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Fuelscher I, Hyde C, Thomson P, Vijayakumar N, Sciberras E, Efron D, Anderson V, Hazell P, Silk TJ. Longitudinal Trajectories of White Matter Development in Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1103-1112. [PMID: 36963498 DOI: 10.1016/j.bpsc.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Few longitudinal studies have investigated whether white matter development reflects differential outcomes for children with and without attention-deficit/hyperactivity disorder (ADHD). To examine whether deviations from typical trajectories of white matter development were associated with the persistence or remission of ADHD symptoms, this study examined microstructural and morphological properties of 71 white matter tracts from 390 high angular diffusion scans acquired prospectively for 62 children with persistent ADHD, 37 children remitted from ADHD, and 85 children without ADHD. METHODS Participants (mean age at wave 1 = 10.39 years, scan interval = 18 months) underwent up to 3 magnetic resonance imaging assessments. White matter tracts were reconstructed using TractSeg, a semiautomated method. For each tract, we derived measures of fiber density (microstructure) and fiber bundle cross-section (morphology) using fixel-based analysis. Linear mixed models were used to compare trajectories of fiber development between the persistent ADHD, remitted ADHD, and non-ADHD groups. RESULTS Compared with the non-ADHD group, the remitted and persistent ADHD groups showed accelerated fiber development in thalamic pathways, striatal pathways, and the superior longitudinal fasciculus. In the remitted ADHD group, accelerated fiber development in corticospinal, frontopontine, striatal-premotor, and thalamo-premotor pathways was associated with greater reductions in ADHD symptom severity. The persistent ADHD group showed ongoing white matter alterations along sensorimotor pathways. CONCLUSIONS These results suggest that variations in white matter development are associated with different clinical trajectories in ADHD. The findings advance our understanding of the neurobiological mechanisms underpinning ADHD symptom progression and provide novel evidence in support of developmental models of ADHD.
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Affiliation(s)
- Ian Fuelscher
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Christian Hyde
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Phoebe Thomson
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Emma Sciberras
- School of Psychology, Deakin University, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Daryl Efron
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Philip Hazell
- Discipline of Psychiatry, The University of Sydney, Sydney, New South Wales, Australia
| | - Timothy J Silk
- School of Psychology, Deakin University, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
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Parlatini V, Itahashi T, Lee Y, Liu S, Nguyen TT, Aoki YY, Forkel SJ, Catani M, Rubia K, Zhou JH, Murphy DG, Cortese S. White matter alterations in Attention-Deficit/Hyperactivity Disorder (ADHD): a systematic review of 129 diffusion imaging studies with meta-analysis. Mol Psychiatry 2023; 28:4098-4123. [PMID: 37479785 PMCID: PMC10827669 DOI: 10.1038/s41380-023-02173-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
Aberrant anatomical brain connections in attention-deficit/hyperactivity disorder (ADHD) are reported inconsistently across diffusion weighted imaging (DWI) studies. Based on a pre-registered protocol (Prospero: CRD42021259192), we searched PubMed, Ovid, and Web of Knowledge until 26/03/2022 to conduct a systematic review of DWI studies. We performed a quality assessment based on imaging acquisition, preprocessing, and analysis. Using signed differential mapping, we meta-analyzed a subset of the retrieved studies amenable to quantitative evidence synthesis, i.e., tract-based spatial statistics (TBSS) studies, in individuals of any age and, separately, in children, adults, and high-quality datasets. Finally, we conducted meta-regressions to test the effect of age, sex, and medication-naïvety. We included 129 studies (6739 ADHD participants and 6476 controls), of which 25 TBSS studies provided peak coordinates for case-control differences in fractional anisotropy (FA)(32 datasets) and 18 in mean diffusivity (MD)(23 datasets). The systematic review highlighted white matter alterations (especially reduced FA) in projection, commissural and association pathways of individuals with ADHD, which were associated with symptom severity and cognitive deficits. The meta-analysis showed a consistent reduced FA in the splenium and body of the corpus callosum, extending to the cingulum. Lower FA was related to older age, and case-control differences did not survive in the pediatric meta-analysis. About 68% of studies were of low quality, mainly due to acquisitions with non-isotropic voxels or lack of motion correction; and the sensitivity analysis in high-quality datasets yielded no significant results. Findings suggest prominent alterations in posterior interhemispheric connections subserving cognitive and motor functions affected in ADHD, although these might be influenced by non-optimal acquisition parameters/preprocessing. Absence of findings in children may be related to the late development of callosal fibers, which may enhance case-control differences in adulthood. Clinicodemographic and methodological differences were major barriers to consistency and comparability among studies, and should be addressed in future investigations.
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Affiliation(s)
- Valeria Parlatini
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK.
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Yeji Lee
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Siwei Liu
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thuan T Nguyen
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, National University of Singapore, Singapore, Singapore
| | - Yuta Y Aoki
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Aoki Clinic, Tokyo, Japan
| | - Stephanie J Forkel
- Donders Centre for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Centre for Neuroimaging Sciences, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
- Departments of Neurosurgery, Technical University of Munich School of Medicine, Munich, Germany
| | - Marco Catani
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Juan H Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Declan G Murphy
- Sackler Institute of Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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Hollingdale J, Woodhouse E, Young S, Gudjonsson G, Charman T, Mandy W. Sex differences in conduct and emotional outcomes for young people with hyperactive/inattentive traits and social communication difficulties between 9 and 16 years of age: a growth curve analysis. Psychol Med 2023; 53:4539-4549. [PMID: 35904163 PMCID: PMC10388317 DOI: 10.1017/s0033291722001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/15/2022] [Accepted: 04/28/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this paper is to identify the trajectory of conduct and emotional problems for young people within the general population at four time points (between 9 years 7 months and 16 years 6 months), investigate their relationship with hyperactive/inattentive traits and explore the moderating effect of autistic social traits (ASTs). METHODS Data from 9305 individuals involved in The Avon Longitudinal Study of Parents and Children (ALSPAC) study were included. Conduct and emotional problems and hyperactive/inattentive traits were measured by the Strengths and Difficulties Questionnaire. ASTs were assessed using the Social Communication Disorder Checklist. Individual trajectories for conduct and emotional problems were identified via growth curve modelling. Hyperactive/inattentive traits were included within the growth curve model as a time-varying covariate to determine their effect on these outcomes. Finally, participants were split into two groups (below and above clinical threshold ASTs Groups) and multi-group invariance testing was conducted on the data to identify the moderating effect of ASTs on the relationship between hyperactive/inattentive traits and outcomes (i.e. conduct and emotional problems). RESULTS Hyperactive/inattentive traits were associated with higher rates of conduct and emotional problems for both boys and girls. The presence of ASTs moderated these relationships for boys, but not for girls, by increasing the risk of boys with hyperactive/inattentive traits developing greater conduct and emotional problems. CONCLUSIONS These findings underscore the importance of identifying hyperactive/inattentive traits and ASTs in young people and addressing the increased risk of conduct and emotional problems. Research and clinical implications are explored.
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The shared white matter developmental trajectory anomalies of attention-deficit/hyperactivity disorder and autism spectrum disorders: A meta-analysis of diffusion tensor imaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 124:110731. [PMID: 36764642 DOI: 10.1016/j.pnpbp.2023.110731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/14/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) show common brain area abnormalities, which may contribute to the high shared co-occurrence symptoms and comorbidity of the two disorders. However, neuroanatomic anomalies in neurodevelopmental disorders may change over the course of development, and the developmental variation of these two disorders is unclear. Our study conducted a systematic literature search of PubMed, Web of Science, and EMBASE databases to identify disorder-shared abnormalities of white matter (WM) from childhood to adulthood in ADHD and ASD. 28 ADHD and 23 ASD datasets were included in this meta-analysis and were analysed by AES-SDM to detect differences in fractional anisotropy in patients compared to typically developing individuals. Our main findings reveal the variable WM developmental trajectories in ADHD and ASD respectively, and the two disorders showed overlapping corpus callosum tract abnormalities in their development from children to adults. Furthermore, the overlapping abnormalities of the corpus callosum tract increased with age, which may be related to their gradually increasing shared symptoms and comorbidity in these two disorders.
