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Guo J, Luo X, Kong Y, Li B, Si B, Jensen O, Sun L, Song Y. The effects of first-dose methylphenidate on the neural signatures of visual selective attention in children with attention-deficit/hyperactivity disorder. Biol Psychol 2023; 177:108481. [PMID: 36572273 DOI: 10.1016/j.biopsycho.2022.108481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
Although methylphenidate (MPH) has been shown to significantly improve selective attention in children with attention-deficit/hyperactivity disorder (ADHD), the neural mechanism of this effect remains unclear. We investigated the effects of first-dose MPH on the neural signatures of visual selective attention in children with ADHD. We measured the impact of first-dose MPH on electrophysiological indexes from eighteen children with ADHD (8.9-15.2 years; 15 boys) while they performed a visual search task. MPH was administered in a double-blind placebo-controlled crossover design. MPH led to decreases in behavioral error rates and reaction times. For the electrophysiological indexes, MPH significantly increased the target-elicited N2pc amplitude and posterior P3 amplitude during the selective attention process. The trial-based correlation analysis revealed that the enhanced N2pc (more negative) and P3 (more positive) promoted the behavioral response speed for children with ADHD. The lower individual P3 amplitude was associated with higher severity of inattention symptoms. The severer inattention symptoms were related to weaker MPH effect on N2pc amplitude. These findings suggest that N2pc and P3 are closely related to the mechanism of MPH in the ADHD treatment.
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Affiliation(s)
- Jialiang Guo
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; School of Systems Science, Beijing Normal University, Beijing, China
| | - Xiangsheng Luo
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China
| | - Yuanjun Kong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Bingkun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Bailu Si
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Ole Jensen
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
| | - Yan Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.
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2
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Patil AU, Madathil D, Fan YT, Tzeng OJL, Huang CM, Huang HW. Neurofeedback for the Education of Children with ADHD and Specific Learning Disorders: A Review. Brain Sci 2022; 12:brainsci12091238. [PMID: 36138974 PMCID: PMC9497239 DOI: 10.3390/brainsci12091238] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
Neurofeedback (NF) is a type of biofeedback in which an individual’s brain activity is measured and presented to them to support self-regulation of ongoing brain oscillations and achieve specific behavioral and neurophysiological outcomes. NF training induces changes in neurophysiological circuits that are associated with behavioral changes. Recent evidence suggests that the NF technique can be used to train electrical brain activity and facilitate learning among children with learning disorders. Toward this aim, this review first presents a generalized model for NF systems, and then studies involving NF training for children with disorders such as dyslexia, attention-deficit/hyperactivity disorder (ADHD), and other specific learning disorders such as dyscalculia and dysgraphia are reviewed. The discussion elaborates on the potential for translational applications of NF in educational and learning settings with details. This review also addresses some issues concerning the role of NF in education, and it concludes with some solutions and future directions. In order to provide the best learning environment for children with ADHD and other learning disorders, it is critical to better understand the role of NF in educational settings. The review provides the potential challenges of the current systems to aid in highlighting the issues undermining the efficacy of current systems and identifying solutions to address them. The review focuses on the use of NF technology in education for the development of adaptive teaching methods and the best learning environment for children with learning disabilities.
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Affiliation(s)
- Abhishek Uday Patil
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
| | - Deepa Madathil
- Jindal Institute of Behavioural Sciences, O.P. Jindal Global University, Haryana 131001, India
| | - Yang-Tang Fan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan 320315, Taiwan
| | - Ovid J. L. Tzeng
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- Centre for Intelligent Drug Systems and Smart Bio-Devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- College of Humanities and Social Sciences, Taipei Medical University, Taipei 106339, Taiwan
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei 106308, Taiwan
- Hong Kong Institute for Advanced Studies, City University of Hong Kong, Hong Kong
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- Centre for Intelligent Drug Systems and Smart Bio-Devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
| | - Hsu-Wen Huang
- Department of Linguistics and Translation, City University of Hong Kong, Hong Kong
- Correspondence: ; Tel.: +852-3442-2579
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Aydin Ü, Capp SJ, Tye C, Colvert E, Lau‐Zhu A, Rijsdijk F, Palmer J, McLoughlin G. Quality of life, functional impairment and continuous performance task event‐related potentials (ERPs) in young adults with ADHD and autism: A twin study. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ümit Aydin
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Simone J. Capp
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Charlotte Tye
- Department of Child and Adolescent Psychiatry Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
- Department of Psychology Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Emma Colvert
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Alex Lau‐Zhu
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
- Oxford Institute for Clinical Psychology Training and Research Medical Sciences Division University of Oxford Oxford UK
| | - Frühling Rijsdijk
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
- Psychology Department Faculty of Social Sciences Anton de Kom University Paramaribo Suriname
| | - Jason Palmer
- Endowed Research Department of Clinical Neuroengineering Global Center for Medical Engineering and Informatics Osaka University Suita Japan
| | - Gráinne McLoughlin
- Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
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Ji H, Wu S, Won J, Weng S, Lee S, Seo S, Park JJ. The Effects of Exergame on Attention in Children with Attention Deficit Hyperactivity Disorder (Preprint). JMIR Serious Games 2022; 11:e40438. [PMID: 37159253 DOI: 10.2196/40438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Despite growing evidence showing the effects of exercise and cognitive trainings on enhancing attention, little is known about the combined effects of exergame on attention in children with attention deficit/hyperactivity disorder (ADHD). Exergame, a form of exercise using a video game, has both cognitive stimulation and physical activity components and has been shown to improve cognitive function in children. OBJECTIVE The purpose of this study was to investigate the effect of exergaming on attention and to compare the effect induced by exergaming with the effect of aerobic exercise on attention in children with ADHD. METHODS In all, 30 children with ADHD, aged 8-12 years, were randomly divided into an exergaming group (EXG; n=16) or a bicycle exercise group (BEG; n=14). Before and after the 4-week intervention, the Frankfurter Aufmerksamkeits-Inventar (FAIR; Frankfurt Attention Inventory) test was administrated, and event-related potentials during the Go/No-go task was measured to assess attention. RESULTS After intervention, both the EXG and BEG had significantly increased selective attention and continuous attention (all P<.001), as well as self-control on the FAIR test (EXG: P=.02 and BEG: P=.005). Similarly, both the EXG and BEG had significantly reduced response time on the Go/No-go test (all P<.001). For the Go response, the N2 amplitude (frontocentral maximal negativity) was significantly increased in Fz (midfrontal line) in the EXG (P=.003) but was not changed in the BEG (P=.97). Importantly, the N2 amplitude in Fz was significantly greater in the EXG compared to the BEG (Go: P=.001 and No-go: P=.008). CONCLUSIONS Exergaming has the comparable effects to bicycle exercise to enhance attention in children with ADHD, suggesting that exergaming can be used as an alternative treatment for children with ADHD. TRIAL REGISTRATION Clinical Research Information Service KCT0008239; https://tinyurl.com/57e4jtnb.
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Affiliation(s)
- HongQing Ji
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Shanshan Wu
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - Shiyang Weng
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
| | - Sujin Lee
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Sangmin Seo
- Busan Children's Mind Clinic, Busan, Republic of Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
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Münger M, Sele S, Candrian G, Kasper J, Abdel-Rehim H, Eich-Höchli D, Müller A, Jäncke L. Longitudinal Analysis of Self-Reported Symptoms, Behavioral Measures, and Event-Related Potential Components of a Cued Go/NoGo Task in Adults With Attention-Deficit/Hyperactivity Disorder and Controls. Front Hum Neurosci 2022; 16:767789. [PMID: 35250513 PMCID: PMC8894259 DOI: 10.3389/fnhum.2022.767789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
This study characterizes a large sample of adults with attention-deficit/hyperactivity disorder (ADHD) and healthy controls regarding their task performance and neurophysiology; cross-sectionally and longitudinally. Self-reported symptoms, behavioral measures, and event-related potentials from a classical cued Go/NoGo task were used to outline the symptom burden, executive function deficits and neurophysiological features, and the associations between these domains. The study participants (N = 210 ADHD, N = 158 controls, age: 18–62 years) were assessed five (ADHD) or three (controls) times over two years. We describe cross-sectional and longitudinal group differences, and associations between symptom burden, and behavioral and event-related potential (ERP) components variables by latent growth curve models, including random slopes and intercepts. The ADHD group showed increased reaction time variability, increased commission and omission errors, and attenuated cueP3, CNV, N2d, and P3d amplitudes. We observed a decrease in self-reported symptoms in the ADHD group over the two years. The behavioral measures (reaction time variability, number of omission, and commission errors) did not change over time, whereas the cueP3, P3d, and N2d amplitude attenuated in both groups. There was no evidence for a robust association between symptom burden and behavioral or ERP measures. The changes in the ERP components with stable task performance, potentially indicate more efficient neuronal processing over the two years. Whether the lack of association between symptom burden and behavioral or ERP measures might be due to the low reliability of the ADHD assessment criteria, or the inappropriateness of the objective measures cannot be inferred.
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Affiliation(s)
- Marionna Münger
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- *Correspondence: Marionna Münger,
| | - Silvano Sele
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
| | - Gian Candrian
- Brain and Trauma Foundation Grisons, Chur, Switzerland
| | - Johannes Kasper
- Praxisgemeinschaft Psychiatrie und Psychotherapie, Lucerne, Switzerland
| | | | - Dominique Eich-Höchli
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Lutz Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
- Lutz Jäncke,
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6
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McLoughlin G, Gyurkovics M, Aydin Ü. What Has Been Learned from Using EEG Methods in Research of ADHD? Curr Top Behav Neurosci 2022; 57:415-444. [PMID: 35637406 DOI: 10.1007/7854_2022_344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electrophysiological recording methods, including electroencephalography (EEG) and magnetoencephalography (MEG), have an unparalleled capacity to provide insights into the timing and frequency (spectral) composition of rapidly changing neural activity associated with various cognitive processes. The current chapter provides an overview of EEG studies examining alterations in brain activity in ADHD, measured both at rest and during cognitive tasks. While EEG resting state studies of ADHD indicate no universal alterations in the disorder, event-related studies reveal consistent deficits in attentional and inhibitory control and consequently inform the proposed cognitive models of ADHD. Similar to other neuroimaging measures, EEG research indicates alterations in multiple neural circuits and cognitive functions. EEG methods - supported by the constant refinement of analytic strategies - have the potential to contribute to improved diagnostics and interventions for ADHD, underlining their clinical utility.
