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Younger JW, Schaerlaeken S, Anguera JA, Gazzaley A. The whole is greater than the sum of its parts: Using cognitive profiles to predict academic achievement. Trends Neurosci Educ 2024; 36:100237. [PMID: 39266121 DOI: 10.1016/j.tine.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/25/2024] [Accepted: 07/10/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Executive functions (EFs) are thought to work in concert to support academic skill. However, EFs are often examined independently, obscuring their symbiotic contribution. We examined the relationship between students' holistic EF profiles and their academic success. METHODS We sampled over 1200 7-15 year old students from a diverse school district (16 % White; 32 % low income) in the United States. We used 9 EF assessments to construct cognitive profiles via self-organizing maps. We then related profiles to academic achievement scores from both laboratory-based assessments and state-administered standardized tests of reading and math. RESULTS Six profiles differed in EF performance, but their differences in academic achievement did not suggest a linear relationship between individual EFs and academic skill. CONCLUSIONS We show cognitive profiles based on individual strengths and weaknesses in EFs can reveal multiple cognitive paths to the same academic outcome.
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Affiliation(s)
- Jessica Wise Younger
- Neuroscape, University of California San Francisco, San Francisco, CA, United States; Department of Neurology, University of California San Francisco, San Francisco, CA, United States.
| | - Simon Schaerlaeken
- Neuroscape, University of California San Francisco, San Francisco, CA, United States
| | - Joaquin A Anguera
- Neuroscape, University of California San Francisco, San Francisco, CA, United States; Department of Neurology, University of California San Francisco, San Francisco, CA, United States; Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States.
| | - Adam Gazzaley
- Neuroscape, University of California San Francisco, San Francisco, CA, United States; Department of Neurology, University of California San Francisco, San Francisco, CA, United States; Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
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2
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Lee KS, Gau SSF, Tseng WL. Autistic Symptoms, Irritability, and Executive Dysfunctions: Symptom Dynamics from Multi-Network Models. J Autism Dev Disord 2024; 54:3078-3093. [PMID: 37453959 DOI: 10.1007/s10803-023-05981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 07/18/2023]
Abstract
Socio-cognitive difficulties in individuals with autism spectrum disorder (ASD) are heterogenuous and often co-occur with irritability symptoms, such as angry/grouchy mood and temper outbursts. However, the specific relations between individual symptoms are not well-represented in conventional methods analyzing aggregated autistic symptoms and ASD diagnosis. Moreover, the cognitive-behavioral mechanisms linking ASD to irritability are largely unknown. This study investigated the dynamics between autistic (Social Responsiveness Scale) and irritability (Affective Reactivity Index) symptoms and executive functions (Cambridge Neuropsychological Test Automated Battery) in a sample of children and adolescents with ASD, their unaffected siblings, and neurotypical peers (N = 345, aged 6-18 years, 78.6% male). Three complementary networks across the entire sample were computed: (1) Gaussian graphical network estimating the conditional correlations between symptom nodes; (2) Relative importance network computing relative influence between symptoms; (3) Bayesian directed acyclic graph estimating predictive directionality between symptoms. Networks revealed numerous partial correlations within autistic (rs = .07-.56) and irritability (rs = .01-.45) symptoms and executive functions (rs = -.83 to .67) but weak connections between clusters. This segregated pattern converged in all directed and supplementary networks. Plausible predictive paths were found between social communication difficulties to autism mannerisms and between "angry frequently" to "lose temper easily." Autistic and irritability symptoms are two relatively independent families of symptoms. It is unlikely that executive dysfunctions explain elevated irritability in ASD. Findings underscore the need for researching other mood and cognitive-behavioral bridge symptoms, which may inform individualized treatments for co-occurring irritability in ASD.
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Grants
- R00 MH110570 NIMH NIH HHS
- R00MH110570 NIMH NIH HHS
- NSC98-3112-B-002-004 Ministry of Science and Technology, Taiwan
- NSC99-2627- B-002-015 Ministry of Science and Technology, Taiwan
- NSC100-2627-B-002-014 Ministry of Science and Technology, Taiwan
- NSC101-2627-B- 002-002 Ministry of Science and Technology, Taiwan
- NSC 101-2314-B-002-136-MY3 Ministry of Science and Technology, Taiwan
- NHRI-EX104-10404PI National Health Research Institute, Taiwan
- NHRI-EX105-10404PI National Health Research Institute, Taiwan
- NHRI-EX106-10404PI National Health Research Institute, Taiwan
- NHRI-EX107-10404PI National Health Research Institute, Taiwan
- NHRI-EX108-10404PI National Health Research Institute, Taiwan
- NHRI-EX110-11002PI National Health Research Institute, Taiwan
- NHRI-EX111-11002PI National Health Research Institute, Taiwan
- 10R81918- 03101R892103 AIM for Top University Excellent Research Project
- 102R892103 AIM for Top University Excellent Research Project
- R00MH110570 NIMH NIH HHS
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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3
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Glass D, Yuill N. Moving Together: Social Motor Synchrony in Autistic Peer Partners Depends on Partner and Activity Type. J Autism Dev Disord 2024; 54:2874-2890. [PMID: 37310543 PMCID: PMC11300670 DOI: 10.1007/s10803-023-05917-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 06/14/2023]
Abstract
Some suggest autistic people display impaired Interpersonal Synchrony. However, partners of different neurotypes can struggle to connect and empathise with one another. We used Motion Energy Analysis to examine Social Motor Synchrony (SMS) in familiar partners of the same neurotype: pairs of autistic and of neurotypical children. Partners played two shared tablet activities, one to support collaboration by facilitating engagement and other-awareness (Connect), and one with no additional design features to facilitate collaboration (Colours). The neurotypical group showed similar SMS to the autistic group in Colours but lower SMS in Connect. The autistic group displayed similar levels of SMS in each activity. Autistic children can synchronise to a similar, or greater, degree than neurotypical children when the social context and type of task are considered.
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Affiliation(s)
- Devyn Glass
- University of Sussex, Brighton, BN1 9QJ, England, UK.
| | - Nicola Yuill
- University of Sussex, Brighton, BN1 9QJ, England, UK
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4
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Zhao W, Le J, Liu Q, Zhu S, Lan C, Zhang Q, Zhang Y, Li Q, Kou J, Yang W, Zhang R, Becker B, Zhang L, Kendrick KM. A clustering approach identifies an Autism Spectrum Disorder subtype more responsive to chronic oxytocin treatment. Transl Psychiatry 2024; 14:312. [PMID: 39075076 PMCID: PMC11286945 DOI: 10.1038/s41398-024-03025-4] [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: 09/03/2023] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
Over the last decade, a number of clinical trials have reported effects of chronic treatment with intranasal oxytocin on autistic symptoms but with inconsistent findings. Autism is a heterogeneous disorder and one factor which may influence treatment outcome is whether a subtype of individuals is more sensitive to oxytocin. In a recent cross-over trial on 41 young autistic children we reported that 44% showed a reliable improvement in clinical symptoms (Autism Diagnostic Observation Schedule, ADOS-2) after a placebo-controlled, 6-week intranasal oxytocin intervention where treatment was given every other day followed by a period of positive social interaction. In the current re-assessment of the data, we used an unsupervised data-driven cluster analysis approach to identify autism subtypes using 23 different demographic, social subtype, endocrine, eye-tracking and clinical symptom measures taken before treatment and this revealed an optimum of two different subtypes. We then assessed the proportion of identified responders to oxytocin and found that while 61.5% of one subtype included responders only 13.3% of the other did so. During the placebo phase there was no difference between the two subtypes for the small proportion of responders (19.2% vs 6.7%). This oxytocin-sensitive subtype also showed overall significant post-treatment clinical and eye-tracking measure changes. The oxytocin-sensitive subtype was primarily characterized at baseline by lower initial clinical severity (ADOS-2) and greater interest in the eye-region of emotional faces. These features alone were nearly as efficient in identifying the two subtypes as all 23 baseline measures and this easy-to-conduct approach may help rapidly and objectively screen for oxytocin responders. Future clinical trials using oxytocin interventions may therefore achieve greater success by focusing on children with this specific autism subtype and help develop individualized oxytocin intervention.
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Affiliation(s)
- Weihua Zhao
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jiao Le
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qi Liu
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Siyu Zhu
- School of Sport Training, Chengdu Sport University, Chengdu, 610041, China
| | - Chunmei Lan
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qianqian Zhang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yingying Zhang
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, 89081, Ulm, Germany
| | - Qin Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Juan Kou
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Wenxu Yang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Rong Zhang
- Key Laboratory for Neuroscience, MOE Key Laboratory for Neuroscience, Ministry of Health, Beijing, China
- Autism Research Center of Peking University Health Science Center, 100191, Beijing, China
| | - Benjamin Becker
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, 999077, China
| | - Lan Zhang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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5
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Yeung MK, Bai J, Mak KL. Longitudinal changes in executive function in autism spectrum disorder: A systematic review and meta-analyses. Autism Res 2024. [PMID: 38975618 DOI: 10.1002/aur.3196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/23/2024] [Indexed: 07/09/2024]
Abstract
Individuals with an autism spectrum disorder (ASD) diagnosis show impairment in executive function (EF). However, findings are mixed regarding differences in the age effect on EF between autistic individuals and persons with typical development (TD). Questions remain regarding whether the age-related trajectories of EF in ASD are the same as or different from those in TD. To bridge this knowledge gap, we conducted a systematic review and meta-analyses of longitudinal studies that compared age-related changes in EF between ASD and TD groups (preregistration: osf.io/j5764). A literature search was conducted using PubMed, PsycINFO, and Web of Science on January 29, 2024. After screening by two independent reviewers, 14 longitudinal studies were included. Random-effects meta-analyses of studies involving a maximum total of 518 autistic and 3558 TD children and adolescents (mean baseline ages: 5.7-12.0 years) showed that ASD had significantly poorer EF than TD at both baseline and follow-up. However, there was no significant group difference in the age-related change in EF across domains, including working memory, inhibition, shifting, and planning. Robust Bayesian meta-analyses also provided substantial evidence in favor of the null hypothesis that ASD and TD groups showed similar changes over time for most EF processes. Limitations of the literature included the limited number of longitudinal studies and a narrow range of developmental stages and EF constructs analyzed across studies. Altogether, these findings suggest that autistic children and adolescents generally can improve in EF over time similarly to their neurotypical peers. This has important implications for parents and educators, encouraging appropriate EF training and intervention for autistic children and adolescents at an early stage.
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Affiliation(s)
- Michael K Yeung
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
- University Research Facility of Human Behavioral Neuroscience, The Education University of Hong Kong, Hong Kong, China
| | - Jieru Bai
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Kwai-Lai Mak
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
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6
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Rodriguez VJ, Basurto KS, Finley JCA, Liu Q, Khalid E, Halliburton AM, Tse PKY, Resch ZJ, Soble JR, Ulrich DM. Multidimensional ADHD Symptom Profiles: Associations with Adverse Childhood Experiences. Arch Clin Neuropsychol 2024:acae050. [PMID: 38916192 DOI: 10.1093/arclin/acae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/14/2024] [Accepted: 06/10/2024] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with a range of negative health outcomes, including attention-deficit/hyperactivity disorder (ADHD) and neurocognitive deficits. This study identified symptom profiles in adult patients undergoing neuropsychological evaluations for ADHD and examined the association between these profiles and ACEs. METHODS Utilizing unsupervised machine learning models, the study analyzed data from 208 adult patients. RESULTS The Gaussian Mixture Model revealed two distinct symptom profiles: "Severely Impaired" and "Moderately Impaired". The "Severely Impaired" profile, 23.6% of the sample, was characterized by more severe ADHD symptomatology in childhood and worse neurocognitive performance. The "Moderately Impaired" profile, 76.4% of the sample, had scores in the average range for self-reported internalizing and externalizing psychopathology and better neurocognitive performance. There was a greater number of ACEs reported by patients in the Severely Impaired profile than the Moderately Impaired profile (p = .022). Specifically, using an ACEs cutoff of ≥4, 53.1% of patients in the Severely Impaired profile reported four or more ACEs, compared with 34.6% in the Moderately Impaired profile (p = .020). Profiles were not related to clinician-ascribed diagnosis. CONCLUSIONS Findings underscore the association between ACEs and worse symptom profiles marked by impaired neurocognitive function, increased internalizing and externalizing psychopathology, and heightened perceived stress in adults with ADHD. Future research may explore the effect of ACEs on symptom profiles in diverse populations and potential moderators or mediators of these associations. Findings offers valuable insights for clinicians in their assessment and treatment planning.
