Color naming deficits and attention-deficit/hyperactivity disorder: a retinal dopaminergic hypothesis

Evaluation of electroretinography (ERG) parameters as a biomarker for ADHD

BACKGROUND

The retina is recognized as an accessible part of the brain due to their common embryonic origin. The electroretinogram (ERG) has proven to be a valuable tool for detecting schizophrenia and bipolarity. We therefore investigated its ability to detect ADHD.

METHODS

The cone and rod luminance response functions of the ERG were recorded in 26 ADHD subjects (17 women and 9 men) and 25 controls (16 women and 9 men).

RESULTS

No significant differences were found between the mixed groups, but sexual dysmorphia was observed in the significant results. In males, a significant prolonged cone a-wave latency was observed in the ADHD group. In females, we observed a significant decrease in the cone a- and b-wave amplitudes and a trend for a prolonged cone b-wave latency as well as a higher scotopic mixed rod-cone a-wave in the ADHD group.

CONCLUSION

The data obtained in this study show the potential of the ERG to detect ADHD, warranting further large-scale studies.

Elimination of the color discrimination impairment along the blue-yellow axis in patients with hypothyroidism after treatment with levothyroxine as assessed by the Farnsworth-Munsell 100 hue test

Our previous study has shown that individuals with untreated hypothyroidism display significantly higher partial error scores (P E S) along the blue-yellow axis compared to the red-green axis than normal individuals using the Farnsworth-Munsell 100 hue test [J. Opt. Soc. Am. A37, A18 (2020)JOAOD60740-323210.1364/JOSAA.382390]. We wished to determine how color discrimination may change when hypothyroidism has been treated to the point of euthyroidism. Color discrimination was reassessed for 17 female individuals who had undergone treatment for hypothyroidism, and the results were compared with 22 female individuals without thyroid dysfunction. No statistically significant difference was found in the total error score (T E S) for the first and second measurements for both groups (p>0.45). The P E S for the hypothyroid group improved significantly in the previously impaired color regions after the treatment. Color discrimination defects found in untreated hypothyroidism can be negated with treatment of the condition over an appropriate time period.

Collagen VI deficiency causes behavioral abnormalities and cortical dopaminergic dysfunction

Mutations of genes coding for Collagen VI (COL6) cause muscle diseases, including Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy (BM). Although more recently COL6 genetic variants were linked to brain pathologies, the impact of COL6 deficiency in brain function is still largely unknown. Here, a thorough behavioral characterization of COL6 null (Col6a1-/-) mice unexpectedly revealed that COL6 deficiency leads to a significant impairment in sensorimotor gating and memory/attention functions. In keeping with these behavioral abnormalities, Col6a1-/- mice displayed alterations in dopaminergic signalling, primarily in the prefrontal cortex (PFC). In vitro co-culture of SH-SY5Y neural cells with primary meningeal fibroblasts from wild-type and Col6a1-/- mice confirmed a direct link between COL6 ablation and defective dopaminergic activity, through a mechanism involving the inability of meningeal cells to sustain dopaminergic differentiation. Finally, patients affected by COL6-related myopathies were evaluated with an ad hoc neuropsychological protocol, revealing distinctive defects in attentional control abilities. Altogether, these findings point at a novel role for COL6 in the proper maintenance of dopamine circuitry function and its related neurobehavioral features in both mice and humans.

Assessment of Optical Coherence Tomography Findings in Adults with Attention Deficit Hyperactivity Disorder: A Case-Control Study

Background

To assess retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness using optical coherence tomography in attention deficit hyperactivity disorder adults on regular methylphenidate treatment, comparing them to healthy controls.

Methods

A total of 33 attention deficit hyperactivity disorder adults and 31 healthy subjects, matched for age, gender, and education (control group), were included in this study. Retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness of both eyes were measured using optical coherence tomography, and symptom severity was evaluated using Adult Attention Deficit Hyperactivity Disorder Self-Report Scale and Wender Utah Rating Scale.

Results

There was no significant difference in retinal nerve fiber layer thickness between the attention deficit hyperactivity disorder and control groups (P > .05). Thinner ganglion cell-inner plexiform layer total (P = .044), inferior (P = .012), and inferior nasal quadrant thickness (P = .049) were observed in attention deficit hyperactivity disorder patients as compared to the controls.

