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Gallagher A, Wallois F, Obrig H. Functional near-infrared spectroscopy in pediatric clinical research: Different pathophysiologies and promising clinical applications. NEUROPHOTONICS 2023; 10:023517. [PMID: 36873247 PMCID: PMC9982436 DOI: 10.1117/1.nph.10.2.023517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Over its 30 years of existence, functional near-infrared spectroscopy (fNIRS) has matured into a highly versatile tool to study brain function in infants and young children. Its advantages, amongst others, include its ease of application and portability, the option to combine it with electrophysiology, and its relatively good tolerance to movement. As shown by the impressive body of fNIRS literature in the field of cognitive developmental neuroscience, the method's strengths become even more relevant for (very) young individuals who suffer from neurological, behavioral, and/or cognitive impairment. Although a number of studies have been conducted with a clinical perspective, fNIRS cannot yet be considered as a truly clinical tool. The first step has been taken in this direction by studies exploring options in populations with well-defined clinical profiles. To foster further progress, here, we review several of these clinical approaches to identify the challenges and perspectives of fNIRS in the field of developmental disorders. We first outline the contributions of fNIRS in selected areas of pediatric clinical research: epilepsy, communicative and language disorders, and attention-deficit/hyperactivity disorder. We provide a scoping review as a framework to allow the highlighting of specific and general challenges of using fNIRS in pediatric research. We also discuss potential solutions and perspectives on the broader use of fNIRS in the clinical setting. This may be of use to future research, targeting clinical applications of fNIRS in children and adolescents.
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Affiliation(s)
- Anne Gallagher
- CHU Sainte-Justine University Hospital, Université de Montréal, LIONLab, Cerebrum, Department of Psychology, Montréal, Quebec, Canada
| | - Fabrice Wallois
- Université de Picardie Jules Verne, Inserm U1105, GRAMFC, Amiens, France
| | - Hellmuth Obrig
- University Hospital and Faculty of Medicine Leipzig/Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology, Clinic for Cognitive Neurology, Leipzig, Germany
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2
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Poliakova E, Conrad AL, Schieltz KM, O’Brien MJ. Using fNIRS to evaluate ADHD medication effects on neuronal activity: A systematic literature review. FRONTIERS IN NEUROIMAGING 2023; 2. [PMID: 37033327 PMCID: PMC10078617 DOI: 10.3389/fnimg.2023.1083036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BackgroundFunctional near infrared spectroscopy (fNIRS) is a relatively non-invasive and inexpensive functional neuroimaging technique that has shown promise as a method for understanding the differences in neuronal activity associated with various neurodevelopmental conditions, including ADHD. Additionally, fNIRS has been suggested as a possible tool to understand the impact of psychotropic medications on brain activity in individuals with ADHD, but this approach is still in its infancy.ObjectiveThe purpose of this systematic literature review was to synthesize the extant research literature on the use of fNIRS to assess the effects of ADHD medications on brain activity in children and adolescents with ADHD.MethodsA literature search following Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses (PRISMA) guidelines was conducted for peer-reviewed articles related to ADHD, medication, and fNIRS in PsychInfo, Scopus, and PubMed electronic databases.ResultsThe search yielded 23 published studies meeting inclusion criteria. There was a high degree of heterogeneity in terms of the research methodology and procedures, which is explained in part by the distinct goals and approaches of the studies reviewed. However, there was also relative consistency in outcomes among a select group of studies that demonstrated a similar research focus.ConclusionAlthough fNIRS has great potential to further our understanding of the effects of ADHD medications on the neuronal activity of children and adolescents with ADHD, the current research base is still relatively small and there are limitations and methodological inconsistencies that should be addressed in future studies.