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Affiliation(s)
| | - Karen S Basurto
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qimin Liu
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Elmma Khalid
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | | | | | - Zachary J Resch
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
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7
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Rodriguez VJ, Finley JCA, Liu Q, Alfonso D, Basurto KS, Oh A, Nili A, Paltell KC, Hoots JK, Ovsiew GP, Resch ZJ, Ulrich DM, Soble JR. Empirically derived symptom profiles in adults with attention-Deficit/hyperactivity disorder: An unsupervised machine learning approach. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38657158 DOI: 10.1080/23279095.2024.2343022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is associated with various cognitive, behavioral, and mood symptoms that complicate diagnosis and treatment. The heterogeneity of these symptoms may also vary depending on certain sociodemographic factors. It is therefore important to establish more homogenous symptom profiles in patients with ADHD and determine their association with the patient's sociodemographic makeup. The current study used unsupervised machine learning to identify symptom profiles across various cognitive, behavioral, and mood symptoms in adults with ADHD. It was then examined whether symptom profiles differed based on relevant sociodemographic factors. METHODS Participants were 382 adult outpatients (62% female; 51% non-Hispanic White) referred for neuropsychological evaluation for ADHD. RESULTS Employing Gaussian Mixture Modeling, we identified two distinct symptom profiles in adults with ADHD: "ADHD-Plus Symptom Profile" and "ADHD-Predominate Symptom Profile." These profiles were primarily differentiated by internalizing psychopathology (Cohen's d = 1.94-2.05), rather than by subjective behavioral and cognitive symptoms of ADHD or neurocognitive test performance. In a subset of 126 adults without ADHD who were referred for the same evaluation, the unsupervised machine learning algorithm only identified one symptom profile. Group comparison analyses indicated that female patients were most likely to present with an ADHD-Plus Symptom Profile (χ2 = 5.43, p < .001). CONCLUSION The machine learning technique used in this study appears to be an effective way to elucidate symptom profiles emerging from comprehensive ADHD evaluations. These findings further underscore the importance of considering internalizing symptoms and patients' sex when contextualizing adult ADHD diagnosis and treatment.
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Affiliation(s)
- Violeta J Rodriguez
- Department of Psychology, University of Illinois at Urbana-Champaign, Illinois, USA
| | - John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Qimin Liu
- Department of Brain and Psychological Sciences, Boston, Massachusetts, USA
| | - Demy Alfonso
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Karen S Basurto
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Amanda Nili
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | | | - Jennifer K Hoots
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois at Chicago, Illinois, USA
- Department of Neurology, University of Illinois at Chicago, Illinois, USA
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8
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Pugliese CE, Handsman R, You X, Anthony LG, Vaidya C, Kenworthy L. Probing heterogeneity to identify individualized treatment approaches in autism: Specific clusters of executive function challenges link to distinct co-occurring mental health problems. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241246091. [PMID: 38642028 DOI: 10.1177/13623613241246091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
LAY ABSTRACT Many autistic people struggle with mental health problems like anxiety, depression, inattention, and aggression, which can be challenging to treat. Executive function challenges, which impact many autistic individuals, may serve as a risk factor for mental health problems or make treating mental health conditions more difficult. While some people respond well to medication or therapy, others do not. This study tried to understand if there are different subgroups of autistic young people who may have similar patterns of executive function strengths and challenges-like flexibility, planning, self-monitoring, and emotion regulation. Then, we investigated whether executive function subgroups were related to mental health problems in autistic youth. We found three different types of executive function subgroups in autistic youth, each with different patterns of mental health problems. This helps us identify specific profiles of executive function strengths and challenges that may be helpful with identifying personalized supports, services, and treatment strategies for mental health conditions.
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9
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Li Y, Ma S, Zhang X, Gao L. ASD and ADHD: Divergent activating patterns of prefrontal cortex in executive function tasks? J Psychiatr Res 2024; 172:187-196. [PMID: 38401362 DOI: 10.1016/j.jpsychires.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/26/2024]
Abstract
The functional Near-infrared Spectroscopy (fNIRS) has been more and more widely used to measure the activation state of prefrontal cortex when performing function-related tasks among children with various developmental disorders. Children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) have shown obvious executive function defects. We aimed to summarize the studies with fNIRS, to summarize the activation patterns of prefrontal cortex (PFC) of participants with ASD or ADHD in performing functional tasks. We selected 630 articles according to PRISMA guidelines, and the eligibility criteria were: 6-16 years old individuals diagnosed with ASD or ADHD by DSM-4 or 5, using fNIRS, having executive function (EF) task, typical development (TD) control, and between-group comparison of PFC activation. Eleven studies were finally included in the quantitative analysis, and compared to TD, ASD and ADHD showed the opposite PFC activation patterns during n-back tasks. We discussed the task-specific PFC activation in young participants with ASD and ADHD, and provided some new ideas on that issue.
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Affiliation(s)
- Yin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shuai Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lei Gao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China.
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Wang X, Zhao K, Yao L, Fonzo GA, Satterthwaite TD, Rekik I, Zhang Y. Delineating Transdiagnostic Subtypes in Neurodevelopmental Disorders via Contrastive Graph Machine Learning of Brain Connectivity Patterns. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.29.582790. [PMID: 38496573 PMCID: PMC10942316 DOI: 10.1101/2024.02.29.582790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Neurodevelopmental disorders, such as Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), are characterized by comorbidity and heterogeneity. Identifying distinct subtypes within these disorders can illuminate the underlying neurobiological and clinical characteristics, paving the way for more tailored treatments. We adopted a novel transdiagnostic approach across ADHD and ASD, using cutting-edge contrastive graph machine learning to determine subtypes based on brain network connectivity as revealed by resting-state functional magnetic resonance imaging. Our approach identified two generalizable subtypes characterized by robust and distinct functional connectivity patterns, prominently within the frontoparietal control network and the somatomotor network. These subtypes exhibited pronounced differences in major cognitive and behavioural measures. We further demonstrated the generalizability of these subtypes using data collected from independent study sites. Our data-driven approach provides a novel solution for parsing biological heterogeneity in neurodevelopmental disorders.
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Affiliation(s)
- Xuesong Wang
- Data 61, Commonwealth Scientific and Industrial Research Organisation, New South Wales, Australia
| | - Kanhao Zhao
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Lina Yao
- Data 61, Commonwealth Scientific and Industrial Research Organisation, New South Wales, Australia
- School of Computer Science and Engineering, University of New South Wales, New South Wales, Australia
| | - Gregory A Fonzo
- Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | | | - Islem Rekik
- BASIRA Lab, Imperial-X and Department of Computing, Imperial College London, London, UK
| | - Yu Zhang
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
- Department of Electrical and Computer Engineering, Lehigh University, Bethlehem, PA, USA
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11
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Mareva S, Holmes J. Mapping neurodevelopmental diversity in executive function. Cortex 2024; 172:204-221. [PMID: 38354470 DOI: 10.1016/j.cortex.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/30/2023] [Accepted: 11/14/2023] [Indexed: 02/16/2024]
Abstract
Executive function, an umbrella term used to describe the goal-directed regulation of thoughts, actions, and emotions, is an important dimension implicated in neurodiversity and established malleable predictor of multiple adult outcomes. Neurodevelopmental differences have been linked to both executive function strengths and weaknesses, but evidence for associations between specific profiles of executive function and specific neurodevelopmental conditions is mixed. In this exploratory study, we adopt an unsupervised machine learning approach (self-organising maps), combined with k-means clustering to identify data-driven profiles of executive function in a transdiagnostic sample of 566 neurodivergent children aged 8-18 years old. We include measures designed to capture two distinct aspects of executive function: performance-based tasks designed to tap the state-like efficiency of cognitive skills under optimal conditions, and behaviour ratings suited to capturing the trait-like application of cognitive control in everyday contexts. Three profiles of executive function were identified: one had consistent difficulties across both types of assessments, while the other two had inconsistent profiles of predominantly rating- or predominantly task-based difficulties. Girls and children without a formal diagnosis were more likely to have an inconsistent profile of primarily task-based difficulties. Children with these different profiles had differences in academic achievement and mental health outcomes and could further be differentiated from a comparison group of children on both shared and profile-unique patterns of neural white matter organisation. Importantly, children's executive function profiles were not directly related to diagnostic categories or to dimensions of neurodiversity associated with specific diagnoses (e.g., hyperactivity, inattention, social communication). These findings support the idea that the two types of executive function assessments provide non-redundant information related to children's neurodevelopmental differences and that they should not be used interchangeably. The findings advance our understanding of executive function profiles and their relationship to behavioural outcomes and neural variation in neurodivergent populations.
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Affiliation(s)
- Silvana Mareva
- MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, UK; Psychology Department, Faculty of Health and Life Sciences, University of Exeter, UK.
| | - Joni Holmes
- MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, UK; School of Psychology, University of East Anglia, UK
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12
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Sha M, Alqahtani A, Alsubai S, Dutta AK. Modified Meta Heuristic BAT with ML Classifiers for Detection of Autism Spectrum Disorder. Biomolecules 2023; 14:48. [PMID: 38254648 PMCID: PMC10813510 DOI: 10.3390/biom14010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
ASD (autism spectrum disorder) is a complex developmental and neurological disorder that impacts the social life of the affected person by disturbing their capability for interaction and communication. As it is a behavioural disorder, early treatment will improve the quality of life of ASD patients. Traditional screening is carried out with behavioural assessment through trained physicians, which is expensive and time-consuming. To resolve the issue, several conventional methods strive to achieve an effective ASD identification system, but are limited by handling large data sets, accuracy, and speed. Therefore, the proposed identification system employed the MBA (modified bat) algorithm based on ANN (artificial neural networks), modified ANN (modified artificial neural networks), DT (decision tree), and KNN (k-nearest neighbours) for the classification of ASD in children and adolescents. A BA (bat algorithm) is utilised for the automatic zooming capability, which improves the system's efficacy by excellently finding the solutions in the identification system. Conversely, BA is effective in the identification, it still has certain drawbacks like speed, accuracy, and falls into local extremum. Therefore, the proposed identification system modifies the BA optimisation with random perturbation of trends and optimal orientation. The dataset utilised in the respective model is the Q-chat-10 dataset. This dataset contains data of four stages of age groups such as toddlers, children, adolescents, and adults. To analyse the quality of the dataset, dataset evaluation mechanism, such as the Chi-Squared Statistic and p-value, are used in the respective research. The evaluation signifies the relation of the dataset with respect to the proposed model. Further, the performance of the proposed detection system is examined with certain performance metrics to calculate its efficiency. The outcome revealed that the modified ANN classifier model attained an accuracy of 1.00, ensuring improved performance when compared with other state-of-the-art methods. Thus, the proposed model was intended to assist physicians and researchers in enhancing the diagnosis of ASD to improve the standard of life of ASD patients.
