1
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Zhang R, Blair RJR, Blair KS, Dobbertin M, Elowsky J, Bashford-Largo J, Dominguez AJ, Hatch M, Bajaj S. Reduced grey matter volume in adolescents with conduct disorder: a region-of-interest analysis using multivariate generalized linear modeling. DISCOVER MENTAL HEALTH 2023; 3:25. [PMID: 37975932 PMCID: PMC10656392 DOI: 10.1007/s44192-023-00052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV). METHODS The whole-brain structural MRI data were collected from 96 adolescents with CD (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 63 males) and 90 TD individuals (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate. RESULTS A diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460-10.317, p < 0.05, partial eta squared = 0.029-0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD-MTD = [- 614.898] mm3-[- 53.461] mm3). CONCLUSIONS Altered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.
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Affiliation(s)
- Ru Zhang
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Matthew Dobbertin
- Inpatient Psychiatric Care Unit, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jaimie Elowsky
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Ahria J Dominguez
- Clinical Health, Emotion, and Neuroscience (CHEN) Laboratory, Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Melissa Hatch
- Mind and Brain Health Labs (MBHL), Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Sahil Bajaj
- Department of Cancer Systems Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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2
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Nirouei M, Kouchekali M, Sadri H, Qorbani M, Montazerlotfelahi H, Eslami N, Tavakol M. Evaluation of the frequency of attention deficit hyperactivity disorder in patients with asthma. Clin Mol Allergy 2023; 21:4. [PMID: 37370089 DOI: 10.1186/s12948-023-00185-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Asthma is the most prevalent respiratory disease caused by chronic airway inflammation. Attention Deficit Hyperactivity Disorder (ADHD) is children's most common psychological and neurodevelopmental disorder. Increased risk for ADHD in patients with inflammatory and autoimmune diseases supports the role of inflammatory mechanisms in the occurrence of ADHD. However, the association between asthma and ADHD remains unclear. OBJECTIVE This study was designed to evaluate the prevalence of ADHD in patients with asthma who were referred to the clinic of allergy and clinical immunology. METHODS This cross-sectional study was conducted on children aged 6 to 18 with asthma at Imam Ali hospital, Karaj, Iran. The patient's demographic data, history of childbirth delivery type, premature birth, hospital admission, family income, birth rate, and family history information related to the patient's asthma and medicines were recorded. ADHD diagnosis was made using the Persian version of Conners Parent Behavioral Problems Rating Scale (CPRS-26). RESULTS In this study, 677 asthmatic patients were enrolled; 46 patients (6.8%) had ADHD. The probability of ADHD in asthmatic patients inhabited in a rural area, males, and patients with a history of food allergy, allergic rhinitis, urticaria, and eczema was significantly higher (p < 0.05). In addition, our result demonstrated that the likelihood of ADHD in patients with asthma and a history of PICU admission was significantly higher (p < 0.05). CONCLUSIONS The present study showed that severe asthma, was the risk factor for ADHD in patients with asthma. Physicians should be aware of this co-morbidity to refer asthmatic patients who have the symptoms of ADHD to a psychologist.
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Affiliation(s)
| | | | - Homa Sadri
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hadi Montazerlotfelahi
- Department of Pediatric Neurology, Imam Ali Hospital, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Narges Eslami
- Department of Allergy and Clinical Immunology, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Tavakol
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
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3
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Chen Y, Lei D, Cao H, Niu R, Chen F, Chen L, Zhou J, Hu X, Huang X, Guo L, Sweeney JA, Gong Q. Altered single-subject gray matter structural networks in drug-naïve attention deficit hyperactivity disorder children. Hum Brain Mapp 2021; 43:1256-1264. [PMID: 34797010 PMCID: PMC8837581 DOI: 10.1002/hbm.25718] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/09/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
Altered topological organization of brain structural covariance networks has been observed in attention deficit hyperactivity disorder (ADHD). However, results have been inconsistent, potentially related to confounding medication effects. In addition, since structural networks are traditionally constructed at the group level, variabilities in individual structural features remain to be well characterized. Structural brain imaging with MRI was performed on 84 drug‐naïve children with ADHD and 83 age‐matched healthy controls. Single‐subject gray matter (GM) networks were obtained based on areal similarities of GM, and network topological properties were analyzed using graph theory. Group differences in each topological metric were compared using nonparametric permutation testing. Compared with healthy subjects, GM networks in ADHD patients demonstrated significantly altered topological characteristics, including higher global and local efficiency and clustering coefficient, and shorter path length. In addition, ADHD patients exhibited abnormal centrality in corticostriatal circuitry including the superior frontal gyrus, orbitofrontal gyrus, medial superior frontal gyrus, precentral gyrus, middle temporal gyrus, and pallidum (all p < .05, false discovery rate [FDR] corrected). Altered global and nodal topological efficiencies were associated with the severity of hyperactivity symptoms and the performance on the Stroop and Wisconsin Card Sorting Test tests (all p < .05, FDR corrected). ADHD combined and inattention subtypes were differentiated by nodal attributes of amygdala (p < .05, FDR corrected). Alterations in GM network topologies were observed in drug‐naïve ADHD patients, in particular in frontostriatal loops and amygdala. These alterations may contribute to impaired cognitive functioning and impulsive behavior in ADHD.
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Affiliation(s)
- Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA
| | - Hengyi Cao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York, USA.,Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Running Niu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Fuqin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jinbo Zhou
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lanting Guo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
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4
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Different effects of the DRD4 genotype on intrinsic brain network connectivity strength in drug-naïve children with ADHD and healthy controls. Brain Imaging Behav 2021; 16:464-475. [PMID: 34406637 PMCID: PMC8825637 DOI: 10.1007/s11682-021-00521-9] [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] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
The dopamine D4 receptor gene (DRD4) has been consistently reported to be associated with attention-deficit/hyperactivity disorder (ADHD). Recent studies have linked DRD4 to functional connectivity among specific brain regions. The current study aimed to compare the effects of the DRD4 genotype on functional integrity in drug-naïve ADHD children and healthy children. Resting-state functional MRI images were acquired from 49 children with ADHD and 37 healthy controls (HCs). We investigated the effects of the 2-repeat allele of DRD4 on brain network connectivity in both groups using a parameter called the degree of centrality (DC), which indexes local functional relationships across the entire brain connectome. A voxel-wise two-way ANCOVA was performed to examine the diagnosis-by-genotype interactions on DC maps. Significant diagnosis-by-genotype interactions with DC were found in the temporal lobe, including the left inferior temporal gyrus (ITG) and bilateral middle temporal gyrus (MTG) (GRF corrected at voxel level p < 0.001 and cluster level p < 0.05, two-tailed). With the further subdivision of the DC network according to anatomical distance, additional brain regions with significant interactions were found in the long-range DC network, including the left superior parietal gyrus (SPG) and right middle frontal gyrus (MFG). The post-hoc pairwise analysis found that altered network centrality related to DRD4 differed according to diagnostic status (p < 0.05). This genetic imaging study suggests that the DRD4 genotype regulates the functional integration of brain networks in children with ADHD and HCs differently. This may have important implications for our understanding of the role of DRD4 in altering functional connectivity in ADHD subjects.
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5
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Lin H, Lin Q, Li H, Wang M, Chen H, Liang Y, Bu X, Wang W, Yi Y, Zhao Y, Zhang X, Xie Y, Du S, Yang C, Huang X. Functional Connectivity of Attention-Related Networks in Drug-Naïve Children With ADHD. J Atten Disord 2021; 25:377-388. [PMID: 30259777 DOI: 10.1177/1087054718802017] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: This study aimed to explore alterations of seed-based functional connectivity (FC) in dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN) in ADHD children. Method: A voxel-based comparison of FC maps between 46 drug-naïve children with ADHD and 31 healthy controls (HCs) and correlation analysis between connectivity features and behavior were performed. Results: Compared with the HCs, children with ADHD were characterized by hyperconnectivity between DAN and regions of DMN and by hyperconnectivity between DMN and a set of regions involved in somatosensory, visual, and auditory cortices. No significant group different FC was found between VAN and the whole brain. Higher FC between DMN and somatosensory, visual, and auditory cortex was associated with better performance in attention and executive function. Conclusion: The dysregulation of networks in children with ADHD not only involves the DAN and DMN but also the somatosensory, motor, visual, and auditory networks.
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Affiliation(s)
- Haixi Lin
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Qingxia Lin
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Hailong Li
- West China Hospital of Sichuan University, Chengdu, China
| | - Meihao Wang
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Hong Chen
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Yan Liang
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Xuan Bu
- West China Hospital of Sichuan University, Chengdu, China
| | - Weiqian Wang
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Yanhong Yi
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Yongzhong Zhao
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Xiaoyan Zhang
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Yupeng Xie
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Songmei Du
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Chuang Yang
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Xiaoqi Huang
- West China Hospital of Sichuan University, Chengdu, China
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6
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Zhang R, Bashford-Largo J, Lukoff J, Elowsky J, Carollo E, Schwartz A, Dobbertin M, Bajaj S, Blair KS, Leibenluft E, Blair RJR. Callous-Unemotional Traits Moderate the Relationship Between Irritability and Threatening Responding. Front Psychiatry 2021; 12:617052. [PMID: 34867494 PMCID: PMC8635046 DOI: 10.3389/fpsyt.2021.617052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Irritability and callous-unemotional (CU; reduced guilt/empathy) traits vary dimensionally in the typically developing population but may be particularly marked in youth with conduct disorder (CD). While these dimensional traits are positively correlated, they have been associated with divergent forms of dysfunction, particularly with respect to threat processing (i.e., irritability with increased, and CU traits with decreased, threat responsiveness). This suggests that interactions between these two dimensions may be complex at the neurobiological level. However, this issue has received minimal empirical attention. Methods: The study included 105 adolescents (typically developing and cases with CD; N = 59). They were scanned with fMRI during a looming threat task that involved images of threatening and neutral human faces or animals that appeared to be either looming or receding. Results: Significant irritability-by-CU traits-by-Direction-by-Emotion interactions were seen within right thalamus/PAG, left lingual gyrus and right fusiform gyrus; irritability was positively associated with the BOLD response for Looming Threatening vs. Receding Threatening trials, particularly for youth with low CU traits. In contrast, CU traits were negatively associated with the same differential BOLD response but particularly for youth showing higher levels of irritability. Similar findings were seen within left ventral anterior and posterior cingulate cortices, though the addition of the interaction with CU traits was only seen at slightly more lenient thresholds. Conclusions: The results support previous work linking irritability to increased, and CU traits to reduced, threat responsiveness. However, for adolescents with high irritability, if CU traits are also high, the underlying neuropathology appears to relate to reduced, rather than increased, threat responsiveness.
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Affiliation(s)
- Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Erin Carollo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Ellen Leibenluft
- Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - R James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
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7
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Yasumura A, Omori M, Fukuda A, Takahashi J, Yasumura Y, Nakagawa E, Koike T, Yamashita Y, Miyajima T, Koeda T, Aihara M, Tachimori H, Inagaki M. Applied Machine Learning Method to Predict Children With ADHD Using Prefrontal Cortex Activity: A Multicenter Study in Japan. J Atten Disord 2020; 24:2012-2020. [PMID: 29154696 DOI: 10.1177/1087054717740632] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To establish valid, objective biomarkers for ADHD using machine learning. Method: Machine learning was used to predict disorder severity from new brain function data, using a support vector machine (SVM). A multicenter approach was used to collect data for machine learning training, including behavioral and physiological indicators, age, and reverse Stroop task (RST) data from 108 children with ADHD and 108 typically developing (TD) children. Near-infrared spectroscopy (NIRS) was used to quantify change in prefrontal cortex oxygenated hemoglobin during RST. Verification data were from 62 children with ADHD and 37 TD children from six facilities in Japan. Results: The SVM general performance results showed sensitivity of 88.71%, specificity of 83.78%, and an overall discrimination rate of 86.25%. Conclusion: A SVM using an objective index from RST may be useful as an auxiliary biomarker for diagnosis for children with ADHD.