Conclusion

Findings detected thinner ganglion cell-inner plexiform layer in some quadrants of attention deficit hyperactivity disorder adults, indicating an early disorder in retinal structure development. Whether retinal structures are sensitive attention deficit hyperactivity disorder biomarkers should be supported and investigated in future multimodal studies.

Is contrast sensitivity a physiological marker in attention-deficit hyperactivity disorder?

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset psychiatric disorders. Although the etiology is complex and has not yet been clarified, dopamine is thought to play a role in the etiology. Methylphenidate (MPH) is a psychostimulant drug used as first-line treatment for ADHD and it inhibits dopamine and norepinephrine reuptake transporters. Dopamine also has an effect on retina and contrast sensitivity. Despite evidence indicating the effects of dopamine on contrast sensitivity, the results of studies examining contrast sensitivity in ADHD patients are inconsistent. Also, no studies have been encountered examining the possible effect of MPH on contrast sensitivity. The hypotheses of this study are that children with ADHD who have not used MPH will have lower contrast sensitivity levels than the members of the control group, that contrast sensitivity levels increase after the use of MPH, and that contrast sensitivity is a potential physiological marker for ADHD. The study was conducted with 30 children with ADHD and 30 children without ADHD. Psychiatric evaluations of the participants were conducted with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime-Turkish version, Conner's Parent Rating Scale-Revised Short form and the Turgay DSM-IV-based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Photopic contrast sensitivity was measured using the Functional Acuity Contrast Test (FACT). Results showed that FACT mean values of the control group were significantly higher than those of the ADHD group (pre-treatment) in all spatial frequencies. In four spatial frequencies (CPD 1.5, 3, 12 and 18), the FACT mean values of the control group were significantly higher than the ADHD group (during the OROS-MPH treatment). At all spatial frequencies, the mean values of the ADHD group during the OROS-MPH treatment were significantly higher than before the OROS-MPH treatment. In conclusion, the present study showed that contrast sensitivity is low in children with ADHD and increases significantly after OROS-MPH medication, but still did not reach the levels of the children without ADHD. Our findings suggest that contrast sensitivity may be a potential physiological marker in ADHD.

Color discrimination assessment in patients with hypothyroidism using the Farnsworth-Munsell 100 hue test

There is evidence in the literature that hypofunction of the thyroid gland (hypothyroidism) affects color vision in rodents by influencing the production of the visual pigment opsin. The effect of hypothyroidism on color vision in humans has not been examined in any great detail. In this cross-sectional study we evaluated color discrimination using the Farnsworth-Munsell 100 hue test (FM-100 test) in 25 individuals with pre-treatment hypothyroidism (mean age ${38}\;{\pm }\;{9}.{2}\;\text{yr}$38±9.2yr), and a control euthyroid group, ${ n} ={26}$n=26 (mean age ${39.6}\;{\pm }\;{8}.{4}\;\text{yr}$39.6±8.4yr). There was no statistically significant difference in the total error score ($\surd{\text{TES}}$√TES) between the groups, but the hypothyroid group had a significantly greater partial error score ($\surd{\text{PES}}$√PES) along the blue-yellow (B-Y) axis compared to the red-green (R-G) axis. No statistically significant differences in B-Y and R-G PES were observed in the control group. This study shows that hypothyroidism affects color vision in humans, causing significant impairment in the B-Y color subsystem.

Attentional blink and putative noninvasive dopamine markers: Two experiments to consolidate possible associations

Adaptive behavioral control involves a balance between top-down persistence and flexible updating of goals under changing demands. According to the metacontrol state model (MSM), this balance emerges from the interaction between the frontal and the striatal dopaminergic system. The attentional blink (AB) task has been argued to tap into the interaction between persistence and flexibility, as it reflects overpersistence—the too-exclusive allocation of attentional resources to the processing of the first of two consecutive targets. Notably, previous studies are inconclusive about the association between the AB and noninvasive proxies of dopamine including the spontaneous eye blink rate (sEBR), which allegedly assesses striatal dopamine levels. We aimed to substantiate and extend previous attempts to predict individual sizes of the AB in two separate experiments with larger sample sizes (N = 71 & N = 65) by means of noninvasive behavioral and physiological proxies of dopamine (DA), such as sEBR and mood measures, which are likely to reflect striatal dopamine levels, and color discrimination, which has been argued to tap into the frontal dopamine levels. Our findings did not confirm the prediction that AB size covaries with sEBR, mood, or color discrimination. The implications of this inconsistency with previous observations are discussed.

