The stroop color-word interference test as an indicator of ADHD in poor readers

High-Frequency Cochlear Amplifier Dysfunction: A Dominating Contribution to the Cognitive-Ear Link

Objective: The objective of this study was to investigate the role of the high-frequency cochlear dysfunction in the cognitive-ear link.

Methods: Seventy-four presbycusis patients (PC group) and seventy-one age-, sex-, and education-level matched normal hearing controls (NH group) were recruited in this study. Participants underwent a battery of cognitive tests estimated by Montreal Cognitive Assessment (MoCA), Stroop Color-Word Interference Test (Stroop), Symbol Digit Modalities Test (SDMT), Auditory Verbal Learning Test (AVLT), and Trail-Making Test (TMT-A and B), as well as auditory tests including distortion product otoacoustic emission (DPOAE), pure tone (PT) thresholds, and speech reception thresholds (SRT). Data were analyzed using the factor analysis, partial correlation analysis, multiple linear regression models, and mediation models.

Results: Distortion product otoacoustic emission detection amplitudes and PT thresholds performed worse gradually from low to high frequencies in both the NH and PC groups. High-frequency DPOAE (H-DPOAE) was significantly correlated with cognitive domains in the PC group (AVLT: r = 0.30, p = 0.04; SDMT: r = 0.36, p = 0.01; Stroop: r = –0.32, p = 0.03; TMT-A: r = –0.40, p = 0.005; TMT-B: r = –0.34, p = 0.02). Multiple linear regression models showed that H-DPOAE predicted cognitive impairment effectively for aspects of memory (R2 = 0.27, 95% CI, 0.03 to 1.55), attention (R2 = 0.32, 95% CI, –6.18 to –0.40), processing speed (R2 = 0.37, 95% CI, 0.20 to 1.64), and executive function (TMT-A: R2 = 0.34, 95% CI, –5.52 to 1.03; TMT-B: R2 = 0.29, 95% CI, –11.30 to –1.12). H-DPOAE directly affected cognition and fully mediated the relationship between pure tone average (PTA)/SRT and cognitive test scores, excluding MoCA.

Conclusion: This study has demonstrated that the high-frequency cochlear amplifier dysfunction has a direct predictive effect on the cognitive decline and makes a large contribution to the cognitive-ear link.

Brain Frequency-Specific Changes in the Spontaneous Neural Activity Are Associated With Cognitive Impairment in Patients With Presbycusis

Presbycusis (PC) is characterized by preferential hearing loss at high frequencies and difficulty in speech recognition in noisy environments. Previous studies have linked PC to cognitive impairment, accelerated cognitive decline and incident Alzheimer’s disease. However, the neural mechanisms of cognitive impairment in patients with PC remain unclear. Although resting-state functional magnetic resonance imaging (rs-fMRI) studies have explored low-frequency oscillation (LFO) connectivity or amplitude of PC-related neural activity, it remains unclear whether the abnormalities occur within all frequency bands or within specific frequency bands. Fifty-one PC patients and fifty-one well-matched normal hearing controls participated in this study. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF) at different frequency bands (slow-4 and slow-5). PC patients showed abnormal LFO amplitudes in the Heschl’s gyrus, dorsolateral prefrontal cortex (dlPFC), frontal eye field and key nodes of the speech network exclusively in slow-4, which suggested that abnormal spontaneous neural activity in PC was frequency dependent. Our findings also revealed that stronger functional connectivity between the dlPFC and the posterodorsal stream of auditory processing, as well as lower functional coupling between the PCC and key nodes of the DMN, which were associated with cognitive impairments in PC patients. Our study might underlie the cross-modal plasticity and higher-order cognitive participation of the auditory cortex after partial hearing deprivation. Our findings indicate that frequency-specific analysis of ALFF could provide valuable insights into functional alterations in the auditory cortex and non-auditory regions involved in cognitive impairment associated with PC.

Multivariate Base Rates of Low Scores on Tests of Executive Functions in a Multi-Country Latin American Sample

The objective of the study was to determine the prevalence of low scores in a diverse Latin American population for two neuropsychological commonly used tests to evaluate executive functions and to compare the number of low scores obtained using normative data from a Spanish-speaking population from Latin America versus an English-speaking population from U.S.A. Healthy adults (N = 5402) were administered the Modified Wisconsin Card Sorting Test and Stroop Color-Word. Low scores on measures of executive functioning are common. Clinicians working with Spanish-speaking adults should take into account the higher probability of low scores on these measures to reduce false-positive diagnoses of cognitive deficits in an individual.

