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Roetner J, Van Doren J, Maschke J, Kulke L, Pontones C, Fasching PA, Beckmann MW, Lenz B, Kratz O, Moll GH, Kornhuber J, Eichler A. Effects of prenatal alcohol exposition on cognitive outcomes in childhood and youth: a longitudinal analysis based on meconium ethyl glucuronide. Eur Arch Psychiatry Clin Neurosci 2024; 274:343-352. [PMID: 37532863 PMCID: PMC10914883 DOI: 10.1007/s00406-023-01657-z] [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: 10/18/2022] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
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.
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Affiliation(s)
- Jakob Roetner
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
- Department of Psychology I - Developmental Psychology, Otto-Friedrich-University Bamberg, Bamberg, Germany
| | - Jessica Van Doren
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Janina Maschke
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Louisa Kulke
- Department of Neurocognitive Developmental Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Constanza Pontones
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Peter A Fasching
- Department of Psychology I - Developmental Psychology, Otto-Friedrich-University Bamberg, Bamberg, Germany
| | - Matthias W Beckmann
- Department of Psychology I - Developmental Psychology, Otto-Friedrich-University Bamberg, Bamberg, Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
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Olaya-Galindo MD, Vargas-Cifuentes OA, Vélez Van-Meerbeke A, Talero-Gutiérrez C. Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review. J Atten Disord 2023; 27:1181-1195. [PMID: 36843351 PMCID: PMC10466982 DOI: 10.1177/10870547231154901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
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.
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Affiliation(s)
- Maria Daniela Olaya-Galindo
- Neuroscience research group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Oscar Alberto Vargas-Cifuentes
- Neuroscience research group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Alberto Vélez Van-Meerbeke
- Neuroscience research group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Claudia Talero-Gutiérrez
- Neuroscience research group (NeURos), NeuroVitae Center for Neuroscience, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
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Seçen Yazıcı M, Serdengeçti N, Dikmen M, Koyuncu Z, Sandıkçı B, Arslan B, Acar M, Kara E, Tarakçıoğlu MC, Kadak MT. Evaluation of p300 and spectral resolution in children with attention deficit hyperactivity disorder and specific learning disorder. Psychiatry Res Neuroimaging 2023; 334:111688. [PMID: 37517295 DOI: 10.1016/j.pscychresns.2023.111688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/11/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Abstract
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.
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Affiliation(s)
- Meryem Seçen Yazıcı
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Nihal Serdengeçti
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Merve Dikmen
- Research Institute for Health Sciences and Technologies (SABITA), Regenerative and Restorative Medicine Research Center (REMER), Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab, Istanbul Medipol University, Istanbul, Turkey; Vocational School of Health Services, Program of Electroneurophysiology, Istanbul Medipol University, Istanbul, Turkey
| | - Zehra Koyuncu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Beyza Sandıkçı
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Büşra Arslan
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melda Acar
- Department of Audiology, Faculty of Health Science, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Eyyup Kara
- Department of Audiology, Faculty of Health Science, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mahmut Cem Tarakçıoğlu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Lv YB, Cheng W, Wang MH, Wang XM, Hu YL, Lv LQ. Multimodal integrated intervention for children with attention-deficit/hyperactivity disorder. World J Clin Cases 2023; 11:4267-4276. [PMID: 37449233 PMCID: PMC10336987 DOI: 10.12998/wjcc.v11.i18.4267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 06/26/2023] Open
Abstract
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.
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Affiliation(s)
- Ying-Bo Lv
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
| | - Wei Cheng
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
| | - Meng-Hui Wang
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
| | - Xiao-Min Wang
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
| | - Yan-Li Hu
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
| | - Lan-Qiu Lv
- Pediatric Health Care Section, Ningbo Women and Children's Hospital, Ningbo 315000, Zhejiang Province, China
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Arnett AB, Gourdet G, Peisch V, Spaulding K, Ferrara E, Li V. The role of single trial variability in event related potentials in children with attention deficit hyperactivity disorder. Clin Neurophysiol 2023; 149:1-8. [PMID: 36841009 PMCID: PMC10101921 DOI: 10.1016/j.clinph.2023.01.021] [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: 08/12/2022] [Revised: 01/21/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023]
Abstract
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.
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Affiliation(s)
- Anne B Arnett
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA; Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Gaelle Gourdet
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Virginia Peisch
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Katherine Spaulding
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Erica Ferrara
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Vivian Li
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
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Coll-Martín T, Carretero-Dios H, Lupiáñez J. Attentional networks, vigilance, and distraction as a function of attention-deficit/hyperactivity disorder symptoms in an adult community sample. Br J Psychol 2021; 112:1053-1079. [PMID: 34089269 DOI: 10.1111/bjop.12513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/09/2021] [Indexed: 01/29/2023]
Abstract
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.
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Affiliation(s)
- Tao Coll-Martín
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Behavioral Sciences Methodology, University of Granada, Spain
| | - Hugo Carretero-Dios
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Behavioral Sciences Methodology, University of Granada, Spain
| | - Juan Lupiáñez
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Experimental Psychology, University of Granada, Spain
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