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Affiliation(s)
- Mohemmed Sha
- Department of Software Engineering, College of Computer Engineering and Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia;
| | - Abdullah Alqahtani
- Department of Software Engineering, College of Computer Engineering and Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia;
| | - Shtwai Alsubai
- Department of Computer Science, College of Computer Engineering and Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia;
| | - Ashit Kumar Dutta
- Department of Computer Science and Information Systems, College of Applied Sciences, Almaarefa University, Riyadh 11597, Saudi Arabia;
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13
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Lang J, Yang LZ, Li H. TSP-GNN: a novel neuropsychiatric disorder classification framework based on task-specific prior knowledge and graph neural network. Front Neurosci 2023; 17:1288882. [PMID: 38188031 PMCID: PMC10768162 DOI: 10.3389/fnins.2023.1288882] [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: 09/05/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Neuropsychiatric disorder (ND) is often accompanied by abnormal functional connectivity (FC) patterns in specific task contexts. The distinctive task-specific FC patterns can provide valuable features for ND classification models using deep learning. However, most previous studies rely solely on the whole-brain FC matrix without considering the prior knowledge of task-specific FC patterns. Insight by the decoding studies on brain-behavior relationship, we develop TSP-GNN, which extracts task-specific prior (TSP) connectome patterns and employs graph neural network (GNN) for disease classification. TSP-GNN was validated using publicly available datasets. Our results demonstrate that different ND types show distinct task-specific connectivity patterns. Compared with the whole-brain node characteristics, utilizing task-specific nodes enhances the accuracy of ND classification. TSP-GNN comprises the first attempt to incorporate prior task-specific connectome patterns and the power of deep learning. This study elucidates the association between brain dysfunction and specific cognitive processes, offering valuable insights into the cognitive mechanism of neuropsychiatric disease.
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Affiliation(s)
- Jinwei Lang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- University of Science and Technology of China, Hefei, China
| | - Li-Zhuang Yang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
| | - Hai Li
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
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14
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Gao Y, Ni H, Chen Y, Tang Y, Liu X. Subtype classification of attention deficit hyperactivity disorder with hierarchical binary hypothesis testing framework. J Neural Eng 2023; 20:056015. [PMID: 37647890 DOI: 10.1088/1741-2552/acf523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 08/30/2023] [Indexed: 09/01/2023]
Abstract
Objective. The diagnosis of attention deficit hyperactivity disorder (ADHD) subtypes is important for the refined treatment of ADHD children. Although automated diagnosis methods based on machine learning are performed with structural and functional magnetic resonance imaging (sMRI and fMRI) data which have full observation of brains, they are not satisfactory with the accuracy of less than80%for the ADHD subtype diagnosis.Approach. To improve the accuracy and obtain the biomarker of ADHD subtypes, we proposed a hierarchical binary hypothesis testing (H-BHT) framework by using brain functional connectivity (FC) as input bio-signals. The framework includes a two-stage procedure with a decision tree strategy and thus becomes suitable for the subtype classification. Also, typical FC is extracted in both two stages of identifying ADHD subtypes. That means the important FC is found out for the subtype recognition.Main results. We apply the proposed H-BHT framework to resting state fMRI datasets from ADHD-200 consortium. The results are achieved with the average accuracy97.1%and an average kappa score 0.947. Discriminative FC between ADHD subtypes is found by comparing the P-values of typical FC.Significance. The proposed framework not only is an effective structure for ADHD subtype classification, but also provides useful reference for multiclass classification of mental disease subtypes.
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Affiliation(s)
- Yuan Gao
- College of Information Science and Engineering, Hohai University, Nanjing, People's Republic of China
| | - Huaqing Ni
- College of Information Science and Engineering, Hohai University, Nanjing, People's Republic of China
| | - Ying Chen
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou, People's Republic of China
| | - Yibin Tang
- College of Information Science and Engineering, Hohai University, Nanjing, People's Republic of China
| | - Xiaofeng Liu
- College of Information Science and Engineering, Hohai University, Nanjing, People's Republic of China
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15
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Wexler BE, Kish R. Using micro-cognition biomarkers of neurosystem dysfunction to redefine ADHD subtypes: A scalable digital path to diagnosis based on brain function. Psychiatry Res 2023; 326:115348. [PMID: 37494880 PMCID: PMC10517859 DOI: 10.1016/j.psychres.2023.115348] [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: 03/14/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
Symptom-based diagnosis does not align with underlying neruropathology, confounding new treatment development and treatment selection for individual patients. Using high precision micro-cognition biomarkers of neurosystem dysfunction acquired during digital neurotherapy (DNT), we characterized subgroups of ADHD children with different neuropathology. K-means clustering applied to 69 children 6-9 years old with ADHD using performance variables from a Go/NoGo test normalized against 58 typically developing (TD) children identified four subgroups that were validated and further characterized by micro-cognition biomarkers extracted from thousands of responses during the DNT. The clusters differed on emblematic features of ADHD. Cluster 4 showed poor response inhibition and inconsistent attention. Cluster 3 showed only poor response inhibition and the other two showed neither. Cluster 2 showed faster and more consistent responses, higher detection of simple targets and better working memory than TD children but marked performance decrements when required to track multiple targets or ignore distractors. Cluster 1 showed much greater ability recognizing members of abstract categories rather than natural categories that children learn through physical interaction with the environment while Cluster 4 was the opposite. Fine-grained, low-cost, noninvasive, and scalable digital micro-cognition biomarkers can identify patients with the same symptom-based diagnosis but differing neuropathology.
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Affiliation(s)
- Bruce E Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; C8 Sciences, New Haven, CT, United States.
| | - Ryan Kish
- C8 Sciences, New Haven, CT, United States
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16
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Bustamante JC, Fernández-Castilla B, Alcaraz-Iborra M. Relation between executive functions and screen time exposure in under 6 year-olds: A meta-analysis. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2023.107739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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17
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Cao M, Martin E, Li X. Machine learning in attention-deficit/hyperactivity disorder: new approaches toward understanding the neural mechanisms. Transl Psychiatry 2023; 13:236. [PMID: 37391419 DOI: 10.1038/s41398-023-02536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and heterogeneous neurodevelopmental disorder in children and has a high chance of persisting in adulthood. The development of individualized, efficient, and reliable treatment strategies is limited by the lack of understanding of the underlying neural mechanisms. Diverging and inconsistent findings from existing studies suggest that ADHD may be simultaneously associated with multivariate factors across cognitive, genetic, and biological domains. Machine learning algorithms are more capable of detecting complex interactions between multiple variables than conventional statistical methods. Here we present a narrative review of the existing machine learning studies that have contributed to understanding mechanisms underlying ADHD with a focus on behavioral and neurocognitive problems, neurobiological measures including genetic data, structural magnetic resonance imaging (MRI), task-based and resting-state functional MRI (fMRI), electroencephalogram, and functional near-infrared spectroscopy, and prevention and treatment strategies. Implications of machine learning models in ADHD research are discussed. Although increasing evidence suggests that machine learning has potential in studying ADHD, extra precautions are still required when designing machine learning strategies considering the limitations of interpretability and generalization.
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Affiliation(s)
- Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | | | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA.
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Leoni M, Vanes LD, Hadaya L, Kanel D, Dazzan P, Simonoff E, Counsell SJ, Happé F, Edwards AD, Nosarti C. Exploring cognitive, behavioral and autistic trait network topology in very preterm and term-born children. Front Psychol 2023; 14:1119196. [PMID: 37187563 PMCID: PMC10176608 DOI: 10.3389/fpsyg.2023.1119196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction Compared to full-term (FT) born peers, children who were born very preterm (VPT; <32 weeks' gestation) are likely to display more cognitive and behavioral difficulties, including inattention, anxiety and socio-communication problems. In the published literature, such difficulties tend to be studied independently, thus failing to account for how different aspects of child development interact. The current study aimed to investigate children's cognitive and behavioral outcomes as interconnected, dynamically related facets of development that influence one another. Methods Participants were 93 VPT and 55 FT children (median age 8.79 years). IQ was evaluated with the Wechsler Intelligence Scale for Children-4th edition (WISC-IV), autism spectrum condition (ASC) traits with the social responsiveness scale-2nd edition (SRS-2), behavioral and emotional problems with the strengths and difficulties questionnaire (SDQ), temperament with the temperament in middle childhood questionnaire (TMCQ) and executive function with the behavior rating inventory of executive functioning (BRIEF-2). Outcome measures were studied in VPT and FT children using Network Analysis, a method that graphically represents partial correlations between variables and yields information on each variable's propensity to form a bridge between other variables. Results VPT and FT children exhibited marked topological differences. Bridges (i.e., the variables most connected to others) in the VPT group network were: conduct problems and difficulties with organizing and ordering their environment. In the FT group network, the most important bridges were: difficulties with initiating a task or activity and prosocial behaviors, and greater emotional problems, such as lower mood. Discussion These findings highlight the importance of targeting different aspects of development to support VPT and FT children in person-based interventions.
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Affiliation(s)
- Marguerite Leoni
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Lucy D. Vanes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust and King's College London, National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, London, United Kingdom
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust and King's College London, National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, London, United Kingdom
| | - Serena J. Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - A. David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, United Kingdom
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Lee SH, Chia S, Chou TL, Gau SSF. Sex differences in medication-naïve adults with attention-deficit/hyperactivity disorder: a counting Stroop functional MRI study. Biol Psychol 2023; 179:108552. [PMID: 37028795 DOI: 10.1016/j.biopsycho.2023.108552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/12/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023]
Abstract
Emerging evidence supports deficits in executive functions in the fronto-striato-parietal network in individuals with attention-deficit/hyperactivity disorder (ADHD). However, most functional studies recruited men with ADHD only, leaving it unclear whether executive deficits are also demonstrated in women with ADHD. Thus, we used functional magnetic resonance imaging to examine the sex differences in a counting Stroop task that explored interference control. The sample consisted of 55 medication-naïve adults with ADHD (28 men, 27 women) and 52 healthy controls (HC, 26 men, 26 women). The Conners' Continuous Performance Test further evaluated the performance of focused attention (standard deviation of the reaction time, RTSD) and vigilance (the reaction time change across different inter-stimulus intervals, RTISI). First, for the main effect of diagnosis, compared to the HC group, the ADHD group showed less activation in the caudate nucleus and inferior frontal gyrus (IFG). Second, for the main effect of sex, no significant effects were found. Third, a diagnosis-by-sex interaction indicated that the magnitude of ADHD-HC difference was greater for women than men in the right IFG and precuneus, reflecting greater difficulties for ADHD women to resolve interference. Conversely, no significant brain activation showed greater ADHD-HC difference in men than women. Also, reduced right IFG and precuneus activation was negatively associated with the scores assessing focused attention and vigilance in ADHD women, indicating that the attentional abilities are disrupted in ADHD women. Abnormalities in the frontoparietal areas may represent the main difference between ADHD women and ADHD men.
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20
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Kleberg JL, Frick MA, Brocki KC. Eye-movement indices of arousal predict ADHD and comorbid externalizing symptoms over a 2-year period. Sci Rep 2023; 13:4767. [PMID: 36959373 PMCID: PMC10036637 DOI: 10.1038/s41598-023-31697-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) follows a variable course across childhood. Disrupted arousal has been hypothesized to underlie core symptoms as well as comorbid internalizing and externalizing conditions. The current study examined eye-movement and pupil-dilation metrics indexing arousal as longitudinal predictors of ADHD, externalizing, and internalizing symptoms over a 2-year period. Participants aged 8-13 years (N = 54, 30% with a diagnosis of ADHD) completed a modified version of the gap-overlap task including arousal-inducing auditory warning signals. Parents rated symptoms at the time of testing and at 2 years follow-up. Phasic alerting (reaction-time reduction after alerting cues) is an index of arousal. Here, larger phasic alerting effects predicted higher ADHD-symptom levels 2 years later. Blunted pupil-dilation responses predicted externalizing symptoms at T2, controlling for ADHD and externalizing at T1. Our results support the theory that ADHD is associated with altered arousal. Blunted arousal reactivity may be a longitudinal risk factor for externalizing problems in children with ADHD symptoms.