Hearing Loss and Cognition Among Older Adults in a Han Chinese Cohort

Presbycusis (PC) is associated with cognitive decline and incident dementia. Speech reception thresholds (SRT) are used to assess speech detection, which points toward a central component of PC. However, to the best of our knowledge, no previous study has reported the relationship between SRT and cognitive function in older adults in a Han Chinese cohort. Therefore, in this study, we investigate the association of hearing loss, indexed using pure tone average (PTA) and SRT, with cognitive function in a Han Chinese cohort using a standardized neurocognitive battery. Subjects (aged ≥60 years) with no history of psychiatric or neurological diseases were recruited. All subjects underwent a battery of neuropsychological and auditory tests. According to the PTA of the better ear, the subjects were further divided into PC and normal PTA (NP) groups. Regression analyses were performed to examine the relationship between cognitive function and hearing loss in the PC and NP groups and all subjects when controlling for age, sex, education level, diabetes, smoking, and hypertension. Cognitive function was significantly associated with PTA and SRT in all subjects. In all subjects, the correlations between non-verbal cognitive scores and SRT were stronger than those between non-verbal cognitive scores and PTA, whereas the correlations between verbal cognitive scores and PTA were stronger than those between verbal cognitive scores and SRT. Moreover, the correlations between PTA or SRT and cognitive function in the PC group were in principle stronger than those in the NP group. Our findings indicate that cognitive function is significantly associated with PTA and SRT in older adults in a Han Chinese cohort. Therefore, SRT could be an important auditory test for exploring cognitive decline in PC and could complement PTA.

Gray Matter Atrophy Is Associated With Cognitive Impairment in Patients With Presbycusis: A Comprehensive Morphometric Study

Presbycusis (PC) is characterized by bilateral sensorineural hearing loss at high frequencies and speech-perception difficulties in noisy environments and has a strikingly detrimental impact on cognitive function. As the neural consequences of PC may involve the whole brain, we hypothesized that patients with PC would show structural alterations not only in the auditory cortex but also in the cortexes involved in cognitive function. The purpose of this study was to use surface-based morphometry (SBM) analysis to elucidate whole-brain structural differences between patients with PC and age-matched normal hearing controls. Three-dimensional T1-weighted MR images of 26 patients with mild PC and 26 age-, sex- and education-matched healthy controls (HCs) were acquired. All participants underwent a battery of neuropsychological tests. Our results revealed gray matter atrophy in several auditory cortical areas, nodes of the default mode network (DMN), including the bilateral precuneus and inferior parietal lobule, the right posterior cingulate cortex (PCC), and the right insula of patients with PC compared to that in the HCs. Our findings also revealed that hearing loss was associated with reduced gray matter volume in the right primary auditory cortex of patients with PC. Moreover, structural alterations in the nodes of the DMN were associated with cognitive impairments in PC patients. Additionally, this study provides evidence that a thicker right insula is associated with better speech perception in patients with PC. Based on these findings, we argue that the onset of PC seems to trigger its own cascade of conditions, including a need for increased cognitive resources during speech comprehension, which might lead to auditory and cognition-related cortical reorganization.

Using task performance to inform treatment planning for youth with ADHD: A systematic review

The role that neuropsychological task performance plays in the assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) is currently ambiguous, and findings are mixed regarding whether tasks have validity for diagnosing the disorder. Irrespective of their validity for diagnosing ADHD, neuropsychological tasks could provide valuable information to mental health professionals if they can inform recommendations for treatment targets and modalities. Therefore, this review sought to synthesize the available evidence related to the use of neuropsychological task performance as a tool for informing treatment planning for youth with ADHD. Reviewed studies focused on examinations of associations between task performance and academic, social, and health outcomes, as well as response to treatment. Twenty-five relevant studies using samples of youth diagnosed with ADHD in clinical, community, and school settings were identified. Review of the evidence suggests that task performance may be useful in identifying individuals with ADHD at risk for academic impairment. However, the evidence is less compelling for identifying youth at risk for impaired social functioning or poor health outcomes. The review also found that task performance is likely useful for predicting response to treatment with methylphenidate. Across studies, evidence indicated that interpreting task performance in an integrated manner, such as a factor score or mean score, was more consistently useful for predicting outcomes of interest than interpreting performance from a single task. Implications for the use of tasks in ADHD assessments are discussed, and future directions are outlined for further examining the clinical utility of task performance.

