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Reicher V, Szalárdy O, Bódizs R, Vojnits B, Magyar TZ, Takács M, Réthelyi JM, Bunford N. NREM Slow-Wave Activity in Adolescents Is Differentially Associated With ADHD Levels and Normalized by Pharmacological Treatment. Int J Neuropsychopharmacol 2024; 27:pyae025. [PMID: 38875132 DOI: 10.1093/ijnp/pyae025] [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: 12/07/2023] [Accepted: 06/13/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND A compelling hypothesis about attention-deficit/hyperactivity disorder (ADHD) etiopathogenesis is that the ADHD phenotype reflects a delay in cortical maturation. Slow-wave activity (SWA) of non-rapid eye movement (NREM) sleep electroencephalogram (EEG) is an electrophysiological index of sleep intensity reflecting cortical maturation. Available data on ADHD and SWA are conflicting, and developmental differences, or the effect of pharmacological treatment, are relatively unknown. METHODS We examined, in samples (Mage = 16.4, SD = 1.2), of ever-medicated adolescents at risk for ADHD (n = 18; 72% boys), medication-naïve adolescents at risk for ADHD (n = 15, 67% boys), and adolescents not at risk for ADHD (n = 31, 61% boys) matched for chronological age and controlling for non-ADHD pharmacotherapy, whether ADHD pharmacotherapy modulates the association between NREM SWA and ADHD risk in home sleep. RESULTS Findings indicated medication-naïve adolescents at risk for ADHD exhibited greater first sleep cycle and entire night NREM SWA than both ever-medicated adolescents at risk for ADHD and adolescents not at risk for ADHD and no difference between ever-medicated, at-risk adolescents, and not at-risk adolescents. CONCLUSIONS Results support atypical cortical maturation in medication-naïve adolescents at risk for ADHD that appears to be normalized by ADHD pharmacotherapy in ever-medicated adolescents at risk for ADHD. Greater NREM SWA may reflect a compensatory mechanism in middle-later adolescents at risk for ADHD that normalizes an earlier occurring developmental delay.
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Affiliation(s)
- Vivien Reicher
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Orsolya Szalárdy
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Blanka Vojnits
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - Mária Takács
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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2
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Feng M, Xu J. Electroencephalogram-Based ConvMixer Architecture for Recognizing Attention Deficit Hyperactivity Disorder in Children. Brain Sci 2024; 14:469. [PMID: 38790448 PMCID: PMC11118831 DOI: 10.3390/brainsci14050469] [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: 04/09/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neuro-developmental disorder that affects approximately 5-10% of school-aged children worldwide. Early diagnosis and intervention are essential to improve the quality of life of patients and their families. In this study, we propose ConvMixer-ECA, a novel deep learning architecture that combines ConvMixer with efficient channel attention (ECA) blocks for the accurate diagnosis of ADHD using electroencephalogram (EEG) signals. The model was trained and evaluated using EEG recordings from 60 healthy children and 61 children with ADHD. A series of experiments were conducted to evaluate the performance of the ConvMixer-ECA. The results showed that the ConvMixer-ECA performed well in ADHD recognition with 94.52% accuracy. The incorporation of attentional mechanisms, in particular ECA, improved the performance of ConvMixer; it outperformed other attention-based variants. In addition, ConvMixer-ECA outperformed state-of-the-art deep learning models including EEGNet, CNN, RNN, LSTM, and GRU. t-SNE visualization of the output of this model layer validated the effectiveness of ConvMixer-ECA in capturing the underlying patterns and features that separate ADHD from typically developing individuals through hierarchical feature learning. These outcomes demonstrate the potential of ConvMixer-ECA as a valuable tool to assist clinicians in the early diagnosis and intervention of ADHD in children.