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Affiliation(s)
- Gráinne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Máté Gyurkovics
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ümit Aydin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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7
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Korfmacher AK, Hirsch O, Chavanon ML, Albrecht B, Christiansen H. Self-management training vs. neurofeedback interventions for attention deficit hyperactivity disorder: Results of a randomized controlled treatment study. Front Psychiatry 2022; 13:969351. [PMID: 36061275 PMCID: PMC9433654 DOI: 10.3389/fpsyt.2022.969351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Neurofeedback (NF) and self-management training (SMT) may be viable treatment options for patients with attention deficit hyperactivity disorder (ADHD) if they alleviate core symptoms, enhance the patients' self-concept and improve their quality of life (QoL). Aim of the current study is evaluating both interventions accordingly and to test whether specific improvements in core symptoms lead to more general improvements in self-concept and QoL. METHODS In a psychotherapeutic outpatient clinic in Germany, a total of N = 139 children with ADHD were screened for eligibility, of which 111 fulfilled inclusion criteria and participated in the study in accordance with the CONSORT 2010 statement. These were randomly assigned to NF vs. SMT interventions. Changes from pre- to post-intervention in core ADHD symptoms relying on parent and teacher reports (CONNERS 3) and objective tests (Qb-Test) as well as self-concept (interview with the children) and QoL assessments (using the KINDL-R self-report) were compared between patients receiving NF or SMT. RESULTS Significant improvements in ADHD symptoms were achieved similarly in both treatment groups, whilst QoL and self-concept improved after SMT only. CONCLUSION This treatment study provides further evidence that SMT and NF may reduce core symptoms, but SMT may also improve patients' self-concept and QoL and may thus in its current form be the favorable treatment option in naturalistic settings. However, several limitations of the current study implicate that further research is required before definitive conclusions and recommendations for clinical practice can be given. CLINICAL TRIAL REGISTRATION [www.clinicaltrials.gov], identifier [NCT01879644].
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Affiliation(s)
- Ann-Kathrin Korfmacher
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, Germany
| | - Mira-Lynn Chavanon
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Björn Albrecht
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
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8
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Kannen K, Aslan B, Boetzel C, Herrmann CS, Lux S, Rosen H, Selaskowski B, Wiebe A, Philipsen A, Braun N. P300 Modulation via Transcranial Alternating Current Stimulation in Adult Attention-Deficit/Hyperactivity Disorder: A Crossover Study. Front Psychiatry 2022; 13:928145. [PMID: 35923453 PMCID: PMC9339709 DOI: 10.3389/fpsyt.2022.928145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE A repeated finding regarding event-related potentials (ERPs) is that patients with ADHD show a reduced P300 amplitude. This raises the question of whether the attention of ADHD patients can be increased by stabilizing the P300. Assuming that the P300 is generated by event-related oscillations (EROs) in the low frequency range (0-8 Hz), one approach to increase the P300 could be to stimulate the patient's P300 underlying ERO by means of transcranial alternating current stimulation (tACS). The aim of this follow-up study was to investigate this hypothesized mechanism of action in adult ADHD patients. MATERIALS AND METHODS Undergoing a crossover design, 20 adult ADHD patients (10 female) received an actual stimulation via tACS on one day and a sham stimulation on another day. Before and after each intervention, EEG characteristics (P300 amplitudes, low frequency power) and attention performances (d2 attention test, visual oddball task (VOT)) were recorded. RESULTS Electrophysiological analyses revealed no evidence for an enhanced P300 amplitude or low frequency power increase after actual stimulation compared to sham stimulation. Instead, a significant effect was found for a stronger N700 amplitude increase after actual stimulation compared to sham stimulation. Consistent with the P300 null results, none of the examined neuropsychological performance measures indicated a tACS-induced improvement in attentional ability. CONCLUSION Contrary to a previous study using tACS to modulate the P300 in adult ADHD patients, the current study yields no evidence that tACS can increase the P300 amplitude in adult ADHD patients and that such P300 enhancement can directly improve neuropsychological parameters of attention.
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Affiliation(s)
- Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Cindy Boetzel
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky University, Oldenburg, Germany
| | - Christoph S Herrmann
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky University, Oldenburg, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Rosen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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9
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Van Dessel J, Sonuga-Barke EJS, Moerkerke M, Van der Oord S, Morsink S, Lemiere J, Danckaerts M. The Limits of Motivational Influence in ADHD: No Evidence for an Altered Reaction to Negative Reinforcement. Soc Cogn Affect Neurosci 2021; 17:482-492. [PMID: 34643738 PMCID: PMC9071417 DOI: 10.1093/scan/nsab111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/14/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022] Open
Abstract
Functional magnetic resonance imaging studies have reported a diminished response in the brain’s reward circuits to contingent cues predicting future monetary gain in adolescents with attention-deficit/hyperactivity disorder (ADHD). The situation with regard to monetary loss is less clear, despite recognition that both positive and negative consequences impact ADHD behaviour. Here, we employ a new Escape Monetary Loss Incentive task in an MRI scanner, which allows the differentiation of contingency and valence effects during loss avoidance, to examine ADHD-related alterations in monetary loss processing. There was no evidence of atypical processing of contingent or non-contingent monetary loss cues in ADHD — either in terms of ratings of emotional and motivational significance or brain responses. This suggests that the ability to process contingencies between performance and negative outcomes is intact in ADHD and that individuals with ADHD are no more (or less) sensitive to negative outcomes than controls. This latter finding stands in stark contrast to recent evidence from a similar task of atypical emotion network recruitment (e.g. amygdala) in ADHD individuals to cues predicting another negative event, the imposition of delay, suggesting marked specificity in the way they respond to negative events.
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Affiliation(s)
- Jeroen Van Dessel
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Matthijs Moerkerke
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Saskia Van der Oord
- Clinical Psychology, KU Leuven, Leuven, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Sarah Morsink
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Marina Danckaerts
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
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10
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Shirvani-Farsani Z, Maloum Z, Bagheri-Hosseinabadi Z, Vilor-Tejedor N, Sadeghi I. DNA methylation signature as a biomarker of major neuropsychiatric disorders. J Psychiatr Res 2021; 141:34-49. [PMID: 34171761 DOI: 10.1016/j.jpsychires.2021.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
DNA methylation is a broadly-investigated epigenetic modification that has been considered as a heritable and reversible change. Previous findings have indicated that DNA methylation regulates gene expression in the central nervous system (CNS). Also, disturbance of DNA methylation patterns has been associated with destructive consequences that lead to human brain diseases such as neuropsychiatric disorders (NPDs). In this review, we comprehensively discuss the mechanism and function of DNA methylation and its most recent associations with the pathology of NPDs-including major depressive disorder (MDD), schizophrenia (SZ), autism spectrum disorder (ASD), bipolar disorder (BD), and attention/deficit hyperactivity disorder (ADHD). We also discuss how heterogeneous findings demand further investigations. Finally, based on the recent studies we conclude that DNA methylation status may have implications in clinical diagnostics and therapeutics as a potential epigenetic biomarker of NPDs.
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Affiliation(s)
- Zeinab Shirvani-Farsani
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C., Tehran, IR, Iran.
| | - Zahra Maloum
- Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University G.C., Tehran, IR, Iran.
| | - Zahra Bagheri-Hosseinabadi
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Natalia Vilor-Tejedor
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Carrer Wellington 30, 08005, Barcelona, Spain; Center for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain; Erasmus University Medical Center, Department of Clinical Genetics, Rotterdam, the Netherlands; Pompeu Fabra University, Barcelona, Spain.
| | - Iman Sadeghi
- BarcelonaBeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Carrer Wellington 30, 08005, Barcelona, Spain; Center for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain.
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11
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Carruthers S, Michelini G, Kitsune V, Hosang GM, Brandeis D, Asherson P, Kuntsi J. Early neurophysiological stimulus processing during a performance-monitoring task differentiates women with bipolar disorder from women with ADHD. Psychiatry Res 2021; 303:114088. [PMID: 34252636 DOI: 10.1016/j.psychres.2021.114088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 11/21/2022]
Abstract
Adults with attention-deficit/hyperactivity disorder (ADHD) or bipolar disorder (BD) may display similar cognitive impairments and clinical symptoms, which might reflect shared mechanisms. Initial evidence indicates disorder-specific and overlapping neurophysiological alterations using event-related potentials (ERPs) in individuals with BD or ADHD during attentional tasks, but it is unknown whether impairments generalize across other processes and tasks. We conduct the first comparison between women with ADHD (n = 20), women with BD (n = 20) and control women (n = 20) on ERPs from a performance-monitoring flanker task. The BD group showed a significantly attenuated frontal ERP of conflict monitoring (N2) compared to the ADHD group across both low-conflict (congruent) and high-conflict (incongruent) task conditions, and compared to controls in the high-conflict condition. However, when controlling for an earlier attentional ERP (frontal N1), which was significantly reduced in participants with BD compared to participants with ADHD and controls, N2 group differences were no longer significant. These results indicate that ERP differences in conflict monitoring may be attributable to differences in earlier attentional processes. These findings identify neural differences in early attention between BD and ADHD which precede conflict monitoring processes, potentially pointing to distinct neural mechanisms implicated in the two disorders.
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Affiliation(s)
- Sophie Carruthers
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK; Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Giorgia Michelini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Viryanaga Kitsune
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Georgina M Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary, University of London, London, UK
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
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12
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Aggensteiner PM, Albrecht B, Strehl U, Wörz S, Ruckes C, Freitag CM, Rothenberger A, Gevensleben H, Millenet S, Hohmann S, Banaschewski T, Legenbauer T, Holtmann M, Brandeis D. Can neurophysiological markers of anticipation and attention predict ADHD severity and neurofeedback outcomes? Biol Psychol 2021; 165:108169. [PMID: 34416347 DOI: 10.1016/j.biopsycho.2021.108169] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/12/2021] [Accepted: 08/12/2021] [Indexed: 01/23/2023]
Abstract
Neurophysiological measures of preparation and attention are often atypical in ADHD. Still, replicated findings that these measures predict which patients improve after Neurofeedback (NF), reveal neurophysiological specificity, and reflect ADHD-severity are limited. METHODS We analyzed children's preparatory (CNV) and attentional (Cue-P3) brain activity and behavioral performance during a cued Continuous Performance Task (CPT) before and after slow cortical potential (SCP)-NF or semi-active control treatment (electromyogram biofeedback). Mixed-effects models were performed with 103 participants at baseline and 77 were assessed for pre-post comparisons focusing on clinical outcome prediction, specific neurophysiological effects of NF, and associations with ADHD-severity. RESULTS Attentional and preparatory brain activity and performance were non-specifically reduced after treatment. Preparatory activity in the SCP-NF group increased with clinical improvement. Several performance and brain activity measures predicted non-specific treatment outcome. CONCLUSION Specific neurophysiological effects after SCP-NF were limited to increased neural preparation associated with improvement on ADHD-subscales, but several performance and neurophysiological measures of attention predicted treatment outcome and reflected symptom severity in ADHD. The results may help to optimize treatment.