The Association between Sleep and Theory of Mind in School Aged Children with ADHD

Theory of Mind (ToM) is defined as the ability to infer a range of internal mental states of others, including beliefs, intentions, desires, and emotions. These abilities are associated with children’s ability to socialize effectively with peers. ToM impairments are associated with peer rejection and psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD). Previous studies have found poor sleep negatively impacts executive functioning (EF) and emotional information processing, which are essential for the effective use of ToM. Youth with ADHD have EF deficits and sleep problems. However, the relationship between sleep, executive functioning, and ToM in children with ADHD has not been studied. In this review, we propose that the poor social and interpersonal skills characterizing individuals with ADHD could be explained by the impact of poor sleep on the emotional and cognitive mechanisms underlying ToM.

Attention and concentration functions in HIV-positive adolescents who are on anti-retroviral treatment

It is generally agreed that patients either in the symptomatic stages of human immunodeficiency virus (HIV) infection or those in whom acquired immunodeficiency syndrome (AIDS) has already developed exhibit cognitive deficits. Specifically, attentional functioning has been investigated and found to be lowered in HIV-positive individuals compared to HIV-negative individuals. Medication regimen may also potentially confound the neuropsychological functioning. The intention of this study was to examine focused and divided attention in 30 adolescents between the ages of 13 and 16 years living with HIV who were commenced on managed anti-retroviral (ARV) programmes following diagnosis of HIV and immune compromise and compared to a contrast group of 71 HIV-negative adolescents. The results show that the mean number of errors on the Trail Making Test (TMT) Part B, as well as the mean time taken on Trials 1 and 3; the mean number of uncorrected errors on Trials 1 and 3; and the mean number of self-corrected errors on Trials 1, 2, and 3 of the Stroop Colour-Word Interference Test were significantly ( p < .05) higher in HIV-positive individuals compared to HIV-negative individuals.

Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

BACKGROUND

This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood.

DISCUSSION

Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria.

SUMMARY

Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

Attention mechanisms in children with anxiety disorders and in children with attention deficit hyperactivity disorder: implications for research and practice

Inattention is among the most commonly referred problems for school-aged youth. Research suggests distinct mechanisms may contribute to attention problems in youth with anxiety disorders versus youth with attention deficit hyperactivity disorder (ADHD). This study compared children (8-17 years) with anxiety disorders (n = 24) and children (8-16 years) with ADHD (n = 23) on neurocognitive tests of both general and emotion-based attention processes. As hypothesized, children with ADHD demonstrated poorer selective and sustained attention, whereas youth with anxiety disorders demonstrated greater attentional bias toward threatening faces on a visual probe task. Findings suggest the neuropsychological differentiation of attention problems in anxious and ADHD children, despite potentially similar phenotypes.

An asymmetric stroop/reverse-stroop interference phenomenon in ADHD

OBJECTIVE

To examine whether participants with ADHD showed a deficit in Stroop/reverse-Stroop interference by comparing them to non-ADHD participants.

METHOD

A group with ADHD, primarily inattentive type (n = 15), and a paired non-ADHD group (n = 15) completed the group version of the Stroop/reverse-Stroop test.

RESULTS

Asymmetric interference was observed between the Stroop test and the reverse-Stroop test in ADHD participants, presenting evidence contrary to Barkley's behavioral inhibition model of ADHD in which response inhibition deficits pertained only to the ADHD-C subtype.

CONCLUSION

Participants with ADHD showed a control deficit in reverse-Stroop interference but not in Stroop interference.

Goal priming and the emotional experience of students with and without attention problems: an application of the emotional stroop task

The primary purpose of the present study is to evaluate the emotional experience of students with (n = 52) and without attention problems (n = 272) during an achievement task. A secondary purpose of the present study is to compare students' emotional response to various stimuli, when motivated by various achievement goals. Participants were randomly assigned into a mastery goal condition, a normative performance goal condition, and a non-normative performance goal condition. Results, using a latent means analysis, indicate that students with attention problems needed additional time to process emotion-loaded but not neutral words, providing evidence for an interference effect. Furthermore, students in the performance-normative, relative to the performance non-normative, condition showed a salient interference effect with respect to various emotion-loaded and neutral words.

Assessing Cognitive Interference Using the Emotional Stroop Task in Students with and Without Attention Problems

The present study describes the Emotional Stroop Task as a means to assess cognitive interference triggered by emotional stimuli in elementary school students with and without attention problems. Using the Emotional Stroop Task in a computerized environment and employing samples of students with and without attention problems (111 without and 29 with attention problems), results indicated that prolonged latencies to stimuli with heavy emotional content related to their school experiences were predictive of students’ membership, after controlling for their gender and grade levels. These effects were independent of students’ processing ability as indicated by the lack of significant differences in reaction time to neutral stimuli. It is concluded that the Emotional Stroop Task can be used to assess cognitive interference in emotionally charged conditions across groups of students.

