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Schmidt SL, da Silva Cunha B, Tolentino JC, Schmidt MJ, Schmidt GJ, Marinho AD, van Duinkerken E, Gjorup ALT, Landeira-Fernandez J, Mello CR, de Souza SP. Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:239. [PMID: 38397729 PMCID: PMC10887969 DOI: 10.3390/ijerph21020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.
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Affiliation(s)
- Sergio L. Schmidt
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Bruno da Silva Cunha
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Julio Cesar Tolentino
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Marcela J. Schmidt
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Guilherme J. Schmidt
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Alice D. Marinho
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Eelco van Duinkerken
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
- Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Ana Lucia Taboada Gjorup
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | | | - Carolina Ribeiro Mello
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
| | - Sarah Pini de Souza
- Post-Graduate Program, Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; (S.L.S.); (J.C.T.); (M.J.S.); (G.J.S.); (A.D.M.); (E.v.D.); (A.L.T.G.); (C.R.M.); (S.P.d.S.)
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Qian Q, Cai S, Zhang X, Huang J, Chen Y, Wang A, Zhang M. Seeing is believing: Larger Colavita effect in school-aged children with attention-deficit/hyperactivity disorder. J Exp Child Psychol 2024; 238:105798. [PMID: 37844345 DOI: 10.1016/j.jecp.2023.105798] [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: 05/04/2023] [Revised: 08/07/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that leads to visually relevant compensatory activities and cognitive strategies in children. Previous studies have identified difficulties with audiovisual integration in children with ADHD, but the characteristics of the visual dominance effect when processing multisensory stimuli are not clear in children with ADHD. The current study used the Colavita paradigm to explore the visual dominance effect in school-aged children with ADHD. The results found that, compared with typically developing children, children with ADHD had a higher proportion of "visual-auditory" trials and a lower proportion of "simultaneous" trials. The study also found that the proportion of visual-auditory trials in children with ADHD decreased as their Swanson, Nolan, and Pelham-IV rating scale (SNAP-IV) inattention scores increased. The results showed that school-aged children with ADHD had a larger Colavita effect, which decreased with the severity of inattentive symptoms. This may be due to an overreliance on visual information and an abnormal integration time window. The connection between multisensory cognitive processing performance and clinical symptoms found in the current study provides empirical and theoretical support for the knowledge base of multisensory and cognitive abilities in disorders.
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Affiliation(s)
- Qinyue Qian
- Department of Psychology, Soochow University, Suzhou, Jiangsu 215123, China; Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, Jiangsu 215123, China
| | - Shizhong Cai
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, China
| | - Xianghui Zhang
- Department of Psychology, Soochow University, Suzhou, Jiangsu 215123, China; Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, Jiangsu 215123, China
| | - Jie Huang
- Department of Psychology, Soochow University, Suzhou, Jiangsu 215123, China; Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, Jiangsu 215123, China
| | - Yan Chen
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou, Jiangsu 215003, China.
| | - Aijun Wang
- Department of Psychology, Soochow University, Suzhou, Jiangsu 215123, China; Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, Jiangsu 215123, China.
| | - Ming Zhang
- Department of Psychology, Soochow University, Suzhou, Jiangsu 215123, China; Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, Jiangsu 215123, China; Department of Psychology, Suzhou University of Science and Technology, Suzhou, Jiangsu 215011, China; Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama 700-8530, Japan.
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Taboada Gjorup AL, Tolentino Júnior JC, van Duinkerken E, Marques AC, do Carmo Filho A, Joaquim AM, Neves VV, Schmidt SL. Association between attention performance and the different dimensions of DSM-5 depression symptoms. Front Psychiatry 2023; 14:1291670. [PMID: 38179242 PMCID: PMC10765948 DOI: 10.3389/fpsyt.2023.1291670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
Objective Depressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and non-somatic clusters. However, the classification of the PHQ-9 item "concentration difficulties" into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions. Methods The participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms. Results After applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses. Conclusion The predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms.
