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Juan SMA, Daglas M, Truong PH, Mawal C, Adlard PA. Alterations in iron content, iron-regulatory proteins and behaviour without tau pathology at one year following repetitive mild traumatic brain injury. Acta Neuropathol Commun 2023; 11:118. [PMID: 37464280 PMCID: PMC10353227 DOI: 10.1186/s40478-023-01603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 07/20/2023] Open
Abstract
Repetitive mild traumatic brain injury (r-mTBI) has increasingly become recognised as a risk factor for the development of neurodegenerative diseases, many of which are characterised by tau pathology, metal dyshomeostasis and behavioural impairments. We aimed to characterise the status of tau and the involvement of iron dyshomeostasis in repetitive controlled cortical impact injury (5 impacts, 48 h apart) in 3-month-old C57Bl6 mice at the chronic (12-month) time point. We performed a battery of behavioural tests, characterised the status of neurodegeneration-associated proteins (tau and tau-regulatory proteins, amyloid precursor protein and iron-regulatory proteins) via western blot; and metal levels using bulk inductively coupled plasma-mass spectrometry (ICP-MS). We report significant changes in various ipsilateral iron-regulatory proteins following five but not a single injury, and significant increases in contralateral iron, zinc and copper levels following five impacts. There was no evidence of tau pathology or changes in tau-regulatory proteins following five impacts, although some changes were observed following a single injury. Five impacts resulted in significant gait deficits, mild anhedonia and mild cognitive deficits at 9-12 months post-injury, effects not seen following a single injury. To the best of our knowledge, we are the first to describe chronic changes in metals and iron-regulatory proteins in a mouse model of r-mTBI, providing a strong indication towards an overall increase in brain iron levels (and other metals) in the chronic phase following r-mTBI. These results bring to question the relevance of tau and highlight the involvement of iron dysregulation in the development and/or progression of neurodegeneration following injury, which may lead to new therapeutic approaches in the future.
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Affiliation(s)
- Sydney M A Juan
- Synaptic Neurobiology Laboratory, The Florey Institute of Neuroscience and Mental Health, The Melbourne Dementia Research Centre, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Maria Daglas
- Synaptic Neurobiology Laboratory, The Florey Institute of Neuroscience and Mental Health, The Melbourne Dementia Research Centre, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Phan H Truong
- Synaptic Neurobiology Laboratory, The Florey Institute of Neuroscience and Mental Health, The Melbourne Dementia Research Centre, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Celeste Mawal
- Synaptic Neurobiology Laboratory, The Florey Institute of Neuroscience and Mental Health, The Melbourne Dementia Research Centre, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia
| | - Paul A Adlard
- Synaptic Neurobiology Laboratory, The Florey Institute of Neuroscience and Mental Health, The Melbourne Dementia Research Centre, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, Melbourne, VIC, 3052, Australia.
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Steiner M, Lidzba K, Bigi S. Processing Speed in Children with Traumatic Brain Injury. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2023. [DOI: 10.1024/1016-264x/a000370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Abstract: Traumatic brain injury (TBI) is a common cause of childhood morbidity and mortality. Information processing speed (IPS) is a central construct of neuropsychology and a mediator for a range of cognitive functions. In adults, the negative effects of TBI on IPS are well documented. This review qualitatively describes the impact of TBI on IPS in children and adolescents and examines various influencing factors. We included a total of 37 studies in the review that explored IPS using various clinical assessments. These clinical assessments often examine other neuropsychological functions besides IPS. In 29 of these studies, we found a negative effect of TBI on IPS. While injury severity has small but consistent effects on IPS, the effects of age at injury, time since injury, and gender were less evident. Because it is a central construct of neuropsychological functions, IPS should be assessed after TBI.
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Affiliation(s)
- Michelle Steiner
- Department of Pediatrics, Division of Neuropediatrics, Development, and Rehabilitation, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Karen Lidzba
- Department of Pediatrics, Division of Neuropediatrics, Development, and Rehabilitation, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Sandra Bigi
- Department of Pediatrics, Division of Neuropediatrics, Development, and Rehabilitation, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Neurology, Bern University Hospital, University of Bern, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
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3
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Jin YT, Chwo MJ, Chen CM, Huang SH, Huang YC, Chung CH, Sun CA, Lin IL, Chien WC, Wu GJ. Relationship between Injuries and Attention-Deficit Hyperactivity Disorder: A Population-Based Study with Long-Term Follow-Up in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074058. [PMID: 35409742 PMCID: PMC8998513 DOI: 10.3390/ijerph19074058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 02/05/2023]
Abstract
Objective: To investigate the association between various injuries and attention-deficit hyperactivity disorder (ADHD) and distinguish ADHD from non-ADHD with regards to risk of various injuries among children in Taiwan. Method: Using the data from the National Health Insurance Research Database, we selected a total of 1802 subjects under the age of 18 who were diagnosed with ADHD as well as an additional 7208 subjects as a comparison group. Results: Compared with children who were not diagnosed with ADHD, children diagnosed with ADHD were more likely to intentionally injure themselves. During the school year, ADHD children were injured less frequently than were non-ADHD children on traffic-related incidents. The adjusted hazard ratio of injury for the ADHD children was 2.493 times higher than that of comparison subjects. The ADHD children had a greater length of stay and medical cost when compared to those of the non-ADHD children. Age showed a significant inverse relationship with injury. Among the ADHD children, the injury rate was evidently higher for the low-income group than for the non-low-income group. Conclusions: Age, cause of injuries, low-income household status, and school season all have a significant connection to the risk of injury for ADHD children.
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Affiliation(s)
- Yo-Ting Jin
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan; (Y.-T.J.); (M.-J.C.); (C.-M.C.)
- Department of Nursing, National Taipei University of Nursing & Health Sciences, Taipei 11230, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Miao-Ju Chwo
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan; (Y.-T.J.); (M.-J.C.); (C.-M.C.)
| | - Chin-Mi Chen
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan; (Y.-T.J.); (M.-J.C.); (C.-M.C.)
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (S.-H.H.); (Y.-C.H.)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yao-Ching Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (S.-H.H.); (Y.-C.H.)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
| | - Chien-An Sun
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan;
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
| | - I-Long Lin
- Department of Computer Science and Engineering, Tatung University, Taipei 104327, Taiwan;
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-2-8792-3311 (ext. 19189)
| | - Gwo-Jang Wu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, Taipei 11490, Taiwan
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Stojanovski S, Scratch SE, Dunkley BT, Schachar R, Wheeler AL. A Systematic Scoping Review of New Attention Problems Following Traumatic Brain Injury in Children. Front Neurol 2021; 12:751736. [PMID: 34858314 PMCID: PMC8631327 DOI: 10.3389/fneur.2021.751736] [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: 08/01/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: To summarize existing knowledge about the characteristics of attention problems secondary to traumatic brain injuries (TBI) of all severities in children. Methods: Computerized databases PubMed and PsychINFO and gray literature sources were used to identify relevant studies. Search terms were selected to identify original research examining new ADHD diagnosis or attention problems after TBI in children. Studies were included if they investigated any severity of TBI, assessed attention or ADHD after brain injury, investigated children as a primary or sub-analysis, and controlled for or excluded participants with preinjury ADHD or attention problems. Results: Thirty-nine studies were included in the review. Studies examined the prevalence of and risk factors for new attention problems and ADHD following TBI in children as well as behavioral and neuropsychological factors associated with these attention problems. Studies report a wide range of prevalence rates of new ADHD diagnosis or attention problems after TBI. Evidence indicates that more severe injury, injury in early childhood, or preinjury adaptive functioning problems, increases the risk for new ADHD and attention problems after TBI and both sexes appear to be equally vulnerable. Further, literature suggests that cases of new ADHD often co-occurs with neuropsychiatric impairment in other domains. Identified gaps in our understanding of new attention problems and ADHD include if mild TBI, the most common type of injury, increases risk and what brain abnormalities are associated with the emergence of these problems. Conclusion: This scoping review describes existing studies of new attention problems and ADHD following TBI in children and highlights important risk factors and comorbidities. Important future research directions are identified that will inform the extent of this outcome across TBI severities, its neural basis and points of intervention to minimize its impact.
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Affiliation(s)
- Sonja Stojanovski
- SickKids Research Institute, Program in Neuroscience and Mental Health, Hospital for Sick Children, Neuroscience and Mental Health Program, Toronto, ON, Canada.,Physiology Department, University of Toronto, Toronto, ON, Canada
| | - Shannon E Scratch
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Benjamin T Dunkley
- SickKids Research Institute, Program in Neuroscience and Mental Health, Hospital for Sick Children, Neuroscience and Mental Health Program, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Russell Schachar
- SickKids Research Institute, Program in Neuroscience and Mental Health, Hospital for Sick Children, Neuroscience and Mental Health Program, Toronto, ON, Canada.,Psychiatry Department, University of Toronto, Toronto, ON, Canada
| | - Anne L Wheeler
- SickKids Research Institute, Program in Neuroscience and Mental Health, Hospital for Sick Children, Neuroscience and Mental Health Program, Toronto, ON, Canada.,Physiology Department, University of Toronto, Toronto, ON, Canada
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Dudschig C, Kaup B, Svaldi J, Gulewitsch MD. Negation Processing in Children with ADHD: The Generic Problem of Using Negation in Instructions. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2021; 50:1309-1320. [PMID: 34374888 PMCID: PMC8660710 DOI: 10.1007/s10936-021-09789-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 05/23/2023]
Abstract
Recent studies have suggested that negation comprehension falls back onto inhibitory brain systems that are also crucial for impulse control and other non-linguistic control domains (Beltran et al., 2018, 2019; de Vega et al., 2016; Liu et al., 2020). Against this backdrop, the present pilot study investigated the use of negation within directional instructions (i.e., "not left", "now left", "not right", "now right") in children with ADHD and a control group. The results indicate that children in general have a long response delay following negative compared to affirmative instructions. Additionally, there was a tendency for this effect to be more pronounced in the ADHD group. Together, these results suggest that negation processing might indeed demand inhibitory control processes, which are differently available across different subgroups. Thus, the current study provides evidence that using negation in imperatives or instructions is generally rather critical and should be avoided if possible, but that negation use is probably even more problematic in specific clinical populations. Potential implications of these results will be discussed.