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Cutler AJ, Suzuki K, Starling B, Balakrishnan K, Komaroff M, Meeves S, Castelli M, Childress A. d-Amphetamine Transdermal System in Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: Secondary Endpoint Results and Post Hoc Effect Size Analyses from a Pivotal Trial. J Child Adolesc Psychopharmacol 2023; 33:176-182. [PMID: 37339441 PMCID: PMC10282809 DOI: 10.1089/cap.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Objectives: Amphetamines are a preferred treatment for attention-deficit/hyperactivity disorder (ADHD), with the dextroamphetamine transdermal system (d-ATS) providing an alternative to oral formulations. A pivotal trial of d-ATS in children and adolescents with ADHD met primary and key secondary endpoints. This analysis reports additional endpoints and safety findings from the pivotal trial and evaluates effect size and number needed to treat (NNT) for d-ATS. Methods: In this study, a 5-week, open-label dose-optimization period (DOP) preceded a 2-week, randomized, crossover double-blind treatment period (DBP). Eligible patients received d-ATS 5 mg during the DOP, with weekly evaluations for increase to 10, 15, and 20 mg (equivalent to labeled doses of 4.5, 9, 13.5, and 18 mg/9 hours, respectively) until reaching and maintaining the optimal dose, which was utilized for the DBP. Secondary endpoints included assessment of Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV), Conners' Parent Rating Scale Revised Short Form (CPRS-R:S), and Clinical Global Impression (CGI) scores. NNT was calculated for ADHD-RS-IV and CGI-Improvement (CGI-I). Safety assessments included treatment-emergent adverse events (TEAEs) and dermal safety. Results: In total, 110 patients entered the DOP, with 106 patients randomized (DBP). During the DBP, the least-squares mean (95% confidence interval) difference for d-ATS versus placebo in ADHD-RS-IV total score was -13.1 (-16.2 to -10.0; p < 0.001), with effect size of 1.1 and NNT of 3 for ADHD-RS-IV remission, ≥30% improvement, and ≥50% improvement. Significant differences between placebo and d-ATS were also observed for CPRS-R:S and CGI-I scales (p < 0.001), with NNT of 2 for CGI-I response. Most TEAEs were mild or moderate, with three leading to study discontinuation in the DOP and none in the DBP. No patients discontinued due to dermal reactions. Conclusions: d-ATS was effective in treating ADHD in children and adolescents, meeting all secondary endpoints, with a large effect size and NNT of 2-3 to achieve a clinically meaningful response. d-ATS was safe and well tolerated, with minimal dermal reactions. Clinical Trial Registration: NCT01711021.
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Affiliation(s)
- Andrew J. Cutler
- Department of Psychiatry, SUNY Upstate Medical University, Neuroscience Education Institute, Lakewood Ranch, Florida, USA
| | - Katsumi Suzuki
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Brittney Starling
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Kanan Balakrishnan
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Marina Komaroff
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | - Suzanne Meeves
- Product Development, Noven Pharmaceuticals, Inc., Jersey City, New Jersey, USA
| | | | - Ann Childress
- Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada, USA
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Halbe E, Kolf F, Heger AS, Hüpen P, Bergmann M, Aslan B, Harrison BJ, Davey CG, Philipsen A, Lux S. Altered interaction of physiological activity and behavior affects risky decision-making in ADHD. Front Hum Neurosci 2023; 17:1147329. [PMID: 37151896 PMCID: PMC10157058 DOI: 10.3389/fnhum.2023.1147329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Adult attention-deficit/hyperactivity disorder (ADHD) is often associated with risky decision-making behavior. However, current research studies are often limited by the ability to adequately reflect daily behavior in a laboratory setting. Over the lifespan impairments in cognitive functions appear to improve, whereas affective functions become more severe. We assume that risk behavior in ADHD arises predominantly from deficits in affective processes. This study will therefore aim to investigate whether a dysfunction in affective pathways causes an abnormal risky decision-making (DM) behavior in adult ADHD. Methods Twenty-eight participants with ADHD and twenty-eight healthy controls completed a battery of questionnaires regarding clinical symptoms, self-assessment of behavior and emotional competence. Furthermore, skin conductance responses were measured during the performance in a modified version of the Balloon Analogue Risk Task. A linear mixed-effects model analysis was used to analyze emotional arousal prior to a decision and after feedback display. Results Results showed higher emotional arousal in ADHD participants before decision-making (β = -0.12, SE = 0.05, t = -2.63, p < 0.001) and after feedback display (β = -0.14, SE = 0.05, t = -2.66, p = 0.008). Although risky behavior was greater in HC than in ADHD, we found a significant interaction effect of group and anticipatory skin conductance responses regarding the response behavior (β = 107.17, SE = 41.91, t = 2.56, p = 0.011). Post hoc analyses revealed a positive correlation between anticipatory skin conductance responses and reaction time in HC, whereas this correlation was negative in ADHD. Self-assessment results were in line with the objective measurements. Conclusion We found altered changes in physiological activity during a risky decision-making task. The results confirm the assumption of an aberrant relationship between bodily response and risky behavior in adult ADHD. However, further research is needed with respect to age and gender when considering physiological activities.
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Affiliation(s)
- Eva Halbe
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- *Correspondence: Eva Halbe,
| | - Fabian Kolf
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Alina Sophie Heger
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA–Translational Brain Medicine, Aachen, Germany
| | - Moritz Bergmann
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Behrem Aslan
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Ben J. Harrison
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | | | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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Luderer M, Seidt J, Gerhardt S, Hoffmann S, Vollstädt-Klein S, Reif A, Sobanski E. Drinking alcohol to cope with hyperactive ADHD? Self-reports vs. continuous performance test in patients with ADHD and/or alcohol use disorder. Front Psychiatry 2023; 14:1112843. [PMID: 36950259 PMCID: PMC10025293 DOI: 10.3389/fpsyt.2023.1112843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Rationale Attention deficit/hyperactivity disorder (ADHD) is common in alcohol use disorder (AUD). Continuous performance tests (CPTs) allow to measure ADHD related deficits in a laboratory setting. Most studies on this topic focused on CPTs measuring inattention or impulsivity, disregarding hyperactivity as one of the core symptoms of ADHD. Methods We examined N = 47 in three groups (ADHD N = 19; AUD N = 16; ADHD + AUD N = 12) with questionnaires on ADHD core symptoms, executive functioning (EF), mind wandering, and quality of life (QoL). N = 46 (ADHD N = 16; AUD N = 16; ADHD + AUD N = 14) were examined with a CPT (QbTest®) that also measures motor activity objectively. Results Inattention and impulsivity were significantly increased in AUD vs. ADHD and in AUD vs. ADHD + AUD. Hyperactivity was significantly higher in ADHD + AUD vs. ADHD and ADHD + AUD vs. AUD, but not in ADHD vs. AUD. EF was lower in both ADHD groups vs. AUD. Mind wandering was increased in both ADHD groups vs. AUD. QoL was significantly lower in ADHD + AUD compared to AUD. In contrast, results of the QbTest were not significantly different between groups. Conclusion Questionnaires are more useful in assessing ADHD core symptoms than the QbTest®. Hyperactivity appears to be a relevant symptom in ADHD + AUD, suggesting a possible pathway from ADHD to AUD. The lower QoL in ADHD + AUD emphasizes the need for routine screening, diagnostic procedures and treatment strategies for this patient group.
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Affiliation(s)
- Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
- *Correspondence: Mathias Luderer,
| | - Johanna Seidt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine Hoffmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Esther Sobanski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Lucerne Cantonal Hospital, Lucerne, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Chiang HL, Tseng WYI, Tseng WL, Tung YH, Hsu YC, Chen CL, Gau SSF. Atypical development in white matter microstructures in ADHD: A longitudinal diffusion imaging study. Asian J Psychiatr 2023; 79:103358. [PMID: 36481569 DOI: 10.1016/j.ajp.2022.103358] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/13/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND In cross-sectional studies, alterations in white matter microstructure are evident in children with attention-deficit/hyperactivity disorder (ADHD) but not so prominent in adults with ADHD compared to typically-developing controls (TDC). Moreover, the developmental trajectories of white matter microstructures in ADHD are unclear, given the limited longitudinal imaging studies that characterize developmental changes in ADHD vs. TDC. METHODS This longitudinal study acquired diffusion spectrum imaging (DSI) at two time points. The sample included 55 participants with ADHD and 61 TDC. The enrollment/first DSI age ranged from 7 to 18 years, with a five-year mean follow-up time. We examined time-by-diagnosis interaction on the generalized fractional anisotropy (GFA) of 45 white matter tracts, adjusting for confounding factors and correcting for multiple comparisons. We also tested whether the longitudinal changes of microstructures were associated with ADHD symptoms and attention performance in a computerized continuous performance test. RESULTS Participants with ADHD showed more rapid development of GFA in the arcuate fasciculus, superior longitudinal fasciculus, frontal aslant tract, cingulum, inferior fronto-occipital fasciculus (IFOF), frontostriatal tract connecting the prefrontal cortex (FS-PFC), thalamic radiation, corticospinal tract, and corpus callosum. Within participants with ADHD, more rapid GFA increases in cingulum and FS-PFC were associated with slower decreases in inattention symptoms. In addition, in all participants, more rapid GFA increases in cingulum and IFOF were associated with greater improvement in attention performance. CONCLUSION Our findings suggest atypical developmental trajectories of white matter tracts in ADHD, characterized by normalization and possible compensatory neuroplastic processes with age from childhood to early adulthood.