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Affiliation(s)
- Ana Lucia Taboada Gjorup
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Julio César Tolentino Júnior
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Eelco van Duinkerken
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - André Casarsa Marques
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Aureo do Carmo Filho
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Alan Marques Joaquim
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Vithória Vidotti Neves
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Sergio Luis Schmidt
- Post-Graduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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Lin HY, Chiu EC, Hsieh HC, Wang PJ. Gender Differences in Auditory and Visual Attentional Performance in Children with and without ADHD. Arch Clin Neuropsychol 2023; 38:891-903. [PMID: 36796801 DOI: 10.1093/arclin/acad019] [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: 01/20/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Despite the relatively high prevalence of attention deficit hyperactivity disorder (ADHD), the impairment of ADHD in women is underestimated due to the different ways the phenomenon manifests compared to traditional male symptoms. In order to close the gender gap in diagnosis and treatment, this study aims to explore the impact of gender on auditory and visual attention in children with and without ADHD. METHOD A total of 220 children with and without ADHD participated in this study. Their auditory and visual attention performances were analyzed by comparative computerized auditory and visual subtests. RESULTS Auditory and visual attention performance in children with and without ADHD did affect by gender, including typically developing (TD) boys are better than TD girls at distinguishing visual targets from non-target stimuli. When performing attention tasks, TD girls generally maintained a cautious response, which was different from TD boys, who generally adopted positive response methods. ADHD girls suffered from more serious auditory inattention problems than ADHD boys; however, ADHD boys suffered from more auditory and visual impulsive problems than ADHD girls. The internal attention problems of female ADHD children were broader than that of their male ADHD peers and were also more severe, especially in problems of auditory omission and auditory response acuity. CONCLUSIONS ADHD children had a significant gap in auditory and visual attention performance compared to TD children. The research results support the impact of gender on the performance of auditory and visual attention in children with and without ADHD.
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Affiliation(s)
- Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
| | - En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan
| | - Pei-Jung Wang
- Department of Physical Therapy, Asia University, Taichung, Taiwan
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Negrini D, Schmidt SL. Comparing online and face-to-face administration of a neuropsychological computerized attention test: Assessment modality does not influence performance. Front Psychol 2023; 14:1134047. [PMID: 37179859 PMCID: PMC10169630 DOI: 10.3389/fpsyg.2023.1134047] [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: 12/29/2022] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
Background The cognitive impairment associated with the COVID-19 pandemic highlighted the need for teleneuropsychology (1). Moreover, neurologic diseases associated with mental deterioration usually require the use of the same neuropsychological instrument to assess cognitive changes across time. Therefore, in such cases, a learning effect upon retesting is not desired. Attention and its subdomains can be measured using Go/no-go tests, such as, the Continuous Visual Attention Test (CVAT). Here, we administered the CVAT to investigate the effect of modality (online vs. face-to-face) on attentional performance. The variables of the CVAT measures four attention domains: focused-attention, behavioral-inhibition, intrinsic-alertness (reaction time, RT), and sustained-attention (intra-individual variability of RTs, VRT). Methods The CVAT was applied face-to face and online in 130 adult Americans and 50 adult Brazilians. Three different study designs were used: (1) Between-subjects design: healthy Americans were tested face-to-face (n = 88) or online (n = 42). We verified if there were any differences between the two modalities. (2) Within-subjects design: Brazilians participants (n = 50) were tested twice (online and face-to-face). For each CVAT variable, repeated measures ANCOVAs were performed to verify whether modality or first vs. second tests differ. Agreement was analyzed using Kappa, intraclass correlation coefficients, and Bland-Altman plots. (3) Paired comparisons: we compared Americans vs. Brazilians, pairing subjects by age, sex, and level of education, grouping by modality. Results Assessment modality did not influence performance using two independent samples (between-subjects design) or the same individual tested twice (within-subjects design). The second test and the first test did not differ. Data indicated significant agreements for the VRT variable. Based on paired samples, Americans did not differ from Brazilians and a significant agreement was found for the VRT variable. Conclusion The CVAT can be administered online or face-to-face without learning upon retesting. The data on agreement (online vs. face-to-face, test vs. retest, Americans vs. Brazilians) indicate that VRT is the most reliable variable. Limitations High educational level of the participants and absence of a perfect balanced within-subjects design.