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Affiliation(s)
- Carolin Dudschig
- Department of Psychology, University of Tübingen, Schleichstr. 4, 72076, Tübingen, Germany.
| | - Barbara Kaup
- Department of Psychology, University of Tübingen, Schleichstr. 4, 72076, Tübingen, Germany
| | - Jennifer Svaldi
- Department of Psychology, University of Tübingen, Schleichstr. 4, 72076, Tübingen, Germany
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Evaluation of different diagnostic modalities of minimal hepatic encephalopathy in cirrhotic patients: case-control study. Clin Exp Hepatol 2021; 7:312-319. [PMID: 34712834 PMCID: PMC8527340 DOI: 10.5114/ceh.2021.109292] [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: 02/24/2021] [Accepted: 06/13/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Minimal hepatic encephalopathy (MHE) represents one of the most overlooked complications of liver cirrhosis. Aim of the study To compare the utility and efficacy of different MHE diagnostic modalities. Material and methods This case-control study was conducted on hepatitis C virus (HCV)-related compensated cirrhotic patients. The Psychometric Hepatic Encephalopathy Score (PHES) was used to assign patients to MHE and controls. All patients were subjected to plasma ammonia, serum 3-nitrotyrosine (3-NT), critical flicker frequency (CFF), and the modified inhibitory control test (ICT). Results CFF was significantly lower in the control group (38.5, 40 Hz, p = 0.003). The unweighted lures on ICT were 8.7, 4.9 in MHE and controls (p < 0.001). Moreover, ammonia was higher in the MHE group (89, 61.5 µmol/l, p < 0.001). 3-NT was also higher in the MHE group (31.5, 13.7 nmol/l, p < 0.001) respectively. CFF at cutoff < 39 Hz had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 57.5%, 77.5%, 71.9% and 64.6%, respectively; in modified ICT, at cutoff > 5 unweighted lures the values were 87.5%, 80%, 81.4% and 86.5%, respectively; in ammonia, at cutoff ≥ 76.45 µmol/l the values were 65%, 72.5%, 70.3% and 67.4%, respectively; for 3-NT at cutoff ≥ 14.15 nmol/l the values were 85%, 82.5%, 82.9% and 84.6%, respectively. The accuracy for MHE diagnosis was 67.5%, 83.3%, 68.8%, 83.8% relying on CFF, 3-NT, ammonia, and ICT respectively. On multivariate analysis, CFF < 39 Hz (OR = 10.2, p = 0.04), modified ICT > 5 unweighted lures (OR = 43.2, p = 0.002), and serum 3-NT levels ≥ 14.15 nmol/l (OR = 50.4, p < 0.001) were independent predictors of MHE. Conclusions 3-NT and ICT are advantageous to reveal MHE in compensated liver cirrhosis, while CFF can be only used as adjuncts, with humble merits of ammonia.
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Cao M, Halperin JM, Li X. Abnormal Functional Network Topology and Its Dynamics during Sustained Attention Processing Significantly Implicate Post-TBI Attention Deficits in Children. Brain Sci 2021; 11:brainsci11101348. [PMID: 34679412 PMCID: PMC8533973 DOI: 10.3390/brainsci11101348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
Traumatic brain injury (TBI) is highly prevalent in children. Attention deficits are among the most common and persistent post-TBI cognitive and behavioral sequalae that can contribute to adverse outcomes. This study investigated the topological properties of the functional brain network for sustained attention processing and their dynamics in 42 children with severe post-TBI attention deficits (TBI-A) and 47 matched healthy controls. Functional MRI data during a block-designed sustained attention task was collected for each subject, with each full task block further divided into the pre-, early, late-, and post-stimulation stages. The task-related functional brain network was constructed using the graph theoretic technique. Then, the sliding-window-based method was utilized to assess the dynamics of the topological properties in each stimulation stage. Relative to the controls, the TBI-A group had significantly reduced nodal efficiency and/or degree of left postcentral, inferior parietal, inferior temporal, and fusiform gyri and their decreased stability during the early and late-stimulation stages. The left postcentral inferior parietal network anomalies were found to be significantly associated with elevated inattentive symptoms in children with TBI-A. These results suggest that abnormal functional network characteristics and their dynamics associated with the left parietal lobe may significantly link to the onset of the severe post-TBI attention deficits in children.
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Affiliation(s)
- Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
| | - Jeffery M. Halperin
- Department of Psychology, Queens College, City University of New York, New York, NY 11367, USA;
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
- Correspondence: ; Tel.: +1-973-596-5880
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Burley DT, Anning KL, van Goozen SHM. The association between hyperactive behaviour and cognitive inhibition impairments in young children. Child Neuropsychol 2021; 28:302-317. [PMID: 34505554 DOI: 10.1080/09297049.2021.1976128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hyperactivity is one of the core features of attention-deficit hyperactivity disorder (ADHD), and yet there is evidence that hyperactive behavior in children with ADHD is not ubiquitous and could be a compensatory response to high cognitive demands. No research has yet objectively measured hyperactive behavior in young children who are demonstrating early signs of ADHD or examined the role of emotional state on hyperactivity levels.The current study measured motor activity using actigraphy during baseline, cognitive inhibition (Flanker task), and emotion arousing (Impossibly Perfect Circles task) conditions in 95 children aged 4-7 years old with developmental difficulties, including emerging symptoms of ADHD. We examined the relationship between objectively recorded activity, parent-rated hyperactivity problems, using the Strengths and Difficulties Questionnaire (SDQ), and cognitive inhibition task performance.Parent ratings of hyperactivity (but not inattention) symptoms were positively related to recorded hyperactivity, and this relationship was specific to activity measured during the cognitive inhibition task. Impaired cognitive inhibition performance was related to increased measured movement and this association was strongest in children who were rated as having the highest levels of hyperactive behavior.These findings confirm theoretically predicted associations between objectively recorded hyperactivity and impaired executive functioning and support the notion that hyperactivity in children emerges in response to high cognitive demands. The results encourage further investigation into the role of hyperactivity as a transdiagnostic dimension that can explain variation within and between different types of diagnostic classifications.
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Affiliation(s)
| | - Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK
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Impact of Secondary ADHD on Long-Term Outcomes After Early Childhood Traumatic Brain Injury. J Head Trauma Rehabil 2021; 35:E271-E279. [PMID: 31834065 PMCID: PMC7205557 DOI: 10.1097/htr.0000000000000550] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the impact of secondary attention-deficit/hyperactivity disorder (SADHD) on long-term global and executive functioning in adolescents after traumatic brain injury (TBI). SETTING Three tertiary cared children's hospitals and 1 general hospital. PARTICIPANTS One hundred twenty children (TBI: n = 54; orthopedic injury: n = 66) without preinjury ADHD evaluated approximately 6.8 years postinjury. DESIGN Cross-sectional data analysis from a prospective, longitudinal study. MAIN MEASURES Outcomes included functional impairment (Child and Adolescent Functional Assessment Scale) and executive functioning (Behavior Rating Inventory of Executive Function [BRIEF]). RESULTS SADHD moderated the association of injury type with the BRIEF-Behavioral Regulation Index (F1,113 = 4.42, P = .04) and the Child and Adolescent Functional Assessment Scale (F1,112 = 8.95, P = .003). TBI was only associated with poorer outcomes in the context of SADHD. SADHD was also associated with poorer outcomes on the BRIEF-Global Executive Composite (F1,113 = 52.92, P < .0001) and BRIEF-Metacognitive Index scores (F1,113 = 48.64, P < .0001) across groups. Adolescents with TBI had greater BRIEF-Global Executive Composite scores than those with orthopedic injury (F1,113 = 5.00, P = .03). CONCLUSIONS Although SADHD was associated with poorer functioning across groups, its adverse effects on behavioral regulation and overall functioning were amplified following TBI. TBI + SADHD may confer an elevated risk for significant impairments in early adolescence.
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Miller N, Prevatt F. Redefining ADHD Using an Adult Population: Should Inattention be Viewed as a Separate Dimension From Cognitive and Physiological Activity Level? J Atten Disord 2020; 24:1977-1988. [PMID: 28984497 DOI: 10.1177/1087054717733045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The purpose of this study was to reexamine the latent structure of ADHD and sluggish cognitive tempo (SCT) due to issues with construct validity. Two proposed changes to the construct include viewing hyperactivity and sluggishness (hypoactivity) as a single continuum of activity level, and viewing inattention as a separate dimension from activity level. Method: Data were collected from 1,398 adults using Amazon's MTurk. A new scale measuring activity level was developed, and scores of Inattention were regressed onto scores of Activity Level using curvilinear regression. Results: The Activity Level scale showed acceptable levels of internal consistency, normality, and unimodality. Curvilinear regression indicates that a quadratic (curvilinear) model accurately explains a small but significant portion of the variance in levels of inattention. Conclusion: Hyperactivity and hypoactivity may be viewed as a continuum, rather than separate disorders. Inattention may have a U-shaped relationship with activity level. Linear analyses may be insufficient and inaccurate for studying ADHD.