Evaluation of potential health effects associated with occupational and environmental exposure to styrene - an update

The potential chronic health risks of occupational and environmental exposure to styrene were evaluated to update health hazard and exposure information developed since the Harvard Center for Risk Analysis risk assessment for styrene was performed in 2002. The updated hazard assessment of styrene's health effects indicates human cancers and ototoxicity remain potential concerns. However, mechanistic research on mouse lung tumors demonstrates these tumors are mouse-specific and of low relevance to human cancer risk. The updated toxicity database supports toxicity reference levels of 20 ppm (equates to 400 mg urinary metabolites mandelic acid + phenylglyoxylic acid/g creatinine) for worker inhalation exposure and 3.7 ppm and 2.5 mg/kg bw/day, respectively, for general population inhalation and oral exposure. No cancer risk value estimates are proposed given the established lack of relevance of mouse lung tumors and inconsistent epidemiology evidence. The updated exposure assessment supports inhalation and ingestion routes as important. The updated risk assessment found estimated risks within acceptable ranges for all age groups of the general population and workers with occupational exposures in non-fiber-reinforced polymer composites industries and fiber-reinforced polymer composites (FRP) workers using closed-mold operations or open-mold operations with respiratory protection. Only FRP workers using open-mold operations not using respiratory protection have risk exceedances for styrene and should be considered for risk management measures. In addition, given the reported interaction of styrene exposure with noise, noise reduction to sustain levels below 85 dB(A) needs be in place.

A Low-Level Perceptual Correlate of Behavioral and Clinical Deficits in ADHD

In many studies of attention-deficit hyperactivity disorder (ADHD), stimulus encoding and processing (perceptual function) and response selection (executive function) have been intertwined. To dissociate deficits in these functions, we introduced a task that parametrically varied low-level stimulus features (orientation and color) for fine-grained analysis of perceptual function. It also required participants to switch their attention between feature dimensions on a trial-by-trial basis, thus taxing executive processes. Furthermore, we used a response paradigm that captured task-irrelevant motor output (TIMO), reflecting failures to use the correct stimulus-response rule. ADHD participants had substantially higher perceptual variability than controls, especially for orientation, as well as higher TIMO. In both ADHD and controls, TIMO was strongly affected by the switch manipulation. Across participants, the perceptual variability parameter was correlated with TIMO, suggesting that perceptual deficits are associated with executive function deficits. Based on perceptual variability alone, we were able to classify participants into ADHD and controls with a mean accuracy of about 77%. Participants' self-reported General Executive Composite score correlated not only with TIMO but also with the perceptual variability parameter. Our results highlight the role of perceptual deficits in ADHD and the usefulness of computational modeling of behavior in dissociating perceptual from executive processes.

Naming speed as a predictive diagnostic measure in reading and attentional problems

This study aimed to describe and compare naming speed abilities in children diagnosed with either Reading Learning Difficulties (RLD) or Attention Deficit/Hyperactivity Disorder (ADHD), or comorbidity for both (ADHD+RLD). To examine the explanatory power of naming speed and ADHD symptomatology in predicting group associations (while controlling for gender and age), the "Rapid Automatized Naming and Rapid Alternating Stimulus Tests" (RAN/RAS) were utilized. A sample of 101 children (age range = 5-16 years) was divided into four groups: RLD (n = 14), ADHD (n = 28), comorbid (n = 19), and control (n = 40). There were statistically significant differences in RAN/RAS results among the diagnostic groups. Moreover, discriminant analysis revealed that naming speed tasks significantly predicted reading and attentional problems, especially at earlier ages. These results demonstrate the potential usefulness of RAN/RAS in the diagnosis of reading and attentional problems, particularly if the children are aged from 5 to 9.

Revisiting the co-existence of Attention-Deficit/Hyperactivity Disorder and Chronic Tic Disorder in childhood-The case of colour discrimination, sustained attention and interference control

Objective

Attention Deficit / Hyperactivity Disorder (ADHD) and Chronic Tic Disorder (CTD) are two common and frequently co-existing disorders, probably following an additive model. But this is not yet clear for the basic sensory function of colour processing sensitive to dopaminergic functioning in the retina and higher cognitive functions like attention and interference control. The latter two reflect important aspects for psychoeducation and behavioural treatment approaches.