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Affiliation(s)
- Huey-Ling Chiang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Yu-Hung Tung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yung-Chin Hsu
- Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chang-Le Chen
- Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan.
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9
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Damatac CG, Chauvin RJM, Zwiers MP, van Rooij D, Akkermans SEA, Naaijen J, Hoekstra PJ, Hartman CA, Oosterlaan J, Franke B, Buitelaar JK, Beckmann CF, Sprooten E. White Matter Microstructure in Attention-Deficit/Hyperactivity Disorder: A Systematic Tractography Study in 654 Individuals. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:979-988. [PMID: 33054990 DOI: 10.1016/j.bpsc.2020.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by age-inappropriate levels of inattention and/or hyperactivity-impulsivity. ADHD has been related to differences in white matter (WM) microstructure. However, much remains unclear regarding the nature of these WM differences and which clinical aspects of ADHD they reflect. We systematically investigated whether fractional anisotropy (FA) is associated with current and/or lifetime categorical diagnosis, impairment in daily life, and continuous ADHD symptom measures. METHODS Diffusion-weighted imaging data were obtained from 654 participants (322 unaffected, 258 affected, 74 subthreshold; 7-29 years of age). We applied automated global probabilistic tractography on 18 major WM pathways. Linear mixed-effects regression models were used to examine associations of clinical measures with overall brain and tract-specific FA. RESULTS There were significant interactions of tract with all ADHD variables on FA. There were no significant associations of FA with current or lifetime diagnosis, nor with impairment. Lower FA in the right cingulum angular bundle was associated with higher hyperactivity-impulsivity symptom severity (pfamilywise error = .045). There were no significant effects for other tracts. CONCLUSIONS This is the first time global probabilistic tractography has been applied to an ADHD dataset of this size. We found no evidence for altered FA in association with ADHD diagnosis. Our findings indicate that associations of FA with ADHD are not uniformly distributed across WM tracts. Continuous symptom measures of ADHD may be more sensitive to FA than diagnostic categories. The right cingulum angular bundle in particular may play a role in symptoms of hyperactivity and impulsivity.
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Affiliation(s)
- Christienne G Damatac
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Roselyne J M Chauvin
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sophie E A Akkermans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Functional MRI of the Brain, University of Oxford, Oxford, United Kingdom
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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10
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Damatac CG, Soheili-Nezhad S, Blazquez Freches G, Zwiers MP, de Bruijn S, Ikde S, Portengen CM, Abelmann AC, Dammers JT, van Rooij D, Akkermans SEA, Naaijen J, Franke B, Buitelaar JK, Beckmann CF, Sprooten E. Longitudinal changes of ADHD symptoms in association with white matter microstructure: A tract-specific fixel-based analysis. Neuroimage Clin 2022; 35:103057. [PMID: 35644111 PMCID: PMC9144034 DOI: 10.1016/j.nicl.2022.103057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 11/19/2022]
Abstract
HI symptom remission is associated with more follow-up lCST FD. Combined symptom remission is associated with more follow-up lCST FC. Altered white matter development may be moderated by preceding symptom trajectory.
Background Variation in the longitudinal course of childhood attention deficit/hyperactivity disorder (ADHD) coincides with neurodevelopmental maturation of brain structure and function. Prior work has attempted to determine how alterations in white matter (WM) relate to changes in symptom severity, but much of that work has been done in smaller cross-sectional samples using voxel-based analyses. Using standard diffusion-weighted imaging (DWI) methods, we previously showed WM alterations were associated with ADHD symptom remission over time in a longitudinal sample of probands, siblings, and unaffected individuals. Here, we extend this work by further assessing the nature of these changes in WM microstructure by including an additional follow-up measurement (aged 18 – 34 years), and using the more physiologically informative fixel-based analysis (FBA). Methods Data were obtained from 139 participants over 3 clinical and 2 follow-up DWI waves, and analyzed using FBA in regions-of-interest based on prior findings. We replicated previously reported significant models and extended them by adding another time-point, testing whether changes in combined ADHD and hyperactivity-impulsivity (HI) continuous symptom scores are associated with fixel metrics at follow-up. Results Clinical improvement in HI symptoms over time was associated with more fiber density at follow-up in the left corticospinal tract (lCST) (tmax = 1.092, standardized effect[SE] = 0.044, pFWE = 0.016). Improvement in combined ADHD symptoms over time was associated with more fiber cross-section at follow-up in the lCST (tmax = 3.775, SE = 0.051, pFWE = 0.019). Conclusions Aberrant white matter development involves both lCST micro- and macrostructural alterations, and its path may be moderated by preceding symptom trajectory.
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Affiliation(s)
- Christienne G Damatac
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Sourena Soheili-Nezhad
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Guilherme Blazquez Freches
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Marcel P Zwiers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Sanne de Bruijn
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Seyma Ikde
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Christel M Portengen
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Amy C Abelmann
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Janneke T Dammers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Daan van Rooij
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Sophie E A Akkermans
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Jilly Naaijen
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.
| | - Jan K Buitelaar
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Reiner Postlaan 12, 6525 GC Nijmegen, The Netherlands.
| | - Christian F Beckmann
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Wellcome Centre for Integrative Neuroimaging, Centre for Functional MRI of the Brain, Nufeld Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom.
| | - Emma Sprooten
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
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11
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Wiebe A, Kannen K, Li M, Aslan B, Anders D, Selaskowski B, Ettinger U, Lux S, Philipsen A, Braun N. Multimodal Virtual Reality-Based Assessment of Adult ADHD: A Feasibility Study in Healthy Subjects. Assessment 2022:10731911221089193. [PMID: 35435010 DOI: 10.1177/10731911221089193] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neuropsychological assessments are often surprisingly inaccurate in mapping clinically-reported attention-deficit hyperactivity disorder (ADHD) symptoms, presumably due to their low ecological validity. Virtual reality (VR) might offer a potential solution for this problem, given its capability to generate standardized and yet highly realistic virtual environments. As the first adaptation of existing virtual classroom scenarios to an adult population, we developed a Virtual Seminar Room (VSR) for multimodal characterization of ADHD symptoms. To test its feasibility, N = 35 healthy participants were immersed into the VSR via a head-mounted display and carried out a VR-embedded continuous performance task (CPT) under varying levels of distractions in two experimental blocks (24 min each). CPT performance, electroencephalography (EEG) measures, and head movements (actigraphy) were simultaneously recorded and analyzed offline. Although CPT performance remained constant throughout the task, head movements increased significantly from Block 1 to Block 2. In addition, EEG theta (4-7 Hz) and beta (13-30 Hz) power was higher during Block 1 than Block 2, and during distractor-present than distractor-absent phases. Moreover, P300 amplitudes were higher during Block 1 than Block 2, and P300 latencies were prolonged in distractor-absent compared with distractor-present phases. Although the paradigm awaits further improvements, this study confirms the general feasibility of the VSR and provides a first step toward a multimodal, ecologically valid, and reliable VR-based adult ADHD assessment.
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Affiliation(s)
- Annika Wiebe
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - David Anders
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - Silke Lux
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department for Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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12
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Sex differences in microstructural alterations in the corpus callosum tracts in drug-naïve children with ADHD. Brain Imaging Behav 2022; 16:1592-1604. [PMID: 35102486 DOI: 10.1007/s11682-021-00556-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 09/05/2021] [Indexed: 02/05/2023]
Abstract
Widespread alterations in the corpus callosum (CC) microstructure and organization have been found in children with attention-deficit/hyperactivity disorder (ADHD); however, few studies have investigated the diffusion characteristics and volume of transcallosal fiber tracts defined by specific cortical projections in ADHD, which is important for identifying distinct functional interhemispheric connection abnormalities. In the current study, an automated fiber-tract quantification (AFQ) approach based on diffusion tensor imaging identified seven CC tracts according to their cortical projections and estimated diffusion parameters and volume among 76 drug-naïve ADHD patients (53 boys and 23 girls) and 37 typically developing children (TDC) (20 boys and 17 girls) matched for age, IQ, and handedness. We found significantly lower fractional anisotropy (FA) in the occipital and superior parietal tracts and higher mean diffusivity (MD) in the posterior, superior parietal and anterior frontal tracts in children with ADHD compared with TDC. In addition, lower FA and higher radial diffusivity (RD) in the occipital callosal tract were significantly associated with higher hyperactivity and impulsivity performance in ADHD. In addition, sex-by-diagnosis interactions were observed in the occipital, posterior and superior parietal tracts. Girls with ADHD showed decreased FA and volume in the occipital tract, which were significantly associated with increased impulsivity performance and poor response control, and increased MD in the posterior and superior parietal callosal tracts, which were significantly associated with increased inattention performance, whereas boys with ADHD merely showed decreased volume in the frontal tract. Our results elucidated that sex-specific alterations in the CC tracts potentially underlie ADHD symptomatology and further suggested a differential contribution of abnormalities in different CC tracts to impulsivity and inattention among girls with ADHD.