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Affiliation(s)
- Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Björn Albrecht
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany; Philipps-University Marburg, Department of Psychology, Marburg, Germany
| | - Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Sonja Wörz
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials at the University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Holger Gevensleben
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zürich, Swiss Federal Institute of Technology and University of Zürich, Zürich, Switzerland
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13
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EEG Data Quality: Determinants and Impact in a Multicenter Study of Children, Adolescents, and Adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 2021; 11:brainsci11020214. [PMID: 33578741 PMCID: PMC7916500 DOI: 10.3390/brainsci11020214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Abstract
Electroencephalography (EEG) represents a widely established method for assessing altered and typically developing brain function. However, systematic studies on EEG data quality, its correlates, and consequences are scarce. To address this research gap, the current study focused on the percentage of artifact-free segments after standard EEG pre-processing as a data quality index. We analyzed participant-related and methodological influences, and validity by replicating landmark EEG effects. Further, effects of data quality on spectral power analyses beyond participant-related characteristics were explored. EEG data from a multicenter ADHD-cohort (age range 6 to 45 years), and a non-ADHD school-age control group were analyzed (ntotal = 305). Resting-state data during eyes open, and eyes closed conditions, and task-related data during a cued Continuous Performance Task (CPT) were collected. After pre-processing, general linear models, and stepwise regression models were fitted to the data. We found that EEG data quality was strongly related to demographic characteristics, but not to methodological factors. We were able to replicate maturational, task, and ADHD effects reported in the EEG literature, establishing a link with EEG-landmark effects. Furthermore, we showed that poor data quality significantly increases spectral power beyond effects of maturation and symptom severity. Taken together, the current results indicate that with a careful design and systematic quality control, informative large-scale multicenter trials characterizing neurophysiological mechanisms in neurodevelopmental disorders across the lifespan are feasible. Nevertheless, results are restricted to the limitations reported. Future work will clarify predictive value.
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14
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James SN, Cheung CHM, Rommel AS, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Peripheral Hypoarousal but Not Preparation-Vigilance Impairment Endures in ADHD Remission. J Atten Disord 2020; 24:1944-1951. [PMID: 28363258 PMCID: PMC5617106 DOI: 10.1177/1087054717698813] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective: This study investigates whether impairments associated with persistent ADHD-impaired attention allocation (P3 amplitude), peripheral hypoarousal (skin conductance level [SCL]), and adjustment in preparatory state (contingent negative variation [CNV])-reflect enduring deficits unrelated to ADHD outcome or are markers of ADHD remission. Method: Young people with childhood ADHD (73 persisters and 18 remitters) and 144 controls were compared on neurophysiological measures during two conditions (baseline and fast-incentive) of a four-choice reaction time task. Results: ADHD remitters differed from persisters, and were indistinguishable from controls, on baseline P3 amplitude and fast-incentive CNV amplitude (p ≤ .05). ADHD remitters differed from controls (p ≤ .01), and were indistinguishable from persisters (p > .05), on baseline SCL. Conclusion: Preparation-vigilance measures were markers of ADHD remission, confirming previous findings with other measures. Yet, SCL-measured peripheral hypoarousal emerges as an enduring deficit unrelated to ADHD improvement. Future studies should explore potential compensatory mechanisms that enable efficient preparation-vigilance processes in ADHD remitters.
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Affiliation(s)
| | | | | | | | - Daniel Brandeis
- Heidelberg University, Germany
- University of Zurich, Switzerland
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15
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Drechsler R, Brem S, Brandeis D, Grünblatt E, Berger G, Walitza S. ADHD: Current Concepts and Treatments in Children and Adolescents. Neuropediatrics 2020; 51:315-335. [PMID: 32559806 PMCID: PMC7508636 DOI: 10.1055/s-0040-1701658] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is among the most frequent disorders within child and adolescent psychiatry, with a prevalence of over 5%. Nosological systems, such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and the International Classification of Diseases, editions 10 and 11 (ICD-10/11) continue to define ADHD according to behavioral criteria, based on observation and on informant reports. Despite an overwhelming body of research on ADHD over the last 10 to 20 years, valid neurobiological markers or other objective criteria that may lead to unequivocal diagnostic classification are still lacking. On the contrary, the concept of ADHD seems to have become broader and more heterogeneous. Thus, the diagnosis and treatment of ADHD are still challenging for clinicians, necessitating increased reliance on their expertise and experience. The first part of this review presents an overview of the current definitions of the disorder (DSM-5, ICD-10/11). Furthermore, it discusses more controversial aspects of the construct of ADHD, including the dimensional versus categorical approach, alternative ADHD constructs, and aspects pertaining to epidemiology and prevalence. The second part focuses on comorbidities, on the difficulty of distinguishing between "primary" and "secondary" ADHD for purposes of differential diagnosis, and on clinical diagnostic procedures. In the third and most prominent part, an overview of current neurobiological concepts of ADHD is given, including neuropsychological and neurophysiological researches and summaries of current neuroimaging and genetic studies. Finally, treatment options are reviewed, including a discussion of multimodal, pharmacological, and nonpharmacological interventions and their evidence base.
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Affiliation(s)
- Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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16
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Rostami M, Khosrowabadi R, Albrecht B, Pouretemad H, Rothenberger A. ADHD subtypes: Do they hold beyond core symptoms? A multilevel testing of an additive model. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:280-290. [DOI: 10.1080/21622965.2020.1806067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohammad Rostami
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Björn Albrecht
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Centers of Göttingen, Göttingen, Germany
| | - Hamidreza Pouretemad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Centers of Göttingen, Göttingen, Germany
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17
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Magliacano A, Fiorenza S, Estraneo A, Trojano L. Eye blink rate increases as a function of cognitive load during an auditory oddball paradigm. Neurosci Lett 2020; 736:135293. [PMID: 32771601 DOI: 10.1016/j.neulet.2020.135293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/08/2020] [Accepted: 08/03/2020] [Indexed: 01/21/2023]
Abstract
Previous evidence suggests that changes in spontaneous eye blink rate (EBR) in human adults might reflect the amount of attentional demand (i.e. cognitive load) during cognitive tasks. However, the actual direction of this relation is uncertain, since most studies investigated the role of cognitive load on EBR by employing visual tasks only. Here we aimed at elucidating the relationship between EBR and cognitive load in non-visual tasks. Sixteen healthy participants performed two auditory oddball tasks, i.e. passive listening to auditory tones versus active counting of target tones; each oddball task was immediately followed by a rest phase. Throughout the oddball tasks we assessed EBR and recorded the P300 on ERPs as an electrophysiological measure of attention. The results showed that participants' EBR increased during the active task compared to the respective rest phase. Amplitude and latency of the P300 too differed between passive and active tasks, but changes in EBR and P300 features were not correlated with each other. Our findings demonstrated that an increase in cognitive load is associated with an increase in EBR in cognitive tasks not involving visual attention. These findings are consistent with previous evidence suggesting shared neurobiological bases between attention and EBR.
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Affiliation(s)
- Alfonso Magliacano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Salvatore Fiorenza
- Istituti Clinici Scientifici Maugeri IRCCS, SB S.p.A., Laboratorio di Valutazione Multimodale dei Disordini della Coscienza, Telese Terme BN, Italy
| | | | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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18
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Towards a Pragmatic Approach to a Psychophysiological Unit of Analysis for Mental and Brain Disorders: An EEG-Copeia for Neurofeedback. Appl Psychophysiol Biofeedback 2020; 44:151-172. [PMID: 31098793 DOI: 10.1007/s10484-019-09440-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article proposes what we call an "EEG-Copeia" for neurofeedback, like the "Pharmacopeia" for psychopharmacology. This paper proposes to define an "EEG-Copeia" as an organized list of scientifically validated EEG markers, characterized by a specific association with an identified cognitive process, that define a psychophysiological unit of analysis useful for mental or brain disorder evaluation and treatment. A characteristic of EEG neurofeedback for mental and brain disorders is that it targets a EEG markers related to a supposed cognitive process, whereas conventional treatments target clinical manifestations. This could explain why EEG neurofeedback studies encounter difficulty in achieving reproducibility and validation. The present paper suggests that a first step to optimize EEG neurofeedback protocols and future research is to target a valid EEG marker. The specificity of the cognitive skills trained and learned during real time feedback of the EEG marker could be enhanced and both the reliability of neurofeedback training and the therapeutic impact optimized. However, several of the most well-known EEG markers have seldom been applied for neurofeedback. Moreover, we lack a reliable and valid EEG targets library for further RCT to evaluate the efficacy of neurofeedback in mental and brain disorders. With the present manuscript, our aim is to foster dialogues between cognitive neuroscience and EEG neurofeedback according to a psychophysiological perspective. The primary objective of this review was to identify the most robust EEG target. EEG markers linked with one or several clearly identified cognitive-related processes will be identified. The secondary objective was to organize these EEG markers and related cognitive process in a psychophysiological unit of analysis matrix inspired by the Research Domain Criteria (RDoC) project.
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19
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Miranda P, Cox CD, Alexander M, Danev S, Lakey JRT. In Quest of Pathognomonic/Endophenotypic Markers of Attention Deficit Hyperactivity Disorder (ADHD): Potential of EEG-Based Frequency Analysis and ERPs to Better Detect, Prevent and Manage ADHD. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:115-137. [PMID: 32547262 PMCID: PMC7250294 DOI: 10.2147/mder.s241205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the “characterizing ADHD” and on the quest for objective “pathognomonic/endophenotypic diagnostic markers of ADHD”. The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.
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Affiliation(s)
- Priya Miranda
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | - Christopher D Cox
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Michael Alexander
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | | | - Jonathan R T Lakey
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
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20
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Does behavioural inhibition system dysfunction contribute to Attention Deficit Hyperactivity Disorder? PERSONALITY NEUROSCIENCE 2020; 2:e5. [PMID: 32435740 PMCID: PMC7219695 DOI: 10.1017/pen.2019.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/30/2019] [Accepted: 06/30/2019] [Indexed: 12/30/2022]
Abstract
The Reinforcement Sensitivity Theory of Personality has as its main foundation a Behavioural Inhibition System (BIS), defined by anxiolytic drugs, in which high trait sensitivity should lead to internalising, anxiety, disorders. Conversely, it has been suggested that low BIS sensitivity would be a characteristic of externalising disorders. BIS output should lead to increased arousal and attention as well as behavioural inhibition. Here, therefore, we tested whether an externalising disorder, Attention Deficit Hyperactivity Disorder (ADHD), involves low BIS sensitivity. Goal-Conflict-Specific Rhythmicity (GCSR) in an auditory Stop Signal Task is a right frontal EEG biomarker of BIS function. We assessed children diagnosed with ADHD-I (inattentive) or ADHD-C (combined) and healthy control groups for GCSR in: a) an initial smaller study in Dunedin, New Zealand (population ~120,000: 15 control, 10 ADHD-I, 10 ADHD-C); and b) a main larger one in Tehran, Iran (population ~9 [city]-16 [metropolis] million: 27 control, 18 ADHD-I, 21 ADHD-C). GCSR was clear in controls (particularly at 6–7 Hz) and in ADHD-C (particularly at 8–9 Hz) but was reduced in ADHD-I. Reduced attention and arousal in ADHD-I could be due, in part, to BIS dysfunction. However, hyperactivity and impulsivity in ADHD-C are unlikely to reflect reduced BIS activity. Increased GCSR frequency in ADHD-C may be due to increased input to the BIS. BIS dysfunction may contribute to some aspects of ADHD (and potentially other externalising disorders) and to some differences between the ADHD subtypes but other prefrontal systems (and, e.g. dopamine) are also important.