Methods

Colour discrimination using the Farnsworth-Munsell 100-hue Test, sustained attention during the Frankfurt Attention Inventory (FAIR), and interference liability during Colour- and Counting-Stroop-Tests were assessed to further clarify the cognitive profile of the co-existence of ADHD and CTD. Altogether 69 children were classified into four groups: ADHD (N = 14), CTD (N = 20), ADHD+CTD (N = 20) and healthy Controls (N = 15) and compared in cognitive functioning in a 2×2-factorial statistical model.

Results

Difficulties with colour discrimination were associated with both ADHD and CTD factors following an additive model, but in ADHD these difficulties tended to be more pronounced on the blue-yellow axis. Attention problems were characteristic for ADHD but not CTD. Interference load was significant in both Colour- and Counting-Stroop-Tests and unrelated to colour discrimination. Compared to Controls, interference load in the Colour-Stroop was higher in pure ADHD and in pure CTD, but not in ADHD+CTD, following a sub-additive model. In contrast, interference load in the Counting-Stroop did not reveal ADHD or CTD effects.

Conclusion

The co-existence of ADHD and CTD is characterized by additive as well as sub-additive performance impairments, suggesting that their co-existence may show simple additive characteristics of both disorders or a more complex interaction, depending on demand. The equivocal findings on interference control may indicate limited validity of the Stroop-Paradigm for clinical assessments.

Color Vision Deficiency and Functional Disorders Among Israeli Male Adolescents Between 2007 and 2013

Color vision deficiency has been associated with educational difficulties among male children, as well as attention-deficit hyperactivity disorder (ADHD). We examined the association of color vision deficiency with functional conditions, including ADHD, irritable bowel syndrome, enuresis and somatoform disorders, in a large population of male adolescents. We included all Israeli male adolescents that underwent medical and cognitive examinations during conscription between the years 2007 and 2013. The prevalence of ADHD, irritable bowel syndrome, enuresis, and somatoform disorders among color vision deficiency patients was compared to a control group. The study included 305 964 males aging 17 ± 0.6, of which 7584 (2.5%) had color vision deficiency. Using a multivariable analysis, the probability for irritable bowel syndrome, enuresis, and somatoform disorders among color vision deficiency patients was increased by 1.41, 1.94, and 3.87, respectively (P < .05). No significant association was found between ADHD and color vision deficiency. Color vision abnormalities are associated with functional disorders in male adolescents, including irritable bowel syndrome, enuresis, and somatoform disorders.

Color vision in attention-deficit/hyperactivity disorder: a pilot visual evoked potential study

BACKGROUND

Individuals with attention-deficit/hyperactivity disorder (ADHD) are reported to manifest visual problems (including ophthalmological and color perception, particularly for blue-yellow stimuli), but findings are inconsistent. Accordingly, this study investigated visual function and color perception in adolescents with ADHD using color Visual Evoked Potentials (cVEP), which provides an objective measure of color perception.

METHOD

Thirty-one adolescents (aged 13-18), 16 with a confirmed diagnosis of ADHD, and 15 healthy peers, matched for age, gender, and IQ participated in the study. All underwent an ophthalmological exam, as well as electrophysiological testing color Visual Evoked Potentials (cVEP), which measured the latency and amplitude of the neural P1 response to chromatic (blue-yellow, red-green) and achromatic stimuli.

RESULT

No intergroup differences were found in the ophthalmological exam. However, significantly larger P1 amplitude was found for blue and yellow stimuli, but not red/green or achromatic stimuli, in the ADHD group (particularly in the medicated group) compared to controls.

CONCLUSION

Larger amplitude in the P1 component for blue-yellow in the ADHD group compared to controls may account for the lack of difference in color perception tasks. We speculate that the larger amplitude for blue-yellow stimuli in early sensory processing (P1) might reflect a compensatory strategy for underlying problems including compromised retinal input of s-cones due to hypo-dopaminergic tone.

Colour vision in ADHD: part 1--testing the retinal dopaminergic hypothesis

OBJECTIVES

To test the retinal dopaminergic hypothesis, which posits deficient blue color perception in ADHD, resulting from hypofunctioning CNS and retinal dopamine, to which blue cones are exquisitely sensitive. Also, purported sex differences in red color perception were explored.

