- Psychological Centre for Adolescents and Children, The Affiliated 102 Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China,
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