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Affiliation(s)
- Akira Yasumura
- National Center of Neurology and Psychiatry, Kodaira, Japan.,The University of Tokyo Hospital, Bunkyo, Japan
| | - Mikimasa Omori
- National Center of Neurology and Psychiatry, Kodaira, Japan.,Showa Women's University, Setagaya, Japan
| | - Ayako Fukuda
- National Center of Neurology and Psychiatry, Kodaira, Japan
| | | | | | | | | | | | | | - Tatsuya Koeda
- Tottori University, Tottori, Japan.,National Center for Child Health and Development, Setagaya, Japan
| | | | | | - Masumi Inagaki
- National Center of Neurology and Psychiatry, Kodaira, Japan
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8
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Bhat V, Sengupta SM, Grizenko N, Joober R. Therapeutic response in children with ADHD: role of observers and settings. World J Pediatr 2020; 16:314-321. [PMID: 31965445 DOI: 10.1007/s12519-019-00332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 12/27/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study aims at characterizing the extent of correlation of treatment response (TR) obtained in various observation settings (home, school, clinic) by different observers (parents, teachers, clinicians). METHODS Children with attention deficit hyperactivity disorder (ADHD) underwent a 2-week double-blind, randomized, cross-over clinical trial with methylphenidate and placebo, and various measures were obtained during the 2 weeks. Interrelationships of TR were examined using Pearson's correlation coefficients. RESULTS The study included 526 children (420 male, 106 female) with ADHD. TR between different observers shows a variable correlation between parents and teachers. No correlation is seen between parents/teacher evaluation of TR and laboratory-based measures (Continuous Performance Task; Restricted Academic Situation Scale). CONCLUSION The results firmly support the need to synthesize information from many sources in evaluating TR in ADHD.
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Affiliation(s)
- Venkat Bhat
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Sarojini M Sengupta
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Natalie Grizenko
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, FBC Building, 6875 Boul. LaSalle, Verdun, QC, H4H 1R3, Canada. .,Department of Psychiatry, McGill University, Montreal, Canada. .,Department of Neurology and Neurosurgery, McGill University, Montreal, Canada. .,Department of Human Genetics, McGill University, Montreal, Canada.
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9
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Kakuszi B, Szuromi B, Bitter I, Czobor P. Attention deficit hyperactivity disorder: Last in, first out - delayed brain maturation with an accelerated decline? Eur Neuropsychopharmacol 2020; 34:65-75. [PMID: 32279924 DOI: 10.1016/j.euroneuro.2020.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 11/25/2022]
Abstract
While early neurodevelopmental processes during the emergence of ADHD in childhood received considerable attention, the neurobiological mechanisms that underlie the changes in ADHD in adulthood remain largely unaddressed. We wanted to delineate neurodevelopmental changes in adult ADHD using an electrophysiological measure, the fronto-central NoGo P3 event-related potential (ERP), which is an important neurophysiological index of brain functioning in ADHD, and biomarker for response inhibition and aging. ERPs were obtained from 45 ADHD and 41 healthy subjects using a 128-channel BioSemi recording-system, applying emotionally-valenced and neutral stimuli in a response inhibition task. Our results indicated that ADHD subjects manifested delayed developmental P3-trajectory in young-adulthood as compared to controls; they also showed P3 reduction across all emotional valences, and the reduction was most pronounced at younger ages. The differences in P3 diminished by mid-adulthood, and started to increase again at more advanced ages. Thus, similar to structural-MRI indices, developmental brain differences in the fronto-central NoGo P3 in ADHD largely normalize in young-adulthood. However, a reduction of P3 occurs again starting from mid-adulthood. As the fronto-central NoGo P3 reflects the functioning of the frontal areas (which show delayed maturation in ADHD), our findings are consistent with the ''last in, first out'' hypothesis, which refers to a mirroring pattern of brain development and aging, and posits that brain regions that develop relatively late degenerate relatively early with age. Thus, ADHD may not only be associated with delayed neurodevelopment, but also with a premature age-related deterioration, at least in some measures of electrophysiological functioning.
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Affiliation(s)
- Brigitta Kakuszi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Balassa u. 6., Budapest 1083, Hungary
| | - Bálint Szuromi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Balassa u. 6., Budapest 1083, Hungary
| | - István Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Balassa u. 6., Budapest 1083, Hungary
| | - Pál Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Balassa u. 6., Budapest 1083, Hungary.
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10
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Ben-Sheetrit J, Peskin M, Newcorn JH, Daniely Y, Shbiro L, Rotem A, Weizman A, Manor I. Characterizing the Placebo Response in Adults With ADHD. J Atten Disord 2020; 24:425-433. [PMID: 29926752 DOI: 10.1177/1087054718780328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: Several ADHD pharmacological trials reported high placebo response (PR) rates. This study aims to characterize the PR in adult ADHD. Method: A retrospective cohort analysis of the placebo arm (140 adults with ADHD, 18-55 yrs, M:F 46.4%-53.6%) of a 6-week randomized, multicenter, double-blind metadoxine study, using Conners' Adult ADHD Rating Scale (CAARS) and the Adult ADHD Self-Report Scale (ASRS), was conducted. Results: Pre-post changes in placebo-treated adults were significant for both the CAARS and ASRS, F(2.9, 404.5) = 61.2, p < .00001, F(2.8, 383.0) = 43.1, p < .00001, respectively. Less than half of the participants had a PR which began early in treatment and persisted; almost 50% had a variable, inconsistent PR. Conclusion: In the current sample, PR in adult ADHD was prominent on both symptom scales and the investigator-rater instrument. Therefore, using investigator ratings as a primary endpoint does not necessarily attenuate PR. Of note, about half of the PR is variable, suggesting unreliable determination of efficacy.
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Affiliation(s)
| | - Miriam Peskin
- Geha Mental Health Center, Petah Tikva, Israel.,Tel-Aviv University, Israel
| | | | | | - Liat Shbiro
- Geha Mental Health Center, Petah Tikva, Israel
| | - Ann Rotem
- Geha Mental Health Center, Petah Tikva, Israel
| | - Abraham Weizman
- Geha Mental Health Center, Petah Tikva, Israel.,Tel-Aviv University, Israel
| | - Iris Manor
- Geha Mental Health Center, Petah Tikva, Israel.,Tel-Aviv University, Israel
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11
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Children’s Color Trail Test for Objective Assessment of Attention in Children with Attention Deficit Hyperactivity Disorder: A Diagnostic Accuracy Study. Indian Pediatr 2019. [DOI: 10.1007/s13312-019-1684-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Chen Y, Huang X, Wu M, Li K, Hu X, Jiang P, Chen L, He N, Dai J, Wang S, He M, Guo L, Sweeney JA, Gong Q. Disrupted brain functional networks in drug-naïve children with attention deficit hyperactivity disorder assessed using graph theory analysis. Hum Brain Mapp 2019; 40:4877-4887. [PMID: 31361385 DOI: 10.1002/hbm.24743] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 02/05/2023] Open
Abstract
Neuroimaging studies have revealed functional brain network abnormalities in attention deficit hyperactivity disorder (ADHD), but the results have been inconsistent, potentially related to confounding medication effects. Furthermore, specific topological alterations in functional networks and their role in behavioral inhibition dysfunction remain to be established. Resting-state functional magnetic resonance imaging was performed on 51 drug-naïve children with ADHD and 55 age-matched healthy controls. Brain functional networks were constructed by thresholding the partial correlation matrices of 90 brain regions, and graph theory was used to analyze network topological properties. The Stroop test was used to assess cognitive inhibitory abilities. Nonparametric permutation tests were used to compare the topological architectures in the two groups. Compared with healthy subjects, brain networks in ADHD patients demonstrated altered topological characteristics, including lower global (FDR q = 0.01) and local efficiency (p = 0.032, uncorrected) and a longer path length (FDR q = 0.01). Lower nodal efficiencies were found in the left inferior frontal gyrus and anterior cingulate cortex in the ADHD group (FDR both q < 0.05). Altered global and nodal topological efficiencies were associated with the severity of inhibitory cognitive control deficits and hyperactivity symptoms in ADHD (p <0 .05). Alterations in network topologies in drug-naïve ADHD patients indicate weaker small-worldization with decreased segregation and integration of functional brain networks. Deficits in the cingulo-fronto-parietal attention network were associated with inhibitory control deficits.
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Affiliation(s)
- Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Kaiming Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ning He
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Dai
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Manxi He
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Lanting Guo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China
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13
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Quintero J, Morales I, Vera R, Zuluaga P, Fernández A. The Impact of Adult ADHD in the Quality of Life Profile. J Atten Disord 2019; 23:1007-1016. [PMID: 28974134 DOI: 10.1177/1087054717733046] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In this multicenter, cross-sectional study, we aimed to investigate the quality of life (QoL) and the neuropsychological and clinical characteristics of adults with ADHD with different developmental pathways. METHOD Our study sample included 25 control (healthy) participants, 31 patients with newly diagnosed ADHD without comorbidities (ADHD-C-D), 31 with newly diagnosed ADHD with comorbidities (ADHD+C-D), and 29 with previously diagnosed ADHD with comorbidities (ADHD+C+D). RESULTS Compared with controls, ADHDs had little differences in the attentional performance but showed higher impulsivity, more severe symptoms of depression and anxiety, and lower QoL. The ADHD+C-D group showed more severe symptoms of depression and anxiety than the ADHD+C+D group ( p = .037 and p = .008, respectively), and poorer QoL in the psychological health sphere ( p = .003). CONCLUSION Differences between ADHD and control subjects were particularly remarkable in mood symptoms and QoL. Previous diagnosis might have a positive impact on mood symptoms and QoL in ADHD adults.
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Affiliation(s)
- Javier Quintero
- 1 Hospital Universitario Infanta Leonor, Madrid, Spain.,2 Complutense University of Madrid, Spain
| | | | - Rosa Vera
- 2 Complutense University of Madrid, Spain
| | | | - Alberto Fernández
- 2 Complutense University of Madrid, Spain.,4 Technical University of Madrid, Spain
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14
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Fuermaier ABM, Groen Y, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O. Everyday Life Attention Scale (ELAS): Normative data of n = 1,874 Dutch participants. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:140-147. [PMID: 31075993 DOI: 10.1080/23279095.2019.1605994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Everyday Life Attention Scale (ELAS) is a sensitive and reliable self-report questionnaire assessing attentional capacities of respondents in nine different situations of daily life. The ELAS has the potential to add relevant information to the clinical evaluation of attention deficits, to guide treatment planning, as well as to evaluate treatment outcome. The present study provides normative data of 1,874 Dutch speaking participants, ranging from 18 to 76 years of age, with mixed levels of education and a roughly equal distribution in gender. Normative data are calculated based on multiple linear regression models for each of the nine ELAS situations. In this article, the ELAS questionnaire as well as norm data are offered free of use. Use of normative ELAS data as presented in this study enables its use in clinical practice and research. Potential applications of the ELAS and future directions are discussed.