METHODS

30 young adults diagnosed with ADHD and 30 healthy young adults, matched on age and gender, performed a psychophysical task to measure blue and red color saturation and contrast discrimination ability. Visual function measures, such as the Visual Activities Questionnaire (VAQ) and Farnsworth-Munsell 100 hue test (FMT), were also administered.

RESULTS

Females with ADHD were less accurate in discriminating blue and red color saturation relative to controls but did not differ in contrast sensitivity. Female control participants were better at discriminating red saturation than males, but no sex difference was present within the ADHD group.

CONCLUSION

Poorer discrimination of red as well as blue color saturation in the female ADHD group may be partly attributable to a hypo-dopaminergic state in the retina, given that color perception (blue-yellow and red-green) is based on input from S-cones (short wavelength cone system) early in the visual pathway. The origin of female superiority in red perception may be rooted in sex-specific functional specialization in hunter-gather societies. The absence of this sexual dimorphism for red colour perception in ADHD females warrants further investigation.

Cognitive control predicted by color vision, and vice versa

One of the most important functions of cognitive control is to continuously adapt cognitive processes to changing and often conflicting demands of the environment. Dopamine (DA) has been suggested to play a key role in the signaling and resolution of such response conflict. Given that DA is found in high concentration in the retina, color vision discrimination has been suggested as an index of DA functioning and in particular blue-yellow color vision impairment (CVI) has been used to indicate a central hypodopaminergic state. We used color discrimination (indexed by the total color distance score; TCDS) to predict individual differences in the cognitive control of response conflict, as reflected by conflict-resolution efficiency in an auditory Simon task. As expected, participants showing better color discrimination were more efficient in resolving response conflict. Interestingly, participants showing a blue-yellow CVI were associated with less efficiency in handling response conflict. Our findings indicate that color vision discrimination might represent a promising predictor of cognitive controlability in healthy individuals.

Altered resting state functional connectivity in young survivors of acute lymphoblastic leukemia

BACKGROUND

Chemotherapy treatment for pediatric acute lymphoblastic leukemia (ALL) has been associated with long-term cognitive impairments in some patients. However, the neurobiologic mechanisms underlying these impairments, particularly in young survivors, are not well understood. This study aimed to examine intrinsic functional brain connectivity in pediatric ALL and its relationship with cognitive status.

PROCEDURE

We obtained resting state functional magnetic resonance imaging (rsfMRI) and cognitive testing data from 15 ALL survivors age 8-15 years and 14 matched healthy children. The ALL group had a history of intrathecal chemotherapy treatment but were off-therapy for at least 6 months at the time of enrollment. We used seed-based analyses to compare intrinsic functional brain network connectivity between the groups. We also explored correlations between connectivity and cognitive performance, demographic, medical, and treatment variables.

RESULTS

We demonstrated significantly reduced connectivity between bilateral hippocampus, left inferior occipital, left lingual gyrus, bilateral calcarine sulcus, and right amygdala in the ALL group compared to controls. The ALL group also showed regions of functional hyperconnectivity including right lingual gyrus, precuneus, bilateral superior occipital lobe, and right inferior occipital lobe. Functional hypoconnectivity was associated with reduced cognitive function as well as younger age at diagnosis in the ALL group.

CONCLUSIONS

This is the first study to demonstrate that intrinsic functional brain connectivity is disrupted in pediatric ALL following chemotherapy treatment. These results help explain cognitive dysfunction even when objective test performance is seemingly normal. Children diagnosed at a younger age may show increased vulnerability to altered functional brain connectivity.

Visual function and color vision in adults with Attention-Deficit/Hyperactivity Disorder

PURPOSE

Color vision and self-reported visual function in everyday life in young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) were investigated.

METHOD

Participants were 30 young adults with ADHD and 30 controls matched for age and gender. They were tested individually and completed the Visual Activities Questionnaire (VAQ), Farnsworth-Munsell 100 Hue Test (FMT) and A Quick Test of Cognitive Speed (AQT).

RESULTS

The ADHD group reported significantly more problems in 4 of 8 areas on the VAQ: depth perception, peripheral vision, visual search and visual processing speed. Further analyses of VAQ items revealed that the ADHD group endorsed more visual problems associated with driving than controls. Color perception difficulties on the FMT were restricted to the blue spectrum in the ADHD group. FMT and AQT results revealed slower processing of visual stimuli in the ADHD group.