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Affiliation(s)
- Eva Poliakova
- Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA, United States
| | - Amy L. Conrad
- Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA, United States
- Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Kelly M. Schieltz
- Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA, United States
- Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Matthew J. O’Brien
- Stead Family Department of Pediatrics, The University of Iowa, Iowa City, IA, United States
- Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
- CORRESPONDENCE: Matthew J. O’Brien,
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3
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Smit D, Trevino L, Mohamed SMH, Enriquez-Geppert S. Theta power and functional connectivity as neurophysiological markers of executive functions in individuals with cognitive complaints in daily life. Biol Psychol 2023; 178:108503. [PMID: 36681295 DOI: 10.1016/j.biopsycho.2023.108503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023]
Abstract
Impairments in executive functions (EFs) are common across psychological disorders. Research into the neural oscillations underlying EFs has the potential to help understand these impairments and contribute to the development of interventions. The aim of this study is to assess theta power and functional theta connectivity in the sensor space of the regions of the superordinate network for the core EFs: conflict monitoring, response inhibition, set-shifting, and working memory updating. We recruited adults with self-reported everyday EFs complaints and formed two groups: one with attention deficit hyperactivity disorder (ADHD) (n=27) and another without any diagnosis (n=22), and compared them to controls (n=21) on the Stroop, Stop-signal, Switching, and N-back task using EEG. Power and functional connectivity analyses were conducted for four regions of interest: frontal-midline, frontolateral left and right, and parietal region. For all four EFs, the groups showed a dynamical increase in theta power over time in the four regions of interest, as well as in functional theta connectivity between these regions. Group differences were found especially for conflict monitoring, with differences in theta power in the frontal-midline and frontolateral right region. These neural markers are also associated with behavioural performance and complaints in daily life. For set-shifting, group differences were less pronounced and for response inhibition and working memory updating no group differences were observed.
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Affiliation(s)
- Diede Smit
- Department of Clinical and Developmental Neuropsychology, University of Groningen, the Netherlands; Research School of Behavioural and Cognitive Neurosciences, University of Groningen, the Netherlands
| | - Lorena Trevino
- Department of Clinical and Developmental Neuropsychology, University of Groningen, the Netherlands
| | - Saleh M H Mohamed
- Department of Clinical and Developmental Neuropsychology, University of Groningen, the Netherlands
| | - Stefanie Enriquez-Geppert
- Department of Clinical and Developmental Neuropsychology, University of Groningen, the Netherlands; Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, the Netherlands.
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4
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Yamamuro K. Near-infrared spectroscopy in child and adolescent neurodevelopmental disorders. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e59. [PMID: 38868653 PMCID: PMC11114441 DOI: 10.1002/pcn5.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/17/2022] [Accepted: 10/19/2022] [Indexed: 06/14/2024]
Abstract
Near-infrared spectroscopy (NIRS) is a noninvasive optical technique that uses the near-infrared spectrum for functional neuroimaging by measuring oxygenation and hemodynamic changes in the cerebral cortex. The advantages of NIRS include its portability and ease of application, which allows for testing with the subject in natural positions, such as sitting or standing. Since 1994, NIRS has been increasingly used to conduct functional activation studies on different psychiatric disorders, most prominently schizophrenia, depression, bipolar disorder, and neurodevelopmental disorders. However, limited information on its use among child and adolescent patients is available. We herein review recent findings obtained using NIRS measurements of the brain during cognitive tasks in neurodevelopmental disorders, such as autism spectrum disorder, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and Tourette's disorder. This will facilitate evaluations of the causation and treatment of prefrontal cortex dysfunctions.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of PsychiatryNara Medical University School of MedicineKashiharaJapan
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5
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Galvez-Contreras AY, Vargas-de la Cruz I, Beltran-Navarro B, Gonzalez-Castaneda RE, Gonzalez-Perez O. Therapeutic Approaches for ADHD by Developmental Stage and Clinical Presentation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12880. [PMID: 36232180 PMCID: PMC9566361 DOI: 10.3390/ijerph191912880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/20/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder with three presentations: inattentive, hyperactive/impulsive and combined. These may represent an independent disease entity. Therefore, the therapeutic approach must be focused on their neurobiological, psychological and social characteristics. To date, there is no comprehensive analysis of the efficacy of different treatments for each presentation of ADHD and each stage of development. This is as narrative overview of scientific papers that summarize the most recent findings and identify the most effective pharmacological and psychosocial treatments by ADHD presentation and age range. Evidence suggests that methylphenidate is the safest and most effective drug for the clinical management of children, adolescents and adults. Atomoxetine is effective in preschoolers and maintains similar efficacy to methylphenidate in adults, whereas guanfacine has proven to be an effective monotherapy for adults and is a worthy adjuvant for the management of cognitive symptoms. The psychosocial treatments with the best results in preschoolers are behavioral interventions that include training of primary caregivers. In adolescents, the combination of cognitive and cognitive-behavioral therapies has shown the best results, whereas cognitive-behavioral interventions are the most effective in adults. Pharmacological and psychosocial treatments must be adjusted to the ADHD presentation and its neurocognitive characteristics through the patient's development.