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Affiliation(s)
- Daniel Negrini
- Department of Anesthesiology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- School of Medicine, Fluminense Federal University, Niterói, Brazil
| | - Sergio L. Schmidt
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Liu H, Zhao X, Xue G, Chen C, Dong Q, Gao X, Yang L, Chen C. TTLL11 gene is associated with sustained attention performance and brain networks: A genome-wide association study of a healthy Chinese sample. GENES, BRAIN, AND BEHAVIOR 2023; 22:e12835. [PMID: 36511133 PMCID: PMC9994169 DOI: 10.1111/gbb.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
Genetic studies on attention have mainly focused on children with attention-deficit/hyperactivity disorder (ADHD), so little systematic research has been conducted on genetic correlates of attention performance and their potential brain mechanisms among healthy individuals. The current study included a genome-wide association study (GWAS, N = 1145 healthy young adults) aimed to identify genes associated with sustained attention and an imaging genetics study (an independent sample of 483 healthy young adults) to examine any identified genes' influences on brain function. The GWAS found that TTLL11 showed genome-wide significant associations with sustained attention, with rs13298112 as the most significant SNP and the GG homozygotes showing more impulsive but also more focused responses than the A allele carriers. A retrospective examination of previously published ADHD GWAS results confirmed an un-reported, small but statistically significant effect of TTLL11 on ADHD. The imaging genetics study replicated this association and showed that the TTLL11 gene was associated with resting state activity and connectivity of the somatomoter network, and can be predicted by dorsal attention network connectivity. Specifically, the GG homozygotes showed lower brain activity, weaker brain network connectivity, and non-significant brain-attention association compared to the A allele carriers. Expression database showed that expression of this gene is enriched in the brain and that the G allele is associated with lower expression level than the A allele. These results suggest that TTLL11 may play a major role in healthy individuals' attention performance and may also contribute to the etiology of ADHD.
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Affiliation(s)
- Hejun Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiaoyu Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Gui Xue
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Qi Dong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xuping Gao
- Child and Adolescent Mental Health Centre, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health (Peking University Sixth Hospital), Beijing, China
| | - Li Yang
- Child and Adolescent Mental Health Centre, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health (Peking University Sixth Hospital), Beijing, China
| | - Chunhui Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
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Zhou R, Dong P, Chen S, Qian A, Tao J, Zheng X, Cheng J, Yang C, Huang X, Wang M. The long-range white matter microstructural alterations in drug-naive children with ADHD: A tract-based spatial statistics study. Psychiatry Res Neuroimaging 2022; 327:111548. [PMID: 36279811 DOI: 10.1016/j.pscychresns.2022.111548] [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: 04/16/2022] [Revised: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND To investigate WM alterations, particularly the changes in long-range fibers, in drug-naive children with attention deficit hyperactivity disorder (ADHD), we conducted tract-based spatial statistics (TBSS) analysis on diffusion tensor imaging (DTI) data. MATERIALS AND METHODS In this study, 57 children with ADHD and 41 healthy controls (HCs) were enrolled. None of the enrolled ADHD children received any medication before data collection. WM changes were then correlated with clinical symptoms, including the hyperactivity index score and the impulsivity score. RESULTS ADHD children demonstrated decreased FA in the right forceps major, left inferior fronto-occipital fasciculus, and left genu Internal capsule. Moreover, higher RD was observed in the right forceps major, superior longitudinal fasciculus, and forceps major. The results of linear regression analysis including learning problem score, hyperactivity index score and impulsivity score showed that higher earning problem and hyperactivity/impulsivity symptom scores were negatively correlated with the mean FA value in the right forceps major, left IFOF and left genu Internal capsule. CONCLUSION Our results demonstrate that microstructural WM alterations and changes in the long-range WM connections are present in children with ADHD. We speculate that these changes may relate to the symptoms of hyperactivity and impulsivity.
