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Senkowski D, Ziegler T, Singh M, Heinz A, He J, Silk T, Lorenz RC. Assessing Inhibitory Control Deficits in Adult ADHD: A Systematic Review and Meta-analysis of the Stop-signal Task. Neuropsychol Rev 2024; 34:548-567. [PMID: 37300725 PMCID: PMC11166755 DOI: 10.1007/s11065-023-09592-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/21/2023] [Indexed: 06/12/2023]
Abstract
In recent years, there has been an increasing quest in improving our understanding of the neurocognitive deficits underlying adult attention-deficit/hyperactivity disorder (ADHD). Current statistical manuals of psychiatric disorders emphasize inattention and hyperactivity-impulsivity symptoms, but empirical studies have also shown consistent alterations in inhibitory control. To date, there is no established neuropsychological test to assess inhibitory control deficits in adult ADHD. A common paradigm for assessing response inhibition is the stop-signal task (SST). Following PRISMA-selection criteria, our systematic review and meta-analysis integrated the findings of 26 publications with 27 studies examining the SST in adult ADHD. The meta-analysis, which included 883 patients with adult ADHD and 916 control participants, revealed reliable inhibitory control deficits, as expressed in prolonged SST response times, with a moderate effect size g = 0.51 (95% CI: 0.376-0.644, p < 0.0001). The deficits were not moderated by study quality, sample characteristics or clinical parameters, suggesting that they may be a phenotype in this disorder. The analyses of secondary outcome measures revealed greater SST omission errors and reduced go accuracy in patients, indicative of altered sustained attention. However, only few (N < 10) studies were available for these measures. Our meta-analysis suggests that the SST, in conjunction with other tests and questionnaires, could become a valuable tool for assessing inhibitory control deficits in adult ADHD.
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Affiliation(s)
- Daniel Senkowski
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charité Campus Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany.
| | - Theresa Ziegler
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charité Campus Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Mervyn Singh
- Centre for Social and Early Emotional Development (SEED) and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charité Campus Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Jason He
- King's College London, London, WC2R 2LS, UK
| | - Tim Silk
- Centre for Social and Early Emotional Development (SEED) and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Robert C Lorenz
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany
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2
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Howard SL, Beaudin SA, Strupp BJ, Smith DR. Maternal choline supplementation lessens the behavioral dysfunction produced by developmental manganese exposure in a rodent model of ADHD. Neurotoxicol Teratol 2024; 102:107337. [PMID: 38423398 DOI: 10.1016/j.ntt.2024.107337] [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: 10/26/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
Studies in children have reported associations between elevated manganese (Mn) exposure and ADHD-related symptoms of inattention, impulsivity/hyperactivity, and psychomotor impairment. Maternal choline supplementation (MCS) during pregnancy/lactation may hold promise as a protective strategy because it has been shown to lessen cognitive dysfunction caused by numerous early insults. Our objectives were to determine whether (1) developmental Mn exposure alters behavioral reactivity/emotion regulation, in addition to impairing learning, attention, impulse control, and sensorimotor function, and (2) MCS protects against these Mn-induced impairments. Pregnant Long-Evans rats were given standard diet, or a diet supplemented with additional choline throughout gestation and lactation (GD 3 - PND 21). Male offspring were exposed orally to 0 or 50 mg Mn/kg/day over PND 1-21. In adulthood, animals were tested in a series of learning, attention, impulse control, and sensorimotor tasks. Mn exposure caused lasting dysfunction in attention, reactivity to errors and reward omission, learning, and sensorimotor function, recapitulating the constellation of symptoms seen in ADHD children. MCS lessened Mn-induced attentional dysfunction and partially normalized reactivity to committing an error or not receiving an expected reward but provided no protection against Mn-induced learning or sensorimotor dysfunction. In the absence of Mn exposure, MCS produces lasting offspring benefits in learning, attention, and reactivity to errors. To conclude, developmental Mn exposure produces a constellation of deficits consistent with ADHD symptomology, and MCS offered some protection against the adverse Mn effects, adding to the evidence that maternal choline supplementation is neuroprotective for offspring and improves offspring cognitive functioning.
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Affiliation(s)
- Shanna L Howard
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Stephane A Beaudin
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Barbara J Strupp
- Division of Nutritional Sciences and Department of Psychology, Cornell University, Ithaca, NY, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA.
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3
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Katabi G, Shahar N. Exploring the steps of learning: computational modeling of initiatory-actions among individuals with attention-deficit/hyperactivity disorder. Transl Psychiatry 2024; 14:10. [PMID: 38191535 PMCID: PMC10774270 DOI: 10.1038/s41398-023-02717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by difficulty in acting in a goal-directed manner. While most environments require a sequence of actions for goal attainment, ADHD was never studied in the context of value-based sequence learning. Here, we made use of current advancements in hierarchical reinforcement-learning algorithms to track the internal value and choice policy of individuals with ADHD performing a three-stage sequence learning task. Specifically, 54 participants (28 ADHD, 26 controls) completed a value-based reinforcement-learning task that allowed us to estimate internal action values for each trial and stage using computational modeling. We found attenuated sensitivity to action values in ADHD compared to controls, both in choice and reaction-time variability estimates. Remarkably, this was found only for first-stage actions (i.e., initiatory actions), while for actions performed just before outcome delivery the two groups were strikingly indistinguishable. These results suggest a difficulty in following value estimation for initiatory actions in ADHD.
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Affiliation(s)
- Gili Katabi
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Nitzan Shahar
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Garcia Pimenta M, Gruhnert RK, Fuermaier ABM, Groen Y. The role of executive functions in mediating the relationship between adult ADHD symptoms and hyperfocus in university students. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 144:104639. [PMID: 38039699 DOI: 10.1016/j.ridd.2023.104639] [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: 10/26/2021] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Hyperfocus, a state of intense, narrow and prolonged attentional focus, has been associated with symptoms of attention-deficit/hyperactivity disorder (ADHD) in both clinical and non-clinical populations. Hyperfocus may be explained by difficulties in executive control, typically observed in ADHD. AIMS To investigate (1) whether ADHD and executive functions (EF) are associated with hyperfocus and (2) whether EF mediate the relationship between ADHD symptoms and hyperfocus. METHODS AND PROCEDURES A non-clinical sample of 380 university students (264 females) completed self-reports of ADHD, EF, hyperfocus and hyperfocus during rewarding activities. OUTCOMES AND RESULTS Increased difficulties in EF and severity of ADHD symptoms were significantly and positively correlated with a higher frequency of hyperfocus. Moreover, EF difficulties partially mediated the relationship between ADHD and hyperfocus (after controlling for sex and substance use), but not the relationship between ADHD and hyperfocus during rewarding activities. CONCLUSIONS AND IMPLICATIONS Difficulties in EF partially explained the higher frequency of hyperfocus, but not of hyperfocus during rewarding activities, among university students reporting more severe ADHD symptoms. Future research should investigate whether and how specific EF and other ADHD-related neurocognitive difficulties (e.g., reward sensitivity) contribute to various types of hyperfocus experiences in ADHD. WHAT THIS PAPER ADDS?: This paper is a first attempt to explain the relationship between adult ADHD symptoms and hyperfocus experiences. Our findings suggest that, although highly correlated, existing self-reports of hyperfocus measure different aspects of this experience: hyperfocus and reward-related hyperfocus. We replicate previous findings that indicated a greater frequency of both types of hyperfocus in ADHD. Additionally, we demonstrate a connection between EF difficulties and different aspects of hyperfocus. Finally, we extend previous findings by proposing that EF difficulties partially explain the relationship between ADHD and hyperfocus, but not the relationship between ADHD and reward-related hyperfocus. We hypothesize that other neurocognitive difficulties (e.g., reward sensitivity) may contribute to explain the relationship between ADHD and different aspects of hyperfocus.
