Neurophysiological markers of ADHD symptoms in typically-developing children

Effects of prenatal alcohol exposition on cognitive outcomes in childhood and youth: a longitudinal analysis based on meconium ethyl glucuronide

BACKGROUND

Prenatal alcohol exposure (PAE) has been linked to severe, adverse child outcomes. However, little is known regarding subclinical outcomes of low/moderate PAE and its longitudinal consequences, especially regarding neurophysiological and neurocognitive development. A newborn biomarker of PAE, meconium ethyl glucuronide (EtG), has been shown to predict cognitive impairments in primary-school-aged children. The current study investigated the ongoing effects of subclinical PAE in adolescence.

METHODS

A sample of n = 96 mother-child dyads of the FRAMES/FRANCES cohort were classified into PAE/no PAE using EtG with a 10 ng/g cutoff. Mothers were recruited during pregnancy and children were assessed during primary-school age (M = 7.57, SD = 0.65, range: 6.00-9.92 years) and adolescence (M = 13.26, SD = 0.31, range: 12.79-14.20 years) on three levels: clinical (ADHD rating), neuropsychological (IQ score and performance in a go/nogo task), and neurophysiological (analysis of P3 event-related potentials (ERP) during said go/nogo task). Developmental outcomes and courses following PAE were assessed using rmANCOVAs, controlling for relevant confounders (socioeconomic status (SES), birth weight, and maternal psychopathology).

RESULTS

Neurophysiological impairments emerged for exposed children in the form of diminished attentional resource recruiting in childhood and adolescence (reduced go-P3 amplitudes) with no differences in performance. Neuropsychological testing showed a reduced IQ score for both time points with dose-dependent effects in childhood. Clinical ADHD symptoms were not significantly affected.

CONCLUSION

Subclinical PAE, as determined by meconium EtG, has negative developmental consequences on cognitive function that persist from childhood to adolescence. These findings suggest that there is no safe limit for alcohol consumption during pregnancy and that more thorough screening of alcohol consumption during pregnancy is necessary for early identification and treatment of at-risk children.

Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review

OBJECTIVE

In this review, we examined if there is a deficit in facial recognition of emotion (FER) in children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD).

BACKGROUND

Emotional regulation is impaired in ADHD. Although a facial emotion recognition deficit has been described in this condition, the underlying causal mechanisms remain unclear.

METHODS

The search was performed in six databases in September 2022. Studies assessing children, adolescents, or adults with isolated or comorbid ADHD that evaluated participants using a FER task were included.

RESULTS

Twelve studies out of 385 were selected, with participants ranging in age from 6 to 37.1 years. A deficit in FER specific to ADHD, or secondary to comorbid autism spectrum disorder, anxiety, and oppositional symptoms, was found.

CONCLUSIONS

There is a FER deficit in patients with ADHD. Adults showed improved recognition accuracy, reflecting partial compensation. ADHD symptoms and comorbidities appear to influence FER deficits.

Evaluation of p300 and spectral resolution in children with attention deficit hyperactivity disorder and specific learning disorder

This study aims to examine auditory processing, P300 values and functional impairment levels among children with Attention Deficit and Hyperactivity Disorder (ADHD), Specific Learning Disorder (SLD), ADHD+SLD and healthy controls. Children with ADHD (n = 17), SLD (n = 15), ADHD+SLD (n = 15), and healthy controls (n = 15) between the ages of 7-12 were evaluated with K-SADS, Weiss Functional Impairment Rating Scale, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale, The Mathematics, Reading, Writing Assessment Scale and Children's Auditory Performance Scale (CHAPS). Auditory P300 event-related potentials and Spectral-Temporally Modulated Ripple Test (SMRT) were applied. Three patient groups were found to be riskier than healthy controls according to the CHAPS. There was no significant difference between the groups in the SMRT. In post-hoc analyses of P300 parietal amplitudes, ADHD, SLD, and ADHD+SLD were found to be significantly lower than the control group. The amplitudes of the ADHD+SLD were by far the lowest. It has been shown that auditory performance skills and p300 amplitudes are lower in children diagnosed with only ADHD or SLD compared to the control group, with the lowest values observed in ADHD+SLD. This study suggests that the difficulties with attention and cognitive functions in the ADHD+SLD are more severe than ADHD and/or SLD without comorbidity.