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21
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Earlier versus later cognitive event-related potentials (ERPs) in attention-deficit/hyperactivity disorder (ADHD): A meta-analysis. Neurosci Biobehav Rev 2020; 112:117-134. [DOI: 10.1016/j.neubiorev.2020.01.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/15/2020] [Accepted: 01/18/2020] [Indexed: 12/21/2022]
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22
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Sidlauskaite J, Dhar M, Sonuga-Barke E, Wiersema JR. Altered proactive control in adults with ADHD: Evidence from event-related potentials during cued task switching. Neuropsychologia 2019; 138:107330. [PMID: 31887312 DOI: 10.1016/j.neuropsychologia.2019.107330] [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: 09/18/2018] [Revised: 09/03/2019] [Accepted: 12/27/2019] [Indexed: 11/26/2022]
Abstract
Cognitive control has two distinct modes - proactive and reactive (Braver, T. S. (2012). The variable nature of cognitive control: a dual mechanisms framework. Trends in Cognitive Sciences, 16(2), 105-112). ADHD has been associated with cognitive control impairments. However, studies have mainly focused on reactive control and not proactive control. Here we investigated neural correlates of proactive and reactive cognitive control in a group of adults with ADHD versus healthy controls by employing a cued switching task while cue informativeness was manipulated and EEG recorded. On the performance level, only a trend to generally slower responding was found in the ADHD group. Cue-locked analyses revealed an attenuated informative-positivity - a differential component appearing when contrasting informative with non-informative alerting cues - and potentially altered lateralisation of the switch-positivity - evident in the contrast between switch and repeat trials for informative cues - in ADHD. No difference in target-locked activity was found. Our results indicate altered proactive rather than reactive control in adults with ADHD, evidenced by less use of cued advance information and abnormal preparatory processes for upcoming tasks.
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Affiliation(s)
- Justina Sidlauskaite
- Motor Control and Neural Plasticity Research Group, Department of Kinesiology, Leuven University, Belgium.
| | - Monica Dhar
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium; Clinical and Lifespan Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium; Center for Cognitive Neuroscience, Ghent University, Belgium
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23
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Machida K, Johnson KA. Integration and Segregation of the Brain Relate to Stability of Performance in Children and Adolescents with Varied Levels of Inattention and Impulsivity. Brain Connect 2019; 9:711-729. [DOI: 10.1089/brain.2019.0671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Keitaro Machida
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Katherine A. Johnson
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
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24
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Lau-Zhu A, Tye C, Rijsdijk F, McLoughlin G. No evidence of associations between ADHD and event-related brain potentials from a continuous performance task in a population-based sample of adolescent twins. PLoS One 2019; 14:e0223460. [PMID: 31584981 PMCID: PMC6777760 DOI: 10.1371/journal.pone.0223460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022] Open
Abstract
We investigated key event-related brain potential markers (ERPs) derived from a flanked continuous performance task (CPT) and whether these would show phenotypic associations with ADHD (attention-deficit/hyperactivity disorder) in a population-based sample. We further explored whether there was preliminary evidence that such ERPs could also index genetic risk for ADHD (depending on finding phenotypic associations). Sixty-seven male-only twin pairs (N = 134; aged 12–15) from a subsample of the Twins’ Early Development Study, concordant and discordant for ADHD symptoms, performed the flanked CPT (or CPT-OX) while electroencephalography (EEG) was recorded. ERPs were obtained for cue (P3, CNV or contingency negative variation), go (P3, N2) and nogo trials (P3, N2). We found no phenotypic associations between CPT-derived ERPs and ADHD—the sizes of the estimated phenotypic correlations were nonsignificant and very small (r’s = -.11 to .04). Twin-model fitting analyses using structural equation modelling provided preliminary evidence that some of the ERPs were heritable (with the most robust effect for go-P3 latency), but there was limited evidence of any genetic associations between ERPs and ADHD, although with the caveat that our sample was small and hence had limited power. Overall, unlike in previous research, there was no evidence of phenotypic (nor preliminary evidence for genetic) associations between ADHD and CPT-derived ERPs in this study. Hence, it may be currently premature for genetic analyses of ADHD to be guided by CPT-derived ERP parameters (unlike alternative cognitive-neurophysiological approaches which may be more promising). Further research with better-powered, population-based, genetically-informative and cross-disorder samples are required, which could be facilitated by emerging mobile EEG technologies.
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Affiliation(s)
- Alex Lau-Zhu
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
- Centre for Psychiatry, Brain Sciences Division, Imperial College London, London, England, United Kingdom
- * E-mail:
| | - Charlotte Tye
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
| | - Frühling Rijsdijk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
| | - Grainne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
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Van Doren J, Arns M, Heinrich H, Vollebregt MA, Strehl U, K Loo S. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2019; 28:293-305. [PMID: 29445867 PMCID: PMC6404655 DOI: 10.1007/s00787-018-1121-4] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/05/2018] [Indexed: 12/11/2022]
Abstract
Neurofeedback (NF) has gained increasing interest in the treatment of attention-deficit/hyperactivity disorder (ADHD). Given learning principles underlie NF, lasting clinical treatment effects may be expected. This systematic review and meta-analysis addresses the sustainability of neurofeedback and control treatment effects by considering randomized controlled studies that conducted follow-up (FU; 2-12 months) assessments among children with ADHD. PubMed and Scopus databases were searched through November 2017. Within-group and between-group standardized mean differences (SMD) of parent behavior ratings were calculated and analyzed. Ten studies met inclusion criteria (NF: ten studies, N = 256; control: nine studies, N = 250). Within-group NF effects on inattention were of medium effect size (ES) (SMD = 0.64) at post-treatment and increased to a large ES (SMD = 0.80) at FU. Regarding hyperactivity/impulsivity, NF ES were medium at post-treatment (SMD = 0.50) and FU (SMD = 0.61). Non-active control conditions yielded a small significant ES on inattention at post-treatment (SMD = 0.28) but no significant ES at FU. Active treatments (mainly methylphenidate), had large ES for inattention (post: SMD = 1.08; FU: SMD = 1.06) and medium ES for hyperactivity/impulsivity (post: SMD = 0.74; FU: SMD = 0.67). Between-group analyses also revealed an advantage of NF over non-active controls [inattention (post: SMD = 0.38; FU: SMD = 0.57); hyperactivity-impulsivity (post: SMD = 0.25; FU: SMD = 0.39)], and favored active controls for inattention only at pre-post (SMD = - 0.44). Compared to non-active control treatments, NF appears to have more durable treatment effects, for at least 6 months following treatment. More studies are needed for a properly powered comparison of follow-up effects between NF and active treatments and to further control for non-specific effects.
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Affiliation(s)
- Jessica Van Doren
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Erlangen, Germany
| | - Martijn Arns
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.
- neuroCare Group, Munich, Germany.
- Research Institute Brainclinics, Bijleveldsingel 34, 6524 AD, Nijmegen, The Netherlands.
| | - Hartmut Heinrich
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Erlangen, Germany
- kbo-Heckscher-Klinikum, Munich, Germany
| | - Madelon A Vollebregt
- Research Institute Brainclinics, Bijleveldsingel 34, 6524 AD, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ute Strehl
- Institute for Medical Psychology, University of Tuebingen, Tuebingen, Germany
| | - Sandra K Loo
- Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine, University of California, Los Angeles, USA
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Chmielewski W, Bluschke A, Bodmer B, Wolff N, Roessner V, Beste C. Evidence for an altered architecture and a hierarchical modulation of inhibitory control processes in ADHD. Dev Cogn Neurosci 2019; 36:100623. [PMID: 30738306 PMCID: PMC6969218 DOI: 10.1016/j.dcn.2019.100623] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 01/23/2023] Open
Abstract
Inhibitory control deficits are a hallmark in ADHD. Yet, inhibitory control includes a multitude of entities (e.g. ‘inhibition of interferences’ and ‘action inhibition’). Examining the interplay between these kinds of inhibitory control provides insights into the architecture of inhibitory control in ADHD. Combining a Simon task and a Go/Nogo task, we assessed the interplay of ‘inhibition of interferences’ and ‘action inhibition’. This was combined with EEG recordings, EEG data decomposition and source localization. Simon interference effects in Go trials were larger in ADHD. At the neurophysiological level, this insufficient inhibition of interferences in ADHD related to the superior parietal cortex. Simon interference effects were absent in action inhibition (Nogo) trials in ADHD, compared to controls. This was supported by bayesian statistics. The power of effects was higher than 95%. The differential effects between the groups were associated with modulations of neurophysiological response selection processes in the superior frontal gyrus. ADHD is not only associated with deficits in inhibitory control. Rather, the organization and architecture of the inhibitory control system is different in ADHD. Distinguishable inhibitory control processes operate on a hierarchical ‘first come, first serve’ basis and are not integrated in ADHD. This is a new facet of ADHD.
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Affiliation(s)
- Witold Chmielewski
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Benjamin Bodmer
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Nicole Wolff
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
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Du Rietz E, Barker AR, Michelini G, Rommel AS, Vainieri I, Asherson P, Kuntsi J. Beneficial effects of acute high-intensity exercise on electrophysiological indices of attention processes in young adult men. Behav Brain Res 2018; 359:474-484. [PMID: 30465815 PMCID: PMC6320386 DOI: 10.1016/j.bbr.2018.11.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/27/2018] [Accepted: 11/16/2018] [Indexed: 12/15/2022]
Abstract
High-intensity exercise improved brain measures of attention processes. Fitness and physical activity level were not related to degree of improvement. We found no effects of exercise on subsequent Flanker and Reaction-time tasks.
Background Emerging research suggests that a single bout of aerobic exercise can improve cognition, brain function and psychological health. Our aim was to examine the effects of high-intensity exercise on cognitive-performance and brain measures of attention, inhibition and performance-monitoring across a test-battery of three cognitive tasks. Method Using a randomised cross-over design, 29 young men completed three successive cognitive tasks (Cued Continuous Performance Task [CPT-OX]; Eriksen Flanker Task; four-choice reaction-time task [Fast Task]) with simultaneous electroencephalogram (EEG) recording before and after a 20-min high-intensity cycling exercise and resting control session. Cognitive-performance measures, EEG power and event-related potential measures, were obtained during the tasks. Random-intercept linear models were used to investigate the effects of exercise, compared to rest, on outcomes. Results A single bout of exercise significantly (p < 0.05) increased the amplitude of the event-related potential Go P3, but had no effect on the contingent negative variation (CNV), Cue P3 or NoGo P3, during the CPT-OX. Delta power, recorded during the CPT-OX, also significantly increased after exercise, whereas there was no effect on cognitive-performance in this task. Exercise did not influence any cognitive-performance or brain measures in the subsequent Flanker or Fast Tasks. Conclusion Acute high-intensity exercise improves brain-indices reflecting executive and sustained attention during task performance (Go P3 and delta activity), in the CPT-OX, but not anticipatory attention (Cue P3 and CNV) or response inhibition (NoGo P3) in young-adult men. Exercise had no effect on cognitive-performance or brain measures in the subsequent Flanker and Fast tasks, which may potentially be explained by the time delay after exercise.