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Affiliation(s)
- Miguel Garcia Pimenta
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands.
| | - Rixa Käthe Gruhnert
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Vienna, Department of Cognition, Emotion and Methods in Psychology, Liebiggasse, 51010 Vienna, Austria
| | - Anselm B M Fuermaier
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
| | - Yvonne Groen
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
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Ben-Dor Cohen M, Nahum M, Traub Bar-Ilan R, Eldar E, Maeir A. Coping with emotional dysregulation among young adults with ADHD: A mixed-method study of self-awareness and strategies in daily life. Neuropsychol Rehabil 2023:1-25. [PMID: 37971947 DOI: 10.1080/09602011.2023.2279181] [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: 12/28/2022] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Emotional dysregulation (ED) impacts functional outcomes among individuals with attention-deficit hyperactivity disorder (ADHD). Self-awareness and strategies may enhance coping with ED yet are rarely studied in ADHD. OBJECTIVES To explore ED-related self-awareness and strategies in daily life of adults with ADHD, and to examine the interrelations between them and their association with symptoms. METHODS Sixty young adults with ADHD participated in a mixed-method study. At baseline, self-awareness and strategies were assessed using the Self-Regulation Skills Interview (SRSI); ADHD symptoms were self-rated using the ASRS symptom checklist. Then, symptoms were rated over 5-days using ecological momentary assessment (EMA). RESULTS Significant challenges in self-awareness and strategies were demonstrated quantitatively and qualitatively. Awareness of ED was associated with variability of ADHD symptoms on EMA yet not with symptom severity. Qualitative content analysis revealed a range of self-awareness levels, which were related to noticing ED-related cues and understanding contextual factors predictive of ED. Self-awareness and strategies were significantly associated. Strategies varied regarding effort, individual preference and temporality. CONCLUSIONS Variability of ADHD symptoms was negatively associated with self-awareness of ED. Strategy selection in daily-life among adults with ADHD may be affected by self-awareness and by a possible trade-off between short-term effort and long-term effectiveness.
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Affiliation(s)
- Maayan Ben-Dor Cohen
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ruthie Traub Bar-Ilan
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eran Eldar
- Psychology Department, Faculty of Social Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Cognitive Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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6
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Einziger T, Devor T, Ben-Shachar MS, Arazi A, Dinstein I, Klein C, Auerbach JG, Berger A. Increased neural variability in adolescents with ADHD symptomatology: Evidence from a single-trial EEG study. Cortex 2023; 167:25-40. [PMID: 37517356 DOI: 10.1016/j.cortex.2023.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/17/2023] [Accepted: 06/09/2023] [Indexed: 08/01/2023]
Abstract
Increased intrasubject variability of reaction time (RT) refers to inconsistency in an individual's speed of responding to a task. This increased variability has been suggested as a fundamental feature of attention deficit hyperactivity disorder (ADHD), however, its neural sources are still unclear. In this study, we aimed to examine whether such inconsistency at the behavioral level would be accompanied by inconsistency at the neural level; and whether different types of neural and behavioral variability would be related to ADHD symptomatology. We recorded electroencephalogram (EEG) data from 62 adolescents, who were part of a prospective longitudinal study on the development of ADHD. We examined trial-by-trial neural variability in response to visual stimuli in two cognitive tasks. Adolescents with high ADHD symptomatology exhibited an increased neural variability before the presentation of the stimulus, but when presented with a visual stimulus, this variability decreased to a level that was similar to that exhibited by participants with low ADHD symptomatology. In contrast with our prediction, neural variability was unrelated to the magnitude of behavioral variability. Our findings suggest that adolescents with higher symptoms are characterized by increased neural variability before the stimulation, which might reflect a difficulty in alertness to the forthcoming stimulus; but this increased neural variability does not seem to account for their RT variability.
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Affiliation(s)
- Tzlil Einziger
- Ruppin Academic Center, Department of Behavioral Sciences, Emek Hefer, Israel.
| | - Tali Devor
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mattan S Ben-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ayelet Arazi
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Ilan Dinstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel; National Autism Research Center of Israel, Beer Sheva, Israel
| | - Christoph Klein
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Freiburg, Germany; Department of Child and Adolescent Psychiatry, Medical Faculty, University of Cologne, Germany; 2(nd) Department of Psychiatry, National and Kapodistrian University of Athens, Greece
| | - Judith G Auerbach
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Andrea Berger
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
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7
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Ben-Dor Cohen M, Maeir A, Eldar E, Nahum M. Everyday Cognitive Control and Emotion Dysregulation in Young Adults With and Without ADHD: An Ecological Momentary Assessment Study. J Atten Disord 2023; 27:539-553. [PMID: 36779529 PMCID: PMC9978869 DOI: 10.1177/10870547231153934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE This study examined the contribution of the temporal dynamics of two cognitive control mechanisms-inhibitory control (IC) and working memory (WM)-to emotion dysregulation (ED) in attention-deficit/hyperactivity disorder (ADHD) in ecological settings. METHOD One hundred twenty-two participants (age 18-33 years; 60 with ADHD) reported their ED at baseline, followed by a 5-day ecological momentary assessment (EMA) study, with short behavioral IC and WM tasks performed five times/day. RESULTS For IC, mean and lability of performance over EMA significantly accounted for differences in ED but not baseline performance. For WM, both baseline and mean of EMA, but not EMA lability, accounted for ED variance. ADHD status further contributed to the explained variance of ED. CONCLUSIONS Our results support the contribution of dynamic IC processes to ED in ADHD, in addition to WM performance level, and highlight the importance of dynamic and ecological investigation of different cognitive control components.
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Affiliation(s)
| | - Adina Maeir
- Hebrew University of Jerusalem,
Jerusalem, Israel
| | - Eran Eldar
- Hebrew University of Jerusalem,
Jerusalem, Israel
| | - Mor Nahum
- Hebrew University of Jerusalem,
Jerusalem, Israel,Mor Nahum, Faculty of Medicine, School of
Occupational Therapy, Hebrew University, Mt Scopus Campus, Jerusalem 9190501,
Israel.
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8
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Mette C. Time Perception in Adult ADHD: Findings from a Decade-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3098. [PMID: 36833791 PMCID: PMC9962130 DOI: 10.3390/ijerph20043098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Time perception is impaired in adult ADHD. Since the term time perception subsumes different constructs, including time estimation, time reproduction, time production, and duration discrimination, it remains open whether certain domains are more affected than other domains in adult ADHD. The aim of this explorative review is to present the current state of research on time perception in adult ADHD by analysing studies from the past 10 years. A review of the literature addressing adult ADHD time perception, time estimation, and time reproduction was performed. The search strategy was conducted by using the databases "PubMed", "Medline", and "PSYNDEX". The results of the present review indicate that the number of studies on time perception in adult ADHD is very scarce. Moreover, the main investigated domains of time perception in the past decade were time estimation, time reproduction and time management. Whereas some of the found studies were able to demonstrate a distinct deficit in time estimation, time reproduction and time management other studies were unable to demonstrate a clear association between ADHD and time estimation and time reproduction deficits. However, the diagnostic protocols, study design, and methodology varied between studies. Further studies on time estimation and time reproduction need to be carried out.
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Affiliation(s)
- Christian Mette
- Department of Psychology, Immanuel-Kant-Str. 18-20, Protestant University of Applied Sciences, 44809 Bochum, Germany
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9
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Selaskowski B, Asché LM, Wiebe A, Kannen K, Aslan B, Gerding TM, Sanchez D, Ettinger U, Kölle M, Lux S, Philipsen A, Braun N. Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder. BMC Psychiatry 2023; 23:74. [PMID: 36703134 PMCID: PMC9879564 DOI: 10.1186/s12888-023-04551-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task. METHODS Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed. RESULTS While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients. CONCLUSIONS Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD. TRIAL REGISTRATION drks.de (identifier: DRKS00022370).