Prediction of ADHD in boys and girls using the D-KEFS

To examine patterns of executive dysfunction associated with ADHD, 123 children (54 ADHD, 69 controls) of ages 8-16 years were administered selected subtests from the Delis-Kaplan Executive Function System (D-KEFS). Children with ADHD performed significantly worse than controls on measures of both basic (less executive demand) skills and those with more executive demand from the Color-Word Interference and Tower subtests; however, no group differences were noted on any of the D-KEFS contrast scores. Most subtype comparisons yielded no differences; however, children with the Combined subtype outperformed children with the Inattentive subtype on measures of both basic and executive skills from the Trail Making Test. Children with ADHD demonstrate executive dysfunction that is identified by D-KEFS summary, but not contrast scores. In this carefully screened sample of children with ADHD, few significant differences were found between groups suggesting limited sensitivity or specificity of the D-KEFS for classifying children with ADHD.

Processing speed deficits in attention deficit/hyperactivity disorder and reading disability

The goal of the current study was to test whether deficits in processing speed (PS) may be a shared cognitive risk factor in reading disability (RD) and Attention Deficit/Hyperactivity Disorder (ADHD), which are known to be comorbid. Literature on ADHD and RD suggests that deficits on tasks with a speeded component are seen in both of these disorders individually. The current study examined a wide range of speeded tasks in RD, ADHD, comorbid RD+ADHD, and a control group to test whether RD and ADHD have similar profiles of PS deficits, and whether these deficits are shared by the two disorders. The results suggest that a general PS deficit exists in both clinical groups compared to controls, although children with RD demonstrate greater PS deficits than children with ADHD. Two tests (underadditivity and partial correlations) were conducted to test whether these PS deficits are shared. Since we found that PS deficits were underadditive in the comorbid group and that partialling PS reduced the correlation between RD and ADHD, it appears that PS is a shared cognitive risk factor that may help explain the comorbidity of these two disorders.

Stroop performance in pathological gamblers

Pathological gambling is a relatively prevalent psychiatric disorder that typically leads to severe family, social, legal, and occupational problems and is associated with a high rate of suicide attempts. Understanding the neurobiological basis of pathological gambling is a current focus of research, and emerging data have demonstrated that pathological gamblers may have impaired decision-making because of an inability to inhibit irrelevant information. In this study, we examined pathological gamblers by using the Stroop Color-Word Test, a neurocognitive task used to assess interference control. The "reverse" variant of the Stroop Color-Word Test was administered to a cohort of medication-free pathological gamblers (n=62) and a cohort of age-matched controls (n=83). In the reverse variant of the Stroop task, subjects are asked to read the meaning of the word rather than name the ink color. The reverse Stroop task was chosen because it highly discriminates ability to inhibit interference in a population of psychiatric patients. In our study, performance on the reverse Stroop task in the pathological gamblers was significantly slower and less accurate than in the healthy subjects. A new finding in our study was that for pathological gamblers, the average reaction time in the neutral condition (where the color names are displayed in black letters) was slower than the average reaction time in the incongruent condition (where the meaning of the color name and the color of the printed letters are different). This controlled study extends previous findings by showing that performance on the Stroop task is impaired in a sample of medication-free pathological gamblers.

Are migraineurs hypersensitive? A test of the stimulus processing disorder hypothesis

The concept of hypersensitivity in migraineurs was advanced mainly on the basis of studies on information processing in which increased amplitudes and reduced habituation in cortical evoked and event related potentials were found in migraine sufferers. The present investigation examined whether migraineurs exhibit hypersensitivity within three different experimental paradigms and various non electrocortical response parameters. Samples of 24 migraine, 19 tension-type headache sufferers, and 24 normal controls were compared regarding their subjective estimation of intensity and discomfort due to visual and acoustical stimuli. Subjects also participated in an experiment using the eyeblink startle response paradigm. In a last experimental task the Stroop test was applied. The trait variables emotionality, arousal, and extraversion were also measured. None of the experimental tasks revealed the predicted hypersensitivity of migraineurs in relation to the control samples. The series of experiments was conducted a second time with half of the participants in order to replicate the findings. The conclusions remained the same. The results of earlier studies on cortical processing can not be interpreted as demonstrating general hypersensitivity in the sense of a dispositional trait in migraine afflicted individuals irrespective of the involved response system.