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Affiliation(s)
- Alma Y. Galvez-Contreras
- Unidad de Atención en Neurociencias, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Ivette Vargas-de la Cruz
- Unidad de Atención en Neurociencias, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Beatriz Beltran-Navarro
- Unidad de Atención en Neurociencias, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Rocio E. Gonzalez-Castaneda
- Instituto de Neurociencias Traslacionales, Departamento de Neurociencias, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Oscar Gonzalez-Perez
- Laboratorio de Neurociencias, Facultad de Psicología, Universidad de Colima, Colima 28040, Mexico
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Li J, Yan WJ, Wu Y, Tian XX, Zhang YW. Synaptosomal-Associated Protein 25 Gene Polymorphisms Affect Treatment Efficiency of Methylphenidate in Children With Attention-Deficit Hyperactivity Disorder: An fNIRS Study. Front Behav Neurosci 2022; 15:793643. [PMID: 35069142 PMCID: PMC8766417 DOI: 10.3389/fnbeh.2021.793643] [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: 10/12/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Methylphenidate (MPH) is the first-line drug for the treatment of children with attention-deficit hyperactivity disorder (ADHD); however, individual curative effects of MPH vary. Many studies have demonstrated that synaptosomal-associated protein 25 (SNAP-25) gene MnlI polymorphisms may be related to the efficacy of MPH. However, the association between SNAP-25MnlI polymorphisms and changes in brain hemodynamic responses after MPH treatment is still unclear. This study used functional near-infrared spectroscopy (fNIRS) to preliminarily investigate the interaction of MPH treatment-related prefrontal inhibitory functional changes with the genotype status of the SNAP-25 gene in children with ADHD. In total, 38 children with ADHD aged 6.76–12.08 years were enrolled in this study and divided into the following two groups based on SNAP-25 gene MnlI polymorphisms: T/T genotype group (wild-type group, 27 children) and G allele carrier group (mutation group, 11 children). The averaged oxygenated hemoglobin concentration changes [Δavg oxy-Hb] and deoxyhemoglobin concentration changes [Δavg deoxy-Hb] in the frontal cortex before MPH treatment and after 1.5 h (post-MPH1.5h) and 4 weeks (post-MPH4w) of MPH treatments were monitored using fNIRS during the go/no-go task. SNAP-IV scores were evaluated both pre-MPH and post-MPH4w treatments. In the T/T genotype group, [Δavg oxy-Hb] in the dorsolateral prefrontal cortex was significantly higher after 4 weeks of MPH (post-MPH4W) treatment than pre-treatment; however, in the G allele group, no significant differences in [Δavg oxy-Hb] were observed between pre- and post-treatments. In the go/no-go task, the accuracy was significantly increased post-MPH4w treatment in the T/T genotype group, while no significant differences were observed in response time and accuracy of the “go” sand no-go task in the G allele group for pre-MPH, post-MPH1.5h, and post-MPH4w treatments. The T/T genotype group exhibited a significant decrease in SNAP-IV scores after MPH treatment, while the G allele group showed no significant difference. In conclusion, fNIRS data combined with SNAP-25 MnlI polymorphism analysis may be a useful biomarker for evaluating the effects of MPH in children with ADHD.