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Affiliation(s)
- Johan Lundin Kleberg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Gävlegatan 22, 113 33, Stockholm, Sweden.
- Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Matilda A Frick
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Karin C Brocki
- Department of Psychology, Uppsala University, Uppsala, Sweden
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Mareva S, Akarca D, Holmes J. Transdiagnostic profiles of behaviour and communication relate to academic and socioemotional functioning and neural white matter organisation. J Child Psychol Psychiatry 2023; 64:217-233. [PMID: 36127748 PMCID: PMC10087495 DOI: 10.1111/jcpp.13685] [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] [Accepted: 06/07/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Behavioural and language difficulties co-occur in multiple neurodevelopmental conditions. Our understanding of these problems has arguably been slowed by an overreliance on study designs that compare diagnostic groups and fail to capture the overlap across different neurodevelopmental disorders and the heterogeneity within them. METHODS We recruited a large transdiagnostic cohort of children with complex needs (N = 805) to identify distinct subgroups of children with common profiles of behavioural and language strengths and difficulties. We then investigated whether and how these data-driven groupings could be distinguished from a comparison sample (N = 158) on measures of academic and socioemotional functioning and patterns of global and local white matter connectome organisation. Academic skills were assessed via standardised measures of reading and maths. Socioemotional functioning was captured by the parent-rated version of the Strengths and Difficulties Questionnaire. RESULTS We identified three distinct subgroups of children, each with different levels of difficulties in structural language, pragmatic communication, and hot and cool executive functions. All three subgroups struggled with academic and socioemotional skills relative to the comparison sample, potentially representing three alternative but related developmental pathways to difficulties in these areas. The children with the weakest language skills had the most widespread difficulties with learning, whereas those with more pronounced difficulties with hot executive skills experienced the most severe difficulties in the socioemotional domain. Each data-driven subgroup could be distinguished from the comparison sample based on both shared and subgroup-unique patterns of neural white matter organisation. Children with the most pronounced deficits in language, cool executive, or hot executive function were differentiated from the comparison sample by altered connectivity in predominantly thalamocortical, temporal-parietal-occipital, and frontostriatal circuits, respectively. CONCLUSIONS These findings advance our understanding of commonly co-morbid behavioural and language problems and their relationship to behavioural outcomes and neurobiological substrates.
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Affiliation(s)
- Silvana Mareva
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Danyal Akarca
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Joni Holmes
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
- School of Psychology, Faculty of Social SciencesUniversity of East AngliaNorwichUK
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Klöbl M, Prillinger K, Diehm R, Doganay K, Lanzenberger R, Poustka L, Plener P, Konicar L. Individual brain regulation as learned via neurofeedback is related to affective changes in adolescents with autism spectrum disorder. Child Adolesc Psychiatry Ment Health 2023; 17:6. [PMID: 36635760 PMCID: PMC9837918 DOI: 10.1186/s13034-022-00549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/18/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Emotions often play a role in neurofeedback (NF) regulation strategies. However, investigations of the relationship between the induced neuronal changes and improvements in affective domains are scarce in electroencephalography-based studies. Thus, we extended the findings of the first study on slow cortical potential (SCP) NF in autism spectrum disorder (ASD) by linking affective changes to whole-brain activity during rest and regulation. METHODS Forty-one male adolescents with ASD were scanned twice at rest using functional magnetic resonance imaging. Between scans, half underwent NF training, whereas the other half received treatment as usual. Furthermore, parents reported on their child's affective characteristics at each measurement. The NF group had to alternatingly produce negative and positive SCP shifts during training and was additionally scanned using functional magnetic resonance imaging while applying their developed regulation strategies. RESULTS No significant treatment group-by-time interactions in affective or resting-state measures were found. However, we found increases of resting activity in the anterior cingulate cortex and right inferior temporal gyrus as well as improvements in affective characteristics over both groups. Activation corresponding to SCP differentiation in these regions correlated with the affective improvements. A further correlation was found for Rolandic operculum activation corresponding to positive SCP shifts. There were no significant correlations with the respective achieved SCP regulation during NF training. CONCLUSION SCP NF in ASD did not lead to superior improvements in neuronal or affective functioning compared to treatment as usual. However, the affective changes might be related to the individual strategies and their corresponding activation patterns as indicated by significant correlations on the whole-brain level. Trial registration This clinical trial was registered at drks.de (DRKS00012339) on 20th April, 2017.
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Affiliation(s)
- Manfred Klöbl
- Department of Psychiatry & Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Karin Prillinger
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Robert Diehm
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Kamer Doganay
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry & Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry, Medical University of Göttingen, Göttingen, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Lilian Konicar
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.
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Aflalo J, Caldani S, Acquaviva E, Moscoso A, Delorme R, Bucci MP. Pilot study to explore poor visual searching capabilities in children with ADHD: a tablet-based computerized test battery study. Nord J Psychiatry 2023:1-7. [PMID: 36598162 DOI: 10.1080/08039488.2022.2162122] [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] [Indexed: 01/05/2023]
Abstract
Aim: The frequent visual attention deficiency reported in children with attention-deficit/hyperactivity disorder (ADHD) could represent a relevant biomarker but robust estimates of such cognitive impairment in clinical populations remained challenging. To assess visual attention impairment in children ADHD using a new design tablet-based computerized test battery which allowed objective recording of visual search performances.Methods: Forty-nine children with ADHD and their IQ- and age-matched typically developmental (TD) children were enrolled in the study. Visual attention abilities were estimated by using the computerized modified barrage test developed by Metrisquare. We analyzed the time spent to achieve the whole battery and, the errors and omissions done by each child during each of the three sub-tasks.Results: We observed a significant association between the load of sustained attention requested to perform a sub-task and the numbers of errors and omissions made by the children whatever the group considered. During the most stringent sub-task in term of visual attention engagement, children with ADHD displayed more significant errors and omissions when compared to IQ- and age-matched controls. This effect was not mediated by the time spent to perform the task since we did not report any significant difference between groups.Conclusion: The different performance of the most stringent sub-task observed in children with ADHD could be due to their deficient neural activity in frontal areas responsible of visual endogenous attention needed for difficult visual searching tasks. This cognitive battery could be a useful instrument to estimate visual attention impairment in children with ADHD.HIGHLIGHTSWe assessed if a new design tablet-based computerized test battery would allow objective recording of visual search performances.We observed that children with ADHD made significantly more errors and omissions with respect to age-, sex- matched controls during the most stringent sub-task in terms of visual attention engagementThe tablet-based computerized test battery could be a promising tool to objectively estimate abnormal attention search impairment in ADHD.
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Affiliation(s)
- Joanna Aflalo
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, Nanterre, France.,ENT Department, EFEE, Centre for Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
| | - Simona Caldani
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, Nanterre, France.,ENT Department, EFEE, Centre for Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Ana Moscoso
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France.,Paris University, Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, Nanterre, France.,ENT Department, EFEE, Centre for Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
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Inconsistencies between Subjective Reports of Cognitive Difficulties and Performance on Cognitive Tests are Associated with Elevated Internalising and Externalising Symptoms in Children with Learning-related Problems. Res Child Adolesc Psychopathol 2022; 50:1557-1572. [PMID: 35838930 PMCID: PMC9653343 DOI: 10.1007/s10802-022-00930-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
Children with learning difficulties are commonly assumed to have underlying cognitive deficits by health and educational professionals. However, not all children referred for psycho-educational assessment will be found to have deficits when their abilities are measured by performance on cognitive tasks. The primary aim of this study was to estimate the prevalence of this inconsistent cognitive profile (ICP) in a transdiagnostic sample of children referred by health and education service providers for problems related to attention, learning and memory (N = 715). A second aim was to explore whether elevated mental health problems were associated with ICPs. Findings suggest that approximately half of this sample could be characterised as having an ICP. Cognitive difficulties, whether identified by parent ratings or task performance, were associated with elevated internalising and externalising difficulties. Crucially, a larger discrepancy between a parent's actual ratings of a child's cognitive difficulties and the ratings that would be predicted based on the child's performance on cognitive tasks was associated greater internalising and externalising difficulties for measures of working memory, and greater externalising difficulties for measures of attention. These findings suggest that subjective cognitive difficulties occurring in the absence of any task-based performance deficits may be a functional problem arising from mental health problems.
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Krakowski AD, Cost KT, Szatmari P, Anagnostou E, Crosbie J, Schachar R, Duku E, Georgiades S, Ayub M, Kelley E, Nicolson R, Pullenayegum E, Barnett-Tapia C. Characterizing the ASD-ADHD phenotype: measurement structure and invariance in a clinical sample. J Child Psychol Psychiatry 2022; 63:1534-1543. [PMID: 35342939 DOI: 10.1111/jcpp.13609] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) have considerable overlap, supporting the need for a dimensional framework that examines neurodevelopmental domains which cross traditional diagnostic boundaries. In the following study, we use factor analysis to deconstruct the ASD-ADHD phenotype into its underlying phenotypic domains and test for measurement invariance across adaptive functioning, age, gender and ASD/ADHD clinical diagnoses. METHODS Participants included children and youth (aged 3-20 years) with a clinical diagnosis of ASD (n = 727) or ADHD (n = 770) for a total of 1,497 participants. Parents of these children completed the Social Communication Questionnaire (SCQ), a measure of autism symptoms, and the Strengths and Weaknesses of ADHD and Normal Behaviour (SWAN) questionnaire, a measure of ADHD symptoms. An exploratory factor analysis (EFA) was performed on combined SCQ and SWAN items. This was followed by a confirmatory factor analysis (CFA) and tests of measurement invariance. RESULTS EFA revealed a four-factor solution (inattention, hyperactivity/impulsivity, social-communication, and restricted, repetitive, behaviours and interests (RRBI)) and a CFA confirmed good model fit. This solution also showed good model fit across subgroups of interest. CONCLUSIONS Our study shows that a combined ASD-ADHD phenotype is characterized by two latent ASD domains (social communication and RRBIs) and two latent ADHD domains (inattention and hyperactivity/impulsivity). We established measurement invariance of the derived measurement model across adaptive functioning, age, gender and ASD/ADHD diagnoses.
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Affiliation(s)
- Aneta D Krakowski
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Carolina Barnett-Tapia
- Division of Neurology, Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Munsell EGS, Orsmond GI, Fulford D, Coster WJ. Self-management of daily life tasks in diploma-track youth with disabilities. Disabil Rehabil 2022; 44:8011-8021. [PMID: 34877919 DOI: 10.1080/09638288.2021.2008524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Youth with disabilities who graduate with a regular high school diploma often continue to have difficulties in their daily functioning that ultimately impact adulthood outcomes. To better understand these functional difficulties and determine how best to address them, it is important to distinguish deficits in discrete skills from difficulty organizing skills to self-manage complex tasks associated with adult roles. The purpose of this study was to explore the extent to which challenges in social, executive function and behavior management factors relate to these two aspects of daily functioning. METHODS This is a secondary analysis of the National Longitudinal Transition Study 2 funded by the United States Department of Education. The direct and indirect associations between youth underlying factors and self-management of daily life tasks (SMDLT) versus discrete functional skills were modelled using structural equation modelling. RESULTS A model incorporating social skills, communication, and behavior regulation explained 55% of the variance in SMDLT. In contrast, the model predicting discrete functional skills had fewer significant associations and described less variance (37%) in the outcome. CONCLUSIONS Findings suggest that using measures of SMDLT and designing targeted interventions for SMDLT might help improve participation in independent living and productivity for diploma-track youth with disabilities.Implications for rehabilitationSuccessful transition from high school to adult roles requires the ability to self-manage the daily life tasks required for those roles, such as employment, post-secondary education, and independent living.The ability to self-manage daily tasks is distinct from mastery of discrete functional skills and should be assessed with measures that uniquely examine this domain.Social and communication skills, executive functioning, and behavioral regulation, are important contributors to the ability to self-manage life tasks for diploma-track youth with disabilities and should be incorporated into multifaceted interventions.Interventions to improve self-management of tasks should include teaching strategies and practice coordinating underlying skills in flexible ways that meet the varying demands of tasks and diverse environments.