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13
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Hochhauser M, Aran A, Grynszpan O. Change Blindness in Adolescents With Attention-Deficit/Hyperactivity Disorder: Use of Eye-Tracking. Front Psychiatry 2022; 13:770921. [PMID: 35295775 PMCID: PMC8918561 DOI: 10.3389/fpsyt.2022.770921] [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: 09/05/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study investigated change detection of central or marginal interest in images using a change-blindness paradigm with eye tracking. METHOD Eighty-four drug-naïve adolescents [44 with attention-deficit/hyperactivity disorder (ADHD)/40 controls with typical development] searched for a change in 36 pairs of original and modified images, with an item of central or marginal interest present or absent, presented in rapid alternation. Collected data were detection rate, response time, and gaze fixation duration, latency, and dispersion data. RESULTS Both groups' change-detection times were similar, with no speed-accuracy trade-off. No between-group differences were found in time to first fixation, fixation duration, or scan paths. Both groups performed better for items of central level of interest. The ADHD group demonstrated greater fixation dispersion in scan paths for central- and marginal-interest items. CONCLUSION Results suggest the greater gaze dispersion may lead to greater fatigue in tasks that require longer attention duration.
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Affiliation(s)
| | - Adi Aran
- Neuropedeatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ouriel Grynszpan
- Laboratoire Interdisciplinaire des Sciences du Numérique, Université Paris-Saclay, Orsay, France
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14
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Leenders AEM, Damatac CG, Soheili‐Nezhad S, Chauvin RJM, Mennes MJJ, Zwiers MP, Rooij D, Akkermans SEA, Naaijen J, Franke B, Buitelaar JK, Beckmann CF, Sprooten E. Associations between attention‐deficit hyperactivity disorder (ADHD) symptom remission and white matter microstructure: A longitudinal analysis. JCPP ADVANCES 2021; 1. [PMID: 35434717 PMCID: PMC9012480 DOI: 10.1002/jcv2.12040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Attention-deficit hyperactivity disorder (ADHD) is associated with white matter (WM) microstructure. Our objective was to investigate how WM microstructure is longitudinally related to symptom remission in adolescents and young adults with ADHD. Methods: We obtained diffusion-weighted imaging (DWI) data from 99 participants at two timepoints (mean age baseline: 16.91 years, mean age follow-up: 20.57 years). We used voxel-wise Tract-Based Spatial Statistics (TBSS) with permutation-based inference to investigate associations of inattention (IA) and hyperactivity-impulsivity (HI) symptom change with fractional anisotropy (FA) at baseline, follow-up, and change between time-points. Results: Remission of combined HI and IA symptoms was significantly associated with reduced FA at follow-up in the left superior longitudinal fasciculus and the left corticospinal tract (CST; PFWE = 0.038 and PFWE = 0.044, respectively), mainly driven by an association between HI remission and follow-up CST FA (PFWE = 0.049). There was no significant association of combined symptom decrease with FA at baseline or with changes in FA between the two assessments. Conclusions: In this longitudinal DWI study of ADHD using dimensional symptom scores, we show that greater symptom decrease is associated with lower follow-up FA in specific WM tracts. Altered FA thus may appear to follow, rather than precede, changes in symptom remission. Our findings indicate divergent WM developmental trajectories between individuals with persistent and remittent ADHD, and support the role of prefrontal and sensorimotor tracts in the remission of ADHD.
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Affiliation(s)
- Anne E. M. Leenders
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
| | - Christienne G. Damatac
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Sourena Soheili‐Nezhad
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Roselyne J. M. Chauvin
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Maarten J. J. Mennes
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Marcel P. Zwiers
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Daan Rooij
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Sophie E. A. Akkermans
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Human Genetics Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Jilly Naaijen
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
| | - Barbara Franke
- Department of Human Genetics Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
- Department of Psychiatry Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
| | - Jan K. Buitelaar
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen The Netherlands
| | - Christian F. Beckmann
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
- Centre for Functional MRI of the Brain University of Oxford Oxford UK
| | - Emma Sprooten
- Centre for Cognitive Neuroimaging Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Cognitive Neuroscience Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Centre Nijmegen The Netherlands
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15
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Izadi-Najafabadi S, Zwicker JG. White Matter Changes With Rehabilitation in Children With Developmental Coordination Disorder: A Randomized Controlled Trial. Front Hum Neurosci 2021; 15:673003. [PMID: 34149383 PMCID: PMC8209514 DOI: 10.3389/fnhum.2021.673003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: Children with developmental coordination disorder (DCD) have difficulty learning motor skills, which can affect their participation in activities of daily living and psychosocial well-being. Over 50% of children with DCD also have attention deficit hyperactivity disorder (ADHD), which further exacerbates their motor problems and impact on quality of life. A rehabilitation approach known as Cognitive Orientation to Occupational Performance uses problem-solving strategies to help children learn motor skills they wish to achieve. While this cognitive approach has been effective for children with DCD, few studies have examined the effectiveness of this approach for children with co-occurring ADHD. Further, the underlying mechanism and neural basis of this intervention are largely unknown. Methods: In this randomized waitlist-controlled trial, we used MRI to examine white matter microstructure after intervention in 8–12-year-old children with DCD (n = 28) and with DCD and co-occurring ADHD (n = 25). Children in both groups were randomized to either a treatment group or waitlist group at their first MRI. The treatment group began the intervention after their MRI scan and returned for a post-treatment scan at 3 months, and follow-up scan at 6 months; the waitlist group waited 3 months before their second MRI, received the intervention, and then had a post-treatment scan. Each child received intervention once weekly for 10 weeks. Diffusion tensor imaging was used to acquire white matter diffusion parameters and was analyzed using tract-based spatial statistics (TBSS). Results and Conclusion: Children with DCD showed significant improvement in white matter microstructure in the bilateral anterior thalamic radiation, bilateral sensorimotor tract, bilateral cingulum, fornix, splenium and body of corpus callosum, right inferior fronto-occipital fasciculus, and white matter pathways to bilateral inferior gyri, right middle frontal gyrus, frontal medial cortex, and left cuneus. We suggest that these rehabilitation-induced neural changes in children with DCD occurred in regions associated with attention, self-regulation, motor planning, and inter-hemispheric communication, which positively affected brain connectivity and motor function. In contrast, children with DCD and co-occurring ADHD did not show any brain changes following the intervention. Modifications to the treatment protocol might help address the attentional and self-regulatory needs of children with a dual diagnosis. Clinical Trial Registration: ClinicalTrials.gov ID: NCT02597751.