CONCLUSION

A comprehensive investigation of mechanisms underlying visual function and color vision in adults with ADHD is warranted, along with the potential impact of these visual problems on driving performance.

Blue-yellow colour vision impairment and cognitive deficits in occasional and dependent stimulant users

Specific blue-yellow colour vision impairment has been reported in dependent cocaine users and it was postulated that drug-induced changes in retinal dopamine neurotransmission are responsible. However, it is unclear whether these changes are confined to chronic cocaine users, whether they are specific for dopaminergic stimulants such as cocaine and amphetamine and whether they are related to cognitive functions such as working memory, encoding and consolidation. In 47 occasional and 29 dependent cocaine users, 23 MDMA (commonly known as 'ecstasy') users and 47 stimulant-naive controls, colour vision discrimination was measured with the Lanthony Desaturated Panel D-15 Test and memory performance with the Auditory Verbal Learning Test. Both occasional and dependent cocaine users showed higher colour confusion indices than controls. Users of the serotonergic stimulant MDMA (26%), occasional (30%) and dependent cocaine users (34%) exhibited more frequent blue-yellow colour vision disorders compared to controls (9%). Inferior performance of MDMA users was caused by a subgroup with high amphetamine co-use (55%), while MDMA use alone was not associated with decreased blue-yellow discrimination (0%). Cognitive performance was worse in cocaine users with colour vision disorder compared to users and controls with intact colour vision and both colour vision impairment and cognitive deficits were related to cocaine use. Occasional cocaine and amphetamine use might induce blue-yellow colour vision impairment, whereas the serotonergic stimulant MDMA does not impair colour vision. The association between colour vision impairment and cognitive deficits in cocaine users may reflect that retinal and cerebral dopamine alterations are linked to a certain degree.

Examining the association between stimulant treatment and cognitive outcomes across the life cycle of adults with attention-deficit/hyperactivity disorder: a controlled cross-sectional study

Few studies have evaluated the effects of stimulants on cognition in adults with attention-deficit/hyperactivity disorder (ADHD). We evaluated the impact of stimulant treatment on neurocognition in a cross-sectional sample of adults with ADHD. Comparisons were made between adults with ADHD who received (n = 105) and who had never received pharmacotherapy (n = 116) and 146 controls. The subjects were assessed cross-sectionally using a structured diagnostic interview and a neurocognitive battery. We modeled cognitive measures as a function of age and group status using linear regression. Treated ADHD subjects had statistically significantly better scores on measures of IQ than did untreated ones. The treated group also had better (not statistically significant) scores on neuropsychological measures. The direction of the effects of stimulant on neurocognition suggests that either good cognitive functioning may be a determinant of seeking treatment or that stimulant treatment may improve cognition in adults with ADHD. However, this does not indicate a clear causal relationship.

Virtual environment to quantify the influence of colour stimuli on the performance of tasks requiring attention

Background

Recent studies indicate that the blue-yellow colour discrimination is impaired in ADHD individuals. However, the relationship between colour and performance has not been investigated. This paper describes the development and the testing of a virtual environment that is capable to quantify the influence of red-green versus blue-yellow colour stimuli on the performance of people in a fun and interactive way, being appropriate for the target audience.

Methods

An interactive computer game based on virtual reality was developed to evaluate the performance of the players.

The game's storyline was based on the story of an old pirate who runs across islands and dangerous seas in search of a lost treasure. Within the game, the player must find and interpret the hints scattered in different scenarios. Two versions of this game were implemented. In the first, hints and information boards were painted using red and green colours. In the second version, these objects were painted using blue and yellow colours. For modelling, texturing, and animating virtual characters and objects the three-dimensional computer graphics tool Blender 3D was used. The textures were created with the GIMP editor to provide visual effects increasing the realism and immersion of the players. The games were tested on 20 non-ADHD volunteers who were divided into two subgroups (A1 and A2) and 20 volunteers with ADHD who were divided into subgroups B1 and B2. Subgroups A1 and B1 used the first version of the game with the hints painted in green-red colors, and subgroups A2 and B2 the second version using the same hints now painted in blue-yellow. The time spent to complete each task of the game was measured.