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Affiliation(s)
- Benjamin Selaskowski
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Marie Asché
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Annika Wiebe
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Thiago Morano Gerding
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Dario Sanchez
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ulrich Ettinger
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Bonn, Germany
| | - Markus Kölle
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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10
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Furukawa E, Bado P, da Costa RQM, Melo B, Erthal P, de Oliveira IP, Wickens JR, Moll J, Tripp G, Mattos P. Reward modality modulates striatal responses to reward anticipation in ADHD: Effects of affiliative and food stimuli. Psychiatry Res Neuroimaging 2022; 327:111561. [PMID: 36334392 DOI: 10.1016/j.pscychresns.2022.111561] [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: 05/06/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Altered reward sensitivity has been proposed to underlie symptoms of attention deficit hyperactivity disorder (ADHD). Functional magnetic resonance imaging (fMRI) studies have reported hypoactivation to reward-predicting cues in the ventral striatum among individuals with ADHD, using experimental designs with and without behavioral response requirements. These studies have typically used monetary incentives as rewards; however, it is unclear if these findings extend to other reward types. The current study examined striatal responses to anticipation and delivery of both affiliative and food reward images using a classical conditioning paradigm. Data from 20 typically developing young adults, and 20 individuals diagnosed with ADHD were included in a region-of-interest analysis for a priori striatal regions. Consistent with findings from studies using monetary rewards, individuals with ADHD showed decreased activation to cues predicting affiliative rewards in the bilateral ventral and dorsal striatum and increased activation to the delivery of affiliative rewards in the ventral striatum. No group differences were found in striatal responses to food reward cues or images. These results suggest hyposensitivity to reward-predicting cues in ADHD extends to affiliative rewards, with important implications for understanding and managing the learning and social functioning of those with ADHD.
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Affiliation(s)
- Emi Furukawa
- Okinawa Institute of Science and Technology Graduate University (OIST), Okinawa, Japan.
| | - Patricia Bado
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Bruno Melo
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Pilar Erthal
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Jeff R Wickens
- Okinawa Institute of Science and Technology Graduate University (OIST), Okinawa, Japan
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Gail Tripp
- Okinawa Institute of Science and Technology Graduate University (OIST), Okinawa, Japan
| | - Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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11
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Marx I, Cortese S, Koelch MG, Hacker T. Meta-analysis: Altered Perceptual Timing Abilities in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:866-880. [PMID: 34923055 DOI: 10.1016/j.jaac.2021.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We meta-analyzed studies comparing perceptual timing abilities in the range of milliseconds to several seconds in persons with attention-deficit/hyperactivity disorder (ADHD) and neurotypical participants, using the well-established time discrimination, time estimation, time production, and time reproduction paradigms. METHOD We searched PubMed, OVID databases, and Web of Knowledge through September 17, 2020. From 2,266 records, 55 studies were retained and meta-analyzed with random effects models. We conducted meta-regression analyses to explore moderating effects of task parameters and neuropsychological measures of working memory, attention, and inhibition on timing performance. RESULTS Compared with persons without ADHD, those with ADHD had significantly more severe difficulties in discriminating stimuli of very brief durations, especially in the sub-second range. They also had more variability in estimating the duration of stimuli lasting several seconds. Moreover, they showed deficits in time estimation and time production accuracy, indicative of an accelerated internal clock. Additional deficits in persons with ADHD were also found in the time reproduction paradigm, involving attentional (slower counting at short time intervals due to distraction) and motivational (faster counting at long time intervals due to increased delay aversion) functions. CONCLUSION There is meta-analytic evidence of a broad range of timing deficits in persons with ADHD. Results have implications for advancing our knowledge in the field (eg, for refinement of recent timing models in ADHD) and clinical practice (eg, testing timing functions to characterize the clinical phenotype of the patient and implementation of interventions to improve timing abilities).
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Affiliation(s)
- Ivo Marx
- Rostock University Medical Center, Rostock, Germany.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, United Kingdom; New York University Grossman School of Medicine, New York
| | | | - Thomas Hacker
- Rostock University Medical Center, Rostock, Germany; Helios Hanseklinikum Stralsund, Stralsund, Germany
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12
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Burton S, Puddephatt JA, Baines L, Sheen F, Warren JG, Jones A. Limited Evidence of Associations Between Executive Functioning and Alcohol Involvement In UK Adolescents. Alcohol Alcohol 2021; 56:754-762. [PMID: 33836535 PMCID: PMC8557664 DOI: 10.1093/alcalc/agab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 11/29/2022] Open
Abstract
Aims Deficits in motor inhibitory control and working memory have been hypothesized to be both a cause and consequence of heavy alcohol use. Adolescence is a critical developmental stage for inhibitory control and working memory, and it is also a stage when individuals are most likely to initiate alcohol use. This study aimed to examine whether inhibitory control and working memory would predict alcohol use and involvement in a group of UK adolescents. Methods We recruited 220 (N = 178, female) adolescents, aged between 16 and 18, from eight higher education settings in the Merseyside region of the UK. Alcohol use was examined using the Timeline Follow-Back and involvement (and related problems) using the Adolescent Alcohol Involvement Scale. A reward-based inhibitory control task (Go/No-Go) was used to examine the inhibition and reward sensitivity, and a self-ordered pointing task was used to measure working memory. Results Multiple regression demonstrated that neither inhibitory control (b = 0.02 (95% confidence interval (CI): −0.21, 0.24)) nor working memory (b = −0.12 (95% CI: −0.30, 0.07)) were significant predictors of alcohol use (units consumed). Inhibitory control (b = 0.61 (95% CI: 0.12, 1.09), specifically, in the no reward condition and school deprivation (b = 0.67 (95% CI: 0.06, 1.28) significantly predicted alcohol-related problems. Conclusions Our findings demonstrated limited evidence that deficits in specific mechanisms of executive functioning (i.e. motor inhibition and working memory) were associated with alcohol-related problems in UK adolescents. This study adds to an increasing body of literature suggesting weak or non-existent links between inhibitory control, working memory and alcohol use.
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Affiliation(s)
- Sam Burton
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Jo-Anne Puddephatt
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Laura Baines
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Florence Sheen
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Jasmine G Warren
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, Institute of Population Health, Eleanor Rathbone Building, Bedford Street South, University of Liverpool, L69 7ZA, UK
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13
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Kallweit C, Paucke M, Strauß M, Exner C. Adult ADHD: Influence of Physical Activation, Stimulation, and Reward on Cognitive Performance and Symptoms. J Atten Disord 2021; 25:809-819. [PMID: 31096844 PMCID: PMC7897786 DOI: 10.1177/1087054719845050] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Models of ADHD consider the influence of situational factors on cognitive performance and symptoms. Method: The influence of acute physical exercise, stimulation through continuous fine motor movement, and performance-related reward on performance and ADHD symptoms was assessed. Thirty-six adults with ADHD and 36 healthy controls performed executive function tasks (EF-tasks) of inhibition, selective attention, and working memory with material close to daily life. Experimental manipulations aimed at increasing cognitive performance. Results: No significant effects were found, but there were indicators for ADHD-specific impacts: Reward resulted in higher reported hyperactivity. Acute physical exercise slightly tended to improve attention performance and subjective inattention. Conclusion: The manipulations may affect performance and especially symptoms in different ways. Potential symptom interactions and identification of factors that determine whether symptoms may be functional or detrimental for task performance could be future research interests.