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Affiliation(s)
- Sara Izadi-Najafabadi
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.,Brain, Behaviour, and Development Theme, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Jill G Zwicker
- Brain, Behaviour, and Development Theme, BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.,Sunny Hill Health Centre at BC Children's Hospital, Vancouver, BC, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
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16
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Nasser A, Kosheleff AR, Hull JT, Liranso T, Qin P, Busse GD, O'Neal W, Fava M, Faraone SV, Rubin J. Translating Attention-Deficit/Hyperactivity Disorder Rating Scale-5 and Weiss Functional Impairment Rating Scale-Parent Effectiveness Scores into Clinical Global Impressions Clinical Significance Levels in Four Randomized Clinical Trials of SPN-812 (Viloxazine Extended-Release) in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2021; 31:214-226. [PMID: 33600233 PMCID: PMC8066343 DOI: 10.1089/cap.2020.0148] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objectives: Clinical trials in psychiatry frequently report results from lengthy, comprehensive assessments to characterize a subject emotionally, cognitively, and behaviorally before and after treatment. However, the potential treatment implications of these results and how they translate into clinical practice remain unclear. Conversely, the Clinical Global Impressions (CGI) scales are quick, intuitive assessments used to assess the functional impact of a treatment in clinically relevant terms. The objectives of the present analyses are to translate scores from comprehensive assessments of symptom severity and functional impairment into clinically meaningful CGI levels. Methods: These post-hoc analyses use data integrated from four pivotal Phase 3 trials in attention-deficit/hyperactivity disorder (ADHD) in children and adolescents treated with the novel nonstimulant SPN-812 (Viloxazine Extended-Release). In this study, we evaluated the ADHD Rating Scale-5 (ADHD-RS-5) and Weiss Functional Impairment Rating Scale-Parent (WFIRS-P), assessments of symptom severity and functional impairment, respectively, by linking these scales with the CGI scales at baseline and end of study. Results: For participants that improved, a one-level change on the CGI-Improvement (CGI-I) was associated with a 10-15-point change on the ADHD-RS-5, and a 0.2-0.5-point change on the WFIRS-P. On the CGI-I, ratings of much improved and very much improved were associated with a percent score decrease (i.e., improvement) of ∼55% and 80% on the ADHD-RS-5 and ∼40% and 70% on the WFIRS-P, respectively. Differences between children and adolescents were minor and are unlikely to be clinically meaningful. Conclusion: These post-hoc analyses provide clinically meaningful benchmarks for the interpretation of scores on the ADHD-RS-5 and WFIRS-P in terms of CGI evaluations in subjects with ADHD. These results may be useful for physicians seeking to understand a treatment's potential impact on their ADHD patients or for researchers looking to define their study results within a clinically relevant context. Data are from clinical trials NCT03247530, NCT03247543, NCT03247517, and NCT03247556.
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Affiliation(s)
- Azmi Nasser
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Joseph T. Hull
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Peibing Qin
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | | | - Welton O'Neal
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Jonathan Rubin
- Supernus Pharmaceuticals, Inc., Rockville, Maryland, USA
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Structural brain network topology underpinning ADHD and response to methylphenidate treatment. Transl Psychiatry 2021; 11:150. [PMID: 33654073 PMCID: PMC7925571 DOI: 10.1038/s41398-021-01278-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/21/2021] [Accepted: 02/12/2021] [Indexed: 02/03/2023] Open
Abstract
Behavioural disturbances in attention deficit hyperactivity disorder (ADHD) are thought to be due to dysfunction of spatially distributed, interconnected neural systems. While there is a fast-growing literature on functional dysconnectivity in ADHD, far less is known about the structural architecture underpinning these disturbances and how it may contribute to ADHD symptomology and treatment prognosis. We applied graph theoretical analyses on diffusion MRI tractography data to produce quantitative measures of global network organisation and local efficiency of network nodes. Support vector machines (SVMs) were used for comparison of multivariate graph measures of 37 children and adolescents with ADHD relative to 26 age and gender matched typically developing children (TDC). We also explored associations between graph measures and functionally-relevant outcomes such as symptom severity and prediction of methylphenidate (MPH) treatment response. We found that multivariate patterns of reduced local efficiency, predominantly in subcortical regions (SC), were able to distinguish between ADHD and TDC groups with 76% accuracy. For treatment prognosis, higher global efficiency, higher local efficiency of the right supramarginal gyrus and multivariate patterns of increased local efficiency across multiple networks at baseline also predicted greater symptom reduction after 6 weeks of MPH treatment. Our findings demonstrate that graph measures of structural topology provide valuable diagnostic and prognostic markers of ADHD, which may aid in mechanistic understanding of this complex disorder.
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Shaw P, Sudre G. Adolescent Attention-Deficit/Hyperactivity Disorder: Understanding Teenage Symptom Trajectories. Biol Psychiatry 2021; 89:152-161. [PMID: 32753233 PMCID: PMC7736482 DOI: 10.1016/j.biopsych.2020.06.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022]
Abstract
Symptoms of attention-deficit/hyperactivity disorder (ADHD) run a variable course through adolescence. While most affected individuals show some improvement, particularly of hyperactivity-impulsivity, symptoms of inattention are more persistent, and some individuals may meet diagnostic criteria for the first time during adolescence. Genetic factors affect adolescent symptom trajectories; those showing persistence likely carry a greater burden of common risk alleles. Rare structural genomic variants, such as copy number variants and point mutations, might also play a role. Although psychostimulant medication is associated with better functional outcomes, an impact on underlying adolescent symptom trajectories has been hard to demonstrate. At a neural level, several studies report that adolescents whose childhood ADHD symptoms have remitted are indistinguishable from neurotypical individuals. This finding could reflect the "carrying forward" of relatively typical childhood neural features among those destined for adolescent remission or the correction of early childhood anomalies with a convergence toward typical dimensions. Other studies have noted unique, possibly compensatory patterns of neural activity among adolescents whose ADHD has improved. Finally, different neural processes might occur in different brain regions. Thus, some functional imaging studies find that subcortical anomalies reflect the onset of ADHD and remain throughout life regardless of symptom change, whereas the variable clinical course of adolescent ADHD is determined by plasticity of the cerebral cortex. Integrating an understanding of the neural processes with genomic risk could elucidate the mechanisms underlying the complex course of adolescent ADHD.
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Affiliation(s)
- Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland.
| | - Gustavo Sudre
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Mayer JS, Bernhard A, Fann N, Boxhoorn S, Hartman CA, Reif A, Freitag CM. Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review. Neurosci Biobehav Rev 2021; 121:307-345. [PMID: 33359622 DOI: 10.1016/j.neubiorev.2020.12.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 01/06/2023]
Abstract
The risk for major depressive disorder (MDD) is considerably increased in young adults with attention-deficit/hyperactivity disorder (ADHD) but underlying mechanisms are poorly understood. This review explores ADHD-specific neurocognitive impairments as possible underlying mechanisms for ADHD-depression comorbidity. Two systematic literature searches were conducted in EBSCOhost, PubMED, and Cochrane Reviews databases according to PRISMA guidelines. The first search identified 18 meta-analyses of cross-sectional and longitudinal studies on cognitive dysfunctions in MDD across the lifespan. The second search identified six original studies on reaction time variability in MDD. During acute depression, children and adults showed cognitive deficits that overlapped with some of the ADHD-related impairments. Findings from remitted patients, high-risk individuals, and few prospective studies suggest that a subset of these shared impairments, specifically executive dysfunctions (selective attention, verbal fluency, working memory) and long-term memory problems, are candidate pre-existing risk markers of depression. We discuss if and how these specific neurocognitive mechanisms may mediate developmental pathways from ADHD to depression. If replicated by longitudinal studies, these findings may guide future prevention strategies.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Nikola Fann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Sara Boxhoorn
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
| | - Catharina A Hartman
- Interdisciplinary Centre Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Centre Groningen, CC 72, P.O. Box 30.001, 9700 RB Groningen, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany
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20
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Ünsel-Bolat G, Baytunca MB, Kardaş B, İpçi M, İnci İzmir SB, Özyurt O, Çallı MC, Ercan ES. Diffusion tensor imaging findings in children with sluggish cognitive tempo comorbid Attention Deficit Hyperactivity Disorder. Nord J Psychiatry 2020; 74:620-626. [PMID: 32543999 DOI: 10.1080/08039488.2020.1772364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The construct of Sluggish Cognitive Tempo (SCT) is characterized by daydreaming, mental confusion, staring blankly and hypoactivity. Our main goal was to explore neuropsychological differences in Attention Deficit Hyperactivity Disorder-Inattentive presentation (ADHD-IA) groups with and without SCT symptoms compared to healthy controls. After detecting specific neuropsychological differences, we examined white matter microstructure using Diffusion Tensor Imaging (DTI) data obtained from 3.0 Tesla MRI scans of the cases with SCT symptoms comparing to Typically Developing (TD) controls.Method: In this study, we included 24 cases in the ADHD-IA group with SCT symptoms, 57 cases in the ADHD-IA group without SCT symptoms and, 24 children in the TD group. We applied tract-based spatial statistics to the DTI measures for obtaining fractional anisotropy (FA), axial, radial and mean diffusivity (AD, RD, MD) to explore white matter differences for the whole brain.Results: Omission error scores and longer reaction time scores were specifically associated with inattention symptoms. Commission error scores were significantly and specifically related to SCT symptoms. Cases with SCT symptoms presented increased FA in the bilateral anterior and posterior limb of the internal capsule, bilateral cerebral peduncle, and the fornix than TD group.Conclusions: Neurobiological differences in ADHD cases are still relatively unexplored. We suggest that including an assessment for SCT in the neuropsychological and neuroimaging studies of ADHD may provide more consistent results.