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Affiliation(s)
- Ronghui Zhou
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Peng Dong
- Department of Radiology, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo University, Ningbo 315000, China
| | - Shuangli Chen
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Andan Qian
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jiejie Tao
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiangwu Zheng
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jingliang Cheng
- Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Chuang Yang
- Department of Mental Health, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqi Huang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
| | - Meihao Wang
- Department of Radiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Cho YJ, Yum JY, Kim K, Shin B, Eom H, Hong YJ, Heo J, Kim JJ, Lee HS, Kim E. Evaluating attention deficit hyperactivity disorder symptoms in children and adolescents through tracked head movements in a virtual reality classroom: The effect of social cues with different sensory modalities. Front Hum Neurosci 2022; 16:943478. [PMID: 35992945 PMCID: PMC9386071 DOI: 10.3389/fnhum.2022.943478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities. Methods Thirty-seven children and adolescents with (n = 20) and without (n = 17) ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test (VR-CPT) was conducted under four conditions: (1) control, (2) no-cue, (3) visual cue, and (4) visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions (pitch [head nods], yaw [head turns], and roll [lateral head inclinations]) using a head-mounted display (HMD) in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT. Results The magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control (HC) groups. Conclusion Children and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner.
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Affiliation(s)
- Yoon Jae Cho
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Yon Yum
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwanguk Kim
- Department of Computer Science, Hanyang University, Seoul, South Korea
| | - Bokyoung Shin
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yeon-ju Hong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiwoong Heo
- Department of Computer Science, Hanyang University, Seoul, South Korea
| | - Jae-jin Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunjoo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, South Korea
- *Correspondence: Eunjoo Kim,
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Negrini D, Wu A, Oba A, Harnke B, Ciancio N, Krause M, Clavijo C, Al-Musawi M, Linhares T, Fernandez-Bustamante A, Schmidt S. Incidence of Postoperative Cognitive Dysfunction Following Inhalational vs Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis. Neuropsychiatr Dis Treat 2022; 18:1455-1467. [PMID: 35874550 PMCID: PMC9296882 DOI: 10.2147/ndt.s374416] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/09/2022] [Indexed: 11/23/2022] Open
Abstract
Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, ie, evaluations up to 30 days postoperative, and neurocognitive disorder, ie, assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1913 articles yielded ten studies with a total of 3390 individuals. For the secondary objective, four studies with a total of 480 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.46 (95% CI = 0.26-0.81; p = 0.01), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Given the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.
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Affiliation(s)
- Daniel Negrini
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,Department of Anesthesiology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andrew Wu
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Atsushi Oba
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,Department of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ben Harnke
- Strauss Health Sciences Library, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Nicholas Ciancio
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Martin Krause
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Claudia Clavijo
- Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Mohammed Al-Musawi
- Department of Surgery-Division of Cardiothoracic Surgery, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Tatiana Linhares
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | - Sergio Schmidt
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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10