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Luo M, Mu R, Liu JF, Bai FH. Novel computerized psychometric tests as primary screening tools for the diagnosis of minimal hepatic encephalopathy. World J Clin Cases 2020; 8:3377-3389. [PMID: 32913845 PMCID: PMC7457114 DOI: 10.12998/wjcc.v8.i16.3377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/05/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023] Open
Abstract
Minimal hepatic encephalopathy (MHE) is a critical neurocognitive complication of decompensated liver cirrhosis and portosystemic shunting, which results in a wide range of cognitive deficits including impairments in working attention, psychomotor speed, and executive function. Current guidelines have recommended paper-and-pencil psychometric tests for the diagnosis of MHE. Most high-risk cirrhotic patients are required to be examined; however, paper-and-pencil psychometric tests are neither convenient nor rapid to perform in the clinic. Recently, novel computerized psychometric tests, including the inhibitory control test, EncephalApp Stroop App, and critical flicker frequency, have been proven to be rapid, effective, and convenient methods for screening MHE in clinical practice and for identifying high-risk cirrhotic patients for further validation using rigid neuropsychometric examinations. However, diagnostic accuracy of these tests is influenced by educational background, age, and cultural differences. This review summarizes clinical evidence of the application of novel computerized psychometric tests for screening MHE.
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Affiliation(s)
- Ming Luo
- Department of Gastroenterology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, Ningxia Hui Autonomous Region, China
| | - Rui Mu
- Department of Gastroenterology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, Ningxia Hui Autonomous Region, China
| | - Jian-Fang Liu
- Department of Gastroenterology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, Ningxia Hui Autonomous Region, China
| | - Fei-Hu Bai
- Department of Gastroenterology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, Ningxia Hui Autonomous Region, China
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Stawicka A, Jaroszewicz J, Zbrzeźniak J, Sołowianowicz N, Woszczenko A, Świderska M, Flisiak R. Clinical Usefulness of the Inhibitory Control Test (ICT) in the Diagnosis of Minimal Hepatic Encephalopathy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3645. [PMID: 32455895 PMCID: PMC7277853 DOI: 10.3390/ijerph17103645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
Background: Minimal hepatic encephalopathy (MHE) refers to a number of neuropsychiatric and neurophysiological disorders in patients with cirrhosis who do not show abnormalities on physical examination or in clinical tests. The aim of this study was to determine the prevalence, risk factors, and predictive value of minimal hepatic encephalopathy and the usefulness of the inhibitory control test (ICT) in the diagnosis. Methods: Seventy patients (mean age 53 years, range 24-77) with liver cirrhosis were enrolled in the study. MHE was diagnosed based on PHES (psychometric hepatic encephalopathy score) and ICT. PHES and ICT were validated in a group of 56 control subjects. Results: Minimal hepatic encephalopathy was diagnosed using PHES in 21 patients (30%). ICT diagnosed MHE in 30 patients (42%), and the test had a sensitivity of 65% and a specificity of 57% compared to PHES. The ICT score (lures/target accuracy rate) correlated with the age of subjects (R = 0.35, p = 0.002) and only slightly with education (education in years R = -0.22, p = 0.06). MHE diagnosed with PHES or ICT was associated with a significantly higher model of end-stage liver disease (MELD) score in the follow-up. MHE diagnosed with ICT was correlated with a significantly higher incidence of symptoms of decompensated cirrhosis (p = 0.02) in the follow-up. Conclusions: ICT had moderate sensitivity and specificity in diagnosing MHE compared to PHES. Importantly, MHE detected with PHES or ICT was associated with poorer survival and a more severe progression of the disease.
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Affiliation(s)
- Agnieszka Stawicka
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
- Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Justyna Zbrzeźniak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
| | - Natalia Sołowianowicz
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
| | - Aleksandra Woszczenko
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
| | - Magdalena Świderska
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland; (J.J.); (J.Z.); (N.S.); (A.W.); (M.Ś.); (R.F.)
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Luo M, Ma P, Li L, Cao WK. Advances in psychometric tests for screening minimal hepatic encephalopathy: From paper-and-pencil to computer-aided assessment. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 30:398-407. [PMID: 31060994 DOI: 10.5152/tjg.2019.18226] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Minimal hepatic encephalopathy (MHE) is a major neuropsychiatric complication of liver cirrhosis and portosystemic shunting. Although MHE produces a spectrum of cognitive impairments in the domains of short-term attention, working memory, and executive function, it generally does not present with obvious clinical manifestation on conventional assessments. Paper-and-pencil psychometric tests, such as the psychometric hepatic encephalopathy score and the repeatable battery for the assessment of neuropsychological status, are recommended to diagnose MHE. However, these tests are neither rapid nor convenient to use in practice. To facilitate repeated testing in clinic and follow-up, computer-aided psychometric tests, such as the scan test, Cognitive Drug Research assessment battery, inhibitory control test, EncephalApp Stroop App, and critical flicker frequency, have been used to screen for MHE among patients with liver cirrhosis. The aim of this review was to describe the progression from the utility of paper-and-pencil to computer-aided psychometric tests for MHE screening in clinical practice.
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Affiliation(s)
- Ming Luo
- Department of Gastroenterology, Ningxia People's Hospital, Ningxia, China
| | - Ping Ma
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Lei Li
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Wu-Kui Cao
- Tianjin Liver Disease Institute, Tianjin Second People's Hospital, Tianjin, China
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14
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Ryan NP, Reyes J, Crossley L, Beauchamp MH, Catroppa C, Anderson VA. Unraveling the Association between Pediatric Traumatic Brain Injury and Social Dysfunction: The Mediating Role of Self-Regulation. J Neurotrauma 2019; 36:2895-2903. [DOI: 10.1089/neu.2018.6308] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Nicholas P. Ryan
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Cognitive Neuroscience Unit, Deakin University, Geelong, Victoria, Australia
- Psychology, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan Reyes
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Louise Crossley
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Research Centre, Ste-Justine Hospital, Montreal, Quebec, Canada
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Psychology, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki A. Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Psychology, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
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15
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Karydakis P, Giakoumettis D, Themistocleous M. The 100 most cited papers about pediatric traumatic brain injury: a bibliometric analysis. Ir J Med Sci 2019; 189:315-325. [PMID: 31418153 DOI: 10.1007/s11845-019-02085-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/08/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The high incidence of traumatic brain injury (TBI) in children, combined with the challenges in diagnosis and treatment options, the difficulty of predicting the outcome of each case, and also the wide variety of possibly lifelong complications, has led to an extraordinary number of published papers regarding this topic. This bibliometric analysis is aimed at identifying and reviewing the 100 most cited papers in the most challenging and trending aspects of pediatric traumatic brain injury. METHODS A search was performed using the Web of Science database in October 2018. Results were organized by citation number, and the 100 most cited papers were further reviewed and analyzed. RESULTS Our search resulted in 2754 published papers from 1975 until October 2018, of which 1783 (64.74%) had been published in the last decade (2010-2018). The 100 most cited papers about traumatic brain injury in children have an average citation of 140.59 and have been published in 44 different journals. Four hundred thirty-five authors have contributed to these prominent articles, most of them from the USA. CONCLUSIONS By reviewing those highly cited papers, we sought to offer significant help not only for studying this challenging field but also for designing new studies.
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Affiliation(s)
- Ploutarchos Karydakis
- Department of Neurosurgery, 251 Hellenic Air Force General Hospital, Athanasiou Diakou 9 str., Cholargos, 15562, Athens, Greece.
| | - Dimitrios Giakoumettis
- Department of Neurosurgery, 'Evangelismos Hospital', University of Athens, Athens, Greece
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16
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Shen IH, Lin YJ, Chen CL, Liao CC. Neural Correlates of Response Inhibition and Error Processing in Individuals with Mild Traumatic Brain Injury: An Event-Related Potential Study. J Neurotrauma 2019; 37:115-124. [PMID: 31317830 DOI: 10.1089/neu.2018.6122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Individuals with a mild traumatic brain injury (mTBI) often have executive control deficits; however, the underlying neural mechanisms of such deficits are yet to be clarified. Inhibitory control and cognitive monitoring are two fundamental aspects of executive control processes. This study investigated the executive control of mTBI by using the Stop-signal task. Eighteen adults with mTBI and 18 age-, sex-, and education level-matched controls were recruited. Behavioral performance and event-related potential correlates of response inhibition and error processing were compared between groups. The mTBI group tended to have a lower probability of inhibition and a longer stop signal reaction time. N1 amplitude was greater on successful trials. Also on successful trials, N2 and P3 peaked earlier than on failed trials. The N2 amplitude of the mTBI group tended to be smaller than that of the controls. The control group had larger P3 amplitude on successful trials than on failed trials, whereas the mTBI group exhibited no P3 amplitudes difference between the two trial types. In addition, the mTBI group showed significantly longer error positivity latency than did the controls. These results suggest that inhibitory control and error processing were inefficient in the mTB group even more than three months after injury. Electrophysiological markers of cognitive dysfunction can be used as a sensitive tool for determining executive control after mTBI.
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Affiliation(s)
- I-Hsuan Shen
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan
| | - Ying-Ju Lin
- Department of Occupational Therapy, Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Northern Service Center, Sunshine Social Welfare Foundation, Taipei, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chih Liao
- Department of Neurosurgery, Division of Neurospine, Chang Gung Memorial Hospital Linkou branch, Taoyuan, Taiwan.,Department of Neurospinal Surgery, Mennonite Christian Hospital, Hualien, Taiwan
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17
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Clasby B, Bennett M, Hughes N, Hodges E, Meadham H, Hinder D, Williams H, Mewse A. The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling. Disabil Rehabil 2019; 42:2412-2421. [PMID: 31282232 DOI: 10.1080/09638288.2019.1635214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Paediatric traumatic brain injury (TBI) can have resultant ongoing significant impairments which can impact life outcomes. The primary aim of this research was to explore whether TBI contributes to the relationship between poor educational outcomes and offending trajectories.Materials and methods: Through analysis of a dataset consisting of self-reported health, educational, and offending histories of 70 incarcerated young males, structural equation modelling was used to explore the mediation of educational outcomes and patterns in offending behaviour by chronic symptoms following TBI.Results: Symptoms related to TBI significantly mediated the relationship between decreased educational attainment and more frequent convictions. It did not mediate any relationships involving age at first conviction.Conclusions: Traumatic brain injury appears to have more influence over frequency of offending patterns than age at first conviction. However, TBI remains a pervasive factor in both higher rates of offending and poorer educational attainment. In order to tackle this effect on adverse social outcomes, greater attention to the impact of TBI is required in education and criminal justice systems.IMPLICATIONS FOR REHABILITATIONHighlights traumatic brain injury as a contributory factor in some education to offending pathways, suggesting that greater focus on rehabilitation within the education and criminal justice systems is required.Reinforces that greater understanding of educational pathways post-injury is needed to better facilitate rehabilitation within the school system.