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Affiliation(s)
- Min Feng
- Nanjing Rehabilitation Medical Center, The Affiliated Brain Hospital, Nanjing Medical University, Nanjing 210029, China
- School of Chinese Language and Literature, Nanjing Normal University, Nanjing 210024, China
| | - Juncai Xu
- School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
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Vojnits B, Magyar TZ, Szalárdy O, Reicher V, Takács M, Bunford N, Bódizs R. Mobile sleep EEG suggests delayed brain maturation in adolescents with ADHD: A focus on oscillatory spindle frequency. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 146:104693. [PMID: 38324945 DOI: 10.1016/j.ridd.2024.104693] [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: 05/30/2023] [Revised: 11/21/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Although data show ADHD is associated with sleep problems, approaches to analyze the association between ADHD and sleep electrophysiology are limited to a few methods with circumscribed foci. AIMS Sleep EEG was analyzed by a mixed-radix FFT routine and power spectrum parametrization in adolescents with ADHD and adolescents not at-risk for ADHD. Spectral components of sleep EEG were analyzed employing a novel, model-based approach of EEG power spectra. METHODS AND PROCEDURES The DREEM mobile polysomnography headband was used to record home sleep EEG from 19 medication-free adolescents with ADHD and 29 adolescents not at-risk for ADHD (overall: N = 56, age range 14-19 years) and groups were compared on characteristics of NREM sleep. OUTCOMES AND RESULTS Adolescents with ADHD exhibited lower frequency of spectral peaks indicating sleep spindle oscillations whereas adolescents not at-risk for ADHD showed lower spectral power in the slow sleep spindle and beta frequency ranges. CONCLUSIONS AND IMPLICATIONS The observed between-groups difference might indicate delayed brain maturity unraveled during sleep in ADHD.
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Affiliation(s)
- Blanka Vojnits
- Institute of Behavioural Science, Semmelweis University, Budapest, Hungary.
| | - Tárek Zoltán Magyar
- Institute of Behavioural Science, Semmelweis University, Budapest, Hungary; Institute of Psychology, Pázmány Péter Catolic University, Budapest, Hungary
| | - Orsolya Szalárdy
- Institute of Behavioural Science, Semmelweis University, Budapest, Hungary; Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Sound and Speech Perception Research Group, Budapest, Hungary
| | - Vivien Reicher
- HUN-REN Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Budapest, Hungary
| | - Mária Takács
- Institute of Behavioural Science, Semmelweis University, Budapest, Hungary
| | - Nóra Bunford
- HUN-REN Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioural Science, Semmelweis University, Budapest, Hungary
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4
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Bunford N, Hámori G, Nemoda Z, Angyal N, Fiáth R, Sebők-Welker TÉ, Pászthy B, Ulbert I, Réthelyi JM. The domain-variant indirect association between electrophysiological response to reward and ADHD presentations is moderated by dopaminergic polymorphisms. Compr Psychiatry 2023; 124:152389. [PMID: 37104986 DOI: 10.1016/j.comppsych.2023.152389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Understanding the etiopathogenesis of attention-deficit/hyperactivity disorder (ADHD) may necessitate decomposition of the heterogeneous clinical phenotype into more homogeneous intermediate phenotypes. Reinforcement sensitivity is a promising candidate, but the exact nature of the ADHD-reward relation - including how, for whom, and to which ADHD dimensions atypicalities in reward processing are relevant - is equivocal. METHODS Aims were to examine, in a carefully phenotyped sample of adolescents (N = 305; Mage = 15.30 years, SD = 1.07; 39.7% girls), whether functional dopaminergic polymorphisms implicated in both reward processing and ADHD (1) are differentially associated with event-related potentials (ERPs) of reward anticipation at distinct levels of ADHD risk (nno risk = 174, nat-risk = 131, ndiagnosed = 83); and (2) moderate the indirect effect of dispositional affectivity on the association between ERPs and ADHD domains. RESULTS In adolescents at-risk for or with ADHD, carrying a hypodopaminergic allele was associated with enhanced ERPs of attention allocation to cue and attenuated ERPs of anticipatory attention to feedback. No associations were observed in adolescents not at-risk for or without ADHD. Controlling for age and sex, both the negative indirect effect of positive affectivity (PA) on the association between ERPs and inattention and the positive indirect effect of PA on the association between ERPs and hyperactivity/impulsivity were supported only for those with high activity dopamine transporter (DAT) alleles. CONCLUSIONS Reward and affective processing are promising intermediate phenotypes relevant to disentangling ADHD developmental pathways. Consistent with developmental multifinality, through the successive effects of reward anticipation and positive affectivity, functional dopaminergic variants may confer protection against inattention or risk for hyperactivity/impulsivity.