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Affiliation(s)
- Anselm B M Fuermaier
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Yvonne Groen
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.,Experimental Psychopathology and Neurophysiology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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15
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Arias-Vásquez A, Groffen AJ, Spijker S, Ouwens KG, Klein M, Vojinovic D, Galesloot TE, Bralten J, Hottenga JJ, van der Most PJ, Kattenberg VM, Pool R, Nolte IM, Penninx BWJH, Fedko IO, Dolan CV, Nivard MG, den Braber A, van Duijn CM, Hoekstra PJ, Buitelaar JK, Kiemeney LA, Hoogman M, Middeldorp CM, Draisma HHM, Vermeulen SH, Sánchez-Mora C, Ramos-Quiroga JA, Ribasés M, Hartman CA, Kooij JJS, Amin N, Smit AB, Franke B, Boomsma DI. A Potential Role for the STXBP5-AS1 Gene in Adult ADHD Symptoms. Behav Genet 2019; 49:270-285. [PMID: 30659475 DOI: 10.1007/s10519-018-09947-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 12/26/2018] [Indexed: 12/15/2022]
Abstract
We aimed to detect Attention-deficit/hyperactivity (ADHD) risk-conferring genes in adults. In children, ADHD is characterized by age-inappropriate levels of inattention and/or hyperactivity-impulsivity and may persists into adulthood. Childhood and adulthood ADHD are heritable, and are thought to represent the clinical extreme of a continuous distribution of ADHD symptoms in the general population. We aimed to leverage the power of studies of quantitative ADHD symptoms in adults who were genotyped. Within the SAGA (Study of ADHD trait genetics in adults) consortium, we estimated the single nucleotide polymorphism (SNP)-based heritability of quantitative self-reported ADHD symptoms and carried out a genome-wide association meta-analysis in nine adult population-based and case-only cohorts of adults. A total of n = 14,689 individuals were included. In two of the SAGA cohorts we found a significant SNP-based heritability for self-rated ADHD symptom scores of respectively 15% (n = 3656) and 30% (n = 1841). The top hit of the genome-wide meta-analysis (SNP rs12661753; p-value = 3.02 × 10-7) was present in the long non-coding RNA gene STXBP5-AS1. This association was also observed in a meta-analysis of childhood ADHD symptom scores in eight population-based pediatric cohorts from the Early Genetics and Lifecourse Epidemiology (EAGLE) ADHD consortium (n = 14,776). Genome-wide meta-analysis of the SAGA and EAGLE data (n = 29,465) increased the strength of the association with the SNP rs12661753. In human HEK293 cells, expression of STXBP5-AS1 enhanced the expression of a reporter construct of STXBP5, a gene known to be involved in "SNAP" (Soluble NSF attachment protein) Receptor" (SNARE) complex formation. In mouse strains featuring different levels of impulsivity, transcript levels in the prefrontal cortex of the mouse ortholog Gm28905 strongly correlated negatively with motor impulsivity as measured in the five choice serial reaction time task (r2 = - 0.61; p = 0.004). Our results are consistent with an effect of the STXBP5-AS1 gene on ADHD symptom scores distribution and point to a possible biological mechanism, other than antisense RNA inhibition, involved in ADHD-related impulsivity levels.
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Affiliation(s)
- A Arias-Vásquez
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands. .,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - A J Groffen
- Department of Functional Genomics and Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam and VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - S Spijker
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - K G Ouwens
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - M Klein
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - D Vojinovic
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T E Galesloot
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J Bralten
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - J J Hottenga
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - P J van der Most
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - V M Kattenberg
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - R Pool
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - I M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - I O Fedko
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - C V Dolan
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - M G Nivard
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
| | - A den Braber
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - C M van Duijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Karakter, Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - C M Middeldorp
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Child Health Research Centre, University of Queensland, Brisbane, Australia.,Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Australia
| | - H H M Draisma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - S H Vermeulen
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C Sánchez-Mora
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - J A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Ribasés
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | | | - C A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J J S Kooij
- Psycho-Medical Programs, PsyQ, Program Adult ADHD, The Hague, The Netherlands
| | - N Amin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A B Smit
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - B Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Route 855, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - D I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health, Amsterdam, The Netherlands
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16
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Begnini GJ, Brancher JA, Guimarães AT, de Araujo MR, Pizzatto E. Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder. Int J Clin Pediatr Dent 2019; 12:543-547. [PMID: 32440072 PMCID: PMC7229396 DOI: 10.5005/jp-journals-10005-1691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of the study was to evaluate the oral health conditions of children and adolescents with attention deficit hyperactivity disorder (ADHD). Materials and methods Two groups were selected: a test group comprising 51 individuals with ADHD and a control group with 50 individuals without ADHD, with ages ranging from 7 to 14 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT index), the visible plaque index (VPI), the gingival bleeding index (GBI), bruxism, and dental traumatism were verified. A questionnaire confirmed oral hygiene supervision. Results In the test group, the average DMFT index was 3.41 while it was 2.52 in the control group (p = 0.405). The VPI in the test and control groups was 36.84% and 24.54%, respectively (p = 0.004). The GBI was 8.37% for the test group and 4.94% for the control group (p = 0.012). The DMFT index when supervised the oral hygiene by those responsible in comparison with the nonsupervision was 1.89 and 4.31, respectively, in the test group, and 1.71 and 2.94, respectively, in the control group. Conclusion These data suggest that children and adolescents with ADHD present with worse oral health conditions and need greater attention from dental professionals and those responsible for their diet and oral hygiene. Clinical significance Attention deficit hyperactivity disorder needs a special attention. This research brings this important issue focus on oral health. How to cite this article Begnini GJ, Brancher JA, Guimarães ATB, et al. Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder. Int J Clin Pediatr Dent 2019;12(6):543–547.
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Affiliation(s)
- Gilmar J Begnini
- Department of Graduate Studies, Faculty of Dentistry, Universidade Positivo, Curitiba, Brazil
| | - João A Brancher
- Department of Biochemistry, Faculty of Dentistry, Universidade Positivo, Curitiba, Brazil
| | - Ana Tb Guimarães
- Department of Biological Sciences, Western Paraná State University, Cascavel, Paraná, Brazil
| | | | - Eduardo Pizzatto
- Department of Preventive Dentistry, Faculty of Dentistry, Universidade Positivo, Curitiba, Brazil
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17
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Lygre GB, Aase H, Haug K, Lie SA, Björkman L. Prenatal exposure to dental amalgam and risk of symptoms of attention-deficit and hyperactivity disorder (ADHD). Community Dent Oral Epidemiol 2018; 46:472-481. [PMID: 30084494 DOI: 10.1111/cdoe.12409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/05/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND ADHD is multifactorial, including both genetic and environmental factors. The safety of amalgam used in dental treatment has been discussed due to its content of mercury and potential risks for negative neurodevelopmental consequences in the offspring. The aim of the study was to investigate possible associations between symptoms related to ADHD in children of three and five years of age and prenatal exposure to mercury from mothers' amalgam fillings. METHODS Data from the Norwegian Mother and Child Cohort Study (MoBa) were used. Data were collected by questionnaires sent to participating women in week 17 (Q1) and 30 (Q3) of pregnancy and when the child was three (Q6) and five years of age (Q7). Information about exposure to amalgam during pregnancy was obtained from Q3. Information about symptoms related to ADHD was obtained from Q6 and Q7. Valid data were obtained for 42 163 children at three years of age and 23 392 children at five years of age. Logistic regression models, including mothers' age, education, body mass index, parity, smoking and alcohol consumption during pregnancy, were used to estimate the association between ADHD symptoms and prenatal exposure to amalgam fillings. RESULTS No significant associations between number of teeth with amalgam filling, amalgam fillings placed or removed during pregnancy, and symptoms related to ADHD in children of three and five years of age were found. CONCLUSIONS In a large, prospective cohort study, we found no indication of increased risk of ADHD-related symptoms in children prenatally exposed to mother's amalgam fillings.
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Affiliation(s)
- Gunvor B Lygre
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway
| | - Heidi Aase
- Norwegian Institute of Public Health, Oslo, Norway
| | - Kjell Haug
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Stein A Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lars Björkman
- Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway.,Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Kakuszi B, Bitter I, Czobor P. Suicidal ideation in adult ADHD: Gender difference with a specific psychopathological profile. Compr Psychiatry 2018; 85:23-29. [PMID: 29957374 DOI: 10.1016/j.comppsych.2018.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To investigate suicidal ideation (SI) in patients with adult ADHD (aADHD), and its association with gender and psychopathology. METHODS Case-control study with 206 participants (patients = 103/healthy controls = 103; matched on gender, age, and education). SI was assessed by the Beck-I Depression-Inventory. The Conners' Adult ADHD Rating Scale (CAARS) was used to characterize the ADHD symptom-domains. RESULTS Compared to controls, the likelihood of SI was significantly higher in females with ADHD (odds ratio[OR] = 25.0 (95%CI:2.98-200.0); the difference was not significant in males (OR = 2.09 (95%CI:0.75-5.81). In females, "Problems with Self-Concept" scores on the CAARS showed the closest association with SI (OR = 5.60,95%CI:2.34-13.41]), while in males it was "Impulsivity" scores (OR = 3.01,95%CI:1.50-6.06). CONCLUSION Our findings extend previously described transdiagnostic associations of specific psychopathological risk factors to aADHD, including problems with self-concept and impulsivity, which are robustly associated with suicidality across diagnostic boundaries. In addition, they indicate that these associations exhibit pronounced gender-specificity in aADHD.
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Affiliation(s)
- Brigitta Kakuszi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - István Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Pál Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
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19
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Todokoro A, Tanaka SC, Kawakubo Y, Yahata N, Ishii-Takahashi A, Nishimura Y, Kano Y, Ohtake F, Kasai K. Deficient neural activity subserving decision-making during reward waiting time in intertemporal choice in adult attention-deficit hyperactivity disorder. Psychiatry Clin Neurosci 2018; 72:580-590. [PMID: 29687930 DOI: 10.1111/pcn.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 11/30/2022]
Abstract
AIM Impulsivity, which significantly affects social adaptation, is an important target behavioral characteristic in interventions for attention-deficit hyperactivity disorder (ADHD). Typically, people are willing to wait longer to acquire greater rewards. Impulsivity in ADHD may be associated with brain dysfunction in decision-making involving waiting behavior under such situations. We tested the hypothesis that brain circuitry during a period of waiting (i.e., prior to the acquisition of reward) is altered in adults with ADHD. METHODS The participants included 14 medication-free adults with ADHD and 16 healthy controls matched for age, sex, IQ, and handedness. The behavioral task had participants choose between a delayed, larger monetary reward and an immediate, smaller monetary reward, where the reward waiting time actually occurred during functional magnetic resonance imaging measurement. We tested for group differences in the contrast values of blood-oxygen-level dependent signals associated with the length of waiting time, calculated using the parametric modulation method. RESULTS While the two groups did not differ in the time discounting rate, the delay-sensitive contrast values were significantly lower in the caudate and visual cortex in individuals with ADHD. The higher impulsivity scores were significantly associated with lower delay-sensitive contrast values in the caudate and visual cortex. CONCLUSION These results suggest that deficient neural activity affects decision-making involving reward waiting time during intertemporal choice tasks, and provide an explanation for the basis of impulsivity in adult ADHD.
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Affiliation(s)
- Ayako Todokoro
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Saori C Tanaka
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Yuki Kawakubo
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriaki Yahata
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan
| | - Ayaka Ishii-Takahashi
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Agency for Medical Research and Development, Tokyo, Japan
| | - Yukiko Kano
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Fumio Ohtake
- Institute of Social and Economic Research, Osaka University, Osaka, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, Tokyo, Japan
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20
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Vazquez AL, Sibley MH, Campez M. Measuring impairment when diagnosing adolescent ADHD: Differentiating problems due to ADHD versus other sources. Psychiatry Res 2018; 264:407-411. [PMID: 29679844 DOI: 10.1016/j.psychres.2018.03.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 11/28/2022]
Abstract
The DSM-5 requires clinicians to link ADHD symptoms to clinically meaningful impairments in daily life functioning. Measuring impairment during ADHD assessments may be particularly challenging in adolescence, when ADHD is often not the sole source of a youth's difficulties. Existing impairment rating scales are criticized for not specifying ADHD as the source of impairment in their instructions, leading to potential problems with rating scale specificity. The current study utilized a within subjects design (N = 107) to compare parent report of impairment on two versions of a global impairment measure: one that specified ADHD as the source of impairment (Impairment Rating Scale-ADHD) and a standard version that did not (Impairment Rating Scale). On the standard family impairment item, parents endorsed greater impairment as compared to the IRS-ADHD. This finding was particularly pronounced when parents reported high levels of parenting stress. More severe ADHD symptoms were associated with greater concordance between the two versions. Findings indicate that adolescent family related impairments reported during ADHD assessments may be due to sources other than ADHD symptoms, such as developmental maladjustment. To prevent false positive diagnoses, symptom-specific wording may optimize impairment measures when assessing family functioning in diagnostic assessments for adolescents with ADHD.