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Affiliation(s)
- Elizabeth G S Munsell
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Gael I Orsmond
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Daniel Fulford
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA.,Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Wendy J Coster
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
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Chaku N, Barry K, Fowle J, Hoyt LT. Understanding patterns of heterogeneity in executive functioning during adolescence: Evidence from population-level data. Dev Sci 2022; 25:e13256. [PMID: 35238432 PMCID: PMC9901488 DOI: 10.1111/desc.13256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/16/2022] [Indexed: 01/13/2023]
Abstract
Executive functioning (EF) is fundamental to positive development. Yet, little is known about how to best characterize constellations of EF skills that may inform disparate associations between EF and behavior during adolescence. In the current study, cross-validated latent profile analysis (LPA) was used to derive profiles of EF based on measures of inhibitory control, working memory, and cognitive flexibility using data from 11,672 youth (52.2% male, mean age = 9.91 years) in the Adolescent Brain and Cognitive Development study. Four meaningful EF profiles emerged from the data representing Average EF, High EF, Low Inhibitory Control, and Low EF. Boys, youth from low-income households, and early developing youth were more likely to be in profiles distinguished by lower EF. Profile membership also predicted differences in externalizing, internalizing, and other problem behaviors assessed one year later. Findings indicate that youth may have distinct constellations of EF skills, underscoring the need for person-centered approaches that focus on patterns of individual characteristics.
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28
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Southon C. The relationship between executive function, neurodevelopmental disorder traits, and academic achievement in university students. Front Psychol 2022; 13:958013. [PMID: 36118426 PMCID: PMC9478894 DOI: 10.3389/fpsyg.2022.958013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/15/2022] [Indexed: 12/13/2022] Open
Abstract
Difficulties with executive function have often been identified in individuals with various neurodevelopmental disorders such as Autism Spectrum Disorder (ASD), Attention-Deficit Hyperactivity Disorder (ADHD), and Developmental Co-ordination Disorder (DCD). Additionally, in childhood and adolescence, executive functioning is an important predictor of academic achievement. However, less research has explored these relationships in adult students, and those with a high level of neurodevelopmental disorder traits but no clinical diagnosis. Therefore, the current study aimed to assess whether ASD, ADHD, and DCD traits can predict academic achievement in university students, and whether traits of these neurodevelopmental conditions moderate the relationship between executive function and academic achievement. Both neurotypical students and those with a clinical diagnosis of a neurodevelopmental disorder were able to participate, with the majority being neurotypical. Participants completed four self-report questionnaires and provided a measure of academic achievement based on their university assignment results. Traits of ASD, ADHD, and DCD alone did not predict achievement, however, traits of ADHD and DCD significantly moderated the relationship between executive function and academic achievement. ASD traits did not significantly moderate this relationship. Implications and suggestions for future research are also discussed.
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Affiliation(s)
- Chloe Southon
- Department of Psychology, Social Work and Counselling, School of Human Sciences, University of Greenwich, London, United Kingdom
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29
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Van Dyck D, Baijot S, Aeby A, De Tiège X, Deconinck N. Cognitive, perceptual, and motor profiles of school-aged children with developmental coordination disorder. Front Psychol 2022; 13:860766. [PMID: 35992485 PMCID: PMC9381813 DOI: 10.3389/fpsyg.2022.860766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/24/2022] [Indexed: 12/05/2022] Open
Abstract
Developmental coordination disorder (DCD) is a heterogeneous condition. Besides motor impairments, children with DCD often exhibit poor visual perceptual skills and executive functions. This study aimed to characterize the motor, perceptual, and cognitive profiles of children with DCD at the group level and in terms of subtypes. A total of 50 children with DCD and 31 typically developing (TD) peers (7–11 years old) underwent a comprehensive neuropsychological (15 tests) and motor (three subscales of the Movement Assessment Battery for Children-2) assessment. The percentage of children with DCD showing impairments in each measurement was first described. Hierarchical agglomerative and K-means iterative partitioning clustering analyses were then performed to distinguish the subtypes present among the complete sample of children (DCD and TD) in a data-driven way. Moderate to large percentages of children with DCD showed impaired executive functions (92%) and praxis (meaningless gestures and postures, 68%), as well as attentional (52%), visual perceptual (46%), and visuomotor (36%) skills. Clustering analyses identified five subtypes, four of them mainly consisting of children with DCD and one of TD children. These subtypes were characterized by: (i) generalized impairments (8 children with DCD), (ii) impaired manual dexterity, poor balance (static/dynamic), planning, and alertness (15 DCD and 1 TD child), (iii) impaired manual dexterity, cognitive inhibition, and poor visual perception (11 children with DCD), (iv) impaired manual dexterity and cognitive inhibition (15 DCD and 5 TD children), and (v) no impairment (25 TD and 1 child with DCD). Besides subtle differences, the motor and praxis measures did not enable to discriminate between the four subtypes of children with DCD. The subtypes were, however, characterized by distinct perceptual or cognitive impairments. These results highlight the importance of assessing exhaustively the perceptual and cognitive skills of children with DCD.
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Affiliation(s)
- Dorine Van Dyck
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- *Correspondence: Dorine Van Dyck,
| | - Simon Baijot
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- Neuropsychology and Functional Neuroimaging Research Group at Center for Research in Cognition and Neurosciences, ULB Neurosciences Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Alec Aeby
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- Neuropsychology and Functional Neuroimaging Research Group at Center for Research in Cognition and Neurosciences, ULB Neurosciences Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Pediatric Neurology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Translational Neuroimaging, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Nicolas Deconinck
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
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Powell K, Macari S, Brennan-Wydra E, Feiner H, Butler M, Goncalves Fortes D, Boxberger A, Torres-Viso M, Morgan C, Lyons M, Chawarska K. Elevated symptoms of executive dysfunction predict lower adaptive functioning in 3-year-olds with autism spectrum disorder. Autism Res 2022; 15:1336-1347. [PMID: 35388596 PMCID: PMC9253075 DOI: 10.1002/aur.2715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022]
Abstract
Executive functioning (EF) deficits co-occur frequently with autism spectrum disorder (ASD) and have a long-term detrimental impact on quality of life of children and their families. Timely identification of risk for EF vulnerabilities may hasten access to early intervention and alleviate their long-term consequences. This study examines (1) if EF deficits are elevated in toddlers with ASD compared to nonautistic siblings of children with ASD, typically developing (TYP) toddlers, and toddlers with atypical developmental presentation; and (2) if EF deficits have a detrimental effect on adaptive functioning in ASD. Participants were recruited between September 2014 and October 2019 and included 73 toddlers with ASD, 33 nonautistic siblings of children with ASD, 35 toddlers with atypical development, and 28 TYP toddlers matched on chronological age (M = 39.01 months, SD = 3.11). EF deficits were measured using the BRIEF-P; adaptive skills were measured using the VABS-II. Whenever appropriate, analyses were controlled for MSEL verbal and nonverbal developmental quotient, ADOS-2 autism severity scores, and sex. Analyses revealed that toddlers with ASD exhibited elevated BRIEF-P scores across all domains compared to each of the three comparison groups. Higher BRIEF-P scores were associated with lower adaptive social, communication, and daily living skills while controlling for symptom severity, verbal and nonverbal functioning, and sex. In conclusion, marked vulnerabilities in EF are already present in 3-year-old toddlers with ASD and are predictive of the level of adaptive functioning in ASD. EF vulnerabilities in toddlers should be targeted for intervention to improve long-term outcomes in ASD. LAY SUMMARY: Many children with autism experience vulnerabilities in executive functioning (EF), which may include challenges with inhibition, working memory, cognitive flexibility, and planning. The study shows that these vulnerabilities can already be detected at age three and that their presence is linked with lower social, communication, and daily living skills. Screening children with ASD for EF challenges and helping those who have difficulties may improve their long-term outcomes.
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Affiliation(s)
- Kelly Powell
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Suzanne Macari
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Emma Brennan-Wydra
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Hannah Feiner
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Maureen Butler
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Diogo Goncalves Fortes
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Alexandra Boxberger
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Mariana Torres-Viso
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Chelsea Morgan
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Megan Lyons
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
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Morris SE, Sanislow CA, Pacheco J, Vaidyanathan U, Gordon JA, Cuthbert BN. Revisiting the seven pillars of RDoC. BMC Med 2022; 20:220. [PMID: 35768815 PMCID: PMC9245309 DOI: 10.1186/s12916-022-02414-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/23/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In 2013, a few years after the launch of the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative, Cuthbert and Insel published a paper titled "Toward the future of psychiatric diagnosis: the seven pillars of RDoC." The RDoC project is a translational research effort to encourage new ways of studying psychopathology through a focus on disruptions in normal functions (such as reward learning or attention) that are defined jointly by observable behavior and neurobiological measures. The paper outlined the principles of the RDoC research framework, including emphases on research that acquires data from multiple measurement classes to foster integrative analyses, adopts dimensional approaches, and employs novel methods for ascertaining participants and identifying valid subgroups. DISCUSSION To mark the first decade of the RDoC initiative, we revisit the seven pillars and highlight new research findings and updates to the framework that are related to each. This reappraisal emphasizes the flexible nature of the RDoC framework and its application in diverse areas of research, new findings related to the importance of developmental trajectories within and across neurobehavioral domains, and the value of computational approaches for clarifying complex multivariate relations among behavioral and neurobiological systems. CONCLUSION The seven pillars of RDoC have provided a foundation that has helped to guide a surge of new studies that have examined neurobehavioral domains related to mental disorders, in the service of informing future psychiatric nosology. Building on this footing, future areas of emphasis for the RDoC project will include studying central-peripheral interactions, developing novel approaches to phenotyping for genomic studies, and identifying new targets for clinical trial research to facilitate progress in precision psychiatry.
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Affiliation(s)
- Sarah E Morris
- National Institute of Mental Health, Neuroscience Center, 6001 Executive Blvd, Bethesda, MD, 20892, USA.
| | | | - Jenni Pacheco
- National Institute of Mental Health, Neuroscience Center, 6001 Executive Blvd, Bethesda, MD, 20892, USA
| | - Uma Vaidyanathan
- National Institute of Mental Health, Neuroscience Center, 6001 Executive Blvd, Bethesda, MD, 20892, USA.,Present affiliation: Boehringer Ingelheim, Ingelheim am Rhein, Germany
| | - Joshua A Gordon
- National Institute of Mental Health, Neuroscience Center, 6001 Executive Blvd, Bethesda, MD, 20892, USA
| | - Bruce N Cuthbert
- National Institute of Mental Health, Neuroscience Center, 6001 Executive Blvd, Bethesda, MD, 20892, USA
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32
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Prillinger K, Radev ST, Doganay K, Poustka L, Konicar L. Impulsivity Moderates the Effect of Neurofeedback Training on the Contingent Negative Variation in Autism Spectrum Disorder. Front Hum Neurosci 2022; 16:838080. [PMID: 35547196 PMCID: PMC9082644 DOI: 10.3389/fnhum.2022.838080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background The contingent negative variation (CNV) is a well-studied indicator of attention- and expectancy-related processes in the human brain. An abnormal CNV amplitude has been found in diverse neurodevelopmental psychiatric disorders. However, its role as a potential biomarker of successful clinical interventions in autism spectrum disorder (ASD) remains unclear. Methods In this randomized controlled trial, we investigated how the CNV changes following an intensive neurofeedback training. Therefore, twenty-one adolescents with ASD underwent 24 sessions of slow cortical potential (SCP) neurofeedback training. Twenty additional adolescents with ASD formed a control group and received treatment as usual. CNV waveforms were obtained from a continuous performance test (CPT), which all adolescents performed before and after the corresponding 3-month long training period. In order to utilize all available neural time series, trial-based area under the curve values for all four electroencephalogram (EEG) channels were analyzed with a hierarchical Bayesian model. In addition, the model included impulsivity, inattention, and hyperactivity as potential moderators of change in CNV. Results Our model implies that impulsivity moderates the effects of neurofeedback training on CNV depending on group. In the control group, the average CNV amplitude decreased or did not change after treatment as usual. In the experimental group, the CNV changed depending on the severity of comorbid impulsivity symptoms. The average CNV amplitude of participants with low impulsivity scores decreased markedly, whereas the average CNV amplitude of participants with high impulsivity increased. Conclusion The degree of impulsivity seems to play a crucial role in the changeability of the CNV following an intensive neurofeedback training. Therefore, comorbid symptomatology should be recorded and analyzed in future EEG-based brain training interventions. Clinical Trial Registration https://www.drks.de, identifier DRKS00012339.