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Affiliation(s)
- N Bunford
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary.
| | - Gy Hámori
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Műegyetem rkp. 3., H-1111 Budapest, Hungary
| | - Z Nemoda
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Tűzoltó utca 37-47., H-1094 Budapest, Hungary
| | - N Angyal
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, Tűzoltó utca 37-47., H-1094 Budapest, Hungary
| | - R Fiáth
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A., H-1083 Budapest, Hungary
| | - T É Sebők-Welker
- Research Centre for Natural Sciences Institute of Cognitive Neuroscience and Psychology, Clinical and Developmental Neuropsychology Research Group, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Doctoral School of Mental Health Sciences, Semmelweis University, Balassa u. 6., 1083 Budapest, Hungary
| | - B Pászthy
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay János u. 53-43., H-1083 Budapest, Hungary
| | - I Ulbert
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok körútja 2., H-1117 Budapest, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A., H-1083 Budapest, Hungary
| | - J M Réthelyi
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Balassa u. 6., H-1083 Budapest, Hungary
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Rádosi A, Ágrez K, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Concurrent and Prospective Associations of Reward Response with Affective and Alcohol Problems: ADHD-Related Differential Vulnerability. J Youth Adolesc 2023:10.1007/s10964-023-01794-7. [PMID: 37270465 DOI: 10.1007/s10964-023-01794-7] [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: 03/06/2023] [Accepted: 05/19/2023] [Indexed: 06/05/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder. Data on the role of transdiagnostic, intermediate phenotypes in ADHD-relevant characteristics and outcomes are needed to advance conceptual understanding and approaches to precision psychiatry. Specifically, the extent to which the association between neural response to reward and ADHD-associated affective, externalizing, internalizing, and substance use problems differ depending on ADHD status is unknown. Aims were to examine, in 129 adolescents, whether concurrent and prospective associations of fMRI-measured initial response to reward attainment (relative to loss) with affectivity and externalizing, internalizing, and alcohol use problems differs between youth at-risk for (i.e., subclinical) (n = 50) and not at-risk for ADHD. Adolescents were, on average, 15.29 years old (SD = 1.00; 38% female), 50 were at-risk for (Mage = 15.18 years, SD = 1.04; 22% female) and 79 not at-risk for (Mage = 15.37 years, SD = 0.98; 48.1% female) ADHD. Both concurrent and prospective relations differed given ADHD risk: across analyses, in at-risk youth, greater superior frontal gyrus response was associated with lower concurrent depressive problems but in not at-risk youth, these characteristics were not related. Controlling for baseline use, in at-risk youth, greater putamen response was associated with greater 18-month hazardous alcohol use, whereas in not at-risk youth, greater putamen response was associated with lower use. Where in brain and for which outcomes modulate (direction of) observed relations: superior frontal gyrus response is relevant for depressive problems whereas putamen response is relevant for alcohol problems and greater neural responsivity is linked to less depressive but to more alcohol problems in adolescents at-risk for ADHD and less alcohol problems in adolescents not at-risk. Differences in neural response to reward differentially confer vulnerability for adolescent depressive and alcohol problems depending on ADHD risk.
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Affiliation(s)
- Alexandra Rádosi
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Kristóf Ágrez
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Bea Pászthy
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - István Ulbert
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.
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Arias-Mera C, Paillama-Raimán D, Lucero-González N, Leiva-Bianchi M, Avello-Sáez D. Relation between sleep disorders and attention deficit disorder with hyperactivity in children and adolescents: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104500. [PMID: 37075589 DOI: 10.1016/j.ridd.2023.104500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Sleep problems have a high recurrence in children and adolescents with attention deficit disorder with hyperactivity (ADHD) experience high rates of sleep problems. OBJECTIVE Understand the relationship between sleep disorders and ADHD symptoms. METHODS AND PROCEDURES A systematic review was performed using electronic databases, including PubMed, Cochrane Library, Scopus, Lilacs, and Psychology Database (ProQuest) systems. The quality of each article was assessed using a 5-criteria checklist, measuring relevant dimensions. OUTCOMES AND RESULTS The review analyzed fifteen articles, were included that raised the realizations among sleep problems in the population of children with ADHD, obtaining a total of 1645 children and adolescents with ADHD that were compared with typical development groups. The articles selected for this systematic review of observational design have a high quality. CONCLUSIONS AND IMPLICATIONS Children and adolescents with ADHD have sleep problems, which may exacerbate or be the cause of the ADHD clinic, affecting the quality of life of children and their families. Early inquiry and a timely approach can contribute to reducing the severity of ADHD symptoms.