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Affiliation(s)
| | - Margaret H Sibley
- Department of Psychiatry & Behavioral Health, Florida International University, Miami, Florida, United States
| | - Mileini Campez
- Department of Psychology, Florida International University, Miami, Florida, United States
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McCarthy H, Stanley J, Piech R, Skokauskas N, Mulligan A, Donohoe G, Mullins D, Kelly J, Johnson K, Fagan A, Gill M, Meaney J, Frodl T. Childhood-Diagnosed ADHD, Symptom Progression, and Reversal Learning in Adulthood. J Atten Disord 2018; 22:561-570. [PMID: 27507767 DOI: 10.1177/1087054716661233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE ADHD persists in up to 60% into adulthood, and the reasons for persistence are not fully understood. The objective of this study was to characterize the neurofunctional basis of decision making in those with a childhood diagnosis of ADHD with either persistent or remitted symptoms in adulthood versus healthy control participants. METHOD Thirty-two adults diagnosed with ADHD as children were split into persistent ( n = 18) or remitted ( n = 14) ADHD groups. Their neural activity and neurofunctional connectivity during a probabilistic reversal learning task were compared with 32 healthy controls. RESULTS Remitters showed significantly higher neural connectivity in final reversal error and probabilistic error conditions, and persisters depict higher neural connectivity in reversal errors than controls at a family-wise error (FWE) corrected whole-brain corrected threshold. CONCLUSION Remitters may have utilized higher neural connectivity than controls to make successful decisions. Also, remitters may have utilized compensatory strategies to override any potential underlying ADHD deficits.
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Affiliation(s)
| | | | | | - Norbert Skokauskas
- 1 Trinity College Dublin, Ireland.,3 Norwegian University of Science and Technology, Trondheim, Norway
| | - Aisling Mulligan
- 4 Children's University Hospital, Dublin, Ireland.,5 Mater Child and Adolescent Mental Health Service, Dublin, Ireland
| | | | | | | | - Katherine Johnson
- 1 Trinity College Dublin, Ireland.,6 University of Melbourne, Victoria, Australia
| | - Andrew Fagan
- 1 Trinity College Dublin, Ireland.,7 St. James's Hospital, Dublin, Ireland
| | - Michael Gill
- 1 Trinity College Dublin, Ireland.,7 St. James's Hospital, Dublin, Ireland
| | | | - Thomas Frodl
- 1 Trinity College Dublin, Ireland.,8 Otto von Guericke University of Magdeburg, Germany
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22
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Groen Y, Fuermaier ABM, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O. A situation-specific approach to measure attention in adults with ADHD: The everyday life attention scale (ELAS). APPLIED NEUROPSYCHOLOGY-ADULT 2018. [DOI: 10.1080/23279095.2018.1437730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Yvonne Groen
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Anselm B. M. Fuermaier
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, German
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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23
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Moreno-López L, Albein-Urios N, Martínez-González JM, Soriano-Mas C, Verdejo-García A. Neural correlates of impaired self-awareness of apathy, disinhibition and dysexecutive deficits in cocaine-dependent individuals. Addict Biol 2017; 22:1438-1448. [PMID: 27397847 DOI: 10.1111/adb.12422] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/14/2016] [Accepted: 05/31/2016] [Indexed: 12/20/2022]
Abstract
Cocaine addiction is characterized by impaired self-awareness about cognitive and motivational deficits, leading to poor treatment outcomes. However, there is still limited understanding of the neurophysiological underpinnings of this impairment. We aimed to establish if impaired self-awareness is underpinned by brain structural phenotypes among cocaine-dependent individuals (CDI). Sixty-five CDI and 65 designated informants completed the Frontal Systems Behavior Scale, and a subsample of 40 CDI were scanned via magnetic resonance imaging. We applied multiple regression models to establish the association between levels of self-awareness indexed by Frontal Systems Behavior Scale's discrepancy scores (i.e. informant ratings minus self-reports of apathy, disinhibition and dysexecutive deficits) and gray matter volumes indexed by magnetic resonance imaging voxel-based measures within five brain regions of interest: anterior cingulate cortex, orbitofrontal cortex (OFC), striatum, insula and dorsolateral prefrontal cortex (DLPFC). We also examined the neural underpinnings of underestimation versus overestimation of deficits, by splitting the CDI group according to the positive or negative value of their discrepancy scores. We found that poorer self-awareness of apathy deficits was associated with greater gray matter volume in the dorsal striatum, and poorer self-awareness of disinhibition deficits was associated with greater gray matter volume in the OFC in the whole sample. More underestimation and more overestimation of executive deficits were linked to lower DLPFC volume. We show that impaired self-awareness of cognitive and motivational deficits in cocaine addiction has a neural underpinning, implicating striatum, OFC and DLPFC structural phenotypes.
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Affiliation(s)
- Laura Moreno-López
- Institute of Neuroscience F. Oloriz and Department of Clinical Psychology; University of Granada; Spain
- Division of Anaesthesia; University of Cambridge; UK
| | | | | | - Carles Soriano-Mas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Spain
- Department of Psychobiology and Methodology of Health Sciences; Universitat Autònoma de Barcelona; Spain
| | - Antonio Verdejo-García
- Institute of Neuroscience F. Oloriz and Department of Clinical Psychology; University of Granada; Spain
- Red de Trastornos Adictivos; Universidad de Granada; Spain
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neuroscience; Monash University; Australia
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24
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Wilbertz G, Delgado MR, Tebartz Van Elst L, Maier S, Philipsen A, Blechert J. Neural response during anticipation of monetary loss is elevated in adult attention deficit hyperactivity disorder. World J Biol Psychiatry 2017; 18:268-278. [PMID: 26508322 DOI: 10.3109/15622975.2015.1112032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Risky behaviour seriously impacts the life of adult patients with attention deficit hyperactivity disorder (ADHD). Such behaviours have often been attributed to their exaggerated reward seeking, but dysfunctional anticipation of negative outcomes might also play a role. METHODS The present study compared adult patients with ADHD (n = 28) with matched healthy controls (n = 28) during anticipation of monetary losses versus gains while undergoing functional magnetic resonance imaging (fMRI) and skin conductance recording. RESULTS Skin conductance was higher during anticipation of losses compared to gains in both groups. Affective ratings of predictive cues did not differ between groups. ADHD patients showed increased activity in bilateral amygdalae, left anterior insula (region of interest analysis) and left temporal pole (whole brain analysis) compared to healthy controls during loss versus gain anticipation. In the ADHD group higher insula and temporal pole activations went along with more negative affective ratings. CONCLUSIONS Neural correlates of loss anticipation are not blunted but rather increased in ADHD, possibly due to a life history of repeated failures and the respective environmental sanctions. Behavioural adaptations to such losses, however, might differentiate them from controls: future research should study whether negative affect might drive more risk seeking than risk avoidance.
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Affiliation(s)
- Gregor Wilbertz
- a Department of Psychology , University of Freiburg , Freiburg , Germany.,b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany.,c Department of Psychiatry and Psychotherapy , Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Mauricio R Delgado
- d Department of Psychology , Rutgers University , Newark , NJ 07102 , USA
| | - Ludger Tebartz Van Elst
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany
| | - Simon Maier
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany
| | - Alexandra Philipsen
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany.,e Medical Campus University of Oldenburg, School of Medicine and Health Sciences , Psychiatry and Psychotherapy - University Hospital , Karl-Jaspers-Klinik, Bad Zwischenahn , Germany
| | - Jens Blechert
- f Center for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria.,g Department of Psychology, University of Salzburg , Salzburg , Austria
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25
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Abstract
OBJECTIVE To investigate clinical and functional outcomes in military men with ADHD. METHOD Clinical outcomes were measured via the Zung Self-Rating Depression Scale (Zung SDS) and the Zung Self-Rating Anxiety Scale (Zung SAS). Functional outcomes were measured using the "Car, Relax, Alone, Forget, Friends, Trouble" (CRAFFT) questionnaire and questionnaires about relationships, conduct problems, substance use, and sleep. RESULTS Men with ADHD ( n = 52) reported more depressive (34 [67.3%] vs. 19 [38%], p = .008) and anxiety symptoms (31 [61.5%] vs. 14 [28%], p = .009) compared with those without ( n = 50). They had relationships lasting less than 1 year (24 [80%] vs. 9 [37.5%], p = .006), were more likely to smoke (17 [32.7%] vs. 5 [10%], p = .005), were most likely to use illicit substances (6 [11.5%] vs. 0 [0%], p < .001), had more conduct problems at school (27 [51.9%] vs. 5 [10%], p < .001), and had longer sleep latency (53.96 min ± 46.48 vs. 25.78 min ± 25.93, p = .006). CONCLUSION Military men with ADHD are significantly associated with worse clinical and functional outcomes. They should be screened and monitored for depression, anxiety, sleep disorders, and substance use.
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Affiliation(s)
| | - Rui Kwan
- 1 Institute of Mental Health, Singapore
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26
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Verdejo-Garcia A, Verdejo-Román J, Albein-Urios N, Martínez-González JM, Soriano-Mas C. Brain substrates of social decision-making in dual diagnosis: cocaine dependence and personality disorders. Addict Biol 2017; 22:457-467. [PMID: 26442666 DOI: 10.1111/adb.12318] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/30/2015] [Accepted: 09/04/2015] [Indexed: 02/04/2023]
Abstract
Cocaine dependence frequently co-occurs with personality disorders, leading to increased interpersonal problems and greater burden of disease. Personality disorders are characterised by patterns of thinking and feeling that divert from social expectations. However, the comorbidity between cocaine dependence and personality disorders has not been substantiated by measures of brain activation during social decision-making. We applied functional magnetic resonance imaging to compare brain activations evoked by a social decision-making task-the Ultimatum Game-in 24 cocaine dependents with personality disorders (CDPD), 19 cocaine dependents without comorbidities and 19 healthy controls. In the Ultimatum Game participants had to accept or reject bids made by another player to split monetary stakes. Offers varied in fairness (in fair offers the proposer shares ~50 percent of the money; in unfair offers the proposer shares <30 percent of the money), and participants were told that if they accept both players get the money, and if they reject both players lose it. We contrasted brain activations during unfair versus fair offers and accept versus reject choices. During evaluation of unfair offers CDPD displayed lower activation in the insula and the anterior cingulate cortex and higher activation in the lateral orbitofrontal cortex and superior frontal and temporal gyri. Frontal activations negatively correlated with emotion recognition. During rejection of offers CDPD displayed lower activation in the anterior cingulate cortex, striatum and midbrain. Dual diagnosis is linked to hypo-activation of the insula and anterior cingulate cortex and hyper-activation of frontal-temporal regions during social decision-making, which associates with poorer emotion recognition.