Results

Data analyzed with ANOVA two-way and posthoc TUKEY LSD showed that the use of blue/yellow instead of green/red colors decreased the game performance of all participants. However, a greater decrease in performance could be observed with ADHD participants where tasks, that require attention, were most affected.

Conclusions

The game proved to be a user-friendly tool capable to detect and quantify the influence of color on the performance of people executing tasks that require attention and showed to be attractive for people with ADHD.

Contrast sensitivity in children with and without attention deficit hyperactivity disorder symptoms

Dopamine regulation may play a role in attention-deficit hyperactivity disorder (ADHD). Visual contrast sensitivity has been proposed as a measure of retinal dopamine that may predict frontal lobe dopamine levels. Individuals with disorders involving dopamine dysregulation (e.g., Parkinson's disease, Phenylketonuria) have shown poor contrast sensitivity. In this study, 110 6- to 13-year-old children with and without ADHD completed a task measuring visual contrast sensitivity. As predicted, contrast sensitivity was significantly worse in children with ADHD-Combined Type than controls. Contrast sensitivity was significantly correlated with inattention and hyperactivity. However, unlike many neuropsychological studies of ADHD, only hyperactivity accounted for unique variance.

Videogames and Young People with Developmental Disorders

Young people with developmental disorders experience difficulties with many cognitive and perceptual tasks, and often suffer social impairments. Yet, like typical youth, many appear to enjoy playing videogames. This review considers the appeal of videogames to individuals with autism spectrum disorders, attention deficit hyperactivity disorder, and specific language impairment. It examines how they respond to the various challenges that play entails with particular reference to sensory, cognitive, and social dimensions. It is argued that research into how these young people engage voluntarily with this dynamic and challenging medium offers great potential to extend our empirical and theoretical understanding of the disorders. Many gaps in our current knowledge are identified and several additional themes for possible future research are proposed.

Negative priming within a stroop task in children and adolescents with attention-deficit hyperactivity disorder, their siblings, and independent controls

OBJECTIVE

Negative priming (NP) is the slowed response to a stimulus that was previously ignored. Response times in NP task conditions were compared with the interference provided by congruent/incongruent stimuli in a Stroop condition in the same task in children diagnosed with attention-deficit hyperactivity disorder (ADHD), their unaffected siblings, and independent controls.

METHOD

Speed, accuracy, and variability of responses were compared using a computerized NP Stroop test for 35 children with ADHD, 24 siblings without diagnosis, and 37 independent healthy controls aged 6 to 17 years.

RESULTS

NP was evident at test onset for congruent trials in children without a diagnosis and was reduced initially in those with ADHD occurring in the absence of a significant Stroop interference effect and independently of age or symptom severity. Incongruency masked NP effects. Cases showed more intraindividual response-time variability.

CONCLUSIONS

Both NP in normal children and its reduction in ADHD cases attenuated across trials reflecting the increased facilitation from previous stimulation.

Neurobiology of attention deficit hyperactivity disorder

This article addresses the current understanding of the neurobiological bases of attention deficit hyperactivity disorder (ADHD), focusing on empiric research findings that connect genetic and environmental factors to structural and functional brain abnormalities, ultimately leading to a set of age-dependent behavioral manifestations. Section one presents evidence for genetic risk factors for ADHD and discusses the role of potential environmental factors in the etiology of the disorder. Section two focuses on brain imaging studies and how they have helped generate different hypotheses regarding the pathophysiology of ADHD. Finally, the article addresses the longitudinal course of symptoms in ADHD from infancy to adulthood in an attempt to place biological findings for this complex brain disorder in the context of maturation and development.

Color perception deficits in co-existing attention-deficit/hyperactivity disorder and chronic tic disorders

Preliminary findings suggest that color perception, particularly of blue-yellow stimuli, is impaired in attention-deficit/hyperactivity disorder (ADHD) as well as in chronic tic disorders (CTD). However, these findings have been not replicated and it is unclear what these deficits mean for the comorbidity of ADHD + CTD. Four groups (ADHD, CTD, ADHD + CTD, controls) of children with similar age, IQ and gender distribution were investigated with the Farnsworth-Munsell 100 Hue Test (FMT) and the Stroop-Color-Word Task using a factorial design. Color perception deficits, as indexed by the FMT, were found for both main factors (ADHD and CTD), but there were no interaction effects. A preponderance of deficits on the blue-yellow compared to the red-green axis was detected for ADHD. In the Stroop task only the 'pure' ADHD group showed impairments in interference control and other parameters of Stroop performance. No significant correlations between any FMT parameter and color naming in the Stroop task were found. Basic color perception deficits in both ADHD and CTD could be found. Beyond that, it could be shown that these deficits are additive in the case of comorbidity (ADHD + CTD). Performance deficits on the Stroop task were present only in the 'pure' ADHD group. Hence, the latter may be compensated in the comorbid group by good prefrontal capabilities of CTD. The influence of color perception deficits on Stroop task performance might be negligible.