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Affiliation(s)
| | - Daniel Paillama-Raimán
- Department of Sociology, Political Sciences and Public Administration, Social Sciences and Humanities Faculty, Universidad Católica de Temuco, Temuco, Chile
| | - Nayadet Lucero-González
- Occupational Therapy School, Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Daniela Avello-Sáez
- Occupational Therapy School, Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Kato T, Ozone M, Kotorii N, Ohshima H, Hyoudou Y, Mori H, Wasano K, Hiejima H, Habukawa M, Uchimura N. Sleep Structure in Untreated Adults With ADHD: A Retrospective Study. J Atten Disord 2023; 27:488-498. [PMID: 36851892 DOI: 10.1177/10870547231154898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Polysomnographic findings in neurodevelopmental disorders have been reported, but previous studies have had several limitations. The purpose of this study was to characterize sleep structure in untreated adults diagnosed with ADHD, excluding ADHD-related sleep disorders as determined by polysomnography and multiple sleep latency testing. METHODS This study included 55 patients aged 18 years or older who visited the Kurume University Hospital Sleep Clinic between April 2015 and March 2020. The diagnosis of ADHD was determined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (ADHD group, n = 28; non-ADHD, n = 27). RESULTS The ADHD group had significantly longer slow wave sleep (SWS) duration than the non-ADHD group (ADHD: 68.3 ± 31.0 minutes vs. non-ADHD: 43.4 ± 36.6 minutes; p = .0127). CONCLUSIONS The increased SWS volume observed in drug-naïve adult patients with ADHD may be related to the pathogenesis of this disorder.
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Affiliation(s)
- Takao Kato
- Kurume University School of Medicine, Japan
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A failure of sleep-dependent consolidation of visuoperceptual procedural learning in young adults with ADHD. Transl Psychiatry 2022; 12:499. [PMID: 36460644 PMCID: PMC9718731 DOI: 10.1038/s41398-022-02239-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 12/04/2022] Open
Abstract
ADHD has been associated with cortico-striatal dysfunction that may lead to procedural memory abnormalities. Sleep plays a critical role in consolidating procedural memories, and sleep problems are an integral part of the psychopathology of ADHD. This raises the possibility that altered sleep processes characterizing those with ADHD could contribute to their skill-learning impairments. On this basis, the present study tested the hypothesis that young adults with ADHD have altered sleep-dependent procedural memory consolidation. Participants with ADHD and neurotypicals were trained on a visual discrimination task that has been shown to benefit from sleep. Half of the participants were tested after a 12-h break that included nocturnal sleep (sleep condition), whereas the other half were tested after a 12-h daytime break that did not include sleep (wakefulness condition) to assess the specific contribution of sleep to improvement in task performance. Despite having a similar degree of initial learning, participants with ADHD did not improve in the visual discrimination task following a sleep interval compared to neurotypicals, while they were on par with neurotypicals during the wakefulness condition. These findings represent the first demonstration of a failure in sleep-dependent consolidation of procedural learning in young adults with ADHD. Such a failure is likely to disrupt automatic control routines that are normally provided by the non-declarative memory system, thereby increasing the load on attentional resources of individuals with ADHD.
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Fasano A, Biancardi C, Masi G, Della Vecchia S, Frumento P, Mazzoni A, Falotico E, Faraguna U, Sicca F. Maximum downward slope of sleep slow waves as a potential marker of attention-deficit/hyperactivity disorder clinical phenotypes. J Psychiatr Res 2022; 156:679-689. [PMID: 36399860 DOI: 10.1016/j.jpsychires.2022.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/25/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Attention-Deficit/Hyperactivity Disorder (ADHD) is a highly heterogeneous diagnostic category, encompassing several endophenotypes and comorbidities, including sleep problems. However, no predictor of clinical long-term trajectories or comorbidity has yet been established. Sleep EEG has been proposed as a potential tool for evaluating the synaptic strength during development, as well as the cortical thickness, which is presumed to be altered in ADHD. We investigated whether the slope of the Slow Waves (SWs), a microstructural parameter of the sleep EEG, was a potential predictive parameter for psychiatric comorbidities and neuropsychological dimensions in ADHD. METHODS 70 children (58 m; 8.76 ± 2.77 y) with ADHD who underwent psychiatric and neurologic evaluations and a standard EEG recording during naps were investigated. After sleep EEG analysis, we grouped the extracted SWs in bins of equal amplitude and then measured the associations, through generalized linear regression, between their maximum downward slopes (MDS) and the individual scores obtained from clinical rating scales. RESULTS The presence of Multiple Anxiety Disorders was positively associated with MDS of medium amplitude SWs in temporo-posterior left areas. The Child Behavior Checklist scores showed negative associations in the same areas for small SWs. The presence of autistic traits was positively associated with MDS of high amplitude SWs in bilateral anterior and temporal left areas. The WISC-IV Processing Speed Index showed negative associations with MDS of small-to-medium SWs in anterior and temporal right areas, while positive associations in posterior and temporal left areas. CONCLUSIONS Consistency of association clusters' localization on the scalp suggests that variations in the local MDS, revealing alterations of local synaptic strength and/or in daytime use of certain cortical circuits, could underlie specific neurodevelopmental trajectories resulting in different ADHD clinical phenotypes.