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Affiliation(s)
- Ebba Du Rietz
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK.
| | - Alan R Barker
- Children's Health and Exercise Research Centre, University of Exeter, St. Luke's Campus, Heavitree Road, EX1 2LU, Exeter, UK.
| | - Giorgia Michelini
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK.
| | - Anna-Sophie Rommel
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK; Icahn School of Medicine at Mount Sinai Department of Psychiatry New York NY USA.
| | - Isabella Vainieri
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK.
| | - Philip Asherson
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK.
| | - Jonna Kuntsi
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, SE5 8AF, London, UK.
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28
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Barth B, Mayer-Carius K, Strehl U, Kelava A, Häußinger FB, Fallgatter AJ, Ehlis AC. Identification of neurophysiological biotypes in attention deficit hyperactivity disorder. Psychiatry Clin Neurosci 2018; 72:836-848. [PMID: 30084523 DOI: 10.1111/pcn.12773] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/23/2018] [Accepted: 07/31/2018] [Indexed: 11/26/2022]
Abstract
AIM Findings on neurophysiological alterations in attention deficit hyperactivity disorder (ADHD) have been proposed to underlie ADHD symptoms, with different etiological pathways for different patient biotypes. We aimed at determining whether neurophysiological deviations confirm distinct neurophysiological profiles in ADHD, thus providing direct evidence for the endophenotype concept. METHODS Neurophysiological biotypes were investigated in 87 adult patients with ADHD using cluster analysis. Parameters fed into the analysis comprised both hemodynamic and electrophysiological data. To validate results, the independent variables of the clusters were compared with healthy controls. RESULTS Cluster analysis yielded three neurophysiologically based ADHD biotypes showing: (i) above-average functioning in attention allocation; (ii) difficulties in attention allocation and inhibitory control but elevated frontal activation during a working memory task; and (iii) functional impairments in state regulation. CONCLUSION Classifying patients with ADHD into neurophysiological biotypes sheds light on etiological pathways, with implications for diagnostics and (individualized) treatment options.
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Affiliation(s)
- Beatrix Barth
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Graduate School of Neural and Behavioral Sciences, University of Tübingen, Tübingen, Germany
| | - Kerstin Mayer-Carius
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | | | - Florian Benedikt Häußinger
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Andreas Jochen Fallgatter
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany.,LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
| | - Ann-Christine Ehlis
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
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29
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Franke B, Michelini G, Asherson P, Banaschewski T, Bilbow A, Buitelaar JK, Cormand B, Faraone SV, Ginsberg Y, Haavik J, Kuntsi J, Larsson H, Lesch KP, Ramos-Quiroga JA, Réthelyi JM, Ribases M, Reif A. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacol 2018; 28:1059-1088. [PMID: 30195575 PMCID: PMC6379245 DOI: 10.1016/j.euroneuro.2018.08.001] [Citation(s) in RCA: 320] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 06/25/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in childhood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review, we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.
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Affiliation(s)
- Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Giorgia Michelini
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Philip Asherson
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andrea Bilbow
- Attention Deficit Disorder Information and Support Service (ADDISS), Edgware, UK; ADHD-Europe, Brussels, Belgium
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York Upstate Medical University, New York, USA; K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Ylva Ginsberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Jan Haavik
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jonna Kuntsi
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE NAP-B Molecular Psychiatry Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Marta Ribases
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
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30
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James SN, Rommel AS, Cheung C, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Association of preterm birth with ADHD-like cognitive impairments and additional subtle impairments in attention and arousal malleability. Psychol Med 2018; 48:1484-1493. [PMID: 29094658 PMCID: PMC6088527 DOI: 10.1017/s0033291717002963] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Whilst preterm-born individuals have an increased risk of developing attention-deficit/hyperactivity disorder (ADHD), and are reported to have ADHD-like attention and arousal impairments, direct group comparisons are scarce. METHODS We directly compared preterm-born adolescents (n = 186) to term-born adolescents with ADHD (n = 69), and term-born controls (n = 135), aged 11-23, on cognitive-performance, event-related potential and skin conductance level (SCL) measures associated with attention and arousal. The measures are from baseline and fast-incentive conditions of a four-choice reaction time task, previously shown to discriminate between the individuals with ADHD and controls. We aimed to establish whether preterm-born adolescents show: (a) identical cognitive-neurophysiological impairments to term-born adolescents with ADHD (b) possible additional impairments, and whether (c) the observed impairments correlate with ADHD symptom scores. RESULTS The preterm group, like the term-born ADHD group, showed increased mean reaction time (MRT) and reaction time variability (RTV) in the baseline condition, and attenuated contingent negative variation (CNV) amplitude (response preparation) in the fast-incentive condition. The preterm group, only, did not show significant within-group adjustments in P3 amplitude (attention allocation) and SCL (peripheral arousal). Dimensional analyses showed that ADHD symptoms scores correlated significantly with MRT, RTV and CNV amplitude only. CONCLUSIONS We find impairments in cognition and brain function in preterm-born adolescents that are linked to increased ADHD symptoms, as well as further impairments, in lack of malleability in neurophysiological processes. Our findings indicate that such impairments extend at least to adolescence. Future studies should extend these investigations into adulthood.
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Affiliation(s)
- S.-N. James
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- MRC Lifelong Health and Ageing Unit at University College London, London, UK
| | - A.-S. Rommel
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - C. Cheung
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - G. McLoughlin
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - D. Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - T. Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - P. Asherson
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Kuntsi
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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31
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Chmielewski WX, Tiedt A, Bluschke A, Dippel G, Roessner V, Beste C. Effects of multisensory stimuli on inhibitory control in adolescent ADHD: It is the content of information that matters. NEUROIMAGE-CLINICAL 2018; 19:527-537. [PMID: 29984161 PMCID: PMC6030566 DOI: 10.1016/j.nicl.2018.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/28/2018] [Accepted: 05/15/2018] [Indexed: 01/29/2023]
Abstract
Even though deficits in inhibitory control and conflict monitoring are well-known in ADHD, factors that further modulate these functions remain to be elucidated. One factor that may be of considerable importance is how inhibitory control is modulated by multisensory information processing. We examined the influence of concurrent auditory conflicting or redundant information on visually triggered response inhibition processes in adolescent ADHD patients and healthy controls. We combined high-density event-related potential (ERP) recordings with source localization to delineate the functional neuroanatomical basis of the involved neurophysiological processes. In comparison to controls, response inhibition (RI) processes in ADHD were compromised in conflicting conditions, but showed no differences to controls when redundant or no concurrent auditory information was presented. These effects were reflected by modulations at the response selection stage (P3 ERP) in the medial frontal gyrus (BA32), but not at the attentional selection (P1, N1 ERPs) or resource allocation level (P2 ERP). Conflicting information during RI exerts its influences in adolescent ADHD via response selection mechanisms, but not via attentional selection. It is not the mere presence of concurrent information, but the presence of conflicting information during RI that may destabilize goal shielding processes in medial frontal cortical regions, by means of increasing the automaticity of response tendencies. The occurring RI deficits might relate to the increased impulsivity in adolescent ADHD and a corresponding vulnerability to react to an increased automaticity of pre-potent response tendencies. ADHD patients show a bias to a specific content of information which can modulate inhibitory control. Response inhibition (RI) performance in ADHD is modulated by multisensory information. Only incongruent/conflicting concurrent information modulates RI performance. RI deficits occur if this conflicting information braces the automaticity of response tendencies. These deficits relate to a predisposition of ADHD to engage in impulsive behavior. This may be due to deficient goal-shielding processes located in the MFG.
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Affiliation(s)
- Witold X Chmielewski
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany.
| | - Angela Tiedt
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Gabriel Dippel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
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32
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Methylphenidate selectively modulates one sub-component of the no-go P3 in pediatric ADHD medication responders. Biol Psychol 2018; 134:30-38. [PMID: 29476840 DOI: 10.1016/j.biopsycho.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/11/2018] [Accepted: 02/18/2018] [Indexed: 11/20/2022]
Abstract
Methylphenidate (MPH) has been shown to modulate the amplitude of the no-go P3 component of the event-related potential (ERP; Øgrim, Aasen, & Brunner, 2016). Using group independent component analysis, the no-go P3 from a cued go/no-go task has been separated into two sub-components (Brunner et al., 2013). This study investigated whether sub-components of the no-go P3 could be identified in children with ADHD, and how MPH modulates their amplitudes. ERPs were registered twice (on/off MPH) in 57 children with ADHD classified as medication responders in a four-week medication trial. Two no-go P3 sub-components were identified. In the MPH session, the amplitude of one sub-component, the IC P3no-goearly (mean latency 378 ms, with a central distribution), was significantly larger than at baseline, whereas the other sub-component, the IC P3no-golate (mean latency 428 ms, with a centro-frontal distribution), was not significantly affected. These results add to the literature documenting that the no-go P3 consists of two overlapping phenomena with different functional correlates.
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33
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Michelini G, Kitsune V, Vainieri I, Hosang GM, Brandeis D, Asherson P, Kuntsi J. Shared and Disorder-Specific Event-Related Brain Oscillatory Markers of Attentional Dysfunction in ADHD and Bipolar Disorder. Brain Topogr 2018; 31:672-689. [PMID: 29417321 PMCID: PMC5999167 DOI: 10.1007/s10548-018-0625-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/25/2018] [Indexed: 12/28/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) often present with overlapping symptoms and cognitive impairments, such as increased fluctuations in attentional performance measured by increased reaction-time variability (RTV). We previously provided initial evidence of shared and distinct event-related potential (ERP) impairments in ADHD and BD in a direct electrophysiological comparison, but no study to date has compared neural mechanisms underlying attentional impairments with finer-grained brain oscillatory markers. Here, we aimed to compare the neural underpinnings of impaired attentional processes in ADHD and BD, by examining event-related brain oscillations during a reaction-time task under slow-unrewarded baseline and fast-incentive conditions. We measured cognitive performance, ERPs and brain-oscillatory modulations of power and phase variability in 20 women with ADHD, 20 women with BD (currently euthymic) and 20 control women. Compared to controls, both ADHD and BD groups showed increased RTV in the baseline condition and increased RTV, theta phase variability and lower contingent negative variation in the fast-incentive condition. Unlike controls, neither clinical group showed an improvement from the slow-unrewarded baseline to the fast-incentive condition in attentional P3 amplitude or alpha power suppression. Most impairments did not differ between the disorders, as only an adjustment in beta suppression between conditions (lower in the ADHD group) distinguished between the clinical groups. These findings suggest shared impairments in women with ADHD and BD in cognitive and neural variability, preparatory activity and inability to adjust attention allocation and activation. These overlapping impairments may represent shared neurobiological mechanisms of attentional dysfunction in ADHD and BD, and potentially underlie common symptoms in both disorders.