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Affiliation(s)
- Antonio Verdejo-Garcia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University; Monash University; Melbourne Australia
- Institute of Neuroscience F. Olóriz and Department of Personality, Assessment and Psychological Treatment; Universidad de Granada; Granada Spain
| | - Juan Verdejo-Román
- Institute of Neuroscience F. Olóriz and Department of Personality, Assessment and Psychological Treatment; Universidad de Granada; Granada Spain
| | - Natalia Albein-Urios
- Cognitive Neuroscience Unit, School of Psychology; Deakin University; Melbourne Australia
| | | | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL and Carlos III Health Institute; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Barcelona Spain
- Department of Psychobiology and Methodology of Health Sciences; Universitat Autònoma de Barcelona; Barcelona Spain
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27
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Groen Y, Börger NA, Koerts J, Thome J, Tucha O. Blink rate and blink timing in children with ADHD and the influence of stimulant medication. J Neural Transm (Vienna) 2017; 124:27-38. [PMID: 26471801 PMCID: PMC5281678 DOI: 10.1007/s00702-015-1457-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/07/2015] [Indexed: 10/26/2022]
Abstract
Spontaneous eye blink rate is modulated by task demands and internal state, and is demonstrated to reflect central dopamine activity. Also, spontaneous eye blinks are strategically timed around salient stimuli. This study investigates whether children with attention deficit hyperactivity disorder (ADHD) show reduced blink rates, blink modulation and blink timing, and whether this is influenced by stimulant medication. The electrooculogram was measured in 18 typically developing children, 16 children with ADHD off methylphenidate (Mph), and 16 children with ADHD on Mph during a rest period and during performance of a 60-min visual selective attention task. Blink rate and timing was extracted from the electrooculogram. No evidence was found for aberrant blink rate or blink modulation in children with ADHD off Mph. All groups increased blink rates from rest to task, and no group differences were found in blink rate during rest and task, or in the modulation of blink rate from rest to task. Time-on task resulted in a similar increase in blink rates in all three groups. Stimulant medication appeared not to influence blink rate and blink modulation, except that in the ADHD off Mph group the blink rate was enhanced only under conditions with performance feedback. All groups inhibited blinks before stimulus presentation and strategically timed their blinks after the stimulus. Children with ADHD off Mph showed reduced blink inhibition before the stimulus; however, given the low incidence (<1 % of the trials) and long latency this is not likely to impair their visual intake.
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Affiliation(s)
- Y Groen
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - N A Börger
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J Koerts
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Straße 20, 18147, Rostock, Germany
| | - O Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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28
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Markovska-Simoska S, Pop-Jordanova N. Quantitative EEG in Children and Adults With Attention Deficit Hyperactivity Disorder: Comparison of Absolute and Relative Power Spectra and Theta/Beta Ratio. Clin EEG Neurosci 2017; 48:20-32. [PMID: 27170672 DOI: 10.1177/1550059416643824] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/17/2022]
Abstract
In recent decades, resting state electroencephalographic (EEG) measures have been widely used to document underlying neurophysiological dysfunction in attention deficit hyperactivity disorder (ADHD). Although most EEG studies focus on children, there is a growing interest in adults with ADHD too. The aim of this study was to objectively assess and compare the absolute and relative EEG power as well as the theta/beta ratio in children and adults with ADHD. The evaluated sample comprised 30 male children and 30 male adults with ADHD diagnosed according to DSM-IV criteria. They were compared with 30 boys and 30 male adults matched by age. The mean age (±SD) of the children's group was 9 (±2.44) years and the adult group 35.8 (±8.65) years. EEG was recorded during an eyes-open condition. Spectral analysis of absolute (μV2) and relative power (%) was carried out for 4 frequency bands: delta (2-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-21 Hz). The findings obtained for ADHD children are increased absolute power of slow waves (theta and delta), whereas adults exhibited no differences compared with normal subjects. For the relative power spectra there were no differences between the ADHD and control groups. Across groups, the children showed greater relative power than the adults in the delta and theta bands, but for the higher frequency bands (alpha and beta) the adults showed more relative power than children. Only ADHD children showed greater theta/beta ratio compared to the normal group. Classification analysis showed that ADHD children could be differentiated from the control group by the absolute theta values and theta/beta ratio at Cz, but this was not the case with ADHD adults. The question that should be further explored is if these differences are mainly due to maturation processes or if there is a core difference in cortical arousal between ADHD children and adults.
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29
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Kakuszi B, Tombor L, Papp S, Bitter I, Czobor P. Altered response-preparation in patients with adult ADHD: A high-density ERP study. Psychiatry Res Neuroimaging 2016; 249:57-66. [PMID: 27000308 DOI: 10.1016/j.pscychresns.2016.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 02/17/2016] [Accepted: 02/20/2016] [Indexed: 11/24/2022]
Abstract
Aberrations in early-developing bottom-up processes, such as stimulus-driven response preparation, are thought to play a critical role in the onset of ADHD, and in its persistence over time. Electrophysiology offers a unique tool to gain insight into response preparation, since response preparation has been associated with distinctive ERP changes, including negative potential-shifts which occur predominantly over frontal brain areas. We examined response-preceding negative potential shifts (RPNS) as a probe of response-preparation in adult ADHD patients by obtaining high-density event-related potentials from 33 ADHD and 29 matched healthy subjects during a Go/Nogo task using a 128-channel BioSemi recording-system. Compared to controls, ADHD patients showed enhancement of the RPNS in fronto-central brain regions in the Go condition during correct responses. This change was associated with poor performance in the Stroop incongruency-task: the greater the enhancement, the higher the proportion of errors. Moreover, the ERP-enhancement showed association with the severity of ADHD-symptoms; and with heightened response-variability. Thus, ADHD patients demonstrate neurophysiological alterations in response-preparation and response-preceding brain activity, suggestive of excessive activation of prefrontal neural circuits. Given the correlation with neuropsychological and psychopathological measures, these changes may constitute a pathway for core symptoms of ADHD, including premature and impaired response-preparation and motor-hyperactivity.
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Affiliation(s)
- Brigitta Kakuszi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - László Tombor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Szilvia Papp
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - István Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Pál Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
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30
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Verdejo-Garcia A, Clark L, Verdejo-Román J, Albein-Urios N, Martinez-Gonzalez JM, Gutierrez B, Soriano-Mas C. Neural substrates of cognitive flexibility in cocaine and gambling addictions. Br J Psychiatry 2015; 207:158-64. [PMID: 26045346 DOI: 10.1192/bjp.bp.114.152223] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 11/23/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Individuals with cocaine and gambling addictions exhibit cognitive flexibility deficits that may underlie persistence of harmful behaviours. AIMS We investigated the neural substrates of cognitive inflexibility in cocaine users v. pathological gamblers, aiming to disambiguate common mechanisms v. cocaine effects. METHOD Eighteen cocaine users, 18 pathological gamblers and 18 controls performed a probabilistic reversal learning task during functional magnetic resonance imaging, and were genotyped for the DRD2/ANKK Taq1A polymorphism. RESULTS Cocaine users and pathological gamblers exhibited reduced ventrolateral prefrontal cortex (PFC) signal during reversal shifting. Cocaine users further showed increased dorsomedial PFC (dmPFC) activation relative to pathological gamblers during perseveration, and decreased dorsolateral PFC activation relative to pathological gamblers and controls during shifting. Preliminary genetic findings indicated that cocaine users carrying the DRD2/ANKK Taq1A1+ genotype may derive unique stimulatory effects on shifting-related ventrolateral PFC signal. CONCLUSIONS Reduced ventrolateral PFC activation during shifting may constitute a common neural marker across gambling and cocaine addictions. Additional cocaine-related effects relate to a wider pattern of task-related dysregulation, reflected in signal abnormalities in dorsolateral and dmPFC.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Luke Clark
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Juan Verdejo-Román
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Natalia Albein-Urios
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - José M Martinez-Gonzalez
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Blanca Gutierrez
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Carles Soriano-Mas
- Antonio Verdejo-Garcia, PhD, School of Psychology and Psychiatry, Monash University, Melbourne, Australia, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain and Red de Trastornos Adictivos, Universidad de Granada. Granada, Spain; Luke Clark, PhD, Department of Psychology, Centre for Gambling Research at UBC, University of British Columbia, Canada; Juan Verdejo-Román, MSc, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; Natalia Albein-Urios, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain; José M. Martinez-Gonzalez, PhD, Red de Trastornos Adictivos, Universidad de Granada, Granada, Spain and Centro Provincial de Drogodependencias, Diputacion de Granada, Granada, Spain; Blanca Gutierrez, PhD, Institute of Neuroscience F. Oloriz, Universidad de Granada, Granada, Spain, Department of Psychiatry, Universidad de Granada, Granada, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain and CIBERSAM, Carlos III Health Institute, Barcelona, Spain, Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
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He N, Li F, Li Y, Guo L, Chen L, Huang X, Lui S, Gong Q. Neuroanatomical deficits correlate with executive dysfunction in boys with attention deficit hyperactivity disorder. Neurosci Lett 2015; 600:45-9. [PMID: 26049007 DOI: 10.1016/j.neulet.2015.05.062] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/08/2015] [Accepted: 05/30/2015] [Indexed: 02/05/2023]
Abstract
Previous structural imaging studies have revealed gray matter volume abnormalities to reflect the etiology of attention deficit hyperactivity disorder (ADHD), however, which are confounded by age, medication and comorbidity and also ignore the core feature of brain structure in the executive impairments of ADHD. In the present study, we explored gray matter volume abnormalities in male children and adolescents with ADHD who were drug-naive and without comorbidities, and tried to connect structural data and behavioral executive dysfunction to provide more information regarding the brain-behavior relationships in ADHD. Seventy-two male subjects (37 patients and 35 controls) underwent three-dimensional high-resolution structural magnetic resonance imaging and executive function assessments, including the Stroop Color-Word Test and Wisconsin Card Sorting Test (WCST). Voxel-based morphometry with diffeomorphic anatomical registration through exponentiated Lie algebra was used to identify gray matter volume differences between the ADHD and controls. Correlation analyses were performed to identify neuroanatomical deficits that were associated with executive dysfunctions. Significantly reduced gray matter volumes were identified in the right orbitofrontal cortex, right primary motor/premotor cortex, left anterior cingulate cortex and left posterior midcingulate cortex of ADHD patients compared with controls (P<0.05, corrected for family-wise errors). In patients group, the gray matter volumes of the right orbitofrontal cortex and left posterior midcingulate cortex were positively correlated with the completed categories on the WCST, and the gray matter volume of the left posterior midcingulate cortex was negatively correlated with the total and non-perseverative errors on the WCST (P<0.05). The present findings show gray matter volume reductions in motor regions as well as the orbitofrontal and cingulate cortex; this evidence supports theories that suggest frontal abnormalities in children and adolescents with ADHD at early illness stage. The correlations between structural abnormalities and executive dysfunction suggest that neuroanatomical substrate deficits are implicated in the pathophysiology of ADHD.
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Affiliation(s)
- Ning He
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yuanyuan Li
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Lanting Guo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
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Levin FR, Mariani JJ, Specker S, Mooney M, Mahony A, Brooks DJ, Babb D, Bai Y, Eberly LE, Nunes EV, Grabowski J. Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2015; 72:593-602. [PMID: 25887096 PMCID: PMC4456227 DOI: 10.1001/jamapsychiatry.2015.41] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Adult attention-deficit/hyperactivity disorder (ADHD) is prevalent but often unrecognized, in part because it tends to co-occur with other disorders such as substance use disorders. Cocaine use disorder is one such disorder with high co-occurrence of ADHD. OBJECTIVE To examine whether treatment of co-occurring ADHD and cocaine use disorder with extended-release mixed amphetamine salts is effective at both improving ADHD symptoms and reducing cocaine use. DESIGN, SETTING, AND PARTICIPANTS Thirteen-week, randomized, double-blind, 3-arm, placebo-controlled trial of participants meeting DSM-IV-TR criteria for both ADHD and cocaine use disorder conducted between December 1, 2007, and April 15, 2013, at 2 academic health center substance abuse treatment research sites. One hundred twenty-six adults diagnosed as having comorbid ADHD and cocaine use disorder were randomized to extended-release mixed amphetamine salts or placebo. Analysis was by intent-to-treat population. INTERVENTIONS Participants received extended-release mixed amphetamine salts (60 or 80 mg) or placebo daily for 13 weeks and participated in weekly individual cognitive behavioral therapy. MAIN OUTCOMES AND MEASURES For ADHD, percentage of participants achieving at least a 30% reduction in ADHD symptom severity, measured by the Adult ADHD Investigator Symptom Rating Scale; for cocaine use, cocaine-negative weeks (by self-report of no cocaine use and weekly benzoylecgonine urine screens) during maintenance medication (weeks 2-13) and percentage of participants achieving abstinence for the last 3 weeks. RESULTS More patients achieved at least a 30% reduction in ADHD symptom severity in the medication groups (60 mg: 30 of 40 participants [75.0%]; odds ratio [OR] = 5.23; 95% CI, 1.98-13.85; P < .001; and 80 mg: 25 of 43 participants [58.1%]; OR = 2.27; 95% CI, 0.94-5.49; P = .07) compared with placebo (17 of 43 participants [39.5%]). The odds of a cocaine-negative week were higher in the 80-mg group (OR = 5.46; 95% CI, 2.25-13.27; P < .001) and 60-mg group (OR = 2.92; 95% CI, 1.15-7.42; P = .02) compared with placebo. Rates of continuous abstinence in the last 3 weeks were greater for the medication groups than the placebo group: 30.2% for the 80-mg group (OR = 11.87; 95% CI, 2.25-62.62; P = .004) and 17.5% for the 60-mg group (OR = 5.85; 95% CI, 1.04-33.04; P = .04) vs 7.0% for placebo. CONCLUSIONS AND RELEVANCE Extended-release mixed amphetamine salts in robust doses along with cognitive behavioral therapy are effective for treatment of co-occurring ADHD and cocaine use disorder, both improving ADHD symptoms and reducing cocaine use. The data suggest the importance of screening and treatment of ADHD in adults presenting with cocaine use disorder. TRIAL REGISTRATION clinicaltrials.gov Identifier:NCT00553319.