Inefficient cognitive control in adult ADHD: evidence from trial-by-trial Stroop test and cued task switching performance

Background

Contemporary neuropsychological models of ADHD implicate impaired cognitive control as contributing to disorder characteristic behavioral deficiencies and excesses; albeit to varying degrees. While the traditional view of ADHD postulates a core deficiency in cognitive control processes, alternative dual-process models emphasize the dynamic interplay of bottom-up driven factors such as activation, arousal, alerting, motivation, reward and temporal processing with top-down cognitive control. However, neuropsychological models of ADHD are child-based and have yet to undergo extensive empirical scrutiny with respect to their application to individuals with persistent symptoms in adulthood. Furthermore, few studies of adult ADHD samples have investigated two central cognitive control processes: interference control and task-set coordination. The current study employed experimental chronometric Stroop and task switching paradigms to investigate the efficiency of processes involved in interference control and task-set coordination in ADHD adults.

Methods

22 adults diagnosed with persistent ADHD (17 males) and 22 matched healthy control subjects performed a manual trial-by-trial Stroop color-word test and a blocked explicitly cued task switching paradigm. Performance differences between neutral and incongruent trials of the Stroop task measured interference control. Task switching paradigm manipulations allowed for measurement of transient task-set updating, sustained task-set maintenance, preparatory mechanisms and interference control. Control analyses tested for the specificity of group × condition interactions.

Results

Abnormal processing of task-irrelevant stimulus features was evident in ADHD group performance on both tasks. ADHD group interference effects on the task switching paradigm were found to be dependent on the time allotted to prepare for an upcoming task. Group differences in sustained task-set maintenance and transient task-set updating were also found to be dependent on experimental manipulation of task preparation processes. With the exception of Stroop task error rates, all analyses revealed generally slower and less accurate ADHD group response patterns.

Conclusion

The current data obtained with experimental paradigms deliver novel evidence of inefficient interference control and task-set coordination in adults with persistent ADHD. However, all group differences observed in these central cognitive control processes were found to be partially dependent on atypical ADHD group task preparation mechanisms and/or response inconsistency. These deficiences may have contributed not only to inefficient cognitive control, but also generally slower and less accurate ADHD group performance. Given the inability to dissociate these impairments with the current data, it remains inconclusive as to whether ineffecient cognitive control in the clinical sample was due to top-down failure or bottom-up engagement thereof. To clarify this issue, future neuropsychological investigations are encouraged to employ tasks with significantly more trials and direct manipulations of bottom-up mechanisms with larger samples.

Are Motor Inhibition and Cognitive Flexibility Dead Ends in ADHD?

Executive dysfunction has been postulated as the core deficit in ADHD, although many deficits in lower order cognitive processes have also been identified. By obtaining an appropriate baseline of lower order cognitive functioning light may be shed on as to whether executive deficits result from problems in lower order and/or higher order cognitive processes. We examined motor inhibition and cognitive flexibility in relation to a baseline measure in 816 children from ADHD and control families. Multiple children in a family were tested in order to examine the familiality of the measures. No evidence was found for deficits in motor inhibition or cognitive flexibility in children with ADHD or their nonaffected siblings: Compared to their baseline speed and accuracy of responding, children with ADHD and their (non)affected siblings were not disproportionally slower or inaccurate when demands for motor inhibition or cognitive flexibility were added to the task. However, children with ADHD and their (non)affected siblings were overall less accurate than controls, which could not be attributed to differences in response speed. This suggests that inaccuracy of responding is characteristic of children having (a familial risk for) ADHD. Motor inhibition and cognitive flexibility as operationalized with mean reaction time were found to be familial. It is concluded that poorer performance on executive tasks in children with ADHD and their (non)affected siblings may result from deficiencies in lower order cognitive processes and not (only) from higher order cognitive processes/executive functions.