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Affiliation(s)
- Claudia Kallweit
- Department of Psychology, Clinical Psychology and Psychotherapy Unit, University of Leipzig, Germany,Claudia Kallweit, Clinical Psychology and Psychotherapy Unit, Department of Psychology, University of Leipzig, Leipzig 04081, Germany.
| | - Madlen Paucke
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Germany
| | - Maria Strauß
- Department of Psychiatry and Psychotherapy, Leipzig University Hospital, Germany
| | - Cornelia Exner
- Department of Psychology, Clinical Psychology and Psychotherapy Unit, University of Leipzig, Germany
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14
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Abramovitch A, Short T, Schweiger A. The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology. Clin Psychol Rev 2021; 86:102007. [PMID: 33864968 DOI: 10.1016/j.cpr.2021.102007] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
Research into cognitive functions across psychological disorders suggests that cognitive deficiencies may be present across multiple disorders, potentially pointing to a transdiagnostic phenomenon. More recently, a single dimension model of psychopathology, the p factor, has been proposed, in which cognitive deficits are thought to be an intrinsic construct, assumed to be transdiagnostic. However, no systematic investigation to date tested this hypothesis. The aim of the present study was to systematically review meta-analyses to assess the hypothesis that the C factor (cognitive dysfunction) is transdiagnostic in psychopathology and review potential moderators that may account for such a phenomenon. We conducted a systematic review of meta-analyses examining cognitive function across all disorders for which data were available. Included meta-analyses (n = 82), comprising 97 clinical samples, yielded 1,055 effect sizes. Twelve major disorders/categories (e.g., bipolar disorder, substance use disorders) were included, comprising 29 distinct clinical entities (e.g., euthymic bipolar disorder; alcohol use disorder). Results show that all disorders reviewed are associated with underperformance across cognitive domains, supporting the hypothesis that the C factor (or cognitive dysfunction) is a transdiagnostic factor related to p. To examine moderators that may explain or contribute to c, we first consider important interpretative limitations of neuropsychological data in psychopathology. More crucially, we review oft-neglected motivational and emotional transdiagnostic constructs of p, as prominent contributing constructs to the C factor. These constructs are offered as a roadmap for future research examining these constructs related to p, that contribute, and may account for cognitive dysfunctions in psychopathology.
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Affiliation(s)
| | - Tatiana Short
- Department of Psychology, Texas State University, USA
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15
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Burton S, Knibb G, Jones A. A meta-analytic investigation of the role of reward on inhibitory control. Q J Exp Psychol (Hove) 2021; 74:1818-1828. [PMID: 33759636 PMCID: PMC8392762 DOI: 10.1177/17470218211008895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Contemporary theories predict that inhibitory control (IC) can be improved when rewards are available for successfully inhibiting. In non-clinical samples empirical research has demonstrated some support; however, "null" findings have also been published. The aim of this meta-analysis was to clarify the magnitude of the effect of reward on IC and identify potential moderators. A total of 73 articles (contributing k = 80 studies) were identified from PubMed, PsycInfo, and Scopus, published between 1997 and 2020, using a systematic search strategy. A random effects meta-analysis was performed on effect sizes generated from IC tasks, which included rewarded and non-rewarded inhibition trials. Moderator analyses were conducted on clinical samples (vs "healthy controls"), task type (go/no-go vs stop signal vs Flanker vs Simon vs Stroop vs Anti-saccade), reward type (monetary vs points vs other), and age (adults vs children). The prospect of reward for successful inhibition significantly improved IC (SMD = 0.429, 95% CI = 0.288, 0.570, I2 = 96.7%) compared with no reward conditions/groups. This finding was robust against influential cases and outliers. The significant effect was present across all IC tasks. There was no evidence of the effect moderated by type of reward, age, or clinical samples. Moderator analyses did not resolve the considerable heterogeneity. The findings suggest that IC is a transient state that fluctuates in response to motivations driven by reward. Future research might examine the potential of improving IC through rewards as a behavioural intervention.
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Affiliation(s)
- Sam Burton
- Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Graeme Knibb
- Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Andrew Jones
- Psychological Sciences, University of Liverpool, Liverpool, UK
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16
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Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
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Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
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17
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Doidge JL, Flora DB, Toplak ME. A Meta-Analytic Review of Sex Differences on Delay of Gratification and Temporal Discounting Tasks in ADHD and Typically Developing Samples. J Atten Disord 2021; 25:540-561. [PMID: 30596297 DOI: 10.1177/1087054718815588] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To examine whether males and females with ADHD differ in their preferences for delayed rewards, since there is some evidence that suggests a sex difference with typically developing (TD) samples. Method: We used meta-analyses to examine sex differences on delay of gratification and temporal discounting tasks in both TD and ADHD samples. We identified 28 papers with 52 effect sizes for children and adults, and calculated the average effect size for sex comparisons within TD and ADHD samples. Results: The estimated mean difference between TD males and TD females was negligible, but males with ADHD were more likely to choose the larger delayed rewards than females with ADHD. Meta-regressions indicated that task type, age, and reward type did not significantly predict sex differences. Conclusion: These findings suggest that females referred for ADHD may make less adaptive choices by preferring smaller immediate rewards over larger delayed rewards more often than males with ADHD. Implications of our findings are discussed.
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18
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Marx I, Hacker T, Yu X, Cortese S, Sonuga-Barke E. ADHD and the Choice of Small Immediate Over Larger Delayed Rewards: A Comparative Meta-Analysis of Performance on Simple Choice-Delay and Temporal Discounting Paradigms. J Atten Disord 2021; 25:171-187. [PMID: 29806533 DOI: 10.1177/1087054718772138] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Impulsive choices can lead to suboptimal decision making, a tendency which is especially marked in individuals with ADHD. We compared two different paradigms assessing impulsive choice: the simple choice paradigm (SCP) and the temporal discounting paradigm (TDP). Method: Random effects meta-analyses on 37 group comparisons (22 SCP; 15 TDP) consisting of 3.763 participants (53% ADHD). Results: Small-to-medium effect sizes emerged for both paradigms, confirming that participants with ADHD choose small immediate over large delayed rewards more frequently than controls. Moderation analyses show that offering real rewards in the SCP almost doubled the odds ratio for participants with ADHD. Conclusion: We suggest that a stronger than normal aversion toward delay interacts with a demotivating effect of hypothetical rewards, both factors promoting impulsive choice in participants with ADHD. Furthermore, we suggest the SCP as the paradigm of choice due to its larger ecological validity, contextual sensitivity, and reliability.
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Affiliation(s)
- Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Thomas Hacker
- Department of Psychiatry and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Xue Yu
- School of Education, Chongqing Normal University, Chongqing, China
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, Southampton, UK.,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK.,Solent NHS Trust, Southampton, UK.,New York University Child Study Center, New York, USA.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
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19
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Ceceli AO, Natsheh JY, Cruz D, Tricomi E. The neurobehavioral mechanisms of motivational control in attention-deficit/hyperactivity disorder. Cortex 2020; 127:191-207. [PMID: 32222572 DOI: 10.1016/j.cortex.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/27/2019] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) poses debilitating impairments in the neurobehavioral systems governing reward-related processes-key to the control of motivated behaviors. Individuals with ADHD may rely on a motivational control system that favors cue-driven habits-rooted in the posterior putamen-over caudate and prefrontal cortex-driven goal-directed behaviors. We examined the neurobehavioral correlates of motivational control in ADHD. Twenty-five adults with ADHD and 25 neurotypicals underwent fMRI while training on two stimulus-response-outcome associations. A devaluation procedure followed, whereby they were selectively satiated on one of the snack outcomes, decreasing its value. A subsequent extinction test determined outcome-sensitivity (i.e., whether responses towards devalued snack diminished). Despite behavioral similarities, the ADHD group displayed a distinct neural signature marked by enhanced posterior putamen activation as a function of training. This region also displayed diminished functional connectivity with the dorsal anterior cingulate cortex, which is associated with top-down control. Our whole-brain analysis yielded ADHD-specific posterior putamen and opercular/insular cortex activity over the course of training-regions associated with stimulus-sensitivity and maladaptively rigid behaviors, respectively. Neural comparisons also identified hyper-recruitment of the hippocampus in the ADHD group. These results highlight corticostriatal discrepancies in ADHD, possibly serving as a biomarker of the disorder.