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Affiliation(s)
- Frances R. Levin
- Division of Substance Abuse, New York State Psychiatric Institute, New York2Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York
| | - John J. Mariani
- Division of Substance Abuse, New York State Psychiatric Institute, New York2Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York
| | - Sheila Specker
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis
| | - Marc Mooney
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis
| | - Amy Mahony
- Division of Substance Abuse, New York State Psychiatric Institute, New York
| | - Daniel J. Brooks
- Division of Substance Abuse, New York State Psychiatric Institute, New York
| | - David Babb
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis
| | - Yun Bai
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | - Lynn E. Eberly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis
| | - Edward V. Nunes
- Division of Substance Abuse, New York State Psychiatric Institute, New York2Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York
| | - John Grabowski
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis
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Moreno-López L, Perales JC, van Son D, Albein-Urios N, Soriano-Mas C, Martinez-Gonzalez JM, Wiers RW, Verdejo-García A. Cocaine use severity and cerebellar gray matter are associated with reversal learning deficits in cocaine-dependent individuals. Addict Biol 2015; 20:546-56. [PMID: 24738841 DOI: 10.1111/adb.12143] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cocaine addiction involves persistent deficits to unlearn previously rewarded response options, potentially due to neuroadaptations in learning-sensitive regions. Cocaine-targeted prefrontal systems have been consistently associated with reinforcement learning and reversal deficits, but more recent interspecies research has raised awareness about the contribution of the cerebellum to cocaine addiction and reversal. We aimed at investigating the link between cocaine use, reversal learning and prefrontal, insula and cerebellar gray matter in cocaine-dependent individuals (CDIs) varying on levels of cocaine exposure in comparison with healthy controls (HCs). Twenty CDIs and 21 HCs performed a probabilistic reversal learning task (PRLT) and were subsequently scanned in a 3-Tesla magnetic resonance imaging scanner. In the PRLT, subjects progressively learn to respond to one predominantly reinforced stimulus, and then must learn to respond according to the opposite, previously irrelevant, stimulus-reward pairing. Performance measures were errors after reversal (reversal cost), and probability of maintaining response after errors. Voxel-based morphometry was conducted to investigate the association between gray matter volume in the regions of interest and cocaine use and PRLT performance. Severity of cocaine use correlated with gray matter volume reduction in the left cerebellum (lobule VIII), while greater reversal cost was correlated with gray matter volume reduction in a partially overlapping cluster (lobules VIIb and VIII). Right insula/inferior frontal gyrus correlated with probability of maintaining response after errors. Severity of cocaine use detrimentally impacted reversal learning and cerebellar gray matter.
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Affiliation(s)
- Laura Moreno-López
- Department of Personality, Evaluation and Psychological Treatment; Universidad de Granada; Spain
| | - José C. Perales
- Mind, Brain and Behavior Research Center (Centro de Investigación Mente, Cerebro y Comportamiento-CIMCYC); Universidad de Granada; Spain
| | - Dana van Son
- Addiction, Development and Psychopathology (ADAPT) Lab; Department of Psychology; University of Amsterdam; The Netherlands
| | - Natalia Albein-Urios
- Department of Personality, Evaluation and Psychological Treatment; Universidad de Granada; Spain
| | - Carles Soriano-Mas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Spain
- Carlos III Health Institute; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Spain
| | - Jose M. Martinez-Gonzalez
- Institute of Neurosciences Federico Olóriz; Universidad de Granada; Spain
- Red de Trastornos Adictivos; RETICS Program; Instituto de Salud Carlos III; Universidad de Granada; Spain
| | - Reinout W. Wiers
- Addiction, Development and Psychopathology (ADAPT) Lab; Department of Psychology; University of Amsterdam; The Netherlands
| | - Antonio Verdejo-García
- Department of Personality, Evaluation and Psychological Treatment; Universidad de Granada; Spain
- Institute of Neurosciences Federico Olóriz; Universidad de Granada; Spain
- Red de Trastornos Adictivos; RETICS Program; Instituto de Salud Carlos III; Universidad de Granada; Spain
- School of Psychological Sciences; Monash University; Australia
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Dovis S, Van der Oord S, Huizenga HM, Wiers RW, Prins PJM. Prevalence and diagnostic validity of motivational impairments and deficits in visuospatial short-term memory and working memory in ADHD subtypes. Eur Child Adolesc Psychiatry 2015; 24:575-90. [PMID: 25193524 DOI: 10.1007/s00787-014-0612-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 08/26/2014] [Indexed: 11/29/2022]
Abstract
Deficits in working memory (WM) and reinforcement sensitivity are thought to give rise to symptoms in the combined (ADHD-C) and inattentive subtype (ADHD-I) of ADHD. Children with ADHD are especially impaired on visuospatial WM, which is composed of short-term memory (STM) and a central executive. Although deficits in visuospatial WM and reinforcement sensitivity appear characteristic of children with ADHD on a group-level, the prevalence and diagnostic validity of these impairments is still largely unknown. Moreover, studies investigating this did not control for the interaction between motivational impairments and cognitive performance in children with ADHD, and did not differentiate between ADHD subtypes. Visuospatial WM and STM tasks were administered in a standard (feedback-only) and a high-reinforcement (feedback + 10 euros) condition, to 86 children with ADHD-C, 27 children with ADHD-I (restrictive subtype), and 62 typically developing controls (aged 8-12). Reinforcement sensitivity was indexed as the difference in performance between the reinforcement conditions. WM and STM impairments were most prevalent in ADHD-C. In ADHD-I, only WM impairments, not STM impairments, were more prevalent than in controls. Motivational impairments were not common (22% impaired) and equally prevalent in both subtypes. Memory and motivation were found to represent independent neuropsychological domains. Impairment on WM, STM, and/or motivation was associated with more inattention symptoms, medication-use, and lower IQ scores. Similar results were found for analyses of diagnostic validity. The majority of children with ADHD-C is impaired on visuospatial WM. In ADHD-I, STM impairments are not more common than in controls. Within both ADHD subtypes only a minority has an abnormal sensitivity to reinforcement.
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Affiliation(s)
- Sebastiaan Dovis
- Developmental Psychology, University of Amsterdam, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands,
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Kordon A, Stollhoff K, Niederkirchner K, Mattejat F, Rettig K, Schäuble B. Exploring the Impact of Once-Daily OROS® Methylphenidate (MPH) on Symptoms and Quality of Life in Children and Adolescents with ADHD Transitioning from Immediate-Release MPH. Postgrad Med 2015; 123:27-38. [DOI: 10.3810/pgm.2011.09.2457] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Vanicek T, Spies M, Rami-Mark C, Savli M, Höflich A, Kranz GS, Hahn A, Kutzelnigg A, Traub-Weidinger T, Mitterhauser M, Wadsak W, Hacker M, Volkow ND, Kasper S, Lanzenberger R. The norepinephrine transporter in attention-deficit/hyperactivity disorder investigated with positron emission tomography. JAMA Psychiatry 2014; 71:1340-1349. [PMID: 25338091 PMCID: PMC4699255 DOI: 10.1001/jamapsychiatry.2014.1226] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) research has long focused on the dopaminergic system's contribution to pathogenesis, although the results have been inconclusive. However, a case has been made for the involvement of the noradrenergic system, which modulates cognitive processes, such as arousal, working memory, and response inhibition, all of which are typically affected in ADHD. Furthermore, the norepinephrine transporter (NET) is an important target for frequently prescribed medication in ADHD. Therefore, the NET is suggested to play a critical role in ADHD. OBJECTIVE To explore the differences in NET nondisplaceable binding potential (NET BPND) using positron emission tomography and the highly selective radioligand (S,S)-[18F]FMeNER-D2 [(S,S)-2-(α-(2-[18F]fluoro[2H2]methoxyphenoxy)benzyl)morpholine] between adults with ADHD and healthy volunteers serving as controls. DESIGN, SETTING, AND PARTICIPANTS Twenty-two medication-free patients with ADHD (mean [SD] age, 30.7 [10.4] years; 15 [68%] men) without psychiatric comorbidities and 22 age- and sex-matched healthy controls (30.9 [10.6] years; 15 [68%] men) underwent positron emission tomography once. A linear mixed model was used to compare NET BPND between groups. MAIN OUTCOMES AND MEASURES The NET BPND in selected regions of interest relevant for ADHD, including the hippocampus, putamen, pallidum, thalamus, midbrain with pons (comprising a region of interest that includes the locus coeruleus), and cerebellum. In addition, the NET BPND was evaluated in thalamic subnuclei (13 atlas-based regions of interest). RESULTS We found no significant differences in NET availability or regional distribution between patients with ADHD and healthy controls in all investigated brain regions (F1,41<0.01; P=.96). Furthermore, we identified no significant association between ADHD symptom severity and regional NET availability. Neither sex nor smoking status influenced NET availability. We determined a significant negative correlation between age and NET availability in the thalamus (R2=0.29; P<.01 corrected) and midbrain with pons, including the locus coeruleus (R2=0.18; P<.01 corrected), which corroborates prior findings of a decrease in NET availability with aging in the human brain. CONCLUSIONS AND RELEVANCE Our results do not indicate involvement of changes in brain NET availability or distribution in the pathogenesis of ADHD. However, the noradrenergic transmitter system may be affected on a different level, such as in cortical regions, which cannot be reliably quantified with this positron emission tomography ligand. Alternatively, different key proteins of noradrenergic neurotransmission might be affected.
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Affiliation(s)
- Thomas Vanicek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Marie Spies
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christina Rami-Mark
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Markus Savli
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Anna Höflich
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Georg S. Kranz
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Andreas Hahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kutzelnigg
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Markus Mitterhauser
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Wadsak
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Nora D. Volkow
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Albein-Urios N, Martinez-González JM, Lozano Ó, Verdejo-Garcia A. Monetary delay discounting in gambling and cocaine dependence with personality comorbidities. Addict Behav 2014; 39:1658-1662. [PMID: 25047890 DOI: 10.1016/j.addbeh.2014.06.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 04/10/2014] [Accepted: 06/05/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cocaine addiction and pathological gambling are commonly associated with steeper (impulsive) discounting of delayed rewards, which promotes ongoing drug and gambling behaviors. However, it is yet unclear whether impulsive delay discounting is a stable trait in cocaine and gambling disorders during abstinence, and whether it is significantly impacted by dysfunctional personality beliefs. METHODS The aim of this study was to compare the delay discounting rates of four groups: 47 cocaine users with comorbid personality disorders, 41 cocaine users without psychiatric comorbidities, 28 pathological gamblers without psychiatric comorbidities, and 36 healthy comparison individuals. We also examined the association between dysfunctional personality beliefs and delay discounting rates. Participants completed the Kirby Delay Discounting Questionnaire and the Beck Personality Belief Questionnaire as part of a larger battery. RESULTS We used non-parametric tests to compare discounting rates between the groups, and bivariate correlation analyses to examine the association between beliefs and discounting rates within each of the groups. We found that discounting rates were significantly higher in individuals with disordered gambling compared to controls. Specifically in cocaine users with Cluster B personality disorders, higher discounting rates were associated with the intensity of "dependent" dysfunctional beliefs (e.g., "I am needy and weak"). Conclusion:We conclude that impulsive delay discounting is increased in gambling relative to controls and linked to personality beliefs in cocaine users with Cluster B personality disorders.