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Affiliation(s)
- Betony Clasby
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Matthew Bennett
- Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK
| | - Nathan Hughes
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Emma Hodges
- Department of Psychology, University of Exeter, Exeter, UK
| | - Hannah Meadham
- Department of Psychology, University of Exeter, Exeter, UK.,Carmarthen Community Team for Learning Disabilities, Hywel Dda University Health Board, Carmarthen, UK
| | - Darren Hinder
- Department of Psychology, University of Exeter, Exeter, UK
| | - Huw Williams
- Department of Psychology, University of Exeter, Exeter, UK
| | - Avril Mewse
- Department of Psychology, University of Exeter, Exeter, UK
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18
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Fullerton AF, Jackson NJ, Tuvblad C, Raine A, Baker LA. Early childhood head injury attenuates declines in impulsivity and aggression across adolescent development in twins. Neuropsychology 2019; 33:1035-1044. [PMID: 31259562 DOI: 10.1037/neu0000570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Head injury during development has been associated with behavioral changes such as impulsivity and antisocial behavior. This study investigates the extent to which behavioral changes associated with childhood head injury are sustained through adolescence and emerging adulthood. METHOD Survey data was collected at 5 waves spanning 12 years (ages 9-20) from the University of Southern California Risk Factors for Antisocial Behavior twin study. Impulsivity was measured by errors of commission in a Go/NoGo behavioral task, and aggression was measured through youth self-report using the Reactive-Proactive Aggression Questionnaire. Head injury was assessed retrospectively using caregiver questionnaires at twin ages 14-15 years and self-reported at ages 19-20 years. RESULTS Participants with a head injury in early childhood showed significant delay in the normative developmental decline of impulsivity relative to the noninjured by mid-adolescence (ages 14-15.) Moreover, earlier age at injury was related to a slower decrease in impulsivity and greater increase in reactive aggression scores. Finally, among discordant monozygotic twin pairs, the twin with a head injury experienced significantly less decline in impulsivity by ages 19-20 than the noninjured co-twin. CONCLUSIONS These findings indicate early childhood head injury may play a significant role in blunting the decline in impulsivity across development, exposing an additional risk factor for antisocial behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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19
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Gatto E, Lucon-Xiccato T, Bisazza A. Factors affecting the measure of inhibitory control in a fish (Poecilia reticulata). Behav Processes 2018; 157:11-17. [DOI: 10.1016/j.beproc.2018.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/12/2018] [Accepted: 08/19/2018] [Indexed: 12/27/2022]
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20
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Natsheh JY, Shiflett MW. Dopaminergic Modulation of Goal-Directed Behavior in a Rodent Model of Attention-Deficit/Hyperactivity Disorder. Front Integr Neurosci 2018; 12:45. [PMID: 30344481 PMCID: PMC6182263 DOI: 10.3389/fnint.2018.00045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 09/13/2018] [Indexed: 11/13/2022] Open
Abstract
Aside from its clinical symptoms of inattention, impulsivity and hyperactivity, patients with Attention/Deficit-Hyperactivity Disorder (ADHD) display reward and motivational impairments. These impairments may reflect a deficit in action control, that is, an inability to flexibly adapt behavior to changing consequences. We previously showed that spontaneously hypertensive rats (SHR), an inbred rodent model of ADHD, show impairments in goal-directed action control, and instead are predominated by habits. In this study, we examined the effects of specific dopamine receptor sub-type (D1 and D2) agonists and antagonists on goal-directed behavior in SHR and the normotensive inbred control strain Wistar-Kyoto (WKY) rats. Rats acquired an instrumental response for different-flavored food rewards. A selective-satiety outcome devaluation procedure followed by a choice test in extinction revealed outcome-insensitive habitual behavior in SHR rats. Outcome-sensitive goal-directed behavior was restored in SHR rats following injection prior to the choice test of the dopamine D2 receptor agonist Quinpirole or dopamine D1 receptor antagonist SCH23390, whereas WKY rats showed habitual responding following exposure to these drugs. This novel finding indicates that the core behavioral deficit in ADHD might not be a consequence of dopamine hypofunction, but rather is due to a misbalance between activation of dopamine D1 and D2 receptor pathways that govern action control.
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Affiliation(s)
- Joman Y Natsheh
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, United States.,Kessler Foundation, East Hanover, NJ, United States.,Palestinian Neuroscience Initiative, Al-Quds University, East Jerusalem, Palestine.,Children's Specialized Hospital Research Center, New Brunswick, NJ, United States
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21
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Neuroprotective Effects of Platonin, a Therapeutic Immunomodulating Medicine, on Traumatic Brain Injury in Mice after Controlled Cortical Impact. Int J Mol Sci 2018; 19:ijms19041100. [PMID: 29642394 PMCID: PMC5979356 DOI: 10.3390/ijms19041100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/02/2018] [Accepted: 04/03/2018] [Indexed: 11/23/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of mortality worldwide and leads to persistent cognitive, sensory, motor dysfunction, and emotional disorders. TBI-caused primary injury results in structural damage to brain tissues. Following the primary injury, secondary injuries which are accompanied by neuroinflammation, microglial activation, and additional cell death subsequently occur. Platonin, a cyanine photosensitizing dye, has been used to treat trauma, ulcers, and some types of acute inflammation. In the present study, the neuroprotective effects of platonin against TBI were explored in a controlled cortical impact (CCI) injury model in mice. Treatment with platonin (200 µg/kg) significantly reduced the neurological severity score, general locomotor activity, and anxiety-related behavior, and improved the rotarod performance of CCI-injured mice. In addition, platonin reduced lesion volumes, the expression of cleaved caspase-3, and microglial activation in TBI-insulted brains. Platonin also suppressed messenger (m)RNA levels of caspase-3, caspase-1, cyclooxygenase-2, tumor necrosis factor-α, interleukin-6, and interleukin-1β. On the other hand, free radical production after TBI was obviously attenuated in platonin-treated mice. Treatment with platonin exhibited prominent neuroprotective properties against TBI in a CCI mouse model through its anti-inflammatory, anti-apoptotic, and anti-free radical capabilities. This evidence collectively indicates that platonin may be a potential therapeutic medicine for use with TBIs.
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22
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Li L, Li Y, McDonald C, Liu J. Parent-Reported Mild Head Injury History in Children: Long-Term Effects on Attention-Deficit Hyperactivity Disorder. Glob Pediatr Health 2018; 5:2333794X18756465. [PMID: 29511708 PMCID: PMC5833162 DOI: 10.1177/2333794x18756465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/27/2017] [Indexed: 12/20/2022] Open
Abstract
Objective. Consequences of mild head injury for behavioral adjustment have not been well researched, and little is known about the long-term effects of mild head injury for attention-deficit hyperactivity disorder (ADHD). Methods. In this longitudinal study of 418 children in Jintan City, China, parents reported children's history of head injury at age 6 years, and the Child Behavior Checklist was used to measure child iDSM-IV-oriented ADHD at ages 6 (Wave I) and 12 years (Wave II). Regression models were used to calculate the long-term (Wave II) effect of mild head injury on diagnosed ADHD, while controlling for diagnosed ADHD in Wave I. Results. Fifty-seven children (13.6%) had a single injury and 42 (10.0%) had multiple injuries before the age of 6 years. The long-term effect of multiple mild injury on ADHD at age 12 years was significant (R2 = 0.103, P < .05), even after controlling for ADHD at age 6 years. Conclusions. Multiple, but not single, mild head injuries before the age of 6 years had a significant long-term effect on ADHD. Thus, injuries traditionally overlooked and underreported still pose significant risks to children's long-term behavioral development.
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Affiliation(s)
- Linda Li
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Yuli Li
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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23
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Wilkinson AA, Dennis M, Taylor MJ, Guerguerian AM, Boutis K, Choong K, Campbell C, Fraser D, Hutchison J, Schachar R. Performance Monitoring in Children Following Traumatic Brain Injury Compared to Typically Developing Children. Child Neurol Open 2017; 4:2329048X17732713. [PMID: 29051909 PMCID: PMC5639967 DOI: 10.1177/2329048x17732713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/12/2017] [Accepted: 08/25/2017] [Indexed: 11/17/2022] Open
Abstract
Children with traumatic brain injury are reported to have deficits in performance monitoring, but the mechanisms underlying these deficits are not well understood. Four performance monitoring hypotheses were explored by comparing how 28 children with traumatic brain injury and 28 typically developing controls (matched by age and sex) performed on the stop-signal task. Control children slowed significantly more following incorrect than correct stop-signal trials, fitting the error monitoring hypothesis. In contrast, the traumatic brain injury group showed no performance monitoring difference with trial types, but significant group differences did not emerge, suggesting that children with traumatic brain injury may not perform the same way as controls.