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Affiliation(s)
- Giorgia Michelini
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Viryanaga Kitsune
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Isabella Vainieri
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Georgina M Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary, University of London, London, UK
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Philip Asherson
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Jonna Kuntsi
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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Eichler A, Hudler L, Grunitz J, Grimm J, Raabe E, Goecke TW, Fasching PA, Beckmann MW, Kratz O, Moll GH, Kornhuber J, Heinrich H. Effects of prenatal alcohol consumption on cognitive development and ADHD-related behaviour in primary-school age: a multilevel study based on meconium ethyl glucuronide. J Child Psychol Psychiatry 2018; 59:110-118. [PMID: 28892122 DOI: 10.1111/jcpp.12794] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Alcohol intake during pregnancy is considered to be a risk factor for child development. Child biomarkers of intrauterine alcohol exposure have been rarely studied. We investigated whether a meconium alcohol metabolite (ethyl glucuronide, EtG) was associated with cognitive development, ADHD-related behaviour and neurophysiological markers of attention and executive control of children at primary-school age. METHODS Mothers provided self-report on prenatal alcohol consumption during their 3rd trimester. Meconium samples were collected at birth. A total of 44 children with a meconium EtG above the detection limit (≥10 ng/g) and 44 nonexposed matched controls were compared. A second threshold (≥154 ng/g) was applied to study the dose effects. When children reached primary-school age, mothers rated ADHD-related behaviour, child cognitive development was measured using an IQ test battery, and event-related potentials were recorded during a cued go/nogo task. RESULTS Children in both EtG-positive groups allocated fewer attentional resources than controls to the go/nogo task (reduced P3 component in go-trials). Children with a meconium EtG above 154 ng/g were also found to have an IQ that was six points lower than the other groups. Within the EtG ≥ 154 ng/g group, there was a positive correlation between EtG value and ADHD-related behaviour. These significant effects were not observed in relation to the maternal self-report data. CONCLUSIONS Associations between EtG and cognitive deficits, attentional resource capacity and ADHD-related behaviour could be documented with effects that were partially dose-dependent. In addition to maternal self-reports, this biomarker of intrauterine alcohol exposure may be considered as a predictor of child development.
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Affiliation(s)
- Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Linda Hudler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Juliane Grunitz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Jennifer Grimm
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Eva Raabe
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Tamme W Goecke
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany.,Department of Obstetrics and Gynecology, University Hospital RWTH Aachen, Aachen, Germany
| | - Peter A Fasching
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Hartmut Heinrich
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany.,kbo-Heckscher-Klinikum, München, Germany
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35
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McLoughlin G, Palmer J, Makeig S, Bigdely-Shamlo N, Banaschewski T, Laucht M, Brandeis D. EEG Source Imaging Indices of Cognitive Control Show Associations with Dopamine System Genes. Brain Topogr 2017; 31:392-406. [PMID: 29222686 PMCID: PMC5889775 DOI: 10.1007/s10548-017-0601-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/10/2017] [Indexed: 01/09/2023]
Abstract
Cognitive or executive control is a critical mental ability, an important marker of mental illness, and among the most heritable of neurocognitive traits. Two candidate genes, catechol-O-methyltransferase (COMT) and DRD4, which both have a roles in the regulation of cortical dopamine, have been consistently associated with cognitive control. Here, we predicted that individuals with the COMT Met/Met allele would show improved response execution and inhibition as indexed by event-related potentials in a Go/NoGo task, while individuals with the DRD4 7-repeat allele would show impaired brain activity. We used independent component analysis (ICA) to separate brain source processes contributing to high-density EEG scalp signals recorded during the task. As expected, individuals with the DRD4 7-repeat polymorphism had reduced parietal P3 source and scalp responses to response (Go) compared to those without the 7-repeat. Contrary to our expectation, the COMT homozygous Met allele was associated with a smaller frontal P3 source and scalp response to response-inhibition (NoGo) stimuli, suggesting that while more dopamine in frontal cortical areas has advantages in some tasks, it may also compromise response inhibition function. An interaction effect emerged for P3 source responses to Go stimuli. These were reduced in those with both the 7-repeat DRD4 allele and either the COMT Val/Val or the Met/Met homozygous polymorphisms but not in those with the heterozygous Val/Met polymorphism. This epistatic interaction between DRD4 and COMT replicates findings that too little or too much dopamine impairs cognitive control. The anatomic and functional separated maximally independent cortical EEG sources proved more informative than scalp channel measures for genetic studies of brain function and thus better elucidate the complex mechanisms in psychiatric illness.
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Affiliation(s)
- G McLoughlin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO80, London, UK.
| | - J Palmer
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California San Diego, La Jolla, CA, USA
| | - S Makeig
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California San Diego, La Jolla, CA, USA
| | - N Bigdely-Shamlo
- Swartz Center for Computational Neuroscience, Institute for Neural Computation, University of California San Diego, La Jolla, CA, USA
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - M Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - D Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zürich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zürich, Zurich, Switzerland
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36
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Chronaki G, Soltesz F, Benikos N, Sonuga-Barke EJS. An electrophysiological investigation of reinforcement effects in attention deficit/hyperactivity disorder: Dissociating cue sensitivity from down-stream effects on target engagement and performance. Dev Cogn Neurosci 2017; 28:12-20. [PMID: 29080475 PMCID: PMC6987869 DOI: 10.1016/j.dcn.2017.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 10/13/2017] [Accepted: 10/17/2017] [Indexed: 01/20/2023] Open
Abstract
Objective Neural hypo-sensitivity to cues predicting positive reinforcement has been observed in ADHD using the Monetary Incentive Delay (MID) task. Here we report the first study using an electrophysiological analogue of this task to distinguish between (i) cue related anticipation of reinforcement and downstream effects on (ii) target engagement and (iii) performance in a clinical sample of adolescents with ADHD and controls. Methods Thirty-one controls and 32 adolescents with ADHD aged 10–16 years performed the electrophysiological (e)-MID task − in which preparatory cues signal whether a response to an upcoming target will be reinforced or not − under three conditions; positive reinforcement, negative reinforcement (response cost) and no consequence (neutral). We extracted values for both cue-related potentials known to be, both, associated with response preparation and modulated by reinforcement (Cue P3 and Cue CNV) and target-related potentials (target P3) and compared these between ADHD and controls. Results ADHD and controls did not differ on cue-related components on neutral trials. Against expectation, adolescents with ADHD displayed Cue P3 and Cue CNV reinforcement-related enhancement (versus neutral trials) compared to controls. ADHD individuals displayed smaller target P3 amplitudes and slower and more variable performance − but effects were not modulated by reinforcement contingencies. When age, IQ and conduct problems were controlled effects were marginally significant but the pattern of results did not change. Discussion ADHD was associated with hypersensitivity to positive (and marginally negative) reinforcement reflected on components often thought to be associated with response preparation − however these did not translate into improved attention to targets. In the case of ADHD, upregulated CNV may be a specific marker of hyper-arousal rather than an enhancement of anticipatory attention to upcoming targets. Future studies should examine the effects of age, IQ and conduct problems on reinforcement sensitivity in ADHD.
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Affiliation(s)
- Georgia Chronaki
- Developmental Cognitive Neuroscience (DCN) Laboratory, School of Psychology, University of Central Lancashire, UK; Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK; Division of Neuroscience & Experimental Psychology, University of Manchester, UK
| | - Fruzsina Soltesz
- Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK
| | - Nicholas Benikos
- Department of Cognitive Science Australian Hearing Hub 16 University Avenue Macquarie University, NSW, 2109, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.
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37
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Boecker-Schlier R, Holz NE, Hohm E, Zohsel K, Blomeyer D, Buchmann AF, Baumeister S, Wolf I, Esser G, Schmidt MH, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M. Association between pubertal stage at first drink and neural reward processing in early adulthood. Addict Biol 2017; 22:1402-1415. [PMID: 27345375 DOI: 10.1111/adb.12413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/20/2016] [Accepted: 04/25/2016] [Indexed: 01/03/2023]
Abstract
Puberty is a critical time period during human development. It is characterized by high levels of risk-taking behavior, such as increased alcohol consumption, and is accompanied by various neurobiological changes. Recent studies in animals and humans have revealed that the pubertal stage at first drink (PSFD) significantly impacts drinking behavior in adulthood. Moreover, neuronal alterations of the dopaminergic reward system have been associated with alcohol abuse or addiction. This study aimed to clarify the impact of PSFD on neuronal characteristics of reward processing linked to alcohol-related problems. One hundred sixty-eight healthy young adults from a prospective study covering 25 years participated in a monetary incentive delay task measured with simultaneous EEG-fMRI. PSFD was determined according to the age at menarche or Tanner stage of pubertal development, respectively. Alcohol-related problems in early adulthood were assessed with the Alcohol Use Disorder Identification Test (AUDIT). During reward anticipation, decreased fMRI activation of the frontal cortex and increased preparatory EEG activity (contingent negative variation) occurred with pubertal compared to postpubertal first alcohol intake. Moreover, alcohol-related problems during early adulthood were increased in pubertal compared to postpubertal beginners, which was mediated by neuronal activation of the right medial frontal gyrus. At reward delivery, increased fMRI activation of the left caudate and higher feedback-related EEG negativity were detected in pubertal compared to postpubertal beginners. Together with animal findings, these results implicate PSFD as a potential modulator of psychopathology, involving altered reward anticipation. Both PSFD timing and reward processing might thus be potential targets for early prevention and intervention.
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Affiliation(s)
- Regina Boecker-Schlier
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Nathalie E. Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Erika Hohm
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Katrin Zohsel
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Dorothea Blomeyer
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Arlette F. Buchmann
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Isabella Wolf
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department Neuroimaging, Central Institute of Mental Health; Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Günter Esser
- Department of Psychology; University of Potsdam; Potsdam Germany
| | - Martin H. Schmidt
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy; Psychiatric Hospital, University of Zurich; Zurich Switzerland
- Center for Integrative Human Physiology; University of Zurich; Zurich Switzerland
- Neuroscience Center Zurich; University of Zurich and ETH Zurich; Zurich Switzerland
| | - Manfred Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
- Department of Psychology; University of Potsdam; Potsdam Germany
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38
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Heinrich H, Grunitz J, Stonawski V, Frey S, Wahl S, Albrecht B, Goecke TW, Beckmann MW, Kornhuber J, Fasching PA, Moll GH, Eichler A. Attention, cognitive control and motivation in ADHD: Linking event-related brain potentials and DNA methylation patterns in boys at early school age. Sci Rep 2017. [PMID: 28630479 PMCID: PMC5476641 DOI: 10.1038/s41598-017-03326-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In order to better understand the underpinnings of attention-deficit/hyperactivity disorder (ADHD), we targeted the relationship of attentional, cognitive control and motivational processes with DNA methylation patterns of 60 candidate genes in boys at early school age. Participants (6 to 8 years; N = 82) were selected from a German longitudinal cohort (FRANCES). ADHD-related behaviour was assessed via maternal ratings. Performance and event-related potential measures (inter alia Cue-P3 and Nogo-P3), which were recorded in a motivational go/nogo task, indicated diminished attentional orienting, reduced inhibitory response control and a larger motivational effect on performance in ADHD already at this relatively young age. Methylation patterns were analysed in buccal cell DNA with the Illumina HumanMethylation 450K array. For CpG sites at genes of the dopaminergic (COMT, ANKK1) and the neurotrophic (BDNF, NGFR) system, associations with the Nogo-P3 as well as ADHD symptom severity were found suggesting that these systems are involved in response control deficits in ADHD. Methylation effects related to both functional aspects and ADHD behaviour were also observed for DPP10 and TPH2. Epigenetic mechanisms may play a role in ADHD-associated deficits but findings need to be replicated in larger samples and are limited by the fact that only peripheral methylation could be considered.