Multimodal integrated intervention for children with attention-deficit/hyperactivity disorder

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders in child and adolescent psychiatry, with a prevalence of more than 5%. Despite extensive research on ADHD in the last 10 to 20 years, effective treat-ments are still lacking. Instead, the concept of ADHD seems to have become broader and more heterogeneous. Therefore, the diagnosis and treatment of ADHD remains challenging for clinicians.

AIM

To investigate the effects of a multimodal integrated intervention for children with ADHD.

METHODS

Between March 2019 and September 2020, a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility, two of whom revoked their consent. A case-control study was conducted in which the children were equally assigned, using a randomized number table, to either a medication group (methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets) or a multimodal integrated intervention group (medication + parent training + behavior modification + sensory integration therapy + sand tray therapy), with 49 patients in each group. The clinical endpoint was the efficacy of the different intervention modalities.

RESULTS

The two groups of children with ADHD had comparable patient characteristics (P > 0.05). Multimodal integrated intervention resulted in a significantly higher treatment efficacy (91.84%) than medication alone (75.51%) (P < 0.05). Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone (P < 0.05). The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group (P < 0.05). Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone (P < 0.05).

CONCLUSION

Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children. It enhanced their memory and attention with high safety and parental satisfaction, demonstrating good potential for clinical promotion.

The role of single trial variability in event related potentials in children with attention deficit hyperactivity disorder

OBJECTIVE

Children with attention deficit hyperactivity disorder (ADHD) show attenuated mean P3 component amplitudes compared to typically developing (TD) children. This finding may be the result of individual differences in P3 amplitudes, P3 latencies, and/or greater single trial variability (STV) in amplitude or latency, suggesting neural "noise."

METHODS

Event related potentials (ERPs) from 75 children with ADHD and 29 TD children were recorded with electroencephalography (EEG). Caregivers provided ratings on child ADHD symptoms. Single-trial ERP amplitudes and latencies were extracted from the P3 component time window during a visual oddball task. Additionally, we computed individual-centered and trial-centered P3 amplitudes to account for inter-individual and inter-trial variability in the timing of the P3 peak.

RESULTS

In line with prior research, greater ADHD symptom severity was associated with reduced mean P3 amplitude. This correlation was no longer significant after correcting for inter-trial differences in P3 latency. In contrast, greater ADHD symptom severity was associated with reduced STV in P3 amplitude.

CONCLUSIONS

Our results suggest that attenuated average P3 amplitude in ADHD samples is due to a consistent reduction in strength of the neurophysiological signal at the single trial level, as well as increased inter-trial variability in the timing of P3 peak amplitudes. The traditional method of extracting P3 amplitudes based on a single time window for all trials may not adequately capture variability in P3 latencies associated with ADHD.

SIGNIFICANCE

Inter- and intra-individual differences in brain signatures should be considered in models of neurobiological differences in neurodevelopmental samples.

Attentional networks, vigilance, and distraction as a function of attention-deficit/hyperactivity disorder symptoms in an adult community sample

Attentional difficulties are a core axis in attention-deficit/hyperactivity disorder (ADHD). However, establishing a consistent and detailed pattern of these neurocognitive alterations has not been an easy endeavour. Based on a dimensional approach to ADHD, the present study aims at comprehensively characterizing three key attentional domains: the three attentional networks (alerting, orienting, and executive attention), two components of vigilance (executive and arousal vigilance), and distraction. To do so, we modified a single, fine-grained task (the ANTI-Vea) by adding irrelevant distractors. One hundred and twenty undergraduates completed three self-reports of ADHD symptoms in childhood and adulthood and performed the ANTI-Vea. Despite the low reliability of some ANTI-Vea indexes, the task worked successfully. While ADHD symptoms in childhood were related to alerting network and arousal vigilance, symptoms in adulthood were linked to executive vigilance. No association between ADHD symptom severity and executive attention and distraction was found. In general, our hypotheses about the relationships between ADHD symptoms and attentional processes were partially supported. We discuss our findings according to ADHD theories and attention measurement.