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Affiliation(s)
- Amy A Wilkinson
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Maureen Dennis
- Dr Maureen Dennis passed away during the completion of this study
| | - Margot J Taylor
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anne-Marie Guerguerian
- Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathy Boutis
- Division of Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen Choong
- Division of Pediatric Intensive Care, Department of Pediatrics, Children's Hospital of Hamilton, Hamilton, Ontario, Canada
| | - Craig Campbell
- Department of Pediatrics, Clinical Neurological Sciences and Epidemiology, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Douglas Fraser
- Department of Pediatrics, Clinical Neurological Sciences and Epidemiology, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Jamie Hutchison
- Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Russell Schachar
- Program in Neuroscience & Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
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24
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Treble-Barna A, Zang H, Zhang N, Taylor HG, Stancin T, Yeates KO, Wade SL. Observed parent behaviors as time-varying moderators of problem behaviors following traumatic brain injury in young children. Dev Psychol 2017; 52:1777-1792. [PMID: 27786528 DOI: 10.1037/dev0000208] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Parent behaviors moderate the adverse consequences of pediatric traumatic brain injury (TBI); however, it is unknown how these moderating effects change over time. This study examined the moderating effect of observed parent behaviors over time since injury on the relation between TBI and behavioral outcomes. Participants included children, ages 3-7 years, hospitalized for moderate (n = 52) or severe (n = 20) TBI or orthopedic injury (OI; n = 95). Parent-child dyads were videotaped during structured task and free play conditions, and parents completed child behavior ratings. Linear mixed models using a lagged, time-varying moderator analysis examined the relationship of observed parent behaviors at the baseline, 6-month, and 12-month assessments to child behavior problems at 6 months, 12 months, and 18 months postinjury, after controlling for preinjury levels of child behavior problems. The effect of TBI on behavior was exacerbated by less favorable parent behaviors, and buffered by more favorable parent behaviors, in children with severe TBI over the first 12 months postinjury. By 18 months postinjury, however, the moderating effect of parent behaviors diminished, such that children with severe TBI showed more behavior problems relative to children with moderate TBI or OI regardless of parent behaviors or in response to parent behaviors that were initially protective. The results suggest that the moderating effects of the family environment are complex and likely vary in relation to both recovery and developmental factors, with potentially important implications for targets and timing of intervention. (PsycINFO Database Record
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Affiliation(s)
- Amery Treble-Barna
- Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center
| | - Huaiyu Zang
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center
| | - Nanhua Zhang
- Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center
| | - H Gerry Taylor
- Division of Developmental and Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital
| | - Terry Stancin
- Department of Psychiatry, Case Western Reserve University School of Medicine
| | | | - Shari L Wade
- Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center
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25
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Wirth P, Yu W, Kimball AL, Liao J, Berkner P, Glenn MJ. New method to induce mild traumatic brain injury in rodents produces differential outcomes in female and male Sprague Dawley rats. J Neurosci Methods 2017; 290:133-144. [PMID: 28780369 DOI: 10.1016/j.jneumeth.2017.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mild traumatic brain injuries (mTBI) are an increasing health concern due to persistent behavioral and neurological effects. To better understand these effects, researchers frequently rely on animal injury models. Existing models, however, may not adequately reproduce the mechanism of injury as it occurs in humans. NEW METHOD Our new model for inducing mTBI in rodents entails acceleration of the animal toward a stationary impact zone to produce rapid rotational movement of the head. The aim of the present experiment was to characterize the effects of this injury in female and male rats on behavior, cognition, and neural plasticity. RESULTS mTBI produced the most widespread effects in females: they were more active during recovery within minutes of mTBI and more active in the center of the open field 4days after mTBI. Spatial learning deficits in the water maze were mild but persistent and accompanied by reduced numbers of immature neurons in the hippocampus along with reductions in sera levels of the neurotrophin, BDNF. By contrast, male mTBI rats mainly exhibited mild spatial learning deficits, with no other observed effects. COMPARISON WITH EXISTING METHODS Our model induced effects on behavior and biology in rats that aligned with existing models. However, new patterns were observed, particularly when comparing females and males. CONCLUSIONS Taken together, these findings confirm the validity of this model and point to key differences between females and males in symptom severity and type. Additionally, our model adds a novel injury mechanism that complements existing rodent models.
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Affiliation(s)
- Peter Wirth
- Department of Biology, Colby College, Waterville, ME, 04901, USA; Maine Concussion Management Initiative, Colby College, Waterville, ME, 04901, USA.
| | - Waylin Yu
- Department of Psychology, Colby College, Waterville, ME, 04901, USA.
| | - Amanda L Kimball
- Department of Psychology, Colby College, Waterville, ME, 04901, USA.
| | - Jennifer Liao
- Department of Biology, Colby College, Waterville, ME, 04901, USA; Maine Concussion Management Initiative, Colby College, Waterville, ME, 04901, USA.
| | - Paul Berkner
- Maine Concussion Management Initiative, Colby College, Waterville, ME, 04901, USA.
| | - Melissa J Glenn
- Department of Psychology, Colby College, Waterville, ME, 04901, USA; Maine Concussion Management Initiative, Colby College, Waterville, ME, 04901, USA.
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26
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Profiles of Executive Function Across Children with Distinct Brain Disorders: Traumatic Brain Injury, Stroke, and Brain Tumor. J Int Neuropsychol Soc 2017; 23:529-538. [PMID: 28502261 DOI: 10.1017/s1355617717000364] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder. METHODS Participants were children with traumatic brain injury (N=82; 8-13 years of age), arterial ischemic stroke (N=36; 6-16 years of age), and brain tumor (N=74; 9-18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children's Version (TEA-Ch) subtests: Creature Counting, Walk-Don't-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age. RESULTS As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups. CONCLUSIONS Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017, 23, 529-538).
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Yu K, Seal ML, Reyes J, Godfrey C, Anderson V, Adamson C, Ryan NP, Hearps SJC, Catroppa C. Brain volumetric correlates of inhibition and cognitive flexibility 16 years following childhood traumatic brain injury. J Neurosci Res 2017; 96:642-651. [PMID: 28675465 DOI: 10.1002/jnr.24087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/06/2017] [Accepted: 05/01/2017] [Indexed: 01/08/2023]
Abstract
Executive functions (EFs), such as inhibition and cognitive flexibility, are essential for everyday functioning, including regulation of socially appropriate emotional responses. These skills develop during childhood and continue maturing into early adulthood. The current study aimed to investigate the very long-term impact of childhood traumatic brain injury (TBI) on inhibition and cognitive flexibility, and to examine whether global white matter is associated with these abilities. Twenty-eight young adult survivors of childhood TBI (mean age at 16-year follow-up = 21.67 years, SD = 2.70) and 16 typically developing controls (TDCs), group-matched for age, sex, and socioeconomic status, completed tests of inhibition and cognitive flexibility and underwent structural MRI. Survivors of childhood TBI did not significantly differ from TDCs on EF or white matter volume. However, the relationship between EF and white matter volume differed between survivors of TBI and TDCs. Survivors of TBI did not mimic the brain behavior relationship that characterized EF in TDCs. The inverse brain behavior relationship, exhibited by childhood TBI survivors, suggests disruptions in the whole brain underpinning EF following childhood TBI.
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Affiliation(s)
- Kelleynne Yu
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Marc L Seal
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan Reyes
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Celia Godfrey
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Psychology, Royal Children's Hospital, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
| | - Chris Adamson
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Nicholas P Ryan
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J C Hearps
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Psychology, Royal Children's Hospital, Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences (MSPS), University of Melbourne, Parkville, Victoria, Australia
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28
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Yang LY, Huang CC, Chiu WT, Huang LT, Lo WC, Wang JY. Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study. Pediatr Res 2016; 80:356-62. [PMID: 27064246 DOI: 10.1038/pr.2016.85] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/08/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND We evaluated the risk of attention-deficit hyperactivity disorder (ADHD) following childhood traumatic brain injury (TBI). METHODS Using Taiwan's National Health Insurance Research Database, we included 10,416 newly diagnosed TBI children (aged ≤12 y) between 2001 and 2002 and 41,664 children without TBI, who were frequency matched by sex, age, and year of the index medical service with each TBI child, as controls. Children who had been diagnosed with ADHD prior to their medical service index were excluded. Each individual was followed for 9 y to identify ADHD diagnosis. We also compared the ADHD risk in children who were treated for fractures but not TBI as sensitivity analysis. RESULTS During the 9-y follow-up period, children with TBI had a higher ADHD risk (adjusted hazard ratio (AHR) = 1.32, 95% confidence interval (CI) = 1.19, 1.45) than did those without TBI. Furthermore, children with mild and severe TBI had higher AHRs for ADHD than did those without TBI (AHR = 1.30; 95% CI = 1.10, 1.53; and AHR = 1.37; 95% CI = 1.22, 1.55). However, no significant association was observed between fractures and ADHD. CONCLUSION TBI in childhood is associated with a greater likelihood of developing ADHD.
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Affiliation(s)
- Ling-Yu Yang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Ta Chiu
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Li-Tung Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Wei-Cheng Lo
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jia-Yi Wang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Ryan NP, Catroppa C, Godfrey C, Noble-Haeusslein LJ, Shultz SR, O'Brien TJ, Anderson V, Semple BD. Social dysfunction after pediatric traumatic brain injury: A translational perspective. Neurosci Biobehav Rev 2016; 64:196-214. [PMID: 26949224 PMCID: PMC5627971 DOI: 10.1016/j.neubiorev.2016.02.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022]
Abstract
Social dysfunction is common after traumatic brain injury (TBI), contributing to reduced quality of life for survivors. Factors which influence the development or persistence of social deficits after injury remain poorly understood, particularly in the context of ongoing brain maturation during childhood and adolescence. Aberrant social interactions have recently been modeled in adult and juvenile rodents after experimental TBI, providing an opportunity to gain new insights into the underlying neurobiology of these behaviors. Here, we review our current understanding of social dysfunction in both humans and rodent models of TBI, with a focus on brain injuries acquired during early development. Modulators of social outcomes are discussed, including injury-related and environmental risk and resilience factors. Disruption of social brain network connectivity and aberrant neuroendocrine function are identified as potential mechanisms of social impairments after pediatric TBI. Throughout, we highlight the overlap and disparities between outcome measures and findings from clinical and experimental approaches, and explore the translational potential of future research to prevent or ameliorate social dysfunction after childhood TBI.