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Affiliation(s)
- Jie Li
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Pediatrics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Wen-Jie Yan
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Wu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-Xin Tian
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Wen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Yi-Wen Zhang
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7
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McLoughlin G, Gyurkovics M, Aydin Ü. What Has Been Learned from Using EEG Methods in Research of ADHD? Curr Top Behav Neurosci 2022; 57:415-444. [PMID: 35637406 DOI: 10.1007/7854_2022_344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electrophysiological recording methods, including electroencephalography (EEG) and magnetoencephalography (MEG), have an unparalleled capacity to provide insights into the timing and frequency (spectral) composition of rapidly changing neural activity associated with various cognitive processes. The current chapter provides an overview of EEG studies examining alterations in brain activity in ADHD, measured both at rest and during cognitive tasks. While EEG resting state studies of ADHD indicate no universal alterations in the disorder, event-related studies reveal consistent deficits in attentional and inhibitory control and consequently inform the proposed cognitive models of ADHD. Similar to other neuroimaging measures, EEG research indicates alterations in multiple neural circuits and cognitive functions. EEG methods - supported by the constant refinement of analytic strategies - have the potential to contribute to improved diagnostics and interventions for ADHD, underlining their clinical utility.
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Affiliation(s)
- Gráinne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Máté Gyurkovics
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ümit Aydin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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8
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Sugimoto A, Suzuki Y, Yoshinaga K, Orime N, Hayashi T, Egawa J, Ono S, Sugai T, Someya T. Influence of Atomoxetine on Relationship Between ADHD Symptoms and Prefrontal Cortex Activity During Task Execution in Adult Patients. Front Hum Neurosci 2021; 15:755025. [PMID: 34899218 PMCID: PMC8663632 DOI: 10.3389/fnhum.2021.755025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: We conducted this non-randomized prospective interventional study to clarify the relationship between improved attention-deficit hyperactivity disorder (ADHD) symptoms and regional brain activity. Methods: Thirty-one adult patients underwent near-infrared spectroscopy examinations during a go/no-go task, both before and 8 weeks after atomoxetine administration. Results: Clinical symptoms, neuropsychological results of the go/no-go task, and bilateral lateral prefrontal activity significantly changed. A positive correlation was observed between right dorsolateral prefrontal cortex activity and Conners' Adult ADHD Rating Scales scores. Before atomoxetine administration, no correlations between prefrontal cortex activity and clinical symptoms were observed in all cases. When participants were divided into atomoxetine-responder and non-responder groups, a positive correlation was observed between prefrontal cortex activity and clinical symptoms in the non-responder group before treatment but not in the responder group, suggesting that non-responders can activate the prefrontal cortex without atomoxetine. Conclusions: Individuals with increased ADHD symptoms appear to recruit the right dorsolateral prefrontal cortex more strongly to perform the same task than those with fewer symptoms. In clinical settings, individuals with severe symptoms are often observed to perform more difficultly when performing the tasks which individuals with mild symptoms can perform easily. The atomoxetine-responder group was unable to properly activate the right dorsolateral prefrontal cortex when necessary, and the oral administration of atomoxetine enabled these patients to activate this region. In brain imaging studies of heterogeneous syndromes such as ADHD, the analytical strategy used in this study, involving drug-responsivity grouping, may effectively increase the signal-to-noise ratio.