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Affiliation(s)
- Ahmet O Ceceli
- Department of Psychology, Rutgers University-Newark, Newark, NJ, United States.
| | - Joman Y Natsheh
- Kessler Foundation, East Hanover, NJ, United States; Children's Specialized Hospital Research Center, New Brunswick, NJ, United States.
| | - Daniel Cruz
- Counseling Services, Rutgers University-Newark, Newark, NJ, United States.
| | - Elizabeth Tricomi
- Department of Psychology, Rutgers University-Newark, Newark, NJ, United States.
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20
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Prehn-Kristensen A, Ngo HVV, Lentfer L, Berghäuser J, Brandes L, Schulze L, Göder R, Mölle M, Baving L. Acoustic closed-loop stimulation during sleep improves consolidation of reward-related memory information in healthy children but not in children with attention-deficit hyperactivity disorder. Sleep 2020; 43:5731400. [DOI: 10.1093/sleep/zsaa017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
Abstract
Study Objectives
Slow oscillations (SO) during slow-wave sleep foster the consolidation of declarative memory. Children with attention-deficit hyperactivity disorder (ADHD) display deficits in the sleep-associated consolidation of declarative memory, possibly due to an altered function of SO. The present study aimed at enhancing SO activity using closed-looped acoustic stimulation during slow-wave sleep in children with ADHD.
Methods
A total of 29 male children (14 with ADHD; aged 8–12 years) participated in a double-blind, placebo-controlled study trial. Children spent two experimental nights in a sleep lab, one stimulation night and one sham night. A declarative learning task (word-pair learning) with a reward condition was used as a primary outcome. Secondary outcome variables were a procedural memory (serial reaction time) and working memory (WM; n-back) task. Encoding of declarative and procedural memory took place in the evening before sleep. After sleep, the retrieval took place followed by the n-back task.
Results
The stimulation successfully induced SO activity during sleep in children with and without ADHD. After stimulation, only healthy children performed better on high-rewarded memory items (primary outcome). In contrast, there were indications that only children with ADHD benefitted from the stimulation with respect to procedural as well as WM performance (secondary outcome).
Conclusions
We were able to show that the acoustic closed-loop stimulation can be applied to enhance SO activity in children with and without ADHD. Our data indicate that SO activity during sleep interacts with subsequent memory performance (primary outcome: rewarded declarative memory; secondary outcome: procedural and WM) in children with and without ADHD.
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Affiliation(s)
- Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Hong-Viet V Ngo
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Luisa Lentfer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Julia Berghäuser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Lena Brandes
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Larissa Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Matthias Mölle
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Lioba Baving
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University, Kiel, Germany
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21
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Ceceli AO, Esposito G, Tricomi E. Habit Expression and Disruption as a Function of Attention-Deficit/Hyperactivity Disorder Symptomology. Front Psychol 2019; 10:1997. [PMID: 31551864 PMCID: PMC6733985 DOI: 10.3389/fpsyg.2019.01997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/14/2019] [Indexed: 12/23/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with neurobehavioral reward system dysfunctions that pose debilitating impairments in adaptive decision-making. A candidate mechanism for such anomalies in ADHD may be a compromise in the control of motivated behaviors. Thus, demonstrating and restoring potential motivational control irregularities may serve significant clinical benefit. The motivational control of action guides goal-directed behaviors that are driven by outcome value, and habits that are inflexibly cue-triggered. We examined whether ADHD symptomology within the general population is linked to habitual control, and whether a motivation-based manipulation can break well-learned habits. We obtained symptom severity scores from 106 participants and administered a Go/NoGo task that capitalizes on familiar, well-learned associations (green-Go and red-NoGo) to demonstrate outcome-insensitivity when compared to newly learned Go/NoGo associations. We tested for outcome-insensitive habits by changing the Go and NoGo contingencies, such that Go signals became NoGo signals and vice versa. We found that generally, participants responded less accurately when green and red stimuli were mapped to color-response contingencies that were incongruent with daily experiences, whereas novel Go/NoGo stimuli evoked similar accuracy regardless of color-response mappings. Thus, our Go/NoGo task successfully elicited outcome-insensitive habits (i.e., persistent responses to familiar stimuli without regard for consequences); however, this effect was independent of ADHD symptomology. Nevertheless, we found an association between hyperactivity and congruent Go response latency, suggesting heightened pre-potency to perform habitual Go actions as hyperactivity increases. To examine habit disruption, participants returned to the lab and underwent the familiar version of the Go/NoGo task, but were given mid-experiment performance tracking information and a monetary incentive prior to contingency change. We found that this motivational boost via dual feedback prevented the incongruency-related accuracy impairment, effectively breaking the habit, albeit independent of ADHD symptomology. Our findings present only a modest link between ADHD symptomology and motivational control, which may be due to compensatory mechanisms in ADHD driving goal-directed control, or our task's potential insensitivity to individual differences in ADHD symptomology. Further investigations may be crucial for determining whether ADHD is related to motivational impairments.
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Affiliation(s)
- Ahmet O. Ceceli
- Department of Psychology, Rutgers University-Newark, Newark, NJ, United States
| | | | - Elizabeth Tricomi
- Department of Psychology, Rutgers University-Newark, Newark, NJ, United States
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22
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Addicott MA, Schechter JC, Sapyta JJ, Selig JP, Kollins SH, Weiss MD. Methylphenidate increases willingness to perform effort in adults with ADHD. Pharmacol Biochem Behav 2019; 183:14-21. [PMID: 31226260 DOI: 10.1016/j.pbb.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/31/2019] [Accepted: 06/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND A reduced willingness to perform effort based on the magnitude and probability of potential rewards has been associated with diminished dopamine function and may be relevant to attention-deficit/hyperactivity disorder (ADHD). Here, we investigated the influence of ADHD status and methylphenidate on effort-based decisions. We hypothesized that ADHD participants would make fewer high-effort selections than non-ADHD subjects, and that methylphenidate would increase the number of high-effort selections. Furthermore, we hypothesized there would be associations among ADHD severity and methylphenidate-related changes in effort-based and attentional performance across all participants. METHODS AND PARTICIPANTS ADHD (n = 23) and non-ADHD (n = 23) adults completed the Effort Expenditure for Rewards Task in which participants select between low-effort and high-effort options to receive monetary rewards at varying levels of reward magnitude and probability. A test of attentional performance was also completed. RESULTS Overall, participants made more high-effort selections as potential reward magnitude and probability increased. ADHD participants did not make fewer high-effort selections than non-ADHD participants, but ADHD participants showed greater methylphenidate-related increases in high-effort selections. ADHD participants had worse attentional performance than non-ADHD participants. ADHD severity was associated with methylphenidate-related changes in high-effort selections, but not changes in attentional performance. CONCLUSIONS These results indicate that methylphenidate increases the willingness to perform effort in individuals with ADHD, possibly due to disorder-related motivational deficits. This provides support for theories of insufficient effort allocation among individuals with ADHD. TRIAL REGISTRATION Clinicaltrials.gov Identifier, NCT02630017.
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Affiliation(s)
| | | | | | - James P Selig
- University of Arkansas for Medical Sciences, United States of America
| | - Scott H Kollins
- Duke University School of Medicine, United States of America
| | - Margaret D Weiss
- University of Arkansas for Medical Sciences, United States of America
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23
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Marx I, Reis O, Berger C. Perceptual timing in children with attention-deficit/hyperactivity disorder (ADHD) as measured by computer-based experiments versus real-life tasks: protocol for a cross-sectional experimental study in an ambulatory setting. BMJ Open 2019; 9:e027651. [PMID: 31028043 PMCID: PMC6502000 DOI: 10.1136/bmjopen-2018-027651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The goal of this study is to get a better understanding of the fundamentals of perceptual timing deficits, that is, difficulties with estimating durations of explicitly attended temporal intervals, in children with attention-deficit/hyperactivity disorder (ADHD). Whereas these deficits were repeatedly demonstrated in laboratory studies using computer-based timing tasks, we will additionally implement a more practical task reflecting real-life activity. In doing so, the research questions of the planned study follow a hierarchically structured path 'from lab to life': Are the timing abilities of children with ADHD really disturbed both in the range of milliseconds and in the range of seconds? What causes these deficits? Do children with ADHD rather display a global perceptual timing deficit, or do different 'timing types' exist? Are timing deficits present during real-life activities as well, and are they based on the same mechanisms as in computerised tasks? METHODS AND ANALYSES A quasi-experimental study with two groups of male children aged 8-12 years (ADHD; controls) and with a cross-sectional design will be used to address our research questions. Statistical analyses of the dependent variables will comprise (repeated) measures analyses of variance, stepwise multiple regression analyses and latent class models. With an estimated dropout rate of 25%, power analysis indicated a sample size of 140 subjects (70 ADHD, 70 controls) to detect medium effect sizes. ETHICS AND DISSEMINATION Ethics approval was obtained from the ethics committee of the Faculty of Medicine, University of Rostock. Results will be disseminated to researcher, clinician and patient communities in peer-reviewed journals and at scientific conferences, at a meeting of the local ADHD competence network and on our web page which will summarise the study results in an easily comprehensible manner. TRIAL REGISTRATION NUMBER DRKS00015760.