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Affiliation(s)
- Hartmut Heinrich
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. .,kbo-Heckscher-Klinikum, München, Germany.
| | - Juliane Grunitz
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Valeska Stonawski
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Stefan Frey
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Simone Wahl
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Björn Albrecht
- Dept. of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Tamme W Goecke
- Dept. of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.,Dept. of Obstetrics and Gynecology, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Matthias W Beckmann
- Dept. of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Kornhuber
- Dept. of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Peter A Fasching
- Dept. of Obstetrics and Gynecology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Gunther H Moll
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Anna Eichler
- Dept. of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Strehl U, Aggensteiner P, Wachtlin D, Brandeis D, Albrecht B, Arana M, Bach C, Banaschewski T, Bogen T, Flaig-Röhr A, Freitag CM, Fuchsenberger Y, Gest S, Gevensleben H, Herde L, Hohmann S, Legenbauer T, Marx AM, Millenet S, Pniewski B, Rothenberger A, Ruckes C, Wörz S, Holtmann M. Neurofeedback of Slow Cortical Potentials in Children with Attention-Deficit/Hyperactivity Disorder: A Multicenter Randomized Trial Controlling for Unspecific Effects. Front Hum Neurosci 2017; 11:135. [PMID: 28408873 PMCID: PMC5374218 DOI: 10.3389/fnhum.2017.00135] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Neurofeedback (NF) in children with attention-deficit/hyperactivity disorder (ADHD) has been investigated in a series of studies over the last years. Previous studies did not unanimously support NF as a treatment in ADHD. Most studies did not control for unspecific treatment effects and did not demonstrate that self-regulation took place. The present study examined the efficacy of NF in comparison to electromyographic (EMG) feedback to control for unspecific effects of the treatment, and assessed self-regulation of slow cortical potentials (SCPs). Methods: A total of 150 children aged 7–9 years diagnosed with ADHD (82% male; 43% medicated) were randomized to 25 sessions of feedback of SCPs (NF) or feedback of coordination of the supraspinatus muscles (EMG). The primary endpoint was the change in parents’ ratings of ADHD core symptoms 4 weeks after the end of treatment compared to pre-tests. Results: Children in both groups showed reduced ADHD-core symptoms (NF 0.3, 95% CI -0.42 to -0.18; EMG 0.13, 95% CI -0.26 to -0.01). NF showed a significant superiority over EMG (treatment difference 0.17, 95% CI 0.02–0.3, p = 0.02). This yielded an effect size (ES) of d = 0.57 without and 0.40 with baseline observation carried forward (BOCF). The sensitivity analysis confirmed the primary result. Successful self-regulation of brain activity was observed only in NF. As a secondary result teachers reported no superior improvement from NF compared to EMG, but within-group analysis revealed effects of NF on the global ADHD score, inattention, and impulsivity. In contrast, EMG feedback did not result in changes despite more pronounced self-regulation learning. Conclusions: Based on the primary parent-rated outcome NF proved to be superior to a semi-active EMG feedback treatment. The study supports the feasibility and efficacy of NF in a large sample of children with ADHD, based on both specific and unspecific effects. Trial Register: Current controlled trials ISRCTN76187185, registered 5 February 2009.
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Affiliation(s)
- Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of TübingenTübingen, Germany
| | - Pascal Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany
| | - Daniel Wachtlin
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany.,Interdisciplinary Center for Clinical Trials at the University Medical Center of the Johannes Gutenberg University of MainzMainz, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of ZurichZurich, Switzerland.,Center for Integrative Human Physiology, University of ZurichZurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH ZurichZurich, Switzerland
| | - Björn Albrecht
- Child and Adolescent Psychiatry, University Medical Center GöttingenGöttingen, Germany
| | - Maria Arana
- Institute for Medical Psychology and Behavioral Neurobiology, University of TübingenTübingen, Germany
| | - Christiane Bach
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital LeipzigLeipzig, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany
| | - Thorsten Bogen
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University BochumHamm, Germany
| | - Andrea Flaig-Röhr
- Child and Adolescent Psychiatry, University Medical Center GöttingenGöttingen, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe UniversityFrankfurt am Main, Germany
| | - Yvonne Fuchsenberger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe UniversityFrankfurt am Main, Germany
| | - Stephanie Gest
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe UniversityFrankfurt am Main, Germany
| | - Holger Gevensleben
- Child and Adolescent Psychiatry, University Medical Center GöttingenGöttingen, Germany
| | - Laura Herde
- Institute for Medical Psychology and Behavioral Neurobiology, University of TübingenTübingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany
| | - Tanja Legenbauer
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University BochumHamm, Germany
| | - Anna-Maria Marx
- Institute for Medical Psychology and Behavioral Neurobiology, University of TübingenTübingen, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of HeidelbergMannheim, Germany
| | - Benjamin Pniewski
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University BochumHamm, Germany
| | - Aribert Rothenberger
- Child and Adolescent Psychiatry, University Medical Center GöttingenGöttingen, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials at the University Medical Center of the Johannes Gutenberg University of MainzMainz, Germany
| | - Sonja Wörz
- Institute for Medical Psychology and Behavioral Neurobiology, University of TübingenTübingen, Germany
| | - Martin Holtmann
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University BochumHamm, Germany
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Cheung CHM, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Neurophysiological Correlates of Attentional Fluctuation in Attention-Deficit/Hyperactivity Disorder. Brain Topogr 2017; 30:320-332. [PMID: 28289850 PMCID: PMC5408051 DOI: 10.1007/s10548-017-0554-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/01/2017] [Indexed: 11/25/2022]
Abstract
Cognitive performance in attention-deficit/hyperactivity disorder (ADHD) is characterised, in part, by frequent fluctuations in response speed, resulting in high reaction time variability (RTV). RTV captures a large proportion of the genetic risk in ADHD but, importantly, is malleable, improving significantly in a fast-paced, rewarded task condition. Using the temporal precision offered by event-related potentials (ERPs), we aimed to examine the neurophysiological measures of attention allocation (P3 amplitudes) and preparation (contingent negative variation, CNV), and their associations with the fluctuating RT performance and its improvement in ADHD. 93 participants with ADHD and 174 controls completed the baseline and fast-incentive conditions of a four-choice reaction time task, while EEG was simultaneously recorded. Compared to controls, individuals with ADHD showed both increased RTV and reduced P3 amplitudes during performance on the RT task. In the participants with ADHD, attenuated P3 amplitudes were significantly associated with high RTV, and the increase in P3 amplitudes from a slow baseline to a fast-paced, rewarded condition was significantly associated with the RTV decrease. Yet, the individuals with ADHD did not show the same increase in CNV from baseline to fast-incentive condition as observed in controls. ADHD is associated both with a neurophysiological impairment of attention allocation (P3 amplitudes) and an inability to adjust the preparatory state (CNV) in a changed context. Our findings suggest that both neurophysiological and cognitive performance measures of attention are malleable in ADHD, which are potential targets for non-pharmacological interventions.
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Affiliation(s)
- Celeste H M Cheung
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland.,Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Philip Asherson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jonna Kuntsi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Bluschke A, von der Hagen M, Papenhagen K, Roessner V, Beste C. Response inhibition in Attention deficit disorder and neurofibromatosis type 1 - clinically similar, neurophysiologically different. Sci Rep 2017; 7:43929. [PMID: 28262833 PMCID: PMC5338250 DOI: 10.1038/srep43929] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 02/01/2017] [Indexed: 01/09/2023] Open
Abstract
There are large overlaps in cognitive deficits occurring in attention deficit disorder (ADD) and neurodevelopmental disorders like neurofibromatosis type 1 (NF1). This overlap is mostly based on clinical measures and not on in-depth analyses of neuronal mechanisms. However, the consideration of such neuronal underpinnings is crucial when aiming to integrate measures that can lead to a better understanding of the underlying mechanisms. Inhibitory control deficits, for example, are a hallmark in ADD, but it is unclear how far there are similar deficits in NF1. We thus compared adolescent ADD and NF1 patients to healthy controls in a Go/Nogo task using behavioural and neurophysiological measures. Clinical measures of ADD-symptoms were not different between ADD and NF1. Only patients with ADD showed increased Nogo errors and reductions in components reflecting response inhibition (i.e. Nogo-P3). Early perceptual processes (P1) were changed in ADD and NF1. Clinically, patients with ADD and NF1 thus show strong similarities. This is not the case in regard to underlying cognitive control processes. This shows that in-depth analyses of neurophysiological processes are needed to determine whether the overlap between ADD and NF1 is as strong as assumed and to develop appropriate treatment strategies.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine to the TU Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Katharina Papenhagen
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine to the TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine to the TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine to the TU Dresden, Germany.,Experimental Neurobiology, National Institute of Mental Health, Czech Republic, Germany
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42
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Rommel AS, James SN, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Association of Preterm Birth With Attention-Deficit/Hyperactivity Disorder-Like and Wider-Ranging Neurophysiological Impairments of Attention and Inhibition. J Am Acad Child Adolesc Psychiatry 2017; 56:40-50. [PMID: 27993227 PMCID: PMC5196005 DOI: 10.1016/j.jaac.2016.10.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 09/16/2016] [Accepted: 10/18/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Preterm birth has been associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD)-like symptoms and cognitive impairments similar to those seen in ADHD, including attention and inhibitory control difficulties. Yet data on direct comparisons across ADHD and preterm birth on cognitive-neurophysiological measures are limited. METHOD We directly compared 186 preterm-born adolescents to 69 term-born adolescents with ADHD and 135 term-born controls on cognitive-performance and event-related potential measures associated with attentional and inhibitory processing from a cued continuous performance test (CPT-OX), which we have previously shown to discriminate between the adolescents with ADHD and controls. We aimed to elucidate whether the ADHD-like symptoms and cognitive impairments in preterm-born individuals reflect identical cognitive-neurophysiological impairments in term-born individuals with ADHD. RESULTS Go-P3 amplitude was reduced, reflecting impaired executive response control, in preterm-born adolescents compared to both controls and adolescents with ADHD. Moreover, in preterm-born adolescents, as in term-born adolescents with ADHD, contingent negative variation amplitude was attenuated, reflecting impairments in response preparation compared to controls. Although the ADHD group showed significantly increased NoGo-P3 amplitude at FCz compared to preterm group, at Cz preterm-born adolescents demonstrated significantly decreased NoGo-P3 amplitude compared to the control group, similar to term-born adolescents with ADHD. CONCLUSION These findings indicate impairments in response preparation, executive response control, and response inhibition in preterm-born adolescents. Although the response preparation and response inhibition impairments found in preterm-born adolescents overlap with those found in term-born adolescents with ADHD, the preterm group also shows unique impairments, suggesting more wide-ranging impairments in the preterm group compared to the ADHD group.