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Affiliation(s)
- Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Celia Godfrey
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia.
| | - Linda J Noble-Haeusslein
- Departments of Neurological Surgery and Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA.
| | - Sandy R Shultz
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Terence J O'Brien
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Vicki Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Bridgette D Semple
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
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Kofler MJ, Raiker JS, Sarver DE, Wells EL, Soto EF. Is hyperactivity ubiquitous in ADHD or dependent on environmental demands? Evidence from meta-analysis. Clin Psychol Rev 2016; 46:12-24. [PMID: 27131918 DOI: 10.1016/j.cpr.2016.04.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/20/2022]
Abstract
Hyperactivity, or excess gross motor activity, is considered a core and ubiquitous characteristic of ADHD. Alternate models question this premise, and propose that hyperactive behavior reflects, to a large extent, purposeful behavior to cope with environmental demands that interact with underlying neurobiological vulnerabilities. The present review critically evaluates the ubiquity and environmental modifiability of hyperactivity in ADHD through meta-analysis of 63 studies of mechanically measured activity level in children, adolescents, and adults with ADHD relative to typically developing groups. Random effects models corrected for publication bias confirmed elevated gross motor activity in ADHD (d=0.86); surprisingly, neither participant age (child vs. adult) nor the proportion of each ADHD sample diagnosed with the inattentive subtype/presentation moderated this effect. In contrast, activity level assessed during high cognitive load conditions in general (d=1.14) and high executive functioning demands in particular (d=1.39) revealed significantly higher effect sizes than activity level during low cognitive load (d=0.36) and in-class schoolwork (d=0.50) settings. Low stimulation environments, more rigorous diagnostic practices, actigraph measurement of movement frequency and intensity, and ADHD samples that included fewer females were also associated with larger effects. Overall, the results are inconsistent with DSM-5 and ADHD models that a) describe hyperactivity as ubiquitous behavior, b) predict a developmental decline in hyperactivity, or c) differentiate subtypes/presentations according to perceived differences in hyperactive behavior. Instead, results suggest that the presence and magnitude of hyperactive behavior in ADHD may be influenced to a considerable extent by environmental factors in general, and cognitive/executive functioning demands in particular.
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Affiliation(s)
- Michael J Kofler
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States.
| | - Joseph S Raiker
- Florida International University
- Department of Psychology Center for Children and Families 11200 SW 8th St.
- Miami, FL 33199, United States
| | - Dustin E Sarver
- University of Mississippi Medical CenterDepartment of Pediatrics, Division of Child Development Center for Advancement of Youth (CAY) 2500 North State Street Jackson, MS 39216, United States
| | - Erica L Wells
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States
| | - Elia F Soto
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States
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De Crescenzo F, Licchelli S, Ciabattini M, Menghini D, Armando M, Alfieri P, Mazzone L, Pontrelli G, Livadiotti S, Foti F, Quested D, Vicari S. The use of actigraphy in the monitoring of sleep and activity in ADHD: A meta-analysis. Sleep Med Rev 2016; 26:9-20. [DOI: 10.1016/j.smrv.2015.04.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 11/27/2022]
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32
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Tegelbeckers J, Schares L, Lederer A, Bonath B, Flechtner HH, Krauel K. Task-Irrelevant Novel Sounds Improve Attentional Performance in Children With and Without ADHD. Front Psychol 2016; 6:1970. [PMID: 26779082 PMCID: PMC4700136 DOI: 10.3389/fpsyg.2015.01970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/09/2015] [Indexed: 11/13/2022] Open
Abstract
Task-irrelevant salient stimuli involuntarily capture attention and can lead to distraction from an ongoing task, especially in children with ADHD. However, there has been tentative evidence that the presentation of novel sounds can have beneficial effects on cognitive performance. In the present study, we aimed to investigate the influence of novel sounds compared to no sound and a repeatedly presented standard sound on attentional performance in children and adolescents with and without ADHD. We therefore had 32 patients with ADHD and 32 typically developing children and adolescents (8 to 13 years) execute a flanker task in which each trial was preceded either by a repeatedly presented standard sound (33%), an unrepeated novel sound (33%) or no auditory stimulation (33%). Task-irrelevant novel sounds facilitated attentional performance similarly in children with and without ADHD, as indicated by reduced omission error rates, reaction times, and reaction time variability without compromising performance accuracy. By contrast, standard sounds, while also reducing omission error rates and reaction times, led to increased commission error rates. Therefore, the beneficial effect of novel sounds exceeds cueing of the target display by potentially increased alerting and/or enhanced behavioral control.
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Affiliation(s)
- Jana Tegelbeckers
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg Magdeburg, Germany
| | - Laura Schares
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg Magdeburg, Germany
| | - Annette Lederer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg Magdeburg, Germany
| | - Bjoern Bonath
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg Magdeburg, Germany
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg Magdeburg, Germany
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University MagdeburgMagdeburg, Germany; Center for Behavioral Brain SciencesMagdeburg, Germany
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33
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Action Video Gaming and Cognitive Control: Playing First Person Shooter Games Is Associated with Improved Action Cascading but Not Inhibition. PLoS One 2015; 10:e0144364. [PMID: 26655929 PMCID: PMC4675555 DOI: 10.1371/journal.pone.0144364] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/17/2015] [Indexed: 01/13/2023] Open
Abstract
There is a constantly growing interest in developing efficient methods to enhance cognitive functioning and/or to ameliorate cognitive deficits. One particular line of research focuses on the possibly cognitive enhancing effects that action video game (AVG) playing may have on game players. Interestingly, AVGs, especially first person shooter games, require gamers to develop different action control strategies to rapidly react to fast moving visual and auditory stimuli, and to flexibly adapt their behaviour to the ever-changing context. This study investigated whether and to what extent experience with such videogames is associated with enhanced performance on cognitive control tasks that require similar abilities. Experienced action videogame-players (AVGPs) and individuals with little to no videogame experience (NVGPs) performed a stop-change paradigm that provides a relatively well-established diagnostic measure of action cascading and response inhibition. Replicating previous findings, AVGPs showed higher efficiency in response execution, but not improved response inhibition (i.e. inhibitory control), as compared to NVGPs. More importantly, compared to NVGPs, AVGPs showed enhanced action cascading processes when an interruption (stop) and a change towards an alternative response were required simultaneously, as well as when such a change had to occur after the completion of the stop process. Our findings suggest that playing AVGs is associated with enhanced action cascading and multi-component behaviour without affecting inhibitory control.
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34
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Fidan E, Lewis J, Kline AE, Garman RH, Alexander H, Cheng JP, Bondi CO, Clark RSB, Dezfulian C, Kochanek PM, Kagan VE, Bayır H. Repetitive Mild Traumatic Brain Injury in the Developing Brain: Effects on Long-Term Functional Outcome and Neuropathology. J Neurotrauma 2015. [PMID: 26214116 DOI: 10.1089/neu.2015.3958] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Although accumulating evidence suggests that repetitive mild TBI (rmTBI) may cause long-term cognitive dysfunction in adults, whether rmTBI causes similar deficits in the immature brain is unknown. Here we used an experimental model of rmTBI in the immature brain to answer this question. Post-natal day (PND) 18 rats were subjected to either one, two, or three mild TBIs (mTBI) or an equivalent number of sham insults 24 h apart. After one or two mTBIs or sham insults, histology was evaluated at 7 days. After three mTBIs or sham insults, motor (d1-5), cognitive (d11-92), and histological (d21-92) outcome was evaluated. At 7 days, silver degeneration staining revealed axonal argyrophilia in the external capsule and corpus callosum after a single mTBI, with a second impact increasing axonal injury. Iba-1 immunohistochemistry showed amoeboid shaped microglia within the amygdalae bilaterally after mTBI. After three mTBI, there were no differences in beam balance, Morris water maze, and elevated plus maze performance versus sham. The rmTBI rats, however, showed impairment in novel object recognition and fear conditioning. Axonal silver staining was observed only in the external capsule on d21. Iba-1 staining did not reveal activated microglia on d21 or d92. In conclusion, mTBI results in traumatic axonal injury and microglial activation in the immature brain with repeated impact exacerbating axonal injury. The rmTBI in the immature brain leads to long-term associative learning deficit in adulthood. Defining the mechanisms damage from rmTBI in the developing brain could be vital for identification of therapies for children.
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Affiliation(s)
- Emin Fidan
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jesse Lewis
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Anthony E Kline
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 Department of Physical Medicine and Rehabilitation, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Robert H Garman
- 4 Consultants in Veterinary Pathology, Inc. , Murrysville, Pennsylvania
| | - Henry Alexander
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jeffrey P Cheng
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 Department of Physical Medicine and Rehabilitation, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Corina O Bondi
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,2 Department of Physical Medicine and Rehabilitation, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Robert S B Clark
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,5 Children's Hospital of Pittsburgh , Pittsburgh, Pennsylvania
| | - Cameron Dezfulian
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,5 Children's Hospital of Pittsburgh , Pittsburgh, Pennsylvania
| | - Patrick M Kochanek
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,5 Children's Hospital of Pittsburgh , Pittsburgh, Pennsylvania
| | - Valerian E Kagan
- 3 Center for Free Radical and Antioxidant Health, Department of Environmental and Occupational Health, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Hülya Bayır
- 1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania.,3 Center for Free Radical and Antioxidant Health, Department of Environmental and Occupational Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,5 Children's Hospital of Pittsburgh , Pittsburgh, Pennsylvania
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35
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Bondi CO, Semple BD, Noble-Haeusslein LJ, Osier ND, Carlson SW, Dixon CE, Giza CC, Kline AE. Found in translation: Understanding the biology and behavior of experimental traumatic brain injury. Neurosci Biobehav Rev 2015; 58:123-46. [PMID: 25496906 PMCID: PMC4465064 DOI: 10.1016/j.neubiorev.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 10/26/2014] [Accepted: 12/02/2014] [Indexed: 12/14/2022]
Abstract
The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided.