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Affiliation(s)
- Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
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24
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Metin B, Tas ZC, Çebi M, Büyükaslan A, Soysal A, Hatıloglu D, Tarhan N. Reward Processing Deficits During a Spatial Attention Task in Patients With ADHD: An fMRI Study. J Atten Disord 2018; 22:694-702. [PMID: 28423978 DOI: 10.1177/1087054717703188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In this study, we aimed to explore how cues signaling rewards and feedbacks about rewards are processed in ADHD. METHOD Inside the scanner, 16 healthy children and 19 children with ADHD completed a spatial attention paradigm where cues informed about the availability of reward and feedbacks were provided about the earned reward. RESULTS In ventral anterior thalamus (VA), the controls exhibited greater activation in response to reward-predicting cues, as compared with no-reward cues, whereby in the ADHD group, the reverse pattern was observed (nonreward > reward). For feedbacks; absence of rewards produced greater activation than presence in the left caudate and frontal eye field for the control group, whereas for the ADHD group, the reverse pattern was again observed (reward > nonreward). DISCUSSION The present findings indicate that ADHD is associated with difficulty integrating reward contingency information with the orienting and regulatory phases of attention.
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Affiliation(s)
| | | | | | | | | | - Deniz Hatıloglu
- 1 Uskudar University, Turkey.,4 NPIstanbul Brain Hospital, Turkey
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25
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Morsink S, Sonuga-Barke E, Mies G, Glorie N, Lemiere J, Van der Oord S, Danckaerts M. What motivates individuals with ADHD? A qualitative analysis from the adolescent's point of view. Eur Child Adolesc Psychiatry 2017; 26:923-932. [PMID: 28233072 DOI: 10.1007/s00787-017-0961-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/09/2017] [Indexed: 12/26/2022]
Abstract
Individuals with ADHD appear to respond differently to incentives than their peers. This could be due to a general altered sensitivity to reinforcers. However, apart from differences in the degree of motivation, individuals with ADHD might also be motivated by qualitatively different factors. This study aimed to harvest a range of motivational factors and identify ADHD-related qualitative differences in motivation, from the adolescent's point of view. Semi-structured interviews allowing participants to describe what motivates them in daily life were conducted with young adolescents (9-16 years) with and without ADHD. Thematic analysis was undertaken using NVivo software. Major themes relating to motivation were identified from the interview data. These were: (1) achieving a sense of togetherness; (2) feeling competent; (3) fulfilling a need for variation; (4) gaining pleasure from applying effort to achieve a goal; (5) valuing social reinforcement; (6) desiring to be absorbed/forget problems; (7) feeling free and independent, (8) attaining material reinforcement; and (9) an enjoyment of bodily stimulation. The theme structure was very similar for both groups. However, individuals with ADHD differed in some specifics: their focus on the passing of time, the absence of preference for predictable and familiar tasks, and their less elaborate description of the togetherness theme. A broad range of motivational themes was identified, stretching beyond the current focus of ADHD research and motivational theories. Similarities and differences in motivational values of individuals with and without ADHD should be taken into account in reward sensitivity research, and in psychological treatment.
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Affiliation(s)
- Sarah Morsink
- Department of Neuroscience, Psychiatry Research, KU Leuven, Louvain, Belgium
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK. .,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Gabry Mies
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Jurgen Lemiere
- Department of Child and Adolescent Psychiatry, UPC KU Leuven, Louvain, Belgium
| | - Saskia Van der Oord
- Clinical Psychology, KU Leuven, Louvain, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Marina Danckaerts
- Department of Neuroscience, Psychiatry Research, KU Leuven, Louvain, Belgium.,Department of Child and Adolescent Psychiatry, UPC KU Leuven, Louvain, Belgium
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26
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Wilbertz G, Delgado MR, Tebartz Van Elst L, Maier S, Philipsen A, Blechert J. Neural response during anticipation of monetary loss is elevated in adult attention deficit hyperactivity disorder. World J Biol Psychiatry 2017; 18:268-278. [PMID: 26508322 DOI: 10.3109/15622975.2015.1112032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Risky behaviour seriously impacts the life of adult patients with attention deficit hyperactivity disorder (ADHD). Such behaviours have often been attributed to their exaggerated reward seeking, but dysfunctional anticipation of negative outcomes might also play a role. METHODS The present study compared adult patients with ADHD (n = 28) with matched healthy controls (n = 28) during anticipation of monetary losses versus gains while undergoing functional magnetic resonance imaging (fMRI) and skin conductance recording. RESULTS Skin conductance was higher during anticipation of losses compared to gains in both groups. Affective ratings of predictive cues did not differ between groups. ADHD patients showed increased activity in bilateral amygdalae, left anterior insula (region of interest analysis) and left temporal pole (whole brain analysis) compared to healthy controls during loss versus gain anticipation. In the ADHD group higher insula and temporal pole activations went along with more negative affective ratings. CONCLUSIONS Neural correlates of loss anticipation are not blunted but rather increased in ADHD, possibly due to a life history of repeated failures and the respective environmental sanctions. Behavioural adaptations to such losses, however, might differentiate them from controls: future research should study whether negative affect might drive more risk seeking than risk avoidance.
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Affiliation(s)
- Gregor Wilbertz
- a Department of Psychology , University of Freiburg , Freiburg , Germany.,b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany.,c Department of Psychiatry and Psychotherapy , Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Mauricio R Delgado
- d Department of Psychology , Rutgers University , Newark , NJ 07102 , USA
| | - Ludger Tebartz Van Elst
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany
| | - Simon Maier
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany
| | - Alexandra Philipsen
- b Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry , University Medical Centre Freiburg , Freiburg , Germany.,e Medical Campus University of Oldenburg, School of Medicine and Health Sciences , Psychiatry and Psychotherapy - University Hospital , Karl-Jaspers-Klinik, Bad Zwischenahn , Germany
| | - Jens Blechert
- f Center for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria.,g Department of Psychology, University of Salzburg , Salzburg , Austria
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27
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Marx I, Weirich S, Berger C, Herpertz SC, Cohrs S, Wandschneider R, Höppner J, Häßler F. Living in the Fast Lane: Evidence for a Global Perceptual Timing Deficit in Childhood ADHD Caused by Distinct but Partially Overlapping Task-Dependent Cognitive Mechanisms. Front Hum Neurosci 2017; 11:122. [PMID: 28373837 PMCID: PMC5357633 DOI: 10.3389/fnhum.2017.00122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 03/03/2017] [Indexed: 11/13/2022] Open
Abstract
Dysfunctions in perceptual timing have been reported in children with ADHD, but so far only from studies that have not used the whole set of timing paradigms available from the literature, with the diversity of findings complicating the development of a unified model of timing dysfunctions and its determinants in ADHD. Therefore, we employed a comprehensive set of paradigms (time discrimination, time estimation, time production, and time reproduction) in order to explore the perceptual timing deficit profile in our ADHD sample. Moreover, we aimed to detect predictors responsible for timing task performance deficits in children with ADHD and how the timing deficits might be positively affected by methylphenidate. Male children with ADHD and healthy control children, all aged between 8 and 13 years, participated in this longitudinal study with three experimental sessions, where children with ADHD were medicated with methylphenidate at the second session but discontinued their medication at the remaining sessions. The results of our study reveal that children with ADHD were impaired in all timing tasks, arguing for a general perceptual timing deficit in ADHD. In doing so, our predictor analyses support the notion that distinct but partially overlapping cognitive mechanisms might exist for discriminating, estimating/producing, and reproducing time intervals. In this sense, working memory deficits in terms of an abnormally fast internal counting process might be common to dysfunctions in the time estimation/time production tasks and in the time reproduction task, with attention deficits (e.g., in terms of disruptions of the counting process) additionally contributing to time estimation/time production deficits and motivational alterations additionally contributing to time reproduction deficits. Methylphenidate did not significantly alter performance of the ADHD sample, presumably due to limited statistical power of our study. The findings of our study demonstrate a pivotal role of disturbed working memory processes in perceptual timing task performance in childhood ADHD, at the same time broadening the view for additional attentional and motivational determinants of impaired task performance.