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Affiliation(s)
- Natalia Albein-Urios
- Department of Clinical Psychology, Universidad de Granada, 18071 Granada, Spain; Cognitive Neuroscience Unit, School of Psychology, Deakin University, Building BC, Burwood Campus, 221 Burwood Hwy, VIC 3125, Australia.
| | - José M Martinez-González
- Red de Trastornos Adictivos, Universidad de Granada, Spain; Centro Provincial de Drogodependencias, Calle San Juan de Dios, 11. Hospital de San Juan de Dios, 18001 Granada, Spain.
| | - Óscar Lozano
- Red de Trastornos Adictivos, Universidad de Granada, Spain; Department of Psychology, Universidad de Huelva, Facultad de Ciencias de la Educación Campus de El Carmen, Avenida de las Fuerzas Armadas, S/N, 21071 Huelva, Spain.
| | - Antonio Verdejo-Garcia
- Department of Clinical Psychology, Universidad de Granada, 18071 Granada, Spain; Red de Trastornos Adictivos, Universidad de Granada, Spain; School of Psychological Sciences, Monash University, 3800 Wellington Road, Melbourne, Australia.
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Decision-making impairment predicts 3-month hair-indexed cocaine relapse. Psychopharmacology (Berl) 2014; 231:4179-87. [PMID: 24728653 DOI: 10.1007/s00213-014-3563-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 03/24/2014] [Indexed: 01/18/2023]
Abstract
RATIONALE One of the key outstanding challenges in cocaine dependence research is determining who is at risk of relapsing during treatment. OBJECTIVES We examined whether cognitive decision-making profiles predict objectively (hair) indexed cocaine relapse at 3-month follow-up. METHODS Thirty-three cocaine-dependent patients commencing outpatient treatment in a public clinic performed baseline decision-making assessments with the original and variant versions of the Iowa Gambling Task, and provided a 3-cm hair sample 3 months afterwards. Based on Iowa Gambling Tasks' performance cut-offs, 5 patients had intact decision-making skills, 17 patients showed impaired sensitivity to reward or punishment (impairment in one of the tasks), and 9 patients showed insensitivity to future consequences (impairment in both tasks). Based on a 0.3 ng/mg cocaine cut-off, 23 patients were classified as relapsers and 10 as non-relapsers at the 3-month follow-up. RESULTS Eighty percent of patients with intact decision-making were abstinent at follow-up, whereas 90% of patients with insensitivity to future consequences had relapsed. The two subgroups (relapsers and non-relapsers) showed no significant differences on drug use, comorbidities, or psychosocial function, and significantly differed on verbal but not performance IQ. A regression model including decision-making scores and verbal IQ predicted abstinence status with high sensitivity (95%) and moderately high specificity (81%). CONCLUSION These preliminary findings demonstrate that decision-making profiles are associated with cocaine relapse. Moreover, combined decision-making and IQ assessments provide optimal predictive values over stimulant relapse, yielding significant opportunities for clinical translation.
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Li F, He N, Li Y, Chen L, Huang X, Lui S, Guo L, Kemp GJ, Gong Q. Intrinsic Brain Abnormalities in Attention Deficit Hyperactivity Disorder: A Resting-State Functional MR Imaging Study. Radiology 2014; 272:514-23. [DOI: 10.1148/radiol.14131622] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Albein-Urios N, Verdejo-Román J, Asensio S, Soriano-Mas C, Martínez-González JM, Verdejo-García A. Re-appraisal of negative emotions in cocaine dependence: dysfunctional corticolimbic activation and connectivity. Addict Biol 2014; 19:415-26. [PMID: 22978709 DOI: 10.1111/j.1369-1600.2012.00497.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cocaine dependence is associated with pronounced elevations of negative affect and deficient regulation of negative emotions. We aimed to investigate the neural substrates of negative emotion regulation in cocaine-dependent individuals (CDI), as compared to non-drug-using controls, using functional magnetic resonance imaging (fMRI) during a re-appraisal task. Seventeen CDI abstinent for at least 15 days and without other psychiatric co-morbidities and 18 intelligence quotient-matched non-drug-using controls participated in the study. Participants performed the re-appraisal task during fMRI scanning: they were exposed to 24 blocks of negative affective or neutral pictures that they should Observe (neutral pictures), Maintain (sustain the emotion elicited by negative pictures) or Suppress (regulate the emotion elicited by negative pictures through previously trained re-appraisal techniques). Task-related activations during two conditions of interest (Maintain>Observe and Suppress>Maintain) were analyzed using the general linear model in SPM8 software. We also performed psychophysiological interaction (PPI) seed-based analyses based on one region from each condition: the dorsolateral prefrontal cortex (dlPFC-Maintain>Observe) and the inferior frontal gyrus (IFG-Suppress>Maintain). Results showed that cocaine users had increased right dlPFC and bilateral temporoparietal junction activations during Maintain>Observe, whereas they showed decreased right IFG, posterior cingulate cortex, insula and fusiform gyrus activations during Suppress>Maintain. PPI analyses showed that cocaine users had increased functional coupling between the dlPFC and emotion-related regions during Maintain>Observe, whereas they showed decreased functional coupling between the right IFG and the amygdala during Suppress>Maintain. These findings indicate that CDI have dysfunctional corticolimbic activation and connectivity during negative emotion experience and re-appraisal.
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Affiliation(s)
| | | | - Samuel Asensio
- Department of Biomedical Sciences; Universidad Cardenal Herrera; Spain
| | - Carles Soriano-Mas
- Institute of Biomedical Sciences; Universidad CEU-Cardenal Herrera; Spain
- Carlos III Health Institute; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Spain
| | | | - Antonio Verdejo-García
- Department of Clinical Psychology; Universidad de Granada; Spain
- Institute of Neurosciences F. Olóriz; Universidad de Granada; Spain
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Ciumas C, Saignavongs M, Ilski F, Herbillon V, Laurent A, Lothe A, Heckemann RA, de Bellescize J, Panagiotakaki E, Hannoun S, Marinier DS, Montavont A, Ostrowsky-Coste K, Bedoin N, Ryvlin P. White matter development in children with benign childhood epilepsy with centro-temporal spikes. Brain 2014; 137:1095-106. [DOI: 10.1093/brain/awu039] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Potter AS, Dunbar G, Mazzulla E, Hosford D, Newhouse PA. AZD3480, a novel nicotinic receptor agonist, for the treatment of attention-deficit/hyperactivity disorder in adults. Biol Psychiatry 2014; 75:207-14. [PMID: 23856296 DOI: 10.1016/j.biopsych.2013.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 05/31/2013] [Accepted: 06/02/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Laboratory studies have found that acute stimulation of nicotinic acetylcholine receptors improves cognition in adult attention-deficit/hyperactivity disorder (ADHD). Clinical trials of nicotinic agonists have been mixed, underscoring the need to understand the mechanisms for individual differences in clinical response. Using cognitive models within a clinical trial framework may provide insight into these differences. METHODS This was a within-subjects, randomized, placebo-controlled double-blind trial of the nicotinic agonist AZD3480 (also termed TC-1734) at doses of 5 mg and 50 mg and placebo in adults with ADHD. The order of the 2-week treatment periods was randomized, and a 3-week wash out separated each drug treatment period. Response inhibition (Stop Signal Task [SST]) and clinical efficacy (Investigator Rated Conners Adult ADHD Rating Scale [CAARS-INV]) were the a priori primary outcome measures of cognitive and clinical effects. We hypothesized that AZD3480 treatment would improve SST performance and clinical symptoms (CAARS-INV Total ADHD Symptoms Score). RESULTS Thirty subjects were randomized, with 24 included in the intent-to-treat analyses. SST performance and total ADHD symptoms were significantly improved with 50 mg of AZD3480. CAARS-INV ratings of inattention, memory problems, and emotional lability/impulsivity were significantly improved with 50 mg of AZD3480. CONCLUSIONS These results support previous work suggesting that nicotinic agonists are viable as treatments for adult ADHD. Measuring cognitive endophenotypes related to both the disorder and mechanism of treatment may help further rational drug development for dimensional features that cross-cut psychiatric disorders.
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Affiliation(s)
- Alexandra S Potter
- Clinical Neuroscience Research Unit, Department of Psychiatry, The University of Vermont, Burlington, Vermont.
| | | | - Emily Mazzulla
- Clinical Neuroscience Research Unit, Department of Psychiatry, The University of Vermont, Burlington, Vermont
| | | | - Paul A Newhouse
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee
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Niederkirchner K, Slawik L, Wermelskirchen D, Rettig K, Schäuble B. Transitioning to OROS®methylphenidate from atomoxetine is effective in children and adolescents with ADHD. Expert Rev Neurother 2014; 11:499-508. [DOI: 10.1586/ern.11.18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Moreno-López L, Albein-Urios N, Martinez-Gonzalez JM, Soriano-Mas C, Verdejo-García A. Prefrontal Gray Matter and Motivation for Treatment in Cocaine-Dependent Individuals with and without Personality Disorders. Front Psychiatry 2014; 5:52. [PMID: 24904436 PMCID: PMC4032993 DOI: 10.3389/fpsyt.2014.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 04/29/2014] [Indexed: 11/13/2022] Open
Abstract
Addiction treatment is a long-term goal and therefore prefrontal-striatal regions regulating goal-directed behavior are to be associated with individual differences on treatment motivation. We aimed at examining the association between gray matter volumes in prefrontal cortices and striatum and readiness to change at treatment onset in cocaine users with and without personality disorders. Participants included 17 cocaine users without psychiatric comorbidities, 17 cocaine users with Cluster B disorders, and 12 cocaine users with Cluster C disorders. They completed the University of Rhode Island Change Assessment Scale, which measures four stages of treatment change (precontemplation, contemplation, action, and maintenance) and overall readiness to change, and were scanned in a 3 T MRI scanner. We defined three regions of interest (ROIs): the ventromedial prefrontal cortex (including medial orbitofrontal cortex and subgenual and rostral anterior cingulate cortex), the dorsomedial prefrontal cortex (i.e., superior medial frontal cortex), and the neostriatum (caudate and putamen). We found that readiness to change correlated with different aspects of ventromedial prefrontal gray matter as a function of diagnosis. In cocaine users with Cluster C comorbidities, readiness to change positively correlated with gyrus rectus gray matter, whereas in cocaine users without comorbidities it negatively correlated with rostral anterior cingulate cortex gray matter. Moreover, maintenance scores positively correlated with dorsomedial prefrontal gray matter in cocaine users with Cluster C comorbidities, but negatively correlated with this region in cocaine users with Cluster B and cocaine users without comorbidities. Maintenance scores also negatively correlated with dorsal striatum gray matter in cocaine users with Cluster C comorbidities. We conclude that the link between prefrontal-striatal gray matter and treatment motivation is modulated by co-existence of personality disorders.