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Wang LJ, Lee SY, Tsai CS, Lee MJ, Chou MC, Kuo HC, Chou WJ. Validity of Visual and Auditory Attention Tests for Detecting ADHD. J Atten Disord 2021; 25:1160-1169. [PMID: 31777308 DOI: 10.1177/1087054719887433] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This investigation examines the discriminative validity of visual and auditory attention tests for differentiating patients with ADHD from healthy control participants. Method: A total of 107 ADHD patients and 58 healthy control participants were recruited. Visual and auditory attention profiles were obtained using the Conners' Continuous Performance Test 3rd Edition (CPT3) and Conners' Continuous Auditory Test of Attention (CATA), respectively. Results: We found that ADHD patients underperformed healthy controls on all CPT3 and CATA indexes, except Response Style and Hit Reaction Time. The CPT3, CATA, and CPT3 plus CATA all significantly differentiate ADHD patients and controls. CPT3 plus CATA had a greater sensitivity (82.6%), specificity (76%), positive predictive value (88.8%), negative predictive value (65.5%), and overall correct classification rate (80.6%) than CPT3 or CATA alone. Conclusion: Neuropsychological tests CPT3 and CATA provide objective information about cases of ADHD and should be used routinely for clinical assessment.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital.,Department of Psychiatry, College of Medicine, Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Min-Jing Lee
- Department of Child and Adolescent Psychiatry, Chiayi Chang Gung Memorial Hospital
| | - Miao-Chun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Ho-Chang Kuo
- Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
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11
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Simões EN, Carvalho ALN, Schmidt SL. The Role of Visual and Auditory Stimuli in Continuous Performance Tests: Differential Effects on Children With ADHD. J Atten Disord 2021; 25:53-62. [PMID: 29671360 DOI: 10.1177/1087054718769149] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Continuous performance tests (CPTs) usually utilize visual stimuli. A previous investigation showed that inattention is partially independent of modality, but response inhibition is modality-specific. Here we aimed to compare performance on visual and auditory CPTs in ADHD and in healthy controls. Method: The sample consisted of 160 elementary and high school students (43 ADHD, 117 controls). For each sensory modality, five variables were extracted: commission errors (CEs) and omission errors (OEs), reaction time (RT), variability of reaction time (VRT), and coefficient of variability (CofV = VRT / RT). Results: The ADHD group exhibited higher rates for all test variables. The discriminant analysis indicated that auditory OE was the most reliable variable for discriminating between groups, followed by visual CE, auditory CE, and auditory CofV. Discriminant equation classified ADHD with 76.3% accuracy. Conclusion: Auditory parameters in the inattention domain (OE and VRT) can discriminate ADHD from controls. For the hyperactive/impulsive domain (CE), the two modalities are equally important.
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12
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Schmidt GJ, Boechat YEM, van Duinkerken E, Schmidt JJ, Moreira TB, Nicaretta DH, Schmidt SL. Detection of Cognitive Dysfunction in Elderly with a Low Educational Level Using a Reaction-Time Attention Task. J Alzheimers Dis 2020; 78:1197-1205. [DOI: 10.3233/jad-200881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Scales for cognitive deterioration usually depend on education level. Objective: We aimed to study the clinical utility of a culture-free Go/No-Go task in a multi-ethnic cohort with low education level. Methods: Sixty-four participants with less than 4 years of formal education were included and divided on the basis of their Clinical-Dementia-Rate scores (CDR) into cognitively unimpaired (CDR = 0), mild cognitive impairment (MCI; CDR = 0.5), and early Alzheimer’s disease (AD, CDR = 1). All underwent a 90-s Continuous Visual Attention Test. This test consisted of a 90-s Go/No-go task with 72 (80%) targets and 18 (20%) non-targets. For each participant, reaction times and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors were evaluated. Coefficient of variability was calculated for each participant by dividing the standard deviation of the reaction times by the mean reaction time. A MANCOVA was performed to examine between-group differences using age and sex as covariates. Discriminate analysis was performed to find the most reliable test-variable to discriminate the three groups. Results: Commission error, intraindividual variability of reaction time, and coefficient of variability progressively worsened with increasing CDR level. Discriminant analysis demonstrated that coefficient of variability was the best discriminant factor, followed by intraindividual variability of reaction time and commission error. Conclusion: The Go/No-Go task was able to discriminate people with MCI or early AD from controls in the setting of illiteracy.