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Affiliation(s)
- Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Steffen Weirich
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Stefan Cohrs
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Roland Wandschneider
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Jacqueline Höppner
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Frank Häßler
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
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28
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Nazari MA, Mirloo MM, Rezaei M, Soltanlou M. Emotional stimuli facilitate time perception in children with attention-deficit/hyperactivity disorder. J Neuropsychol 2016; 12:165-175. [PMID: 27566601 DOI: 10.1111/jnp.12111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 07/17/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study was to compare the effect of different emotional stimuli (neutral, positive, and negative) on time perception in children with attention-deficit/hyperactivity disorder (ADHD) and normal children in dual-task form. Five hundred and ninety-nine students from primary schools were randomly selected. The Conner's Teacher Rating Scale (CTRS) questionnaire was completed by teachers. A total of 100 children with a score above the cut-off point for the CTRS were further assessed using the Child Symptom Inventory-4 (CSI-4). A total of 34 children with ADHD and 31 controls completed an emotional time discrimination task in two blocks of 1000 and 2000 ms duration. Children were asked to compare three image groups: neutral with neutral, neutral with positive, and neutral with negative images. Children with ADHD had significantly better performance in the emotional time discrimination task across all conditions when compared with controls: On average, discrimination thresholds were approximately 35 ms shorter for the children with ADHD. Our results indicate that children with ADHD have higher sensitivity to time relative to controls in a situation in which they must distribute resources between temporal and emotional processing. On the basis of the interference effect and the working memory capacity hypothesis, this dividing of attention causes a decrease of time accuracy in normal children.
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Affiliation(s)
- Mohammad A Nazari
- Cognitive Neuroscience Laboratory, Department of Psychology, University of Tabriz, Iran
| | | | - Mazaher Rezaei
- Departments of Psychiatry and Clinical Psychology, Zanjan University of Medical Sciences, Iran
| | - Mojtaba Soltanlou
- Graduate Training Centre of Neuroscience/IMPRS for Cognitive and Systems Neuroscience, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Germany
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29
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ERP Correlates of Proactive and Reactive Cognitive Control in Treatment-Naïve Adult ADHD. PLoS One 2016; 11:e0159833. [PMID: 27448275 PMCID: PMC4957760 DOI: 10.1371/journal.pone.0159833] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/08/2016] [Indexed: 11/19/2022] Open
Abstract
This study investigated whether treatment naïve adults with Attention Deficit Hyperactivity Disorder (ADHD; n = 33; 19 female) differed from healthy controls (n = 31; 17 female) in behavioral performance, event-related potential (ERP) indices of preparatory attention (CueP3 and late CNV), and reactive response control (Go P3, NoGo N2, and NoGo P3) derived from a visual cued Go/NoGo task. On several critical measures, Cue P3, late CNV, and NoGo N2, there were no significant differences between the groups. This indicated normal preparatory processes and conflict monitoring in ADHD patients. However, the patients had attenuated Go P3 and NoGoP3 amplitudes relative to controls, suggesting reduced allocation of attentional resources to processes involved in response control. The patients also had a higher rate of Go signal omission errors, but no other performance decrements compared with controls. Reduced Go P3 and NoGo P3 amplitudes were associated with poorer task performance, particularly in the ADHD group. Notably, the ERPs were not associated with self-reported mood or anxiety. The results provide electrophysiological evidence for reduced effortful engagement of attentional resources to both Go and NoGo signals when reactive response control is needed. The absence of group differences in ERP components indexing proactive control points to impairments in specific aspects of cognitive processes in an untreated adult ADHD cohort. The associations between ERPs and task performance provided additional support for the altered electrophysiological responses.
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30
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Gonen-Yaacovi G, Arazi A, Shahar N, Karmon A, Haar S, Meiran N, Dinstein I. Increased ongoing neural variability in ADHD. Cortex 2016; 81:50-63. [PMID: 27179150 DOI: 10.1016/j.cortex.2016.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 12/31/2015] [Accepted: 04/07/2016] [Indexed: 11/30/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) has been described as a disorder where frequent lapses of attention impair the ability of an individual to focus/attend in a sustained manner, thereby generating abnormally large intra-individual behavioral variability across trials. Indeed, increased reaction time (RT) variability is a fundamental behavioral characteristic of individuals with ADHD found across a large number of cognitive tasks. But what is the underlying neurophysiology that might generate such behavioral instability? Here, we examined trial-by-trial EEG response variability to visual and auditory stimuli while subjects' attention was diverted to an unrelated task at the fixation cross. Comparisons between adult ADHD and control participants revealed that neural response variability was significantly larger in the ADHD group as compared with the control group in both sensory modalities. Importantly, larger trial-by-trial variability in ADHD was apparent before and after stimulus presentation as well as in trials where the stimulus was omitted, suggesting that ongoing (rather than stimulus-evoked) neural activity is continuously more variable (noisier) in ADHD. While the patho-physiological mechanisms causing this increased neural variability remain unknown, they appear to act continuously rather than being tied to a specific sensory or cognitive process.
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Affiliation(s)
- Gil Gonen-Yaacovi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ayelet Arazi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nitzan Shahar
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Karmon
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shlomi Haar
- Department of Cognitive and Brain Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nachshon Meiran
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilan Dinstein
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Cognitive and Brain Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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31
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Time windows matter in ADHD-related developing neuropsychological basic deficits: A comprehensive review and meta-regression analysis. Neurosci Biobehav Rev 2015; 55:165-72. [DOI: 10.1016/j.neubiorev.2015.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 03/24/2015] [Accepted: 04/25/2015] [Indexed: 11/19/2022]
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32
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Peskin VA, Ordóñez A, Mackin RS, Delucchi K, Monge S, McGough JJ, Chavira DA, Berrocal M, Cheung E, Fournier E, Badner JA, Herrera LD, Mathews CA. Neuropsychological and dimensional behavioral trait profiles in Costa Rican ADHD sib pairs: Potential intermediate phenotypes for genetic studies. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:247-57. [PMID: 25832558 PMCID: PMC4437811 DOI: 10.1002/ajmg.b.32305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 02/12/2015] [Indexed: 01/19/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is associated with substantial functional impairment in children and in adults. Many individuals with ADHD have clear neurocognitive deficits, including problems with visual attention, processing speed, and set shifting. ADHD is etiologically complex, and although genetic factors play a role in its development, much of the genetic contribution to ADHD remains unidentified. We conducted clinical and neuropsychological assessments of 294 individuals (269 with ADHD) from 163 families (48 multigenerational families created using genealogical reconstruction, 78 affected sib pair families, and 37 trios) from the Central Valley of Costa Rica (CVCR). We used principal components analysis (PCA) to group neurocognitive and behavioral variables using the subscales of the Child Behavior Checklist (CBCL) and 15 neuropsychological measures, and created quantitative traits for heritability analyses. We identified seven cognitive and two behavioral domains. Individuals with ADHD were significantly more impaired than their unaffected siblings on most behavioral and cognitive domains. The verbal IQ domain had the highest heritability (92%), followed by auditory attention (87%), visual processing speed and problem solving (85%), and externalizing symptoms (81%). The quantitative traits identified here have high heritabilities, similar to the reported heritability of ADHD (70-90%), and may represent appropriate alternative phenotypes for genetic studies. The use of multigenerational families from a genetically isolated population may facilitate the identification of ADHD risk genes in the face of phenotypic and genetic heterogeneity.