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Affiliation(s)
- Karin Prillinger
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefan T. Radev
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
- Department of Quantitative Research Methods, Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Kamer Doganay
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Lilian Konicar
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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33
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Loh HW, Ooi CP, Barua PD, Palmer EE, Molinari F, Acharya UR. Automated detection of ADHD: Current trends and future perspective. Comput Biol Med 2022; 146:105525. [DOI: 10.1016/j.compbiomed.2022.105525] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
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34
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van Eijndhoven P, Collard R, Vrijsen J, Geurts DEM, Vasquez AA, Schellekens A, van den Munckhof E, Brolsma S, Duyser F, Bergman A, van Oort J, Tendolkar I, Schene A. Measuring Integrated Novel Dimensions in Neurodevelopmental and Stress-Related Mental Disorders (MIND-SET): Protocol for a Cross-sectional Comorbidity Study From a Research Domain Criteria Perspective. JMIRX MED 2022; 3:e31269. [PMID: 37725542 PMCID: PMC10414459 DOI: 10.2196/31269] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/13/2021] [Accepted: 12/06/2021] [Indexed: 09/21/2023]
Abstract
BACKGROUND It is widely acknowledged that comorbidity between psychiatric disorders is common. Shared and diverse underpinnings of psychiatric disorders cannot be systematically understood based on symptom-based categories of mental disorders, which map poorly onto pathophysiological mechanisms. In the Measuring Integrated Novel Dimensions in Neurodevelopmental and Stress-Related Mental Disorders (MIND-SET) study, we make use of current concepts of comorbidity that transcend the current diagnostic categories. We test this approach to psychiatric problems in patients with frequently occurring psychiatric disorders and their comorbidities (excluding psychosis). OBJECTIVE The main aim of the MIND-SET project is to determine the shared and specific mechanisms of neurodevelopmental and stress-related psychiatric disorders at different observational levels. METHODS This is an observational cross-sectional study. Data from different observational levels as defined in the Research Domain Criteria (genetics, physiology, neuropsychology, system-level neuroimaging, behavior, self-report, and experimental neurocognitive paradigms) are collected over four time points. Included are adult (aged ≥18 years), nonpsychotic, psychiatric patients with a clinical diagnosis of a stress-related disorder (mood disorder, anxiety disorder, or substance use disorder) or a neurodevelopmental disorder (autism spectrum disorder or attention-deficit/hyperactivity disorder). Individuals with no current or past psychiatric diagnosis are included as neurotypical controls. Data collection started in June 2016 with the aim to include a total of 650 patients and 150 neurotypical controls by 2021. The data collection procedure includes online questionnaires and three subsequent sessions with (1) standardized clinical examination, physical examination, and blood sampling; (2) psychological constructs, neuropsychological tests, and biological marker sampling; and (3) neuroimaging measures. RESULTS We aim to include a total of 650 patients and 150 neurotypical control participants in the time period between 2016 and 2022. In October 2021, we are at 95% of our target. CONCLUSIONS The MIND-SET study enables us to investigate the mechanistic underpinnings of nonpsychotic psychiatric disorders transdiagnostically. We will identify both shared and disorder-specific markers at different observational levels that can be used as targets for future diagnostic and treatment approaches.
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Affiliation(s)
- Philip van Eijndhoven
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Rose Collard
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Janna Vrijsen
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Pro Persona Mental Health Care, Depression Expertise Centre, Nijmegen, Netherlands
| | - Dirk E M Geurts
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Alejandro Arias Vasquez
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Nijmegen Institute of Scientist-Practitioners in Addiction, Radboud University, Nijmegen, Netherlands
| | - Eva van den Munckhof
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Sophie Brolsma
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Fleur Duyser
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Annemiek Bergman
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Jasper van Oort
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Indira Tendolkar
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- LVR-Klinikum Essen, Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany
| | - Aart Schene
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
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Zhang M, Huang Y, Jiao J, Yuan D, Hu X, Yang P, Zhang R, Wen L, Situ M, Cai J, Sun X, Guo K, Huang X, Huang Y. Transdiagnostic symptom subtypes across autism spectrum disorders and attention deficit hyperactivity disorder: validated by measures of neurocognition and structural connectivity. BMC Psychiatry 2022; 22:102. [PMID: 35139813 PMCID: PMC8827180 DOI: 10.1186/s12888-022-03734-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUNDS Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders that exhibit within-disorder heterogeneity and cross-disorder phenotypic overlap, thus suggesting that the current disease categories may not fully represent the etiologic essence of the disorders, especially for highly comorbid neurodevelopmental disorders. In this study, we explored the subtypes of a combined sample of ASD and ADHD by integrating measurements of behavior, cognition and brain imaging. METHODS A total of 164 participants, including 65 with ASD, 47 with ADHD, and 52 controls, were recruited. Unsupervised machine learning with an agglomerative hierarchical clustering algorithm was used to identify transdiagnostic symptom clusters. Neurocognition and brain structural connectivity measurements were used to assess symptom clusters. Mediation analysis was used to explore the relationship between transdiagnostic symptoms, neurocognition and brain structural connectivity. RESULTS We identified three symptom clusters that did not fall within the diagnostic boundaries of DSM. External measurements from neurocognition and neuroimaging domains supported distinct profiles, including fine motor function, verbal fluency, and structural connectivity in the corpus callosum between these symptom clusters, highlighting possible biomarkers for ASD and ADHD. Additionally, fine motor function was shown to mediate the relationship between the corpus callosum and perseveration symptoms. CONCLUSIONS In this transdiagnostic study on ASD and ADHD, we identified three subtypes showing meaningful associations between symptoms, neurocognition and brain white matter structural connectivity. The fine motor function and structural connectivity of corpus callosum might be used as biomarkers for neurodevelopmental disorders with social skill symptoms. The results of this study highlighted the importance of precise phenotyping and further supported the effects of fine motor intervention on ASD and ADHD.
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Affiliation(s)
- Manxue Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jian Jiao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Danfeng Yuan
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao Hu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Pingyuan Yang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Rui Zhang
- University of Electronic Science and Technology of China, Chengdu, China
| | - Liangjian Wen
- University of Electronic Science and Technology of China, Chengdu, China
| | - Mingjing Situ
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jia Cai
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xueli Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Kuifang Guo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xia Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
- Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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Chu Y, Wu J, Wang D, Huang J, Li W, Zhang S, Ren H. Altered voxel-mirrored homotopic connectivity in right temporal lobe epilepsy as measured using resting-state fMRI and support vector machine analyses. Front Psychiatry 2022; 13:958294. [PMID: 35958657 PMCID: PMC9360423 DOI: 10.3389/fpsyt.2022.958294] [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: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Prior reports revealed abnormalities in voxel-mirrored homotopic connectivity (VMHC) when analyzing neuroimaging data from patients with various psychiatric conditions, including temporal lobe epilepsy (TLE). Whether these VHMC changes can be leveraged to aid in the diagnosis of right TLE (rTLE), however, remains to be established. This study was thus developed to examine abnormal VMHC findings associated with rTLE to determine whether these changes can be used to guide rTLE diagnosis. METHODS The resultant imaging data of resting-state functional MRI (rs-fMRI) analyses of 59 patients with rTLE and 60 normal control individuals were analyzed using VMHC and support vector machine (SVM) approaches. RESULTS Relative to normal controls, patients with rTLE were found to exhibit decreased VMHC values in the bilateral superior and the middle temporal pole (STP and MTP), the bilateral middle and inferior temporal gyri (MTG and ITG), and the bilateral orbital portion of the inferior frontal gyrus (OrbIFG). These patients further exhibited increases in VMHC values in the bilateral precentral gyrus (PreCG), the postcentral gyrus (PoCG), and the supplemental motor area (SMA). The ROC curve of MTG VMHC values showed a great diagnostic efficacy in the diagnosis of rTLE with AUCs, sensitivity, specificity, and optimum cutoff values of 0.819, 0.831, 0.717, and 0.465. These findings highlight the value of the right middle temporal gyrus (rMTG) when differentiating between rTLE and control individuals, with a corresponding SVM analysis yielding respective accuracy, sensitivity, and specificity values of 70.59% (84/119), 78.33% (47/60), and 69.49% (41/59). CONCLUSION In summary, patients with rTLE exhibit various forms of abnormal functional connectivity, and SVM analyses support the potential value of abnormal VMHC values as a neuroimaging biomarker that can aid in the diagnosis of this condition.
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Affiliation(s)
- Yongqiang Chu
- Department of Imaging Center, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, China.,Key Laboratory of Occupational Hazards and Identification, Wuhan University of Science and Technology, Wuhan, China
| | - Jun Wu
- Department of Neurosurgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Du Wang
- Department of Imaging Center, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Junli Huang
- Department of Imaging Center, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Li
- Department of Otolaryngology-Head and Neck Surgery, Wuhan Asia General Hospital, Wuhan, China
| | - Sheng Zhang
- Department of Psychiatry, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongwei Ren
- Department of Imaging Center, Tianyou Hospital, Affiliated to Wuhan University of Science and Technology, Wuhan, China
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Vaidya CJ, Klein C. Comorbidity of Attention-Deficit Hyperactivity Disorder and Autism Spectrum Disorders: Current Status and Promising Directions. Curr Top Behav Neurosci 2022; 57:159-177. [PMID: 35397063 DOI: 10.1007/7854_2022_334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
High rates of co-occurring Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) suggest common causal pathways, which await elucidation. What is well-established, however, is the negative impact of comorbid ADHD and ASD on outcomes for everyday living, particularly in social interaction and communication and on broader psychopathology. Neurocognitive approaches suggest correlates of comorbidity are rooted in functional connectivity networks associated with executive control. There is support for familial origins, with molecular-genetic studies suggesting a causal role of pleiotropic genes. Further investigation is needed to elucidate fully how genetic risk for ADHD and ASD affects neurodevelopment and to identify structural and functional neural correlates and their behavioral sequelae. Identification of intermediate phenotypes is necessary to advance understanding, which requires studies that include the full spectrum of ASD and ADHD symptom severity, use longitudinal designs and multivariate methods to probe broad constructs, such as executive and social function, and consider other sources of heterogeneity, such as age, sex, and other psychopathology. Randomized efficacy trials targeting comorbid symptomatology are needed to mitigate negative developmental outcomes.
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Affiliation(s)
- Chandan J Vaidya
- Department of Psychology, Georgetown University, Washington, DC, USA.