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Affiliation(s)
- Alessio Fasano
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Carlo Biancardi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
| | - Gabriele Masi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | | | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Egidio Falotico
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ugo Faraguna
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federico Sicca
- Child and Adolescent Epilepsy and Clinical Neurophysiology Departmental Unit, USL Centro Toscana, 59100, Prato, Italy
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Darchia N, Campbell IG, Basishvili T, Eliozishvili M, Tchintcharauli T, Oniani N, Sakhelashvili I, Feinberg I. Sleep electroencephalogram evidence of delayed brain maturation in attention deficit hyperactivity disorder: a longitudinal study. Sleep 2022; 45:6648473. [DOI: 10.1093/sleep/zsac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/25/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study Objectives
This study investigates whether longitudinally measured changes in adolescent brain electrophysiology corroborate the maturational lag associated with attention deficit hyperactivity disorder (ADHD) reported in magnetic resonance imaging (MRI) studies and cross-sectional sleep electroencephalogram (EEG) data.
Methods
Semiannually nine adolescents diagnosed with ADHD (combined presentation, DSM-V criteria, mean age 12.39 ± 0.61 years at first time-point, two females) and nine typically developing controls (12.08 ± 0.35 years, four females) underwent all-night laboratory polysomnography, yielding four recordings.
Results
Sleep macrostructure was similar between groups. A quadratic model of the age change in non-rapid eye movement (NREM) delta (1.07–4 Hz) power, with sex effects accounted for, found that delta power peaked 0.92 ± 0.37 years later in the ADHD group. A Gompertz function fit to the same data showed that the age of most rapid delta power decline occurred 0.93 ± 0.41 years later in the ADHD group (p = 0.037), but this group difference was not significant (p = 0.38) with sex effects accounted for. For very low frequency (0.29–1.07 Hz) EEG, the ADHD lag (1.07 ± 0.42 years later, p = 0.019) was significant for a Gompertz model with sex effects accounted for (p = 0.044). Theta (4–7.91 Hz) showed a trend (p = 0.064) toward higher power in the ADHD group. Analysis of the EEG decline across the night found that standardized delta and theta power in NREMP1 were significantly (p < 0.05 for both) lower in adolescents with ADHD.
Conclusions
This is the first longitudinal study to reveal electrophysiological evidence of a maturational lag associated with ADHD. In addition, our findings revealed basically unaltered sleep macrostructure but altered sleep homeostasis associated with ADHD.
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Affiliation(s)
- Nato Darchia
- Tengiz Oniani Laboratory of Sleep-Wakefulness Cycle Study, Ilia State University , Tbilisi , Georgia
| | - Ian G Campbell
- Department of Psychiatry and Behavioral Sciences, University of California Davis , Davis, CA , USA
| | - Tamar Basishvili
- Tengiz Oniani Laboratory of Sleep-Wakefulness Cycle Study, Ilia State University , Tbilisi , Georgia
| | - Marine Eliozishvili
- Tengiz Oniani Laboratory of Sleep-Wakefulness Cycle Study, Ilia State University , Tbilisi , Georgia
| | | | - Nikoloz Oniani
- Tengiz Oniani Laboratory of Sleep-Wakefulness Cycle Study, Ilia State University , Tbilisi , Georgia
| | - Irine Sakhelashvili
- Tengiz Oniani Laboratory of Sleep-Wakefulness Cycle Study, Ilia State University , Tbilisi , Georgia
| | - Irwin Feinberg
- Department of Psychiatry and Behavioral Sciences, University of California Davis , Davis, CA , USA
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11
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Nguyen J, Zhang B, Hanson E, Mylonas D, Maski K. Neurobehavioral Associations with NREM and REM Sleep Architecture in Children with Autism Spectrum Disorder. CHILDREN 2022; 9:children9091322. [PMID: 36138632 PMCID: PMC9497778 DOI: 10.3390/children9091322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022]
Abstract
Objective: Insomnia and daytime behavioral problems are common issues in pediatric autism spectrum disorder (ASD), yet specific underlying relationships with NonRapid Eye Movement sleep (NREM) and Rapid Eye Movement (REM) sleep architecture are understudied. We hypothesize that REM sleep alterations (REM%, REM EEG power) are associated with more internalizing behaviors and NREM sleep deficits (N3%; slow wave activity (SWA) 0.5–3 Hz EEG power) are associated with increased externalizing behaviors in children with ASD vs. typical developing controls (TD). Methods: In an age- and gender-matched pediatric cohort of n = 23 ASD and n = 20 TD participants, we collected macro/micro sleep architecture with overnight home polysomnogram and daytime behavior scores with Child Behavior Checklist (CBCL) scores. Results: Controlling for non-verbal IQ and medication use, ASD and TD children have similar REM and NREM sleep architecture. Only ASD children show positive relationships between REM%, REM theta power and REM beta power with internalizing scores. Only TD participants showed an inverse relationship between NREM SWA and externalizing scores. Conclusion: REM sleep measures reflect concerning internalizing behaviours in ASD and could serve as a biomarker for mood disorders in this population. While improving deep sleep may help externalizing behaviours in TD, we do not find evidence of this relationship in ASD.