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Affiliation(s)
- Laura Moreno-López
- Department of Personality, Evaluation and Psychological Treatment, University of Granada , Granada , Spain
| | - Natalia Albein-Urios
- Department of Personality, Evaluation and Psychological Treatment, University of Granada , Granada , Spain
| | - José Miguel Martinez-Gonzalez
- Red de Trastornos Adictivos, University of Granada , Granada , Spain ; Centro Provincial de Drogodependencias, Diputación de Granada , Granada , Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona , Spain ; Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Madrid , Spain
| | - Antonio Verdejo-García
- Department of Personality, Evaluation and Psychological Treatment, University of Granada , Granada , Spain ; Red de Trastornos Adictivos, University of Granada , Granada , Spain ; Institute of Neurosciences Federico Olóriz, University of Granada , Granada , Spain ; School of Psychological Sciences, Monash University , Melbourne, VIC , Australia
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Albein-Urios N, Verdejo-Román J, Soriano-Mas C, Asensio S, Martínez-González JM, Verdejo-García A. Cocaine users with comorbid Cluster B personality disorders show dysfunctional brain activation and connectivity in the emotional regulation networks during negative emotion maintenance and reappraisal. Eur Neuropsychopharmacol 2013; 23:1698-707. [PMID: 23712090 DOI: 10.1016/j.euroneuro.2013.04.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/21/2013] [Accepted: 04/20/2013] [Indexed: 11/16/2022]
Abstract
Cocaine dependence often co-occurs with Cluster B personality disorders. Since both disorders are characterized by emotion regulation deficits, we predicted that cocaine comorbid patients would exhibit dysfunctional patterns of brain activation and connectivity during reappraisal of negative emotions. We recruited 18 cocaine users with comorbid Cluster B personality disorders, 17 cocaine users without comorbidities and 21 controls to be scanned using functional magnetic resonance imaging (fMRI) during performance on a reappraisal task in which they had to maintain or suppress the emotions induced by negative affective stimuli. We followed region of interest (ROI) and whole-brain approaches to investigate brain activations and connectivity associated with negative emotion experience and reappraisal. Results showed that cocaine users with comorbid personality disorders had reduced activation of the subgenual anterior cingulate cortex during negative emotion maintenance and increased activation of the lateral orbitofrontal cortex and the amygdala during reappraisal. Amygdala activation correlated with impulsivity and antisocial beliefs in the comorbid group. Connectivity analyses showed that in the cocaine comorbid group the subgenual cingulate was less efficiently connected with the amygdala and the fusiform gyri and more efficiently connected with the anterior insula during maintenance, whereas during reappraisal the left orbitofrontal cortex was more efficiently connected with the amygdala and the right orbitofrontal cortex was less efficiently connected with the dorsal striatum. We conclude that cocaine users with comorbid Cluster B personality disorders have distinctive patterns of brain activation and connectivity during maintenance and reappraisal of negative emotions, which correlate with impulsivity and dysfunctional beliefs.
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46
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Verdejo-García A, Albein-Urios N, Molina E, Ching-López A, Martínez-González JM, Gutiérrez B. A MAOA gene*cocaine severity interaction on impulsivity and neuropsychological measures of orbitofrontal dysfunction: preliminary results. Drug Alcohol Depend 2013; 133:287-90. [PMID: 23755928 DOI: 10.1016/j.drugalcdep.2013.04.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/11/2013] [Accepted: 04/27/2013] [Indexed: 01/26/2023]
Abstract
BACKGROUND Based on previous evidence of a MAOA gene*cocaine use interaction on orbitofrontal cortex volume attrition, we tested whether the MAOA low activity variant and cocaine use severity are interactively associated with impulsivity and behavioral indices of orbitofrontal dysfunction: emotion recognition and decision-making. METHODS 72 cocaine dependent individuals and 52 non-drug using controls (including healthy individuals and problem gamblers) were genotyped for the MAOA gene and tested using the UPPS-P Impulsive Behavior Scale, the Iowa Gambling Task and the Ekman's Facial Emotions Recognition Test. To test the main hypothesis, we conducted hierarchical multiple regression analyses including three sets of predictors: (1) age, (2) MAOA genotype and severity of cocaine use, and (3) the interaction between MAOA genotype and severity of cocaine use. UPPS-P, Ekman Test and Iowa Gambling Task's scores were the outcome measures. We computed the statistical significance of the prediction change yielded by each consecutive set, with 'a priori' interest in the MAOA*cocaine severity interaction. RESULTS We found significant effects of the MAOA gene*cocaine use severity interaction on the emotion recognition scores and the UPPS-P's dimensions of Positive Urgency and Sensation Seeking: Low activity carriers with higher cocaine exposure had poorer emotion recognition and higher Positive Urgency and Sensation Seeking. CONCLUSION Cocaine users carrying the MAOA low activity show a greater impact of cocaine use on impulsivity and behavioral measures of orbitofrontal cortex dysfunction.
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Affiliation(s)
- Antonio Verdejo-García
- Department of Clinical Psychology, School of Psychology, University of Granada, Spain; Institute of Neurosciences Federico Olóriz, Centro de Investigacion Biomedica, University of Granada, Spain; School of Psychology and Psychiatry, Monash University, Melbourne, Australia.
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Cortese S, Imperati D, Zhou J, Proal E, Klein RG, Mannuzza S, Ramos-Olazagasti MA, Milham MP, Kelly C, Castellanos FX. White matter alterations at 33-year follow-up in adults with childhood attention-deficit/hyperactivity disorder. Biol Psychiatry 2013; 74:591-8. [PMID: 23566821 PMCID: PMC3720804 DOI: 10.1016/j.biopsych.2013.02.025] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 02/02/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is increasingly conceived as reflecting altered functional and structural brain connectivity. The latter can be addressed with diffusion tensor imaging (DTI). We examined fractional anisotropy (FA), a DTI index related to white matter structural properties, in adult male subjects diagnosed with ADHD in childhood (probands) and matched control subjects without childhood ADHD. Additionally, we contrasted FA among probands with and without current ADHD in adulthood and control subjects. METHODS Participants were from an original cohort of 207 boys and 178 male control subjects. At 33-year follow-up, analyzable DTI scans were obtained in 51 probands (41.3 ± 2.8 yrs) and 66 control subjects (41.2 ± 3.1 yrs). Voxel-based FA was computed with tract-based spatial statistics, controlling for multiple comparisons. RESULTS Probands with childhood ADHD exhibited significantly lower FA than control subjects without childhood ADHD in the right superior and posterior corona radiata, right superior longitudinal fasciculus, and in a left cluster including the posterior thalamic radiation, the retrolenticular part of the internal capsule, and the sagittal stratum (p<.05, corrected). Fractional anisotropy was significantly decreased relative to control subjects in several tracts in both probands with current and remitted ADHD, who did not differ significantly from each other. Fractional anisotropy was not significantly increased in probands in any region. CONCLUSIONS Decreased FA in adults with childhood ADHD regardless of current ADHD might be an enduring trait of ADHD. White matter tracts with decreased FA connect regions involved in high-level as well as sensorimotor functions, suggesting that both types of processes are involved in the pathophysiology of ADHD.
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Affiliation(s)
- Samuele Cortese
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, New York University Langone School of Medicine, New York; Child Neuropsychiatry Unit, G. B. Rossi Hospital, Department of Life Science and Reproduction, Verona University, Verona, Italy; UMR_S INSERM U 930, CNRS ERL 3106, François-Rabelais University, Child Psychiatry Centre, University Hospital, Tours, France.
| | - Davide Imperati
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Juan Zhou
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Duke-NUS Graduate Medical School, Neuroscience and Behavioral Disorders Program, & the Agency for Science, Technology and Research, Neuroscience Research Partnership, Singapore
| | - Erika Proal
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Neuroingenia Clinical and Research Center, México, D.F., México
| | - Rachel G. Klein
- Anita Saltz Institute for Anxiety and Mood Disorders, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Salvatore Mannuzza
- Anita Saltz Institute for Anxiety and Mood Disorders, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Maria A. Ramos-Olazagasti
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - Michael P. Milham
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA,Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Clare Kelly
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA
| | - F. Xavier Castellanos
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Child Study Center, NYU Langone School of Medicine, New York, NY, USA,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
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Albein-Urios N, Pilatti A, Lozano Ó, Martínez-González JM, Verdejo-García A. The Value of Impulsivity to Define Subgroups of Addicted Individuals Differing in Personality Dysfunction, Craving, Psychosocial Adjustment, and Wellbeing: A Latent Class Analysis. Arch Clin Neuropsychol 2013; 29:38-46. [DOI: 10.1093/arclin/act072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Albein-Urios N, Martinez-Gonzalez JM, Lozano Ó, Moreno-López L, Soriano-Mas C, Verdejo-Garcia A. Negative urgency, disinhibition and reduced temporal pole gray matter characterize the comorbidity of cocaine dependence and personality disorders. Drug Alcohol Depend 2013; 132:231-7. [PMID: 23466222 DOI: 10.1016/j.drugalcdep.2013.02.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/03/2013] [Accepted: 02/05/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Individuals with cocaine dependence and co-occurring personality disorders are more likely to have increased impulsivity, dysfunctional beliefs, executive dysfunction and brain structural abnormalities by virtue of the conjoint impact of both pathologies. METHODS We recruited 32 cocaine dependent patients with comorbid Cluster B personality disorders, 44 cocaine dependent patients without comorbidities and 34 non-drug-using controls. They completed the UPPS-P impulsivity scale, the Personality Belief Questionnaire, and executive function tests of working memory, attention/response inhibition and shifting. A subsample (n=61) was also scanned using Magnetic Resonance Imaging. We used univariate ANOVAs for group comparisons, and tested the association between impulsivity, executive control and personality dysfunction and diagnoses using correlation and multivariate logistic regression analyses. RESULTS Cocaine dependent patients with personality disorders had elevated negative urgency and borderline beliefs, decreased inhibition and attention regulation, and reduced temporal pole gray matter with respect to the rest of the sample. Trait and cognitive measures correctly classified 73% of comorbid patients (60% sensitivity and 82% specificity). CONCLUSION The co-occurrence of cocaine dependence and personality disorders is associated with negative-mood impulsivity and beliefs, executive dysfunction and temporal pole attrition.
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Frontal systems related symptoms in cocaine dependent patients with comorbid personality disorders. Psychopharmacology (Berl) 2013; 228:367-73. [PMID: 23483199 DOI: 10.1007/s00213-013-3040-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 02/18/2013] [Indexed: 10/27/2022]
Abstract
RATIONALE The co-occurrence of cocaine dependence and personality disorders may contribute to frontal systems-related behavioral symptoms in cocaine users. OBJECTIVE This study aims to characterize apathy, disinhibition, and dysexecutive symptoms in cocaine users with comorbid personality disorders. METHODS Thirty-nine participants meeting criteria for cocaine dependence and personality disorders, 35 participants meeting criteria for cocaine dependence without comorbidities, and 29 controls matched for age, education, and IQ completed the Frontal Systems Behavior Scale (FrSBe), which provides present and retrospective assessments (of the period preceding cocaine use) about apathy, disinhibition, and dysexecutive symptoms. Additionally, relatives of cocaine patients (34 relatives from comorbid patients and 31 relatives from noncomorbid patients) completed the informant version of the FrSBe. We used one-way ANOVAs to investigate present-moment differences between the groups and related samples t tests to quantify changes between pre-disorder and present-moment symptoms. RESULTS Cocaine users with personality disorders self-reported higher present-moment apathy and disinhibition symptoms than noncomorbid users and controls. Informant ratings showed that comorbid users exhibited pre-disorder elevations in apathy, disinhibition and dysexecutive symptoms, and that these symptoms did not significantly change between the pre-disorder and the present-moment assessments. In contrast, noncomorbid users exhibited increased apathy, disinhibition, and dysexecutive symptoms at present-moment compared with pre-disorder measures. CONCLUSIONS The co-occurrence of cocaine dependence and personality disorders is associated with elevated frontal systems-related behavioral symptoms. Comorbid and noncomorbid users differ in frontal symptoms' trajectories, with the former showing pre-disorder stable elevations and the latter showing lower baseline symptoms but greater addiction-related elevations.
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