- Children's Research Institute, Children's National Health System, Washington, DC, USA.
| | - Christoph Klein
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece
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McKowen J, Woodward D, Yule AM, DiSalvo M, Rao V, Greenbaum J, Joshi G, Wilens TE. Characterizing autistic traits in treatment-seeking young adults with substance use disorders. Am J Addict 2021; 31:108-114. [PMID: 34957636 DOI: 10.1111/ajad.13247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/04/2021] [Accepted: 12/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent work highlights an increase in the overlap of autism spectrum disorder (ASD) and substance use disorder (SUD). Little is known about the presence of ASD symptoms in SUD-treatment-seeking populations. METHODS The informant-rated Social Responsiveness Scale-2 (SRS-2) was completed at intake to an outpatient SUD clinic for youth aged 16-26 (N = 69). Comparisons were made between those with elevated SRS-2 scores on demographic, psychiatric, and substance use variables. RESULTS Parents of sixty-nine patients with SUD completed the SRS-2. Fourteen (20%) (average age 18.7 ± 2.5) had elevated SRS-2 Total T-scores (≥66) and 55 (average age 18.1 ± 2.8) had non-clinical SRS-2 Total T-scores. There were few differences between groups; however, those with elevated SRS-2 Total T-scores were more likely to have a stimulant use disorder (odds ratio [OR] = 7.59, 95% confidence interval [CI] = 0.77, 101.88; p = 0.05) or an opioid use disorder (OR = 5.02, 95% CI = 0.59, 43.27; p = 0.08) than patients with normal SRS-2 Total T-scores as well as alcohol use in the week prior to intake. DISCUSSION AND CONCLUSIONS A significant proportion of treatment-seeking SUD outpatients suffer from clinically elevated autistic traits. These findings highlight the importance of assessing for autistic traits in SUD treatment settings yet additional research is needed to determine if these findings are specific to the presence of ASD or secondary to sequelae of specific SUD presentations. SCIENTIFIC SIGNIFICANCE This study is, to our knowledge, the first to have examined the prevalence, morbidity, or clinical characteristics, associated with ASD symptoms in a SUD-specific population.
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Affiliation(s)
- James McKowen
- Addiction Recovery Management Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Diana Woodward
- Addiction Recovery Management Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy M Yule
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Pharmacology and Adult ADHD, Boston, Massachusetts, USA
| | - Vinod Rao
- Addiction Recovery Management Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Julia Greenbaum
- Clinical and Research Programs in Pediatric Pharmacology and Adult ADHD, Boston, Massachusetts, USA
| | - Gagan Joshi
- Clinical and Research Programs in Pediatric Pharmacology and Adult ADHD, Boston, Massachusetts, USA
| | - Timothy E Wilens
- Addiction Recovery Management Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Clinical and Research Programs in Pediatric Pharmacology and Adult ADHD, Boston, Massachusetts, USA
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Testing the Stability and Validity of an Executive Dysfunction Classification Using Task-Based Assessment in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2021; 60:1501-1512. [PMID: 33346031 DOI: 10.1016/j.jaac.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/11/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE It is unclear if pediatric executive dysfunction assessed only with cognitive tasks predicts clinically relevant outcomes independently of psychiatric diagnoses. This study tested the stability and validity of a task-based classification of executive function. METHOD A total of 2,207 individuals (6-17 years old) from the Brazilian High-Risk Cohort Study participated in this study (1,930 at baseline, 1,532 at follow-up). Executive function was measured using tests of working memory and inhibitory control. Dichotomized age- and sex-standardized performances were used as input in latent class analysis and receiver operating curves to create an executive dysfunction classification (EDC). The study tested EDC's stability over time, association with symptoms, functional impairment, a polymorphism in the CADM2 gene, polygenic risk scores (PRS), and brain structure. Analyses covaried for age, sex, social class, IQ, and psychiatric diagnoses. RESULTS EDC at baseline predicted itself at follow-up (odds ratio [OR] = 5.11; 95% CI 3.41-7.64). Participants in the EDC reported symptoms spanning several domains of psychopathology and exhibited impairment in multiple settings, including more adverse school events (OR = 2.530; 95% CI 1.838-3.483). Children in the EDC presented higher attention-deficit/hyperactivity disorder and lower educational attainment PRS at baseline; higher schizophrenia PRS at follow-up; and lower chances of presenting a polymorphism in a gene previously linked to high performance in executive function (CADM2 gene). They also exhibited smaller intracranial volumes and smaller bilateral cortical surface areas in several brain regions. CONCLUSION Task-based executive dysfunction is associated with several validators, independently of psychiatric diagnoses and intelligence. Further refinement of task-based assessments might generate clinically useful tools.
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Boulton KA, Coghill D, Silove N, Pellicano E, Whitehouse AJO, Bellgrove MA, Rinehart NJ, Lah S, Redoblado‐Hodge M, Badawi N, Heussler H, Rogerson N, Burns J, Farrar MA, Nanan R, Novak I, Goldwater MB, Munro N, Togher L, Nassar N, Quinn P, Middeldorp CM, Guastella AJ. A national harmonised data collection network for neurodevelopmental disorders: A transdiagnostic assessment protocol for neurodevelopment, mental health, functioning and well-being. JCPP ADVANCES 2021; 1:e12048. [PMID: 37431407 PMCID: PMC10242941 DOI: 10.1002/jcv2.12048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background Children with neurodevelopmental disorders share common phenotypes, support needs and comorbidities. Such overlap suggests the value of transdiagnostic assessment pathways that contribute to knowledge about research and clinical needs of these children and their families. Despite this, large transdiagnostic data collection networks for neurodevelopmental disorders are not well developed. This paper describes the development of a nationally supported transdiagnostic clinical and research assessment protocol across Australia. The vision is to establish a harmonised network for data collection and collaboration that promotes transdiagnostic clinical practice and research. Methods Clinicians, researchers and community groups across Australia were consulted using surveys and national summits to identify assessment instruments and unmet needs. A national research committee was formed and, using a consensus approach, selected assessment instruments according to pre-determined criteria to form a harmonised transdiagnostic assessment protocol. Results Identified assessment instruments were clustered into domains of transdiagnostic assessment needs, which included child functioning/quality of life, child mental health, caregiver mental health, and family background information. From this, the research committee identified a core set of nine measures and an extended set of 14 measures that capture these domains with potential for further modifications as recommended by clinicians, researchers and community members. Conclusion The protocol proposed here was established through a strong partnership between clinicians, researchers and the community. It will enable (i) consensus driven transdiagnostic clinical assessments for children with neurodevelopmental disorders, and (ii) research studies that will inform large transdiagnostic datasets across neurodevelopmental disorders and that can be used to inform research and policy beyond narrow diagnostic groups. The long-term vision is to use this framework to facilitate collaboration across clinics to enable large-scale data collection and research. Ultimately, the transdiagnostic assessment data can be used to inform practice and improve the lives of children with neurodevelopmental disorders and their families.
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Amestoy A, Guillaud E, Bucchioni G, Zalla T, Umbricht D, Chatham C, Murtagh L, Houenou J, Delorme R, Moal MLL, Leboyer M, Bouvard M, Cazalets JR. Visual attention and inhibitory control in children, teenagers and adults with autism without intellectual disability: results of oculomotor tasks from a 2-year longitudinal follow-up study (InFoR). Mol Autism 2021; 12:71. [PMID: 34774105 PMCID: PMC8590241 DOI: 10.1186/s13229-021-00474-2] [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: 09/23/2020] [Accepted: 10/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inhibitory control and attention processing atypicalities are implicated in various diseases, including autism spectrum disorders (ASD). These cognitive functions can be tested by using visually guided saccade-based paradigms in children, adolescents and adults to determine the time course of such disorders. METHODS In this study, using Gap, Step, Overlap and Antisaccade tasks, we analyzed the oculomotor behavior of 82 children, teenagers and adults with high functioning ASD and their peer typically developing (TD) controls in a two-year follow-up study under the auspices of the InFoR-Autism project. Analysis of correlations between oculomotors task measurements and diagnostic assessment of attentional (ADHD-RS and ADHD comorbidity indices) and executive functioning (BRIEF scales) were conducted in order to evaluate their relationship with the oculomotor performance of participants with ASD. RESULTS As indicated by the presence of a Gap and Overlap effects in all age groups, the oculomotor performances of ASD participants showed a preserved capability in overt attention switching. In contrast, the difference in performances of ASD participants in the Antisaccade task, compared to their TD peers, indicated an atypical development of inhibition and executive functions. From correlation analysis between our oculomotor data and ADHD comorbidity index, and scores of attention and executive function difficulties, our findings support the hypothesis that a specific dysfunction of inhibition skills occurs in ASD participants that is independent of the presence of ADHD comorbidity. LIMITATIONS These include the relatively small sample size of the ASD group over the study's two-year period, the absence of an ADHD-only control group and the evaluation of a TD control group solely at the study's inception. CONCLUSIONS Children and teenagers with ASD have greater difficulty in attention switching and inhibiting prepotent stimuli. Adults with ASD can overcome these difficulties, but, similar to teenagers and children with ASD, they make more erroneous and anticipatory saccades and display a greater trial-to-trial variability in all oculomotor tasks compared to their peers. Our results are indicative of a developmental delay in the maturation of executive and attentional functioning in ASD and of a specific impairment in inhibitory control.
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Affiliation(s)
- Anouck Amestoy
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, 33000, Bordeaux, France. .,Fondation FondaMental, Créteil, France. .,centre hospitalier Charles-Perrens, Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, 121, rue de la Béchade, CS 81285, 33076, Bordeaux Cedex, France.
| | - Etienne Guillaud
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, 33000, Bordeaux, France
| | - Giulia Bucchioni
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, 33000, Bordeaux, France.,iBrain, UMR 1253 Inserm, Université de Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex, France
| | | | - Daniel Umbricht
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Christopher Chatham
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Lorraine Murtagh
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Josselin Houenou
- Fondation FondaMental, Créteil, France.,NeuroSpin, UNIACT Lab, Equipe de psychiatrie, Commissariat à l'énergie atomique, Saclay, Gif-sur-Yvette, France
| | - Richard Delorme
- Fondation FondaMental, Créteil, France.,Institut Pasteur, Paris, France.,AP-HP, DMU IMPACT, Psychiatry and Addictology Department, Mondor University Hospital, Université Paris Est Créteil, Créteil, France
| | - Myriam Ly-Le Moal
- Institut Roche, Tour horizons- Bureau 18M3, Roche S.A.S., 30, cours de l'île Seguin, 92650, Boulogne-Billancourt, France
| | - Marion Leboyer
- Laboratoire de NeuroPsychiatrie translationnelle, INSERM, U955, IMRB, Créteil, France.,Fondation FondaMental, Créteil, France.,AP-HP, DMU IMPACT, Psychiatry and Addictology Department, Mondor University Hospital, Université Paris Est Créteil, Créteil, France
| | - Manuel Bouvard
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, 33000, Bordeaux, France.,Fondation FondaMental, Créteil, France.,centre hospitalier Charles-Perrens, Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, 121, rue de la Béchade, CS 81285, 33076, Bordeaux Cedex, France
| | - Jean-René Cazalets
- CNRS, Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA, UMR 5287, Université de Bordeaux, 33000, Bordeaux, France
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Wang XH, Li L. A Unified Framework for Inattention Estimation From Resting State Phase Synchrony Using Machine Learning. Front Genet 2021; 12:728913. [PMID: 34630522 PMCID: PMC8495194 DOI: 10.3389/fgene.2021.728913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Inattention is one of the most significant clinical symptoms for evaluating attention deficit hyperactivity disorder (ADHD). Previous inattention estimations were performed using clinical scales. Recently, predictive models for inattention have been established for brain-behavior estimation using neuroimaging features. However, the performance of inattention estimation could be improved for conventional brain-behavior models with additional feature selection, machine learning algorithms, and validation procedures. This paper aimed to propose a unified framework for inattention estimation from resting state fMRI to improve the classical brain-behavior models. Phase synchrony was derived as raw features, which were selected with minimum-redundancy maximum-relevancy (mRMR) method. Six machine learning algorithms were applied as regression methods. 100 runs of 10-fold cross-validations were performed on the ADHD-200 datasets. The relevance vector machines (RVMs) based on the mRMR features for the brain-behavior models significantly improve the performance of inattention estimation. The mRMR-RVM models could achieve a total accuracy of 0.53. Furthermore, predictive patterns for inattention were discovered by the mRMR technique. We found that the bilateral subcortical-cerebellum networks exhibited the most predictive phase synchrony patterns for inattention. Together, an optimized strategy named mRMR-RVM for brain-behavior models was found for inattention estimation. The predictive patterns might help better understand the phase synchrony mechanisms for inattention.