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Affiliation(s)
- Jennifer Nguyen
- Department of Neurology, Division of Child Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Bo Zhang
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ellen Hanson
- Department of Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Dimitrios Mylonas
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, USA
| | - Kiran Maski
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-857-218-5536; Fax: +1-781-216-2518
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12
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Lambek R, Thomsen PH, Sonuga-Barke EJS, Jennum P, Sørensen AV. The Association between Sleep Problems and Neuropsychological Deficits in Medication-naïve Children with ADHD. Behav Sleep Med 2022; 20:429-441. [PMID: 34081546 DOI: 10.1080/15402002.2021.1931222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Children with ADHD are reported to have sleep problems and neuropsychological deficits, but studies examining a potential association between the two are scarce and the use of varying methodology can complicate conclusions. PARTICIPANTS A clinical sample of 59 medication-naïve children with ADHD between the ages of 6 and 14 years (71% male). METHODS Children underwent polysomnography and multiple sleep latency test, and parent rated sleep habits on the Children's Sleep Habits Questionnaire. Children also completed an extensive neuropsychological battery of executive function and delay aversion tasks, and parents and teachers rated executive function behavior on the Behavior Rating Inventory of Executive Function. Linear regression analyses were conducted with each of the neuropsychological outcomes included as the outcome variable and the sleep parameters as the predictor variables. RESULTS The correlations between sleep and neuropsychological outcomes were generally modest, but some sleep parameters (primarily sleep stages and sleep latencies) were associated with objectively and subjectively measured executive function and delay aversion. CONCLUSIONS Using objective and subjective gold standard assessment procedures this study supports a (modest) association between sleep and neuropsychological function in children with ADHD.
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Affiliation(s)
- Rikke Lambek
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Per Hove Thomsen
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark
| | - Edmund J S Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark.,School of Academic Psychiatry, King's College London, London, UK
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - Anne Virring Sørensen
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark
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13
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Castelnovo A, Lividini A, Bernardi G, Pezzoli V, Foderaro G, Ramelli GP, Manconi M, Miano S. Sleep Power Topography in Children with Attention Deficit Hyperactivity Disorder (ADHD). CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020197. [PMID: 35204918 PMCID: PMC8870029 DOI: 10.3390/children9020197] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Recent years saw an increasing interest towards sleep microstructure abnormalities in attention-deficit/hyperactivity disorder (ADHD). However, the existing literature on sleep electroencephalographic (EEG) power in ADHD is still controversial, often based on single electrode recordings, and mainly focused on slow wave activity (SWA) during NREM sleep. This study aimed to systematically investigate sleep power topography in all traditional frequency bands, in all sleep stages and across sleep cycles using high-density EEG (HD-EEG). METHOD Thirty drug-naïve children with ADHD (10.5 ± 2.1 years, 21 male) and 23 typically developing (TD) control participants (mean age: 10.2 ± 1.6 years, 13 male) were included in the current analysis. Signal power topography was computed in classical frequency bands during sleep, contrasted between groups and sleep cycles, and correlated with measures of ADHD severity, cognitive functioning and estimated total sleep time. RESULTS Compared to TD subjects, patients with ADHD consistently displayed a widespread increase in low-frequency activity (between 3 and 10 Hz) during NREM sleep, but not during REM sleep and wake before sleep onset. Such a difference involved a wide centro-posterior cluster of channels in the upper SWA range, in Theta, and low-Alpha. Between-group difference was maximal in sleep stage N3 in the first sleep cycle, and positively correlated with average total sleep time. CONCLUSIONS These results support the concept that children with ADHD, compared to TD peers, have a higher sleep pressure and altered sleep homeostasis, which possibly interfere with (and delay) cortical maturation.