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Affiliation(s)
- Atsunori Sugimoto
- Department of Community Psychiatric Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan
| | - Yutaro Suzuki
- Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan.,Department of Psychiatry, Suehirobashi Hospital Keiaikai, Niigata, Japan
| | - Kiyohiro Yoshinaga
- Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan.,Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoki Orime
- Department of Psychiatry, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Taketsugu Hayashi
- Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan.,Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Egawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shin Ono
- Department of Community Psychiatric Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Psychiatry, Niigata Psychiatric Center, Nagaoka, Japan
| | - Takuro Sugai
- Comprehensive Medical Education Center, Niigata University School of Medicine, Niigata, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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9
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Lee YJ, Kim M, Kim JS, Lee YS, Shin JE. Clinical Applications of Functional Near-Infrared Spectroscopy in Children and Adolescents with Psychiatric Disorders. Soa Chongsonyon Chongsin Uihak 2021; 32:99-103. [PMID: 34285634 PMCID: PMC8262974 DOI: 10.5765/jkacap.210011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 11/24/2022] Open
Abstract
The purpose of this review is to examine the clinical use of functional near-infrared spectroscopy (fNIRS) in children and adolescents with psychiatric disorders. Many studies have been conducted using objective evaluation tools for psychiatric evaluation, such as predicting psychiatric symptoms and treatment responses. Compared to other tools, fNIRS has the advantage of being a noninvasive, inexpensive, and portable method and can be used with patients in the awake state. This study mainly focused on its use in patients with attention-deficit/hyperactivity disorder and autism spectrum disorder. We hope that research involving fNIRS will be actively conducted in various diseases in the future.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji-Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Yun Sung Lee
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
| | - Jeong Eun Shin
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
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10
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A low-cost multichannel NIRS oximeter for monitoring systemic low-frequency oscillations. Neural Comput Appl 2020. [DOI: 10.1007/s00521-020-04897-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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11
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Intact Stimulus-Response Conflict Processing in ADHD-Multilevel Evidence and Theoretical Implications. J Clin Med 2020; 9:jcm9010234. [PMID: 31952353 PMCID: PMC7019707 DOI: 10.3390/jcm9010234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/03/2020] [Accepted: 01/11/2020] [Indexed: 01/31/2023] Open
Abstract
Attention-deficit-hyperactivity disorder (ADHD) is closely associated with deficits in cognitive control. It seems, however, that the degree of deficits strongly depends on the examined subprocess, with the resolution of stimulus–stimulus conflicts being particularly difficult for patients with ADHD. The picture is far less clear regarding stimulus–response conflicts. The current study provides multi-level behavioural and neurophysiological data on this type of conflict monitoring in children with ADHD compared to healthy controls. To account for the potentially strong effects of intra-individual variability, electroencephalogram (EEG) signal decomposition methods were used to analyze the data. Crucially, none of the analyses (behavioural, event-related potentials, or decomposed EEG data) show any differences between the ADHD group and the control group. Bayes statistical analysis confirmed the high likelihood of the null hypothesis being true in all cases. Thus, the data provide multi-level evidence showing that conflict monitoring processes are indeed partly intact in ADHD, even when eliminating possible biasing factors such as intra-individual variability. While stimulus–stimulus conflict processing has been shown to be consistently dysfunctional in ADHD, the resolution of stimulus–response conflicts is not deficient in this patient group. In comparison to other studies, the results provide novel theoretical insights into the nature of conflict control deficits in childhood ADHD.