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Affiliation(s)
- Guilherme J. Schmidt
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Yolanda Eliza Moreira Boechat
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Geriatrics, Fluminense Federal University, Niteroi, Brazil
| | - Eelco van Duinkerken
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Juliana J. Schmidt
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tayssa B. Moreira
- Department of Geriatrics, Fluminense Federal University, Niteroi, Brazil
| | - Denise H. Nicaretta
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sergio L. Schmidt
- Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil
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13
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Elbaum T, Braw Y, Lev A, Rassovsky Y. Attention-Deficit/Hyperactivity Disorder (ADHD): Integrating the MOXO-dCPT with an Eye Tracker Enhances Diagnostic Precision. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6386. [PMID: 33182303 PMCID: PMC7664925 DOI: 10.3390/s20216386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022]
Abstract
Clinical decision-making may be enhanced when combining psychophysiological sensors with computerized neuropsychological tests. The current study explored the utility of integrating an eye tracker with a commercially available continuous performance test (CPT), the MOXO-dCPT. As part of the study, the performance of adult attention-deficit/hyperactivity disorder (ADHD) patients and healthy controls (n = 43, n = 42, respectively) was compared in the integrated system. More specifically, the MOXO-dCPT has four stages, which differ in their combinations of ecological visual and auditory dynamic distractors. By exploring the participants' performance in each of the stages, we were able to show that: (a) ADHD patients spend significantly more time gazing at irrelevant areas of interest (AOIs) compared to healthy controls; (b) visual distractors are particularly effective in impacting ADHD patients' eye movements, suggesting their enhanced utility in diagnostic procedures; (c) combining gaze direction data and conventional CPT indices enhances group prediction, compared to the sole use of conventional indices. Overall, the findings indicate the utility of eye tracker-integrated CPTs and their enhanced diagnostic precision. They also suggest that the use of attention-grabbing visual distractors may be a promising path for the evolution of existing CPTs by shortening their duration and enhancing diagnostic precision.
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Affiliation(s)
- Tomer Elbaum
- Department of Industrial Engineering and Management, Ariel University, Ariel 40700, Israel;
| | - Yoram Braw
- Department of Psychology, Ariel University, Ariel 40700, Israel
| | - Astar Lev
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; (A.L.); or (Y.R.)
| | - Yuri Rassovsky
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; (A.L.); or (Y.R.)
- Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
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14
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The role of event rate, temporal expectancy, and sensory modality in continuous performance of children and adults. Atten Percept Psychophys 2020; 82:3931-3944. [PMID: 32935293 DOI: 10.3758/s13414-020-02126-8] [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: 11/08/2022]
Abstract
This study explored developmental differences in the effects of event rate, temporal expectancy, and sensory modality on continuous performance. Children (ages 7-8 years) and college-aged adults completed visual and auditory continuous performance tasks (CPTs) that were equated at an intermediate (20 events/min) rate using the perceptual sensitivity index (d') and then were compared at faster (40 events/min) and slower (10 events/min) rates to determine the influence of event rate on continuous performance of children and adults. To investigate the effects of temporal expectancy, 20% of the critical signals and neutral events occurred early or late relative to the regular rhythm of the task. The findings (a) suggest that event rate influences continuous performance differently for children and adults, (b) highlight the role of temporal expectancy in continuous performance, and (c) reveal differences in the effects of event rate and temporal expectancy on visual and auditory continuous performance.