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Affiliation(s)
- Anna Castelnovo
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3011 Bern, Switzerland
- Correspondence: (A.C.); (S.M.)
| | - Althea Lividini
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Giulio Bernardi
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, 55100 Lucca, Italy;
| | - Valdo Pezzoli
- Department of Pediatrics, Ospedale Civico, 6900 Lugano, Switzerland; (V.P.); (G.F.)
| | - Giuseppe Foderaro
- Department of Pediatrics, Ospedale Civico, 6900 Lugano, Switzerland; (V.P.); (G.F.)
| | - Gian Paolo Ramelli
- Department of Pediatrics, San Giovanni Hospital, 6500 Bellinzona, Switzerland;
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, 6900 Lugano, Switzerland;
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Department of Neurology, University Hospital, Inselspital, 3010 Bern, Switzerland
| | - Silvia Miano
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, 6900 Lugano, Switzerland;
- Correspondence: (A.C.); (S.M.)
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14
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Bondopadhyay U, Diaz-Orueta U, Coogan AN. A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:149-224. [PMID: 33402013 DOI: 10.1177/1087054720978556] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. METHODS Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. RESULTS 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. CONCLUSION Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
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Affiliation(s)
- Upasana Bondopadhyay
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
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15
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Pratiwi RDN, Fitri SYR, Mulya AP. The Interventions for Sleep Disorders in Children with Attention Deficit and Hyperactivity Disorder: A Narrative Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Children with ADHD have more frequent comorbid sleep disorders than healthy children. The current methods of treating sleep disorders in ADHD children are still focused on pharmacological interventions which in fact only provide little benefit.
AIM: This study aims to identify existing studies regarding the types of nonpharmacological and complementary interventions for sleep disorders in children with ADHD using a narrative review approach.
METHODS: This was a narrative review. Inclusion criteria included articles in English and Bahasa, full-text articles, primary studies, and children with ADHD aged 18 years with or without comorbidities as the research sample, and the article having been published in the last 10 years. Searches were performed in several databases: PubMed, Springer, Web of Science, and Google Scholar.
RESULTS: The result showed that programs for managing sleep disorder in ADHD are behavioral therapy, behavioral parent training (BPT), behavioral sleep intervention, neurofeedback, mind-body therapy, L-theanine supplementation, horse milk supplementation, and play therapy. The programs are found to be effective in improving sleep.
CONCLUSION: The program most comprehensive with a high level of ease of implementation was BPT.
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16
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Biancardi C, Sesso G, Masi G, Faraguna U, Sicca F. Sleep EEG microstructure in children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis. Sleep 2021; 44:6081934. [PMID: 33555021 DOI: 10.1093/sleep/zsab006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/29/2020] [Indexed: 01/21/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is commonly associated with sleep problems, possibly due to shared pathophysiology. Microstructural sleep electroencephalographic (EEG) alterations may likely represent markers of disordered cortical maturation in ADHD, although literature data are still conflicting, deserving further assessment. After having systematically reviewed the literature, we included 11 studies from 598 abstracts, and assessed 23 parameters of cyclic alternating pattern (CAP), four parameters of sleep EEG power and one parameter of sleep graphoelements through 29 meta-analyses and, when possible, univariate meta-regressions. Slow wave activity (SWA) in ADHD was significantly higher in early childhood and lower in late childhood/adolescence compared to controls, with an inversion point at 10 years. Total CAP rate and CAP A1 index in non-rapid eye movement (NREM) stage 2 sleep, and CAP A1 rate in NREM sleep were significantly lower in ADHD patients than controls. SWA and CAP A1 changes are therefore possible markers of altered cortical maturation in ADHD, consistently with the neuropsychological deficits characterizing the disorder, likely fostering earlier detection of at-risk/milder conditions, and more tailored therapeutic interventions.