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12
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Jang S, Choi J, Oh J, Yeom J, Hong N, Lee N, Kwon JH, Hong J, Kim JJ, Kim E. Use of Virtual Reality Working Memory Task and Functional Near-Infrared Spectroscopy to Assess Brain Hemodynamic Responses to Methylphenidate in ADHD Children. Front Psychiatry 2020; 11:564618. [PMID: 33551860 PMCID: PMC7859615 DOI: 10.3389/fpsyt.2020.564618] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
Virtual reality (VR) neuropsychological tests have emerged as a method to explore drug effects in real-life contexts in attention deficit hyperactivity disorder (ADHD) children. Functional near-infrared spectroscopy (fNIRS) is a useful tool to measure brain activity during VR tasks in ADHD children with motor restlessness. The present study aimed to explore the acute effects of methylphenidate (MPH) on behavioral performance and brain activity during a VR-based working memory task simulating real-life classroom settings in ADHD children. In total, 23 children with ADHD performed a VR n-back task before and 2 h after MPH administration concurrent with measurements of oxygenated hemoglobin signal changes with fNIRS. Altogether, 12 healthy control (HC) subjects participated in the same task but did not receive MPH treatment. Reaction time (RT) was shortened after MPH treatment in the 1-back condition, but changes in brain activation were not observed. In the 2-back condition, activation of the left dorsolateral prefrontal cortex (DLPFC) and bilateral medial prefrontal cortex (mPFC) was decreased alongside behavioral changes such as shorter RT, lower RT variability, and higher accuracy after MPH administration. Bilateral mPFC activation in the 2-back condition inversely correlated with task accuracy in the pre-MPH condition; this inverse correlation was not observed after MPH administration. In ADHD children, deactivation of the default mode network mediated by mPFC reduced during high working memory load, which was restored through MPH treatment. Our results suggest that the combination of VR classroom tasks and fNIRS examination makes it easy to assess drug effects on brain activity in ADHD children in settings simulating real-life.
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Affiliation(s)
- Sooah Jang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Jooyoung Oh
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University Gangman Severance Hospital, Seoul, South Korea
| | - Jungyeon Yeom
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Narae Hong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Narae Lee
- College of Medicine, Hallym University, Chuncheon, South Korea
| | - Joon Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jieun Hong
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University Gangman Severance Hospital, Seoul, South Korea
| | - Eunjoo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University Gangman Severance Hospital, Seoul, South Korea
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13
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Grazioli S, Mauri M, Crippa A, Maggioni E, Molteni M, Brambilla P, Nobile M. Light up ADHD: II. Neuropharmacological effects measured by near infrared spectroscopy: is there a biomarker? J Affect Disord 2019; 244:100-106. [PMID: 30332620 DOI: 10.1016/j.jad.2018.10.100] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/27/2018] [Accepted: 10/08/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by deficits in self-controlling attention, behavior, and emotions. In recent years, noninvasive optical techniques, such as near infrared spectroscopy (NIRS), have been used to measure the neural correlates of pharmacological-therapy outcomes in children and adolescents with ADHD. METHODS We reviewed a short series of articles that investigated the results of functional NIRS (fNIRS) on developmental-age ADHD. The review was limited to fNIRS studies that investigated the cortical responses that occurred during neuropsychological tasks in ADHD patients who received methylphenidate or atomoxetine. RESULTS The majority of the reviewed studies revealed the presence of increased oxygenated hemoglobin concentrations in the prefrontal cortex following pharmacotherapy in ADHD samples. A higher frequency of right-lateralized results was found. LIMITATIONS The considered studies are characterized by substantial methodological heterogeneity in terms of the patients' medication status and washout period, explored cerebral regions, and neuropsychological tasks. CONCLUSIONS fNIRS seems to be a promising tool for the detection of pharmacological-treatment biomarkers in samples of children and adolescents with ADHD.
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Affiliation(s)
- Silvia Grazioli
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, via Don Luigi Monza 20, Bosisio Parini (LC), Lecco 23842, Italy
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, via Don Luigi Monza 20, Bosisio Parini (LC), Lecco 23842, Italy.
| | - Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, via Don Luigi Monza 20, Bosisio Parini (LC), Lecco 23842, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, via Don Luigi Monza 20, Bosisio Parini (LC), Lecco 23842, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, USA
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, via Don Luigi Monza 20, Bosisio Parini (LC), Lecco 23842, Italy
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Efficacy and safety of drugs for attention deficit hyperactivity disorder in children and adolescents: a network meta-analysis. Eur Child Adolesc Psychiatry 2018; 27:1335-1345. [PMID: 29460165 DOI: 10.1007/s00787-018-1125-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/09/2018] [Indexed: 12/12/2022]
Abstract
The aim of this study is to gather evidence of head-to-head double-blind randomized-controlled trials on the efficacy and safety of available treatments for attention deficit hyperactivity disorder (ADHD) in children and adolescents. A systematic review was conducted by two independent reviewers in ten electronic databases (PROSPERO register CRD42016043239). Methodological quality of included studies was evaluated according to the Jadad scale. Network meta-analyses were performed including double-blinded head-to-head trials comparing active allopathic drugs in patients (0-18 years old) diagnosed with ADHD. The results of efficacy and safety of atomoxetine (ATX), bupropion, buspirone (BSP), dexamphetamine, edivoxetine (EDX), guanfacine (GXR), lisdexamfetamine (LDX), methylphenidate (MPH), mixed amphetamine salts, modafinil, pindolol (PDL), reboxetine (RBX), selegiline, and venlafaxine were analyzed using ADDIS software v.1.16.5. Forty-eight trials were identified (n = 4169 participants), of which 12 were used for efficacy analysis and 33 for safety analysis. On the CGI-I scale, the analysis revealed that MPH was more effective than ATX and GXR. For the safety outcomes, according to drug ranks, LDX was more likely to cause sleep disorders (39%) as well as loss of appetite (65%) and behavior problems such as irritability (60%). BSP (71%) and EDX (44%) caused less appetite decrease. For behavioral effects, PDL was considered safest (50%). For any adverse events, RBX (89%) was the safest alternative. The lack of head-to-head trials properly reporting outcomes of interest limited some comparisons. Network meta-analysis offered a broader overview on the available treatments for ADHD, especially for safety issues, and contributes towards evidence gathering and clinical practice decisions. A core outcome set for ADHD should be designed to guide the conduction and report of clinical trials.
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Ramalho R, Pereira AC, Vicente F, Pereira P. Docosahexaenoic acid supplementation for children with attention deficit hyperactivity disorder: A comprehensive review of the evidence. Clin Nutr ESPEN 2018; 25:1-7. [PMID: 29779801 DOI: 10.1016/j.clnesp.2018.03.126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/22/2018] [Accepted: 03/28/2018] [Indexed: 12/27/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is considered the most common behavioural disorder in school-age children. ADHD is a complex and multifactorial disorder characterised by a variety of symptoms, including concentration problems, excessive motor activity and impulsivity which interferes with execution of simple school tasks. Diagnosis has been essentially subjective, since no specific laboratory tests are available. However, ADHD remains overdiagnosed, probably due to social pressures for children to be successful in school from an early age, which leads parents to seek medical support. Although therapeutic approaches for ADHD have been essentially pharmacologic, in recent years several studies were performed to investigate the role of nutrition, especially omega 3 polyunsaturated fatty acid (omega 3-PUFA), in the development and treatment of this disorder. In this review, the authors gathered the most relevant evidence regarding omega 3-PUFA, mainly docosahexaenoic acid, as coadjutant or as a single therapy, in the management of ADHD symptoms. The authors also reviewed this disorder's current medical and therapeutic features.
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Affiliation(s)
- Renata Ramalho
- Instituto Superior de Ciências da Saúde Egas Moniz (ISCSEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal.
| | - Ana Colaço Pereira
- Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal
| | - Filipa Vicente
- Instituto Superior de Ciências da Saúde Egas Moniz (ISCSEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal
| | - Paula Pereira
- Instituto Superior de Ciências da Saúde Egas Moniz (ISCSEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal; Grupo de Estudos em Nutrição Aplicada (GENA), Campus Universitário Quinta da Granja, Monte de Caparica, 2829-511, Caparica, Portugal
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