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Affiliation(s)
- Gül Ünsel-Bolat
- Department of Child and Adolescent Psychiatry, Balıkesir University, Balıkesir, Turkey
| | | | - Burcu Kardaş
- Department of Child and Adolescent Psychiatry, Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Melis İpçi
- Department of Clinical Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
| | | | - Onur Özyurt
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Mehmet Cem Çallı
- Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Eyüp Sabri Ercan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
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21
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Stibbe T, Huang J, Paucke M, Ulke C, Strauss M. Gender differences in adult ADHD: Cognitive function assessed by the test of attentional performance. PLoS One 2020; 15:e0240810. [PMID: 33057383 PMCID: PMC7561166 DOI: 10.1371/journal.pone.0240810] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/05/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The aim of this study was to assess cognitive differences between male and female adults with Attention Deficit Hyperactivity Disorder (ADHD). Methods Patients with an ADHD diagnosis according to the DSM-IV guidelines were included in a cross-sectional study evaluating cognitive measures. 28 women and 41 men from ages 19 to 56 completed self-report questionnaires and performed a computer-based test of attentional performance (TAP). The TAP assesses cognitive functions highly affected in ADHD patients, including working memory, alertness and attention as well as behavioral control and response inhibition. Results There were no measurable differences in self-report scales assessing current symptomology between the sexes, however men scored higher on the scale for childhood symptoms. Performance measures for general wakefulness were comparable between men and women, while working memory and behavioral control test results differed. Females reacted significantly slower and more unstable for both the TAP Go/NoGo paradigm and working memory subtest, while also making more errors in the latter. Conclusions We found gender-specific effects regarding working memory and behavioral control in this sample of adult patients with ADHD. Further studies are warranted, examining whether these differences relate to differences in clinical presentation and comorbidity patterns between men and women.
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Affiliation(s)
- Tina Stibbe
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Madlen Paucke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Maria Strauss
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
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22
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Cupertino RB, Soheili-Nezhad S, Grevet EH, Bandeira CE, Picon FA, Tavares MEDA, Naaijen J, van Rooij D, Akkermans S, Vitola ES, Zwiers MP, Rovaris DL, Hoekstra PJ, Breda V, Oosterlaan J, Hartman CA, Beckmann CF, Buitelaar JK, Franke B, Bau CHD, Sprooten E. Reduced fronto-striatal volume in attention-deficit/hyperactivity disorder in two cohorts across the lifespan. NEUROIMAGE-CLINICAL 2020; 28:102403. [PMID: 32949876 PMCID: PMC7502360 DOI: 10.1016/j.nicl.2020.102403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) has been associated with altered brain anatomy in neuroimaging studies. However, small and heterogeneous study samples, and the use of region-of-interest and tissue-specific analyses have limited the consistency and replicability of these effects. We used a data-driven multivariate approach to investigate neuroanatomical features associated with ADHD in two independent cohorts: the Dutch NeuroIMAGE cohort (n = 890, 17.2 years) and the Brazilian IMpACT cohort (n = 180, 44.2 years). Using independent component analysis of whole-brain morphometry images, 375 neuroanatomical components were assessed for association with ADHD. In both discovery (corrected-p = 0.0085) and replication (p = 0.032) cohorts, ADHD was associated with reduced volume in frontal lobes, striatum, and their interconnecting white-matter. Current results provide further evidence for the role of the fronto-striatal circuit in ADHD in children, and for the first time show its relevance to ADHD in adults. The fact that the cohorts are from different continents and comprise different age ranges highlights the robustness of the findings.
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Affiliation(s)
| | - Sourena Soheili-Nezhad
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eugenio Horacio Grevet
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Cibele Edom Bandeira
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Almeida Picon
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maria Eduarda de Araujo Tavares
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daan van Rooij
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Akkermans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eduardo Schneider Vitola
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcel P Zwiers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Diego Luiz Rovaris
- Universidade de Sao Paulo Instituto de Ciencias Biomedicas Departamento de Fisiologia e Biofisica, São Paulo, Brazil
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Vitor Breda
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Amsterdam, The Netherlands; Vrije Universiteit, Clinical Neuropsychology Section, Van der Boechortstraat 7, 1081 BT Amsterdam, The Netherlands
| | - Catharina A Hartman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Amsterdam, The Netherlands; Vrije Universiteit, Clinical Neuropsychology Section, Van der Boechortstraat 7, 1081 BT Amsterdam, The Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Claiton Henrique Dotto Bau
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands.
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Chiang HL, Hsu YC, Shang CY, Tseng WYI, Gau SSF. White matter endophenotype candidates for ADHD: a diffusion imaging tractography study with sibling design. Psychol Med 2020; 50:1203-1213. [PMID: 31115278 DOI: 10.1017/s0033291719001120] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Brain structural alterations are frequently observed in probands with attention-deficit/hyperactivity disorder (ADHD). Here we examined the microstructural integrity of 76 white matter tracts among unaffected siblings of patients with ADHD to evaluate the potential familial risk and its association with clinical and neuropsychological manifestations. METHODS The comparison groups included medication-naïve ADHD probands (n = 50), their unaffected siblings (n = 50) and typically developing controls (n = 50, age-and-sex matched with ADHD probands). Whole brain tractography was reconstructed automatically by tract-based analysis of diffusion spectrum imaging (DSI). Microstructural properties of white matter tracts were represented by the values of generalized fractional anisotropy (GFA), fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD). RESULTS Compared to the control group, ADHD probands showed higher AD values in the perpendicular fasciculus, superior longitudinal fasciculus I, corticospinal tract, and corpus callosum. The AD values of unaffected siblings were in the intermediate position between those of the ADHD and control groups. These AD values were significantly associated with ADHD symptoms, sustained attention and working memory, for all white matter tracks evaluated except for the perpendicular fasciculus. Higher FA and lower RD values in the right frontostriatal tract connecting ventrolateral prefrontal cortex (FS-VLPFC) were associated with better performance in spatial span only in the unaffected sibling group. CONCLUSIONS Abnormal AD values of specific white matter tracts among unaffected siblings of ADHD probands suggest the presence of familial risk in this population. The right FS-VLPFC may have a role in preventing the expression of the ADHD-related behavioral phenotype. CLINICALTRIALS.GOV NUMBER NCT01682915.
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Affiliation(s)
- Huey-Ling Chiang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yung-Chin Hsu
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
- AcroViz Technology Inc., Taipei, Taiwan
| | - Chi-Yuan Shang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
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24
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Bu X, Yang C, Liang K, Lin Q, Lu L, Zhang L, Li H, Gao Y, Tang S, Hu X, Wang Y, Hu X, Wang M, Huang X. Quantitative tractography reveals changes in the corticospinal tract in drug-naïve children with attention-deficit/hyperactivity disorder. J Psychiatry Neurosci 2020; 45:134-141. [PMID: 31765114 PMCID: PMC7828908 DOI: 10.1503/jpn.190024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The specific role of the corticospinal tract with respect to inattention and impulsive symptoms in children with attention-deficit/hyperactivity disorder (ADHD) has been explored in the past. However, to our knowledge, no study has identified the exact regions of the corticospinal tract that are affected in ADHD. We aimed to determine comprehensive alterations in the white matter microstructure of the corticospinal tract and underlying neuropsychological substrates in ADHD. METHODS We recruited 38 drug-naïve children with ADHD and 34 typically developing controls. We employed a tract-based quantitative approach to measure diffusion parameters along the trajectory of the corticospinal tract, and we further correlated alterations with attention and response inhibition measures. RESULTS Compared with controls, children with ADHD demonstrated significantly lower fractional anisotropy and higher radial diffusivity at the level of cerebral peduncle, and higher fractional anisotropy at the level of the posterior limb of the internal capsule in the right corticospinal tract only. As well, increased fractional anisotropy in the posterior limb of the internal capsule was negatively correlated with continuous performance test attention quotients and positively correlated with reaction time on the Stroop Colour–Word Test; increased radial diffusivity in the right peduncle region was positively correlated with omissions in the Stroop test. LIMITATIONS The sample size was relatively small. Moreover, we did not consider the different subtypes of ADHD and lacked sufficient power to analyze subgroup differences. Higher-order diffusion modelling is needed in future white matter studies. CONCLUSION We demonstrated specific changes in the right corticospinal tract in children with ADHD. Correlations with measures of attention and response inhibition underscored the functional importance of corticospinal tract disturbance in ADHD.