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Affiliation(s)
- Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bridgette D Semple
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shaun W Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Christopher C Giza
- Pediatric Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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36
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Hehar H, Yeates K, Kolb B, Esser MJ, Mychasiuk R. Impulsivity and Concussion in Juvenile Rats: Examining Molecular and Structural Aspects of the Frontostriatal Pathway. PLoS One 2015; 10:e0139842. [PMID: 26448536 PMCID: PMC4598031 DOI: 10.1371/journal.pone.0139842] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/17/2015] [Indexed: 01/09/2023] Open
Abstract
Impulsivity and poor executive control have been implicated in the pathogenesis of many developmental and neuropsychiatric disorders. Similarly, concussions/mild traumatic brain injuries (mTBI) have been associated with increased risk for neuropsychiatric disorders and the development of impulsivity and inattention. Researchers and epidemiologists have therefore considered whether or not concussions induce symptoms of attention-deficit/hyperactivity disorder (ADHD), or merely unmask impulsive tendencies that were already present. The purpose of this study was to determine if a single concussion in adolescence could induce ADHD-like impulsivity and impaired response inhibition, and subsequently determine if inherent impulsivity prior to a pediatric mTBI would exacerbate post-concussion symptomology with a specific emphasis on impulsive and inattentive behaviours. As these behaviours are believed to be associated with the frontostriatal circuit involving the nucleus accumbens (NAc) and the prefrontal cortex (PFC), the expression patterns of 8 genes (Comt, Drd2, Drd3, Drd4, Maoa, Sert, Tph1, and Tph2) from these two regions were examined. In addition, Golgi-Cox staining of medium spiny neurons in the NAc provided a neuroanatomical examination of mTBI-induced structural changes. The study found that a single early brain injury could induce impulsivity and impairments in response inhibition that were more pronounced in males. Interestingly, when animals with inherent impulsivity experienced mTBI, injury-related deficits were exacerbated in female animals. The single concussion increased dendritic branching, but reduced synaptic density in the NAc, and these changes were likely associated with the increase in impulsivity. Finally, mTBI-induced impulsivity was associated with modifications to gene expression that differed dramatically from the gene expression pattern associated with inherent impulsivity, despite very similar behavioural phenotypes. Our findings suggest the need to tailor treatment strategies for mTBI in light of an individual's premorbid characteristics, given significant differences in molecular profiles of the frontostriatal circuits that depend upon sex and the etiology of the behavioural phenotype.
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Affiliation(s)
- Harleen Hehar
- Alberta Children’s Hospital Research Institute, University of Calgary, Faculty of Medicine, Calgary, Canada
| | - Keith Yeates
- Alberta Children’s Hospital Research Institute, University of Calgary, Department of Psychology, Calgary, Canada
| | - Bryan Kolb
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
| | - Michael J. Esser
- Alberta Children’s Hospital Research Institute, University of Calgary, Faculty of Medicine, Calgary, Canada
| | - Richelle Mychasiuk
- Alberta Children’s Hospital Research Institute, University of Calgary, Faculty of Medicine, Calgary, Canada
- * E-mail:
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37
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Transcranial magnetic stimulation facilitates neurorehabilitation after pediatric traumatic brain injury. Sci Rep 2015; 5:14769. [PMID: 26440604 PMCID: PMC4594036 DOI: 10.1038/srep14769] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/09/2015] [Indexed: 11/08/2022] Open
Abstract
Traumatic brain injury (TBI) is the leading cause of death and disability among children in the United States. Affected children will often suffer from emotional, cognitive and neurological impairments throughout life. In the controlled cortical impact (CCI) animal model of pediatric TBI (postnatal day 16-17) it was demonstrated that injury results in abnormal neuronal hypoactivity in the non-injured primary somatosensory cortex (S1). It materializes that reshaping the abnormal post-injury neuronal activity may provide a suitable strategy to augment rehabilitation. We tested whether high-frequency, non-invasive transcranial magnetic stimulation (TMS) delivered twice a week over a four-week period can rescue the neuronal activity and improve the long-term functional neurophysiological and behavioral outcome in the pediatric CCI model. The results show that TBI rats subjected to TMS therapy showed significant increases in the evoked-fMRI cortical responses (189%), evoked synaptic activity (46%), evoked neuronal firing (200%) and increases expression of cellular markers of neuroplasticity in the non-injured S1 compared to TBI rats that did not receive therapy. Notably, these rats showed less hyperactivity in behavioral tests. These results implicate TMS as a promising approach for reversing the adverse neuronal mechanisms activated post-TBI. Importantly, this intervention could readily be translated to human studies.
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Rosch KS, Dirlikov B, Mostofsky SH. Reduced intrasubject variability with reinforcement in boys, but not girls, with ADHD: Associations with prefrontal anatomy. Biol Psychol 2015; 110:12-23. [PMID: 26141238 PMCID: PMC4564325 DOI: 10.1016/j.biopsycho.2015.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 06/19/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
This study examined the impact of motivational contingencies (reinforcement and punishment) on go/no-go (GNG) task performance in girls and boys with ADHD relative to typically developing (TD) children and associations with prefrontal anatomy. Children ages 8-12 with ADHD (n=107, 36 girls) and TD controls (n=95, 34 girls) completed a standard and a motivational GNG task and associations with prefrontal cortex (PFC) surface area were examined. Intrasubject variability (ISV) was lower during the motivational compared to the standard GNG among TD girls and boys, and boys with ADHD, but not among girls with ADHD. A greater reduction in ISV was associated with greater PFC surface area among children with ADHD. This novel demonstration of improvement in ISV with motivational contingencies for boys, but not girls, with ADHD and associations with PFC anatomy informs our understanding of sex differences and motivational factors contributing to ISV in children with ADHD.
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Affiliation(s)
- Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Baltimore, MD, USA; Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Benjamin Dirlikov
- Center for Neurodevelopmental and Imaging Research, Baltimore, MD, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Baltimore, MD, USA; Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Gupta D, Ingle M, Shah K, Phadke A, Sawant P. Prospective comparative study of inhibitory control test and psychometric hepatic encephalopathy score for diagnosis and prognosis of minimal hepatic encephalopathy in cirrhotic patients in the Indian subcontinent. J Dig Dis 2015; 16:400-7. [PMID: 25858627 DOI: 10.1111/1751-2980.12248] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aimed to determine the usefulness of inhibitory control test (ICT) for diagnosing minimal hepatic encephalopathy (MHE) in the Indian subcontinent and its correlation with the severity of liver disease and to determine its prognostic significance. METHODS Two hundred patients with cirrhosis and 200 healthy controls were enrolled. Only patients were administered with psychometric hepatic encephalopathy score (PHES), while both patients and controls were subjected to ICT. MHE was diagnosed when PHES ≤ -5. ICT was considered abnormal when the numbers of ICT lures were ≥ 14. RESULTS Overall, 135 (67.5%) patients had MHE. Mean ICT lures were higher in cirrhotic patients with MHE than those without MHE (17.27, 95% confidence interval [CI] 13.9-22.3 vs 8.79, 95% CI 6.8-12.60, P < 0.001). Target accuracy was lower in patients with MHE than in those without (84.35, 95% CI 78.5-89.8 vs 95.36, 95% CI 90.1-99.2, P < 0.001). ICT had a sensitivity of 92.6% and specificity of 78.5% with the area under the receiver operating characteristic curve of 0.855 (95% CI 0.791-0.920) for MHE. ICT was correlated with Child-Turcotte-Pugh class (P < 0.001) and the model for end-stage liver disease score (P < 0.001) and predicted the development of overt hepatic encephalopathy (OHE) and probable survival with excellent test-retest reliability. CONCLUSIONS ICT is useful for diagnosing MHE in patients with cirrhosis. It is correlated with disease severity and predicts the development of OHE and probable survival with excellent test-retest reliability.
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Affiliation(s)
- Dhaval Gupta
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Mumbai, India
| | - Meghraj Ingle
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Mumbai, India
| | - Kaivan Shah
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Mumbai, India
| | - Aniruddha Phadke
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Mumbai, India
| | - Prabha Sawant
- Department of Gastroenterology, Lokmanya Tilak Municipal Medical College & Hospital, Mumbai, India
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Mychasiuk R, Hehar H, Esser MJ. A mild traumatic brain injury (mTBI) induces secondary attention-deficit hyperactivity disorder-like symptomology in young rats. Behav Brain Res 2015; 286:285-92. [DOI: 10.1016/j.bbr.2015.03.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/16/2015] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
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Hebert K. The association between impulsivity and sensory processing patterns in healthy adults. Br J Occup Ther 2015. [DOI: 10.1177/0308022615575670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Growing evidence suggests that an individual's style of processing sensory information plays a role in affective disorders. However, most of this work focuses on the relationship between sensory hypersensitivity and factors related to internalizing disorders. This study explores the association between sensory processing styles and impulsivity, a fundamental feature of externalizing disorders, in healthy adults. Method Two hundred and twenty-six healthy individuals aged 18–60 years completed the adolescent/adult sensory profile, Barratt impulsiveness scale, and a computerized response inhibition task (go/no-go task). Findings Low registration sensory processing scores were positively correlated with Barratt impulsivity scores. In addition, individuals high in low registration were more likely to meet criteria for high impulsivity. Individuals higher in sensory sensitivity made more impulsive errors on the response inhibition task. Conclusion The findings suggest that individuals with low registration are more impulsive. When helping clients manage impulsivity, occupational therapists should consider their sensory processing patterns and utilize interventions that address sensory needs. Future studies should examine these associations in clinical populations characterized by high rates of impulsive behavior.