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Affiliation(s)
- Anna-Sophie Rommel
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah-Naomi James
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Brandeis
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Psychiatric Hospital, University of Zurich, Zurich, Switzerland; the Center for Integrative Human Physiology, University of Zurich, and the Neuroscience Center Zurich, University of Zurich
| | - Tobias Banaschewski
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Philip Asherson
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jonna Kuntsi
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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The neuronal mechanisms underlying improvement of impulsivity in ADHD by theta/beta neurofeedback. Sci Rep 2016; 6:31178. [PMID: 27514985 PMCID: PMC4981886 DOI: 10.1038/srep31178] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/13/2016] [Indexed: 11/10/2022] Open
Abstract
Neurofeedback is increasingly recognized as an intervention to treat core symptoms of attention deficit hyperactivity disorder (ADHD). Despite the large number of studies having been carried out to evaluate its effectiveness, it is widely elusive what neuronal mechanisms related to the core symptoms of ADHD are modulated by neurofeedback. 19 children with ADHD undergoing 8 weeks of theta/beta neurofeedback and 17 waiting list controls performed a Go/Nogo task in a pre-post design. We used neurophysiological measures combining high-density EEG recording with source localization analyses using sLORETA. Compared to the waiting list ADHD control group, impulsive behaviour measured was reduced after neurofeedback treatment. The effects of neurofeedback were very specific for situations requiring inhibitory control over responses. The neurophysiological data shows that processes of perceptual gating, attentional selection and resource allocation processes were not affected by neurofeedback. Rather, neurofeedback effects seem to be based on the modulation of response inhibition processes in medial frontal cortices. The study shows that specific neuronal mechanisms underlying impulsivity are modulated by theta/beta neurofeedback in ADHD. The applied neurofeedback protocol could be particularly suitable to address inhibitory control. The study validates assumed functional neuroanatomical target regions of an established neurofeedback protocol on a neurophysiological level.
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ERP Correlates of Proactive and Reactive Cognitive Control in Treatment-Naïve Adult ADHD. PLoS One 2016; 11:e0159833. [PMID: 27448275 PMCID: PMC4957760 DOI: 10.1371/journal.pone.0159833] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/08/2016] [Indexed: 11/19/2022] Open
Abstract
This study investigated whether treatment naïve adults with Attention Deficit Hyperactivity Disorder (ADHD; n = 33; 19 female) differed from healthy controls (n = 31; 17 female) in behavioral performance, event-related potential (ERP) indices of preparatory attention (CueP3 and late CNV), and reactive response control (Go P3, NoGo N2, and NoGo P3) derived from a visual cued Go/NoGo task. On several critical measures, Cue P3, late CNV, and NoGo N2, there were no significant differences between the groups. This indicated normal preparatory processes and conflict monitoring in ADHD patients. However, the patients had attenuated Go P3 and NoGoP3 amplitudes relative to controls, suggesting reduced allocation of attentional resources to processes involved in response control. The patients also had a higher rate of Go signal omission errors, but no other performance decrements compared with controls. Reduced Go P3 and NoGo P3 amplitudes were associated with poorer task performance, particularly in the ADHD group. Notably, the ERPs were not associated with self-reported mood or anxiety. The results provide electrophysiological evidence for reduced effortful engagement of attentional resources to both Go and NoGo signals when reactive response control is needed. The absence of group differences in ERP components indexing proactive control points to impairments in specific aspects of cognitive processes in an untreated adult ADHD cohort. The associations between ERPs and task performance provided additional support for the altered electrophysiological responses.
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Cheung CHM, Rijsdijk F, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, Kuntsi J. Cognitive and neurophysiological markers of ADHD persistence and remission. Br J Psychiatry 2016; 208:548-55. [PMID: 26250744 PMCID: PMC4887724 DOI: 10.1192/bjp.bp.114.145185] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 12/22/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) persists in around two-thirds of individuals in adolescence and early adulthood. AIMS To examine the cognitive and neurophysiological processes underlying the persistence or remission of ADHD. METHOD Follow-up data were obtained from 110 young people with childhood ADHD and 169 controls on cognitive, electroencephalogram frequency, event-related potential (ERP) and actigraph movement measures after 6 years. RESULTS ADHD persisters differed from remitters on preparation-vigilance measures (contingent negative variation, delta activity, reaction time variability and omission errors), IQ and actigraph count, but not on executive control measures of inhibition or working memory (nogo-P3 amplitudes, commission errors and digit span backwards). CONCLUSIONS Preparation-vigilance measures were markers of remission, improving concurrently with ADHD symptoms, whereas executive control measures were not sensitive to ADHD persistence/remission. For IQ, the present and previous results combined suggest a role in moderating ADHD outcome. These findings fit with previously identified aetiological separation of the cognitive impairments in ADHD. The strongest candidates for the development of non-pharmacological interventions involving cognitive training and neurofeedback are the preparation-vigilance processes that were markers of ADHD remission.
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Affiliation(s)
| | | | | | | | | | | | - Jonna Kuntsi
- Celeste H. M. Cheung, MSc, King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK and Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Fruhling Rijsdijk, PhD, Gráinne McLoughlin, PhD, King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Daniel Brandeis, PhD, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland, Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland, and Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland; Tobias Banaschewski, MD, PhD, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Philip Asherson, MRC Psych, PhD, Jonna Kuntsi, PhD, King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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46
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Zhang T, Wang C, Tan F, Mou D, Zheng L, Chen A. Different relationships between central dopamine system and sub-processes of inhibition: Spontaneous eye blink rate relates with N2 but not P3 in a Go/Nogo task. Brain Cogn 2016; 105:95-103. [DOI: 10.1016/j.bandc.2016.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 04/09/2016] [Accepted: 04/14/2016] [Indexed: 02/06/2023]
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47
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Schmüser L, Sebastian A, Mobascher A, Lieb K, Feige B, Tüscher O. Data-driven analysis of simultaneous EEG/fMRI reveals neurophysiological phenotypes of impulse control. Hum Brain Mapp 2016; 37:3114-36. [PMID: 27133468 DOI: 10.1002/hbm.23230] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 03/09/2016] [Accepted: 04/15/2016] [Indexed: 01/10/2023] Open
Abstract
Response inhibition is the ability to suppress inadequate but prepotent or ongoing response tendencies. A fronto-striatal network is involved in these processes. Between-subject differences in the intra-individual variability have been suggested to constitute a key to pathological processes underlying impulse control disorders. Single-trial EEG/fMRI analysis allows to increase sensitivity for inter-individual differences by incorporating intra-individual variability. Thirty-eight healthy subjects performed a visual Go/Nogo task during simultaneous EEG/fMRI. Of 38 healthy subjects, 21 subjects reliably showed Nogo-related ICs (Nogo-IC-positive) while 17 subjects (Nogo-IC-negative) did not. Comparing both groups revealed differences on various levels: On trait level, Nogo-IC-negative subjects scored higher on questionnaires regarding attention deficit/hyperactivity disorder; on a behavioral level, they displayed slower response times (RT) and higher intra-individual RT variability while both groups did not differ in their inhibitory performance. On the neurophysiological level, Nogo-IC-negative subjects showed a hyperactivation of left inferior frontal cortex/insula and left putamen as well as significantly reduced P3 amplitudes. Thus, a data-driven approach for IC classification and the resulting presence or absence of early Nogo-specific ICs as criterion for group selection revealed group differences at behavioral and neurophysiological levels. This may indicate electrophysiological phenotypes characterized by inter-individual variations of neural and behavioral correlates of impulse control. We demonstrated that the inter-individual difference in an electrophysiological correlate of response inhibition is correlated with distinct, potentially compensatory neural activity. This may suggest the existence of electrophysiologically dissociable phenotypes of behavioral and neural motor response inhibition with the Nogo-IC-positive phenotype possibly providing protection against impulsivity-related dysfunction. Hum Brain Mapp 37:3114-3136, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lena Schmüser
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Alexandra Sebastian
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Arian Mobascher
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany.,Department of Psychiatry and Psychotherapy, St. Elisabeth Krankenhaus Lahnstein, Lahnstein, Germany
| | - Klaus Lieb
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Albert Ludwigs University of Freiburg Medical Center, Freiburg, Germany
| | - Oliver Tüscher
- Emotion Regulation and Impulse Control Group, Focus Program Translational Neuroscience, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany.,Department of Psychiatry and Psychotherapy, Albert Ludwigs University of Freiburg Medical Center, Freiburg, Germany.,Department of Neurology, Albert Ludwigs University of Freiburg Medical Center, Freiburg, Germany
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48
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Boecker-Schlier R, Holz NE, Buchmann AF, Blomeyer D, Plichta MM, Jennen-Steinmetz C, Wolf I, Baumeister S, Treutlein J, Rietschel M, Meyer-Lindenberg A, Banaschewski T, Brandeis D, Laucht M. Interaction between COMT Val158Met polymorphism and childhood adversity affects reward processing in adulthood. Neuroimage 2016; 132:556-570. [DOI: 10.1016/j.neuroimage.2016.02.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 01/01/2023] Open
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49
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Bluschke A, Roessner V, Beste C. Specific cognitive-neurophysiological processes predict impulsivity in the childhood attention-deficit/hyperactivity disorder combined subtype. Psychol Med 2016; 46:1277-1287. [PMID: 26803921 DOI: 10.1017/s0033291715002822] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders in childhood. Besides inattention and hyperactivity, impulsivity is the third core symptom leading to diverse and serious problems. However, the neuronal mechanisms underlying impulsivity in ADHD are still not fully understood. This is all the more the case when patients with the ADHD combined subtype (ADHD-C) are considered who are characterized by both symptoms of inattention and hyperactivity/impulsivity. METHOD Combining high-density electroencephalography (EEG) recordings with source localization analyses, we examined what information processing stages are dysfunctional in ADHD-C (n = 20) compared with controls (n = 18). RESULTS Patients with ADHD-C made more impulsive errors in a Go/No-go task than healthy controls. Neurophysiologically, different subprocesses from perceptual gating to attentional selection, resource allocation and response selection processes are altered in this patient group. Perceptual gating, stimulus-driven attention selection and resource allocation processes were more pronounced in ADHD-C, are related to activation differences in parieto-occipital networks and suggest attentional filtering deficits. However, only response selection processes, associated with medial prefrontal networks, predicted impulsive errors in ADHD-C. CONCLUSIONS Although the clinical picture of ADHD-C is complex and a multitude of processing steps are altered, only a subset of processes seems to directly modulate impulsive behaviour. The present findings improve the understanding of mechanisms underlying impulsivity in patients with ADHD-C and might help to refine treatment algorithms focusing on impulsivity.
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Affiliation(s)
- A Bluschke
- Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Cognitive Neurophysiology,Dresden,Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Cognitive Neurophysiology,Dresden,Germany
| | - C Beste
- Department of Child and Adolescent Psychiatry,Faculty of Medicine of the TU Dresden,Cognitive Neurophysiology,Dresden,Germany
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50
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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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