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Affiliation(s)
- Xuan Bu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Chuang Yang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Kaili Liang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Qingxia Lin
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Lu Lu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Lianqing Zhang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Hailong Li
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Yingxue Gao
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Shi Tang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Xiaoxiao Hu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Yanlin Wang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Xinyu Hu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Meihao Wang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
| | - Xiaoqi Huang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, Sichuan University West China Hospital, 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China (Bu, Liang, Lu, Zhang, Li, Gao, Tang, Hu, Wang, Hu, Huang); the Department of Psychiatry, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Yang, Lin); and the Department of Radiology, Wenzhou Medical University First Affiliated Hospital, Nan Bai Xiang, Wenzhou, Zhejiang 325003, China (Wang)
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Meijer M, Klein M, Hannon E, van der Meer D, Hartman C, Oosterlaan J, Heslenfeld D, Hoekstra PJ, Buitelaar J, Mill J, Franke B. Genome-Wide DNA Methylation Patterns in Persistent Attention-Deficit/Hyperactivity Disorder and in Association With Impulsive and Callous Traits. Front Genet 2020; 11:16. [PMID: 32082368 PMCID: PMC7005250 DOI: 10.3389/fgene.2020.00016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/07/2020] [Indexed: 12/27/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often persists into adulthood. ADHD and related personality traits, such as impulsivity and callousness, are caused by genetic and environmental factors and their interplay. Epigenetic modifications of DNA, including methylation, are thought to mediate between such factors and behavior and may behave as biomarkers for disorders. Here, we set out to study DNA methylation in persistent ADHD and related traits. We performed epigenome-wide association studies (EWASs) on peripheral whole blood from participants in the NeuroIMAGE study (age range 12-23 years). We compared participants with persistent ADHD (n = 35) with healthy controls (n = 19) and with participants with remittent ADHD (n = 19). Additionally, we performed EWASs of impulsive and callous traits derived from the Conners Parent Rating Scale and the Callous-Unemotional Inventory, respectively, across all participants. For every EWAS, the linear regression model analyzed included covariates for age, sex, smoking scores, and surrogate variables reflecting blood cell type composition and genetic background. We observed no epigenome-wide significant differences in single CpG site methylation between participants with persistent ADHD and healthy controls or participants with remittent ADHD. However, epigenome-wide analysis of differentially methylated regions provided significant findings showing that hypermethylated regions in the APOB and LPAR5 genes were associated with ADHD persistence compared to ADHD remittance (p = 1.68 * 10-24 and p = 9.06 * 10-7, respectively); both genes are involved in cholesterol signaling. Both findings appeared to be linked to genetic variation in cis. We found neither significant epigenome-wide single CpG sites nor regions associated with impulsive and callous traits; the top-hits from these analyses were annotated to genes involved in neurotransmitter release and the regulation of the biological clock. No link to genetic variation was observed for these findings, which thus might reflect environmental influences. In conclusion, in this pilot study with a small sample size, we observed several DNA-methylation-disorder/trait associations of potential significance for ADHD and the related behavioral traits. Although we do not wish to draw conclusions before replication in larger, independent samples, cholesterol signaling and metabolism may be of relevance for the onset and/or persistence of ADHD.
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Affiliation(s)
- Mandy Meijer
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marieke Klein
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eilis Hannon
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Faculty of Health, Medicine and Life Sciences, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Catharina Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jaap Oosterlaan
- Experimental and Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Dirk Heslenfeld
- Experimental and Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pieter J. Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jan Buitelaar
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands
- Karakter Child and Adolescent Psychiatric University Centre, Nijmegen, Netherlands
| | - Jonathan Mill
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
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Rahmani F, Sanjari Moghaddam H, Aarabi MH. Microstructural changes and internet addiction behaviour: A preliminary diffusion MRI study. Addict Behav 2019; 98:106039. [PMID: 31302309 DOI: 10.1016/j.addbeh.2019.106039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/05/2019] [Accepted: 06/26/2019] [Indexed: 11/18/2022]
Abstract
Internet addiction (IA) is a major health problem and is associated with comorbidities like insomnia and depression. These consequences frequently confound neuroanatomical correlates of IA in those suffering from it. We enrolled a number of 123 healthy native German-speaking adults (53 male, mean age: 36.8 ± 18.86) from the Leipzig Study for Mind-Body-Emotion Interactions (LEMON) database, for whom diffusion MRI data, internet addiction test, brief self-control scale (SCS), coping orientations to problems experienced (COPE), and depression scores were available. DMRI connectometry was used to investigate white matter microstructural correlates of the severity of internet addiction identified through IAT, in a group of healty young individuals. A multiple regression model was adopted with age, gender, SCS total score, COPE total score, and BDI-sum as covariates to track white matter fibers in which connectivity was associated with IAT. The connectometry analysis identified a direct correlation between connectivity in the splenium of corpus callosum (CC), parts of bilateral corticospinal tracts (CST), and bilateral arcuate fasciculi (AF) (FDR = 0.0023001), and an inverse correlation of the connectivity in the genu of CC and right fornix (FDR = 0.047138), with the IAT score in healthy adults. We suggest connectivity in the CC and CST as well as fornix and AF to be considered as microstructural biomarkers of predisposition to IA in healthy population.
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Affiliation(s)
- Farzaneh Rahmani
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neuroimaging Network (NIN), Universal Scientific Education and Research Network, Tehran, Iran
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Franke B, Michelini G, Asherson P, Banaschewski T, Bilbow A, Buitelaar JK, Cormand B, Faraone SV, Ginsberg Y, Haavik J, Kuntsi J, Larsson H, Lesch KP, Ramos-Quiroga JA, Réthelyi JM, Ribases M, Reif A. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacol 2018; 28:1059-1088. [PMID: 30195575 PMCID: PMC6379245 DOI: 10.1016/j.euroneuro.2018.08.001] [Citation(s) in RCA: 321] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 06/25/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in childhood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review, we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.
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Affiliation(s)
- Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Giorgia Michelini
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Philip Asherson
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andrea Bilbow
- Attention Deficit Disorder Information and Support Service (ADDISS), Edgware, UK; ADHD-Europe, Brussels, Belgium
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York Upstate Medical University, New York, USA; K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Ylva Ginsberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Jan Haavik
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Jonna Kuntsi
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany; Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE NAP-B Molecular Psychiatry Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Marta Ribases
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
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Sudre G, Mangalmurti A, Shaw P. Growing out of attention deficit hyperactivity disorder: Insights from the 'remitted' brain. Neurosci Biobehav Rev 2018; 94:198-209. [PMID: 30194962 DOI: 10.1016/j.neubiorev.2018.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/14/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022]
Abstract
We consider developmental and cognitive models to explain why some children 'grow out' of attention deficit hyperactivity disorder (ADHD) by adulthood. The first model views remission as a convergence towards more typical brain function and structure. In support, some studies find that adult remitters are indistinguishable from those who were never affected in the neural substrates of 'top-down' mechanisms of cognitive control, some 'bottom-up' processes of vigilance/response preparation, prefrontal cortical morphology and intrinsic functional connectivity. A second model postulates that remission is driven by the recruitment of new brain systems that compensate for ADHD symptoms. It draws support from demonstrations of atypical, but possibly beneficial, patterns of connectivity within the cognitive control network in adult remitters. The final model holds that some childhood ADHD anomalies show lifelong persistence, regardless of adult outcome, supported by shared reports of anomalies in remitters and persisters in posterior cerebral and striato-thalamic regions. The models are compatible: different processes driving remission might occur in different brain regions. These models provide a framework for future studies which might inform novel treatments to 'accelerate' remission.
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Affiliation(s)
- Gustavo Sudre
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States
| | - Aman Mangalmurti
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, and The National Institute of Mental Health, NIH, United States.
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Structural brain imaging correlates of ASD and ADHD across the lifespan: a hypothesis-generating review on developmental ASD-ADHD subtypes. J Neural Transm (Vienna) 2016; 124:259-271. [PMID: 28000020 PMCID: PMC5285408 DOI: 10.1007/s00702-016-1651-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 11/11/2016] [Indexed: 12/22/2022]
Abstract
We hypothesize that it is plausible that biologically distinct developmental ASD-ADHD subtypes are present, each characterized by a distinct time of onset of symptoms, progression and combination of symptoms. The aim of the present narrative review was to explore if structural brain imaging studies may shed light on key brain areas that are linked to both ASD and ADHD symptoms and undergo significant changes during development. These findings may possibly pinpoint to brain mechanisms underlying differential developmental ASD-ADHD subtypes. To this end we brought together the literature on ASD and ADHD structural brain imaging symptoms and particularly highlight the adolescent years and beyond. Findings indicate that the vast majority of existing MRI studies has been cross-sectional and conducted in children, and sometimes did include adolescents as well, but without explicitly documenting on this age group. MRI studies documenting on age effects in adults with ASD and/or ADHD are rare, and if age is taken into account, only linear effects are examined. Data from various studies suggest that a crucial distinctive feature underlying different developmental ASD-ADHD subtypes may be the differential developmental thinning patterns of the anterior cingulate cortex and related connections towards other prefrontal regions. These regions are crucial for the development of cognitive/effortful control and socio-emotional functioning, with impairments in these features as key to both ASD and ADHD.