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Affiliation(s)
- Xun-Heng Wang
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, China
| | - Lihua Li
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, China
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Cook KM, You X, Cherry JB, Merchant JS, Skapek M, Powers MD, Pugliese CE, Kenworthy L, Vaidya CJ. Neural correlates of schema-dependent episodic memory and association with behavioral flexibility in autism spectrum disorders and typical development. J Neurodev Disord 2021; 13:35. [PMID: 34525948 PMCID: PMC8442441 DOI: 10.1186/s11689-021-09388-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Conceptual knowledge frameworks termed schemas facilitate memory formation and are posited to support flexible behavior. In adults, the medial temporal lobe (MTL) and medial prefrontal cortex (mPFC) trade-off in supporting schema-based memory formation, such that encoding of subsequently remembered schema-congruent information relies on mPFC, whereas schema-incongruent information relies on MTL. Whether this is true in the immature brain and relates to behavioral flexibility is unknown. In this preliminary investigation, we aimed to replicate the adult findings in typically developing (TD) children and to investigate the relevance to behavioral flexibility by examining a disorder with pathognomonic behavioral rigidity, autism spectrum disorder (ASD). METHODS Children completed an associative subsequent memory paradigm, encoding object-scene pairs in an MRI scanner and subsequently completing a recognition test outside the scanner after a delay. Recognition performance was back sorted to construct remembered vs forgotten contrasts. One-way ANOVAS were conducted in MTL and mPFC masks for schema-congruency, followed by congruency by flexibility scores. Exploratory analyses were then conducted within the whole brain. RESULTS As reported in adults, episodic memory was strongest for schema-congruent object-scene pairs, followed by intermediate pairs, and lowest for schema-incongruent pairs in both TD and ASD groups. However, the trade-off between mPFC and MTL in TD children differed from adult reports such that mPFC supported memory for intermediate schema-congruency and left anterior MTL supported memory for schema-congruent pairs. In ASD, mPFC engagement interacted with flexibility such that activation supporting memory for intermediate schema-congruency varied with parent-reported flexibility and was higher in those with more flexible behavior. A similar interaction was also observed in both the left dorsolateral and rostrolateral PFC in whole-brain analysis. CONCLUSION Our findings provide the first preliminary evidence for the association of schema-based episodic memory formation and behavioral flexibility, an executive function impaired in multiple developmental disorders. Upon replication, this line of research holds promise for memory-based interventions addressing executive problems of behavioral rigidity.
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Affiliation(s)
- Kevin M Cook
- Interdisciplinary Program in Neuroscience, Georgetown University, 401 White-Gravenor, 37th and O Streets NW, Washington, DC, 20007, USA.
| | - Xiaozhen You
- Children's Research Institute, Children's National Health System, Washington, DC, 20010, USA
| | - Joseph Bradley Cherry
- Interdisciplinary Program in Neuroscience, Georgetown University, 401 White-Gravenor, 37th and O Streets NW, Washington, DC, 20007, USA
| | - Junaid S Merchant
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Mary Skapek
- University of Connecticut, Storrs, CT, 06269, USA
| | | | - Cara E Pugliese
- Children's Research Institute, Children's National Health System, Washington, DC, 20010, USA
| | - Lauren Kenworthy
- Children's Research Institute, Children's National Health System, Washington, DC, 20010, USA
| | - Chandan J Vaidya
- Children's Research Institute, Children's National Health System, Washington, DC, 20010, USA.
- Department of Psychology, Georgetown University, Washington, DC, 20007, USA.
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The Effect of Comorbid Attention-Deficit/Hyperactivity Disorder Symptoms on Face Memory in Children with Autism Spectrum Disorder: Insights from Transdiagnostic Profiles. Brain Sci 2021; 11:brainsci11070859. [PMID: 34203375 PMCID: PMC8301798 DOI: 10.3390/brainsci11070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/20/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
Face memory impairments are common but heterogeneous in autism spectrum disorder (ASD), which may be influenced by co-occurrence with attention-deficit/hyperactivity disorder (ADHD). Here, we aimed to investigate the phenotype change of face memory in children with ASD comorbid ADHD symptoms, and discuss the potential role of executive function (EF). Ninety-eight children were analyzed in the present study, including ASD- (ASD-only, n = 24), ADHD (n = 23), ASD+ (with ADHD symptoms, n = 23) and neurotypical controls (NTC, n = 28). All participants completed two tests: face encoding and retrieving task and Wisconsin Card Sorting Test (WCST) for measuring face memory and EF, respectively. Results revealed that: compared with the NTC group, children with ASD- exhibited lower accuracy in both face encoding and retrieving, and participants with ASD+ showed lower accuracy only in the retrieving, whereas no differences were found among participants with ADHD. Moreover, in the ASD+ group, face encoding performance was correlated with response perseverative errors (RPE) and failure to maintain sets (FMS) of WCST; significantly, there were no group differences between ASD+ and NTC in these two indices. The transdiagnostic profiles indicated that comorbid ADHD symptoms could modulate the face encoding deficiency of ASD, which may be partially compensated by EF. Shared and distinct intervention strategies to improve social cognition are recommended for children undergoing treatment for each condition.
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Agelink van Rentergem JA, Deserno MK, Geurts HM. Validation strategies for subtypes in psychiatry: A systematic review of research on autism spectrum disorder. Clin Psychol Rev 2021; 87:102033. [PMID: 33962352 DOI: 10.1016/j.cpr.2021.102033] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 12/11/2022]
Abstract
Heterogeneity within autism spectrum disorder (ASD) is recognized as a challenge to both biological and psychological research, as well as clinical practice. To reduce unexplained heterogeneity, subtyping techniques are often used to establish more homogeneous subtypes based on metrics of similarity and dissimilarity between people. We review the ASD literature to create a systematic overview of the subtyping procedures and subtype validation techniques that are used in this field. We conducted a systematic review of 156 articles (2001-June 2020) that subtyped participants (range N of studies = 17-20,658), of which some or all had an ASD diagnosis. We found a large diversity in (parametric and non-parametric) methods and (biological, psychological, demographic) variables used to establish subtypes. The majority of studies validated their subtype results using variables that were measured concurrently, but were not included in the subtyping procedure. Other investigations into subtypes' validity were rarer. In order to advance clinical research and the theoretical and clinical usefulness of identified subtypes, we propose a structured approach and present the SUbtyping VAlidation Checklist (SUVAC), a checklist for validating subtyping results.
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Affiliation(s)
- Joost A Agelink van Rentergem
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands.
| | - Marie K Deserno
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands
| | - Hilde M Geurts
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands; Dr. Leo Kannerhuis, the Netherlands
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Abstract
Cognitive and behavioural flexibility permit the appropriate adjustment of thoughts and behaviours in response to changing environmental demands. Brain mechanisms enabling flexibility have been examined using non-invasive neuroimaging and behavioural approaches in humans alongside pharmacological and lesion studies in animals. This work has identified large-scale functional brain networks encompassing lateral and orbital frontoparietal, midcingulo-insular and frontostriatal regions that support flexibility across the lifespan. Flexibility can be compromised in early-life neurodevelopmental disorders, clinical conditions that emerge during adolescence and late-life dementias. We critically evaluate evidence for the enhancement of flexibility through cognitive training, physical activity and bilingual experience.
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Affiliation(s)
- Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
- Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, USA.
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Crisci G, Caviola S, Cardillo R, Mammarella IC. Executive Functions in Neurodevelopmental Disorders: Comorbidity Overlaps Between Attention Deficit and Hyperactivity Disorder and Specific Learning Disorders. Front Hum Neurosci 2021; 15:594234. [PMID: 33732121 PMCID: PMC7958764 DOI: 10.3389/fnhum.2021.594234] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/13/2021] [Indexed: 11/29/2022] Open
Abstract
The present study examines the comorbidity between specific learning disorders (SLD) and attention deficit and hyperactivity disorder (ADHD) by comparing the neuropsychological profiles of children with and without this comorbidity. Ninety-seven schoolchildren from 8 to 14 years old were tested: a clinical sample of 49 children with ADHD (n = 18), SLD (n = 18) or SLD in comorbidity with ADHD (n = 13), and 48 typically-developing (TD) children matched for age and intelligence. Participants were administered tasks and questionnaires to confirm their initial diagnosis, and a battery of executive function (EF) tasks testing inhibition, shifting, and verbal and visuospatial updating. Using one-way ANOVAs, our results showed that all children in the clinical samples exhibited impairments on EF measures (inhibition and shifting tasks) when compared with TD children. A more specific pattern only emerged for the updating tasks. Only children with SLD had significant impairment in verbal updating, whereas children with ADHD, and those with SLD in comorbidity with ADHD, had the worst performance in visuospatial updating. The clinical and educational implications of these findings are discussed.
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Affiliation(s)
- Giulia Crisci
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Sara Caviola
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Ramona Cardillo
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Irene C. Mammarella
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
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Uddin LQ. Brain Mechanisms Supporting Flexible Cognition and Behavior in Adolescents With Autism Spectrum Disorder. Biol Psychiatry 2021; 89:172-183. [PMID: 32709415 PMCID: PMC7677208 DOI: 10.1016/j.biopsych.2020.05.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 02/08/2023]
Abstract
Cognitive flexibility enables appropriate responses to a changing environment and is associated with positive life outcomes. Adolescence, with its increased focus on transitioning to independent living, presents particular challenges for youths with autism spectrum disorder (ASD) who often struggle to behave in a flexible way when faced with challenges. This review focuses on brain mechanisms underlying the development of flexible cognition during adolescence and how these neural systems are affected in ASD. Neuroimaging studies of task switching and set-shifting provide evidence for atypical lateral frontoparietal and midcingulo-insular network activation during cognitive flexibility task performance in individuals with ASD. Recent work also examines how intrinsic brain network dynamics support flexible cognition. These dynamic functional connectivity studies provide evidence for alterations in the number of transitions between brain states, as well as hypervariability of functional connections in adolescents with ASD. Future directions for the field include addressing issues related to measurement of cognitive flexibility using a combination of metrics with ecological and construct validity. Heterogeneity of executive function ability in ASD must also be parsed to determine which individuals will benefit most from targeted training to improve flexibility. The influence of pubertal hormones on brain network development and cognitive maturation in adolescents with ASD is another area requiring further exploration. Finally, the intriguing possibility that bilingualism might be associated with preserved cognitive flexibility in ASD should be further examined. Addressing these open questions will be critical for future translational neuroscience investigations of cognitive and behavioral flexibility in adolescents with ASD.
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Affiliation(s)
- Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, and the Neuroscience Program, University of Miami Miller School of Medicine, Miami, Florida.
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Nigg JT, Sibley MH, Thapar A, Karalunas SL. Development of ADHD: Etiology, Heterogeneity, and Early Life Course. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2020; 2:559-583. [PMID: 34368774 PMCID: PMC8336725 DOI: 10.1146/annurev-devpsych-060320-093413] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
ADHD represents a powerful entry point for developmental approaches to psychopathology due to its major role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seem to have largely benign outcomes, while a larger group continue on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland OR, USA
| | - Margaret H Sibley
- University of Washington and Seattle Children's Research Institute, Seattle WA, USA
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