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15
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Rostami M, Khosrowabadi R, Albrecht B, Pouretemad H, Rothenberger A. ADHD subtypes: Do they hold beyond core symptoms? A multilevel testing of an additive model. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:280-290. [DOI: 10.1080/21622965.2020.1806067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohammad Rostami
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Björn Albrecht
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Centers of Göttingen, Göttingen, Germany
| | - Hamidreza Pouretemad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Centers of Göttingen, Göttingen, Germany
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16
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Schmidt SL, Schmidt GJ, Padilla CS, Simões EN, Tolentino JC, Barroso PR, Narciso JH, Godoy ES, Costa Filho RL. Decrease in Attentional Performance After Repeated Bouts of High Intensity Exercise in Association-Football Referees and Assistant Referees. Front Psychol 2019; 10:2014. [PMID: 31555185 PMCID: PMC6742921 DOI: 10.3389/fpsyg.2019.02014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/19/2019] [Indexed: 12/19/2022] Open
Abstract
Referees and assistant referees are submitted to high physical stress during matches. Pressure to make decisions in front of large crowds is another potential stressor. These two stressors can impair attention executive control, depending on physical fitness and individual vulnerability or resilience to situational pressure. Error percentage for referees and assistants may reach around 14% during a soccer match. Although previous studies have suggested that soccer referees and assistants should take cognitive assessments, they are only required by Fédération Internationale de Football Association (FIFA) to demonstrate knowledge of the rules and pass annually in a fitness test (FIFA-Test). This study aimed to assess attention performance in referees and assistants before and after the mandatory FIFA-Test. It is hypothesized that the high physical demands associated with the pressure to pass the FIFA-Test would interfere with attention performance. The sample included 33 referees and 20 assistants. The Continuous Visual Attention Test (CVAT) consisted of a 15-min Go/No-go task. Performance in the CVAT is based on four variables: omission and commission errors, reaction time, and variability of reaction time (VRT). Failure in the CVAT was defined by a performance below the 5th percentile of the age- and sex-matched normative data in at least one variable of the CVAT. Before the FIFA-Test all participants performed the CVAT. The second CVAT began 3-7 min directly following completion of the FIFA-test. Considering only the officials who passed both the FIFA-Test and the first CVAT (19 referees and 15 assistants), 44% (9 referees and 6 assistants) exhibited a performance decline in the second CVAT. A significant increase in VRT was found after the high intensity exercise. As increase in VRT is thought to reflect executive dysfunctions and lapses of attention, we concluded that physical fitness alone may not be enough to help officials cope with the physical and contextual stresses associated with the FIFA-Test. These data suggest that over 35% of soccer referees and their assistants who were considered physically able to referee matches may not be mentally prepared for the attentional demands of refereeing soccer matches.
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Affiliation(s)
- Sergio L. Schmidt
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Eunice N. Simões
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julio C. Tolentino
- Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo R. Barroso
- Federation of Football-Association of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge H. Narciso
- Federation of Football-Association of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erik S. Godoy
- Federation of Football-Association of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rubens L. Costa Filho
- Federation of Football-Association of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Schmidt SL, Santos da Silva M, Schmidt JJ, Carvalho ALN, Vasconcelos CCF, Paes RA, Boechat YE, Neder R, Alvarenga RP. Neuropsychiatric assessments in patients with multiple sclerosis in early phases and with low disability. Neuropsychiatr Dis Treat 2018; 14:1665-1670. [PMID: 29950848 PMCID: PMC6018925 DOI: 10.2147/ndt.s163480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In the early phases of multiple sclerosis (MS), patients exhibit slight neuropsychiatric deficits that can only be detected using reliable tools. AIM The present investigation aimed to examine neuropsychological performance in 35 patients with incipient MS. PATIENTS AND METHODS For the MS group, the inclusion criteria included time of disease <3 years and low disability. The neuropsychological battery consisted of Rey Auditory Learning Test, Controlled Oral Word Association Test, Hooper Visual Organization Test, and Symbol Digit Modalities Test (SDMT). RESULTS After correction for the educational level, no significant effect of MS on performance was found for all the tests except for the number of errors of the SDMT (NE-SDMT). Higher levels of education were associated with better performances in all tests, except for the NE-SDMT. MS patients made more errors than the controls. CONCLUSION The effect on the NE-SDMT may reflect difficulties in the ability to inhibit inadequate responses. Patients may exhibit impulsive control disorders in incipient MS, independent of their educational level.