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Affiliation(s)
- Viviana A. Peskin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Anna Ordóñez
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland
| | - R. Scott Mackin
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Silvia Monge
- Department of Psychiatry, Hospital CIMA, San José, Costa Rica
| | - James J. McGough
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA
| | - Denise A. Chavira
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | - Monica Berrocal
- Department of Psychiatry, Hospital CIMA, San José, Costa Rica
| | - Erika Cheung
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | | | - Judith A. Badner
- Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, Illinois
| | | | - Carol A. Mathews
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
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33
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Thoma P, Edel MA, Suchan B, Bellebaum C. Probabilistic reward learning in adults with Attention Deficit Hyperactivity Disorder--an electrophysiological study. Psychiatry Res 2015; 225:133-144. [PMID: 25467706 DOI: 10.1016/j.psychres.2014.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 10/22/2014] [Accepted: 11/04/2014] [Indexed: 12/18/2022]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is hypothesized to be characterized by altered reinforcement sensitivity. The main aim of the present study was to assess alterations in the electrophysiological correlates of monetary reward processing in adult patients with ADHD of the combined subtype. Fourteen adults with ADHD of the combined subtype and 14 healthy control participants performed an active and an observational probabilistic reward-based learning task while an electroencephalogramm (EEG) was recorded. Regardless of feedback valence, there was a general feedback-related negativity (FRN) enhancement in combination with reduced learning performance during both active and observational reward learning in patients with ADHD relative to healthy controls. Other feedback-locked potentials such as the P200 and P300 and response-locked potentials were unaltered in the patients. There were no significant correlations between learning performance, FRN amplitudes and clinical symptoms, neither in the overall group involving all participants, nor in patients or controls considered separately. This pattern of findings might reflect generally impaired reward prediction in adults with ADHD of the combined subtype. We demonstrated for the first time that patients with ADHD of the combined subtype show not only deficient active reward learning but are also impaired when learning by observing other people׳s outcomes.
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Affiliation(s)
- Patrizia Thoma
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Marc-Andreas Edel
- Department of Psychiatry, Ruhr-University of Bochum, LWL University Hospital, Alexandrinenstraße 1, 44791 Bochum, Germany
| | - Boris Suchan
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Christian Bellebaum
- Institute for Experimental Psychology, Heinrich Heine University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
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34
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Grane VA, Endestad T, Pinto AF, Solbakk AK. Attentional control and subjective executive function in treatment-naive adults with Attention Deficit Hyperactivity Disorder. PLoS One 2014; 9:e115227. [PMID: 25545156 PMCID: PMC4278892 DOI: 10.1371/journal.pone.0115227] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/20/2014] [Indexed: 11/19/2022] Open
Abstract
We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD.
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Affiliation(s)
- Venke Arntsberg Grane
- Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Tor Endestad
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Anne-Kristin Solbakk
- Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
- Department of Neurosurgery, Division of Surgery and Clinical Neuroscience, Oslo University Hospital—Rikshospitalet, Oslo, Norway
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35
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Abstract
Research on cognitive control and executive function has long recognized the relevance of motivational factors. Recently, however, the topic has come increasingly to center stage, with a surge of new studies examining the interface of motivation and cognitive control. In the present article we survey research situated at this interface, considering work from cognitive and social psychology and behavioral economics, but with a particular focus on neuroscience research. We organize existing findings into three core areas, considering them in the light of currently vying theoretical perspectives. Based on the accumulated evidence, we advocate for a view of control function that treats it as a domain of reward-based decision making. More broadly, we argue that neuroscientific evidence plays a critical role in understanding the mechanisms by which motivation and cognitive control interact. Opportunities for further cross-fertilization between behavioral and neuroscientific research are highlighted.
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Affiliation(s)
- Matthew Botvinick
- Princeton Neuroscience Institute and Department of Psychology, Princeton University, Princeton, New Jersey 08540;
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36
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Kollins SH, Adcock RA. ADHD, altered dopamine neurotransmission, and disrupted reinforcement processes: implications for smoking and nicotine dependence. Prog Neuropsychopharmacol Biol Psychiatry 2014; 52:70-8. [PMID: 24560930 PMCID: PMC4004668 DOI: 10.1016/j.pnpbp.2014.02.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 11/19/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common and impairing disorder affecting millions of children, adolescents, and adults. Individuals with ADHD smoke cigarettes at rates significantly higher than their non-diagnosed peers and the disorder also confers risk for a number of related adverse smoking outcomes including earlier age of initiation, faster progression to regular use, heavier smoking/greater dependence, and more difficulty quitting. Progress in our understanding of dopamine neurotransmission and basic behavioral reinforcement processes in ADHD may help increase our understanding of the ADHD-smoking comorbidity. This review will examine how these areas have been studied and how further work may aid in the development of better prevention and treatment for smoking in those with ADHD.
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Affiliation(s)
- Scott H Kollins
- Department of Psychiatry & Behavioral Science, Duke University School of Medicine, Durham, NC, USA.
| | - R Alison Adcock
- Department of Psychiatry & Behavioral Science, Duke University School of Medicine, Durham, NC, USA; Duke Center for Cognitive Neuroscience, Duke University, Durham, NC, USA
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37
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Tannock R. Commentary: Are ADHD symptoms habit-like? A commentary on Goodman et al (2014). J Child Psychol Psychiatry 2014; 55:611-4. [PMID: 24840171 DOI: 10.1111/jcpp.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Rosemary Tannock
- Neurosciences & Mental Health Research Program, The Hospital for Sick Children, Toronto, ONT, Canada
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38
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Abnormal striatal BOLD responses to reward anticipation and reward delivery in ADHD. PLoS One 2014; 9:e89129. [PMID: 24586543 PMCID: PMC3935853 DOI: 10.1371/journal.pone.0089129] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 01/21/2014] [Indexed: 02/06/2023] Open
Abstract
Altered reward processing has been proposed to contribute to the symptoms of attention deficit hyperactivity disorder (ADHD). The neurobiological mechanism underlying this alteration remains unclear. We hypothesize that the transfer of dopamine release from reward to reward-predicting cues, as normally observed in animal studies, may be deficient in ADHD. Functional magnetic resonance imaging (fMRI) was used to investigate striatal responses to reward-predicting cues and reward delivery in a classical conditioning paradigm. Data from 14 high-functioning and stimulant-naïve young adults with elevated lifetime symptoms of ADHD (8 males, 6 females) and 15 well-matched controls (8 males, 7 females) were included in the analyses. During reward anticipation, increased blood-oxygen-level-dependent (BOLD) responses in the right ventral and left dorsal striatum were observed in controls, but not in the ADHD group. The opposite pattern was observed in response to reward delivery; the ADHD group demonstrated significantly greater BOLD responses in the ventral striatum bilaterally and the left dorsal striatum relative to controls. In the ADHD group, the number of current hyperactivity/impulsivity symptoms was inversely related to ventral striatal responses during reward anticipation and positively associated with responses to reward. The BOLD response patterns observed in the striatum are consistent with impaired predictive dopamine signaling in ADHD, which may explain altered reward-contingent behaviors and symptoms of ADHD.
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