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Caye A, Swanson J, Thapar A, Sibley M, Arseneault L, Hechtman L, Arnold LE, Niclasen J, Moffitt T, Rohde LA. Life Span Studies of ADHD-Conceptual Challenges and Predictors of Persistence and Outcome. Curr Psychiatry Rep 2016; 18:111. [PMID: 27783340 PMCID: PMC5919196 DOI: 10.1007/s11920-016-0750-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.
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Affiliation(s)
- Arthur Caye
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Swanson
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Margaret Sibley
- Department of Psychiatry and Behavioral Health at the Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Louise Arseneault
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - L Eugene Arnold
- Department of Psychiatry, Nisonger Center, Ohio State University, Columbus, OH, USA
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Centre for Collaborative Health, Aarhus University, Aarhus, Denmark
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil.
- Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clinicas de Porto Alegre, 4o andar, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil.
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Caye A, Spadini AV, Karam RG, Grevet EH, Rovaris DL, Bau CHD, Rohde LA, Kieling C. Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta-analysis. Eur Child Adolesc Psychiatry 2016; 25:1151-1159. [PMID: 27021056 DOI: 10.1007/s00787-016-0831-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder that continues into adulthood in up to half of diagnosed cases. In light of current evidence, factors associated with the course of the disorder remain unknown. We performed a systematic review of the literature searching for risk markers from childhood that predicted the persistence of ADHD into adulthood. We reviewed 26,168 abstracts and selected 72 for full-text review. We identified data from 16 studies, comprising 6 population-based retrospective samples and 10 clinical follow-ups. We performed meta-analyses of factors evaluated by at least three studies. Severity of ADHD (OR 2.33, 95 % CI = 1.6-3.39, p < 0.001), treatment for ADHD (OR 2.09, 95 % CI = 1.04-4.18, p = 0.037), comorbid conduct disorder (OR 1.85, 95 % CI = 1.06-3.24, p = 0.030), and comorbid major depressive disorder (OR 1.8, 95 % CI = 1.1-2.95, p = 0.019) emerged as predictors already presented in childhood for ADHD persistence into adulthood. Further, we suggest that cohort studies should be designed to clarify such an important question for research and clinical practice.
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Affiliation(s)
- Arthur Caye
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Alex V Spadini
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Rafael G Karam
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Eugenio H Grevet
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis A Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil
| | - Christian Kieling
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
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Mode of Anisotropy Reveals Global Diffusion Alterations in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2016; 55:137-45. [PMID: 26802781 PMCID: PMC4760693 DOI: 10.1016/j.jaac.2015.11.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/16/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Diffusion tensor imaging (DTI) can identify structural connectivity alterations in attention-deficit/hyperactivity disorder (ADHD). Most ADHD DTI studies have concentrated on regional differences in fractional anisotropy (FA) despite its limited sensitivity to complex white matter architecture and increasing evidence of global brain differences in ADHD. Here, we examine multiple DTI metrics in separate samples of children and adults with and without ADHD with a principal focus on global between-group differences. METHOD Two samples: adults with ADHD (n = 42) and without (n = 65) and children with ADHD (n = 82) and without (n = 80) were separately group matched for age, sex, and head motion. Five DTI metrics (FA, axial diffusivity, radial diffusivity, mean diffusivity, and mode of anisotropy) were analyzed via tract-based spatial statistics. Group analyses tested for diagnostic differences at the global (averaged across the entire white matter skeleton) and regional level for each metric. RESULTS Robust global group differences in diffusion indices were found in adults, with the largest effect size for mode of anisotropy (MA; Cohen's d = 1.45). Global MA also differed significantly between groups in the pediatric sample (d = 0.68). In both samples, global MA increased classification accuracy compared to the model with clinical Conners' ADHD ratings alone. Regional diagnostic differences did not survive familywise correction for multiple comparisons. CONCLUSION Global DTI metrics, particularly the mode of anisotropy, which is sensitive to crossing fibers, capture connectivity abnormalities in ADHD across both pediatric and adult samples. These findings highlight potential diffuse white matter microarchitecture differences in ADHD.
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Erratum. J Child Psychol Psychiatry 2016; 57:E1. [PMID: 29943381 DOI: 10.1111/jcpp.12476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Sonuga-Barke EJS, Tannock R, Franke B. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 2015; 1:15020. [PMID: 27189265 DOI: 10.1038/nrdp.2015.20] [Citation(s) in RCA: 800] [Impact Index Per Article: 88.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide. Throughout an individual's lifetime, ADHD can increase the risk of other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. In most cases ADHD arises from several genetic and environmental risk factors that each have a small individual effect and act together to increase susceptibility. The multifactorial causation of ADHD is consistent with the heterogeneity of the disorder, which is shown by its extensive psychiatric co-morbidity, its multiple domains of neurocognitive impairment and the wide range of structural and functional brain anomalies associated with it. The diagnosis of ADHD is reliable and valid when evaluated with standard criteria for psychiatric disorders. Rating scales and clinical interviews facilitate diagnosis and aid screening. The expression of symptoms varies as a function of patient developmental stage and social and academic contexts. Although there are no curative treatments for ADHD, evidenced-based treatments can markedly reduce its symptoms and associated impairments. For example, medications are efficacious and normally well tolerated, and various non-pharmacological approaches are also valuable. Ongoing clinical and neurobiological research holds the promise of advancing diagnostic and therapeutic approaches to ADHD. For an illustrated summary of this Primer, visit: http://go.nature.com/J6jiwl.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York (SUNY) Upstate Medical University, Syracuse, New York 13210, USA
- K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, 5020 Bergen, Norway
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joseph Biederman
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Josep Antoni Ramos-Quiroga
- ADHD Program, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Sao Paulo, Brazil
| | - Edmund J S Sonuga-Barke
- Department of Psychology, University of Southampton, Southampton, UK
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Rosemary Tannock
- Neuroscience and Mental Health Research Program, Research Institute of The Hospital for Sick Children, Toronto, Canada
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Departments of Human Genetics and Psychiatry, Nijmegen, The Netherlands
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Schweren LJS, Hartman CA, Heslenfeld DJ, van der Meer D, Franke B, Oosterlaan J, Buitelaar JK, Faraone SV, Hoekstra PJ. Thinner Medial Temporal Cortex in Adolescents With Attention-Deficit/Hyperactivity Disorder and the Effects of Stimulants. J Am Acad Child Adolesc Psychiatry 2015. [PMID: 26210335 DOI: 10.1016/j.jaac.2015.05.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) has been associated with widespread changes in cortical thickness (CT). Findings have been inconsistent, however, possibly due to age differences between samples. Cortical changes have also been suggested to be reduced or to disappear with stimulant treatment. We investigated differences in CT between adolescents/young adults with and without ADHD in the largest ADHD sample to date, the NeuroIMAGE sample. Second, we investigated how such differences were related to age and stimulant treatment. METHOD Participants (participants with ADHD = 306; healthy controls = 184, 61% male, 8-28 years of age, mean age = 17 years) underwent structural magnetic resonance imaging. Participants and pharmacies provided detailed information regarding lifetime stimulant treatment, including cumulative intake and age of treatment initiation and cessation. Vertexwise statistics were performed in Freesurfer, modeling the main effect of diagnosis on CT and its interaction with age. Effects of stimulant treatment parameters on CT were modeled within the sample with ADHD. RESULTS After correction for multiple comparisons, participants with ADHD showed decreased medial temporal CT in both left (pCLUSTER = .008) and right (pCLUSTER = .038) hemispheres. These differences were present across different ages and were associated with symptoms of hyperactivity and prosocial behavior. There were no age-by-diagnosis interaction effects. None of the treatment parameters predicted CT within ADHD. CONCLUSION Individuals with ADHD showed thinner bilateral medial temporal cortex throughout adolescence and young adulthood compared to healthy controls. We found no association between CT and stimulant treatment. The cross-sectional design of the current study warrants cautious interpretation of the findings.
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Affiliation(s)
- Lizanne J S Schweren
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Dennis van der Meer
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | | | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre Nijmegen
| | - Stephen V Faraone
- State University of New York Upstate Medical University, Syracuse, New York
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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