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Affiliation(s)
- Sergio L Schmidt
- Department of Neurophysiology, State University of Rio de Janeiro, RJ, Brazil.,Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | | | - Juliana J Schmidt
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | | | | | - Renata Alves Paes
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | - Yolanda Em Boechat
- Department of Internal Medicine, Fluminense Federal University, Niteroi, Brazil
| | - Rafael Neder
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
| | - Regina P Alvarenga
- Neurology Department, Federal University of the State of Rio de Janeiro, RJ, Brazil
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18
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Simões EN, Padilla CS, Bezerra MS, Schmidt SL. Analysis of Attention Subdomains in Obstructive Sleep Apnea Patients. Front Psychiatry 2018; 9:435. [PMID: 30337887 PMCID: PMC6180239 DOI: 10.3389/fpsyt.2018.00435] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/23/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Obstructive sleep apnea (OSA) is characterized by apnea-hypopnea during sleep. Overnight polysomnography (PSG) is usually used to detect the frequency of apneic and hypopneic events. Attention and executive deficits are commonly reported in OSA patients. Previous investigations suggested that cognitive impairments were dependent on attention deficits. However, attention is not a unitary domain and consists of different subdomains such as alertness, sustained attention, focused attention, and executive attention (impulsivity/hyperactivity). Little is known about the attention subdomains affected in OSA. Attention is commonly assessed using continuous performance tests, such as the continuous visual attention test (CVAT). Distinct variables can be derived from the CVAT. Each CVAT variable is associated with a specific attention subdomain. Objective: This study aimed to examine the variables of the CVAT that are affected by OSA and to identify the most reliable CVAT variable that distinguishes OSA from controls via discriminant analysis. Method: Patients scheduled to perform a PSG were invited to participate in this study. Immediately before the PSG, they performed the CVAT. Based on the PSG results, 27 treatment-naïve OSA patients were sampled. The same number of healthy controls were selected to match the two groups by age and gender. Five CVAT variables were examined: commission errors, omission errors, reaction time (RT), variability of reaction time (VRT), and coefficient of variability (VRT/RT). Results: ANCOVAs indicated that RT and VRT were affected by OSA. No difference in accuracy (omission and commission errors) was observed between healthy controls and OSA patients. When the VRT measurements were corrected for their respective RT values (VRT/RT), the mean difference on this coefficient did not reach significance. The discriminant analysis indicated that the two groups could be best differentiated by the RT variable. Conclusions: Attention problems, commonly observed in OSA patients, may reflect a primary problem on the alertness subdomain. The CVAT was able to detect the primary (alertness-RT parameter) and the secondary deficits (sustained attention-VRT parameter) associated with OSA. As there is no learning effect in the condition of retests, the CVAT can be used to assess the cognitive recovery in OSA patients during treatment.
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Affiliation(s)
- Eunice N Simões
- Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Catarina S Padilla
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Sergio L Schmidt
- Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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19
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Schmidt SL, Carvaho ALN, Simoes EN. Effect of handedness on auditory attentional performance in ADHD students. Neuropsychiatr Dis Treat 2017; 13:2921-2924. [PMID: 29238197 PMCID: PMC5716334 DOI: 10.2147/ndt.s149454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The relationship between handedness and attentional performance is poorly understood. Continuous performance tests (CPTs) using visual stimuli are commonly used to assess subjects suffering from attention deficit hyperactivity disorder (ADHD). However, auditory CPTs are considered more useful than visual ones to evaluate classroom attentional problems. A previous study reported that there was a significant effect of handedness on students' performance on a visual CPT. Here, we examined whether handedness would also affect CPT performance using only auditory stimuli. From an initial sample of 337 students, 11 matched pairs were selected. Repeated ANOVAs showed a significant effect of handedness on attentional performance that was exhibited even in the control group. Left-handers made more commission errors than right-handers. The results were interpreted considering that the association between ADHD and handedness reflects that consistent left-handers are less lateralized and have decreased interhemispheric connections. Auditory attentional data suggest that left-handers have problems in the impulsive/hyperactivity domain. In ADHD, clinical therapeutics and rehabilitation must take handedness into account because consistent sinistrals are more impulsive than dextrals.
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Affiliation(s)
- Sergio L Schmidt
- Department of Neurophysiology, State University of Rio de Janeiro, Rio de Janeiro.,Neurology Department, Federal University of the State of Rio de Janeiro, Rio de Janeiro
| | | | - Eunice N Simoes
- Neurology Department, Federal University of the State of Rio de Janeiro, Rio de Janeiro
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