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Affiliation(s)
- Carlo Biancardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gianluca Sesso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Masi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Ugo Faraguna
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Federico Sicca
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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17
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Ruiz-Herrera N, Cellini N, Prehn-Kristensen A, Guillén-Riquelme A, Buela-Casal G. Characteristics of sleep spindles in school-aged children with attention-deficit/hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 112:103896. [PMID: 33607483 DOI: 10.1016/j.ridd.2021.103896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Attention deficit/hyperactivity disorder (ADHD) is a complex disorder, characterized by different presentations with distinct cognitive and neurobiological characterizations. Here we aimed to investigate whether sleep spindle activity, which has been associated with brain maturation, may be a potential biomarker able to differentiate ADHD presentations in school-aged children (7-11 years). METHOD Spindle characteristics were extracted from overnight polysomnography in 74 children (27 ADHD-Inattentive [IQ = 96.04], 25 ADHD-hyperactive/impulsive [IQ = 98.9], and 22 ADHD-combined [IQ = 96.1]). We obtained data of the frontal (Fz) and parietal (Pz) derivations using a validated spindle detection algorithm. RESULTS Children with ADHD showed a higher number and density of slow compared to fast spindles which were more frequent in frontal area. No differences were observed among ADHD presentations for any spindle characteristics. Spindle frequency and density increased with age, indicating an age-dependent maturation of different sleep spindles. However, no associations between IQ and spindle characteristics were observed. CONCLUSIONS In children with ADHD the spindle characteristics evolve with age but sleep spindle activity does not seem to be a valid biomarker of ADHD phenotypes or general cognitive ability.
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Affiliation(s)
- Noelia Ruiz-Herrera
- Department of Health Sciences, International University of La Rioja, La Rioja, Spain.
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Italy
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University Kiel, Germany
| | | | - Gualberto Buela-Casal
- Sleep and Health Promotion Laboratory, Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
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18
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Fadeuilhe C, Daigre C, Richarte V, Grau-López L, Palma-Álvarez RF, Corrales M, Ramos-Quiroga JA. Insomnia Disorder in Adult Attention-Deficit/Hyperactivity Disorder Patients: Clinical, Comorbidity, and Treatment Correlates. Front Psychiatry 2021; 12:663889. [PMID: 34122179 PMCID: PMC8187558 DOI: 10.3389/fpsyt.2021.663889] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Several investigations have been performed on insomnia symptoms in adult attention-deficit/hyperactivity disorder (ADHD). However, the relationship between insomnia disorder and adult ADHD has been neglected in research. The main objective of the current study is to analyze the differences between adult ADHD patients with and without insomnia disorder, in terms of ADHD clinical severity, medical and psychiatric comorbidity, psychopharmacological treatment, and quality of life. Material and Methods: Two hundred and fifty-two adult patients with ADHD (mean age 37.60 ± 13.22 years; ADHD presentations-combined: 56.7%, inattentive: 39.7%, hyperactive/impulsive: 3.6%) were evaluated with an exhaustive clinical and psychological evaluation protocol including semistructured interviews (for comorbidities and ADHD assessment) and symptom rating scales for ADHD. The diagnosis of ADHD and insomnia disorder was made according to DSM-5 criteria. Furthermore, the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale were administered. Results: Insomnia disorder was found in 44.4% of adult ADHD patients and was more common in combined presentation (64.3%) and in patients with more ADHD severity. Comorbidities (both medical and psychiatric), especially mood disorders (42%), anxiety disorder (26.8%), personality disorder (39.3%), and any substance use disorder (11.6%), were associated with a higher insomnia disorder prevalence. ADHD stimulant treatment was related to lower insomnia disorder compared to patients without medication, as well as ADHD stable treatment. Additionally, worse health-related quality of life was associated with insomnia disorder. Conclusion: Insomnia disorder is highly prevalent in adult ADHD and is related to higher ADHD severity and more psychiatric and medical comorbidities. Some stimulants and stable pharmacological ADHD treatment are associated with better outcomes of insomnia disorder.
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Affiliation(s)
- Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raul F Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montse Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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19
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Miranda P, Cox CD, Alexander M, Danev S, Lakey JRT. In Quest of Pathognomonic/Endophenotypic Markers of Attention Deficit Hyperactivity Disorder (ADHD): Potential of EEG-Based Frequency Analysis and ERPs to Better Detect, Prevent and Manage ADHD. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:115-137. [PMID: 32547262 PMCID: PMC7250294 DOI: 10.2147/mder.s241205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the “characterizing ADHD” and on the quest for objective “pathognomonic/endophenotypic diagnostic markers of ADHD”. The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.
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Affiliation(s)
- Priya Miranda
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | - Christopher D Cox
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Michael Alexander
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | | | - Jonathan R T Lakey
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
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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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