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Affiliation(s)
- Karen Hebert
- Assistant Professor, Department of Occupational Therapy, University of Missouri–Columbia, USA
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Neuropsychological performance of youth with secondary attention-deficit/hyperactivity disorder 6- and 12-months after traumatic brain injury. J Int Neuropsychol Soc 2014; 20:971-81. [PMID: 25489810 PMCID: PMC5010863 DOI: 10.1017/s1355617714000903] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6-16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions.
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Mannix R, Berglass J, Berkner J, Moleus P, Qiu J, Andrews N, Gunner G, Berglass L, Jantzie LL, Robinson S, Meehan WP. Chronic gliosis and behavioral deficits in mice following repetitive mild traumatic brain injury. J Neurosurg 2014; 121:1342-50. [PMID: 25267088 DOI: 10.3171/2014.7.jns14272] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECT With the recent increasing interest in outcomes after repetitive mild traumatic brain injury (rmTBI; e.g., sports concussions), several models of rmTBI have been established. Characterizing these models in terms of behavioral and histopathological outcomes is vital to assess their clinical translatability. The purpose of this study is to provide an in-depth behavioral and histopathological phenotype of a clinically relevant model of rmTBI. METHODS The authors used a previously published weight-drop model of rmTBI (7 injuries in 9 days) in 2- to 3-month-old mice that produces cognitive deficits without persistent loss of consciousness, seizures, gross structural imaging findings, or microscopic evidence of structural brain damage. Injured and sham-injured (anesthesia only) mice were subjected to a battery of behavioral testing, including tests of balance (rotarod), spatial memory (Morris water maze), anxiety (open field plus maze), and exploratory behavior (hole-board test). After behavioral testing, brains were assessed for histopathological outcomes, including brain volume and microglial and astrocyte immunolabeling. RESULTS Compared with sham-injured mice, mice subjected to rmTBI showed increased exploratory behavior and had impaired balance and worse spatial memory that persisted up to 3 months after injury. Long-term behavioral deficits were associated with chronic increased astrocytosis and microgliosis but no volume changes. CONCLUSIONS The authors demonstrate that their rmTBI model results in a characteristic behavioral phenotype that correlates with the clinical syndrome of concussion and repetitive concussion. This model offers a platform from which to study therapeutic interventions for rmTBI.
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Heym N, Kantini E, Checkley HLR, Cassaday HJ. Tourette-like behaviors in the normal population are associated with hyperactive/impulsive ADHD-like behaviors but do not relate to deficits in conditioned inhibition or response inhibition. Front Psychol 2014; 5:946. [PMID: 25228890 PMCID: PMC4151087 DOI: 10.3389/fpsyg.2014.00946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 08/07/2014] [Indexed: 11/21/2022] Open
Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) and Tourette Syndrome (TS) present as distinct conditions clinically; however, comorbidity and inhibitory control deficits have been proposed for both. Whilst such deficits have been studied widely within clinical populations, findings are mixed—partly due to comorbidity and/or medication effects—and studies have rarely distinguished between subtypes of the disorders. Studies in the general population are sparse. Using a continuity approach, the present study examined (i) the relationships between inattentive and hyperactive/impulsive aspects of ADHD and TS-like behaviors in the general population, and (ii) their unique associations with automatic and executive inhibitory control, as well as (iii) yawning (a proposed behavioral model of TS). One hundred and thirty-eight participants completed self-report measures for ADHD and TS-like behaviors as well as yawning, and a conditioned inhibition task to assess automatic inhibition. A sub-sample of fifty-four participants completed three executive inhibition tasks. An exploratory factor analysis of the TS behavior checklist supported a distinction between phonic and motor like pure TS behaviors. Whilst hyperactive/impulsive aspects of ADHD were associated with increased pure and compulsive TS-like behaviors, inattention in isolation was related to reduced obsessive-compulsive TS-like behaviors. TS-like behaviors were associated with yawning during situations of inactivity, and specifically motor TS was related to yawning during stress. Phonic TS and inattention aspects of ADHD were associated with yawning during concentration/activity. Whilst executive interference control deficits were linked to hyperactive/impulsive ADHD-like behaviors, this was not the case for inattentive ADHD or TS-like behaviors, which instead related to increased performance on some measures. No associations were observed for automatic conditioned inhibition.
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Affiliation(s)
- Nadja Heym
- School of Psychology, University of Nottingham Nottingham, UK ; Division of Psychology, School of Social Science, Nottingham Trent University Nottingham, UK
| | - Ebrahim Kantini
- School of Psychology, University of Nottingham Nottingham, UK
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Lipszyc J, Levin H, Hanten G, Hunter J, Dennis M, Schachar R. Frontal white matter damage impairs response inhibition in children following traumatic brain injury. Arch Clin Neuropsychol 2014; 29:289-99. [PMID: 24618405 DOI: 10.1093/arclin/acu004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Inhibition, the ability to suppress inappropriate cognitions or behaviors, can be measured using computer tasks and questionnaires. Inhibition depends on the frontal cortex, but the role of the underlying white matter (WM) is unclear. We assessed the specific impact of frontal WM damage on inhibition in 29 children with moderate-to-severe traumatic brain injury (15 with and 14 without frontal WM damage), 21 children with orthopedic injury, and 29 population controls. We used the Stop Signal Task to measure response inhibition, the Behavior Rating Inventory of Executive Function to assess everyday inhibition, and T2 fluid-attenuated inversion recovery magnetic resonance imaging to identify lesions. Children with frontal WM damage had impaired response inhibition compared with all other groups and poorer everyday inhibition than the orthopedic injury group. Frontal WM lesions most often affected the superior frontal gyrus. These results provide evidence for the critical role of frontal WM in inhibition.
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Affiliation(s)
- Jonathan Lipszyc
- Department of Psychiatry, Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
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Luo J, Nguyen A, Villeda S, Zhang H, Ding Z, Lindsey D, Bieri G, Castellano JM, Beaupre GS, Wyss-Coray T. Long-term cognitive impairments and pathological alterations in a mouse model of repetitive mild traumatic brain injury. Front Neurol 2014; 5:12. [PMID: 24550885 PMCID: PMC3912443 DOI: 10.3389/fneur.2014.00012] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 01/17/2014] [Indexed: 11/23/2022] Open
Abstract
Mild traumatic brain injury (mTBI, also referred to as concussion) accounts for the majority of all traumatic brain injuries. The consequences of repetitive mTBI have become of particular concern for individuals engaged in certain sports or in military operations. Many mTBI patients suffer long-lasting neurobehavioral impairments. In order to expedite pre-clinical research and therapy development, there is a need for animal models that reflect the long-term cognitive and pathological features seen in patients. In the present study, we developed and characterized a mouse model of repetitive mTBI, induced onto the closed head over the left frontal hemisphere with an electromagnetic stereotaxic impact device. Using GFAP-luciferase bioluminescence reporter mice that provide a readout of astrocyte activation, we observed an increase in bioluminescence relative to the force delivered by the impactor after single impact and cumulative effects of repetitive mTBI. Using the injury parameters established in the reporter mice, we induced a repetitive mTBI in wild-type C57BL/6J mice and characterized the long-term outcome. Animals received repetitive mTBI showed a significant impairment in spatial learning and memory when tested at 2 and 6 months after injury. A robust astrogliosis and increased p-Tau immunoreactivity were observed upon post-mortem pathological examinations. These findings are consistent with the deficits and pathology associated with mTBI in humans and support the use of this model to evaluate potential therapeutic approaches.
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Affiliation(s)
- Jian Luo
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Andy Nguyen
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Saul Villeda
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Hui Zhang
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Zhaoqing Ding
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Derek Lindsey
- Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Gregor Bieri
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Joseph M Castellano
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Gary S Beaupre
- Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
| | - Tony Wyss-Coray
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine , Stanford, CA , USA ; Center for Tissue Regeneration, Repair and Restoration, VA Palo Alto Health Care System , Palo Alto, CA , USA
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Liu J, Li L. Parent-reported mild head injury history and behavioural performance in children at 6 years. Brain Inj 2013; 27:1263-70. [PMID: 23875827 DOI: 10.3109/02699052.2013.804205] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Mild head and brain injuries have gained increasing attention from health professionals and researchers. Little is known about mild injuries, which may not always be diagnosed or brought to medical attention. This study examines the associations between parent-reported history of mild head injury and behavioural problems in a large community-based sample of Chinese children. METHOD Subjects included 725 children from China. Parents reported on children's head injury history and behaviour at age 6 years using the Chinese version of the Child Behavior Checklist. Mild head injury was defined as injury without loss of consciousness or hospitalization. Standardized T-scores were compared for each of the seven clinical sub-scales and three summary behavioural measures, adjusting for confounders. Logistic models were used to calculate odds ratios (ORs) between head injury and behavioural problems. RESULTS Parents reported that 97 children (14%) had a single injury and 70 (10%) had multiple injuries. Compared to the controls, head-injured children had worse behavioural outcomes and a higher prevalence of behavioural problems. Multiple injuries were associated with higher risk of certain internalizing and externalizing problems. CONCLUSION Mild head injuries, especially incurred repeatedly, may still be a significant risk for adverse behaviours in children.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania, Schools of Nursing and Medicine , Philadelphia, PA , USA
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Childers C, Hux K. Environmental accommodations for a child with traumatic brain injury. Brain Inj 2013; 27:850-61. [DOI: 10.3109/02699052.2013.775498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Boecker M, Gauggel S, Drueke B. Stop or stop-change — Does it make any difference for the inhibition process? Int J Psychophysiol 2013; 87:234-43. [DOI: 10.1016/j.ijpsycho.2012.09.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 08/30/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
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