Abstract
BackgroundSymptoms of hyperactivity are believed to fade with age leaving ADHD adults mostly inattentive and impulsive. Our aim was to test this assertion using objective measures of hyperactivity, impulsivity and inattention.MethodParticipants were 40 subjects with ADHD (23M/17F; 35±10 yrs) and 60 healthy adults (28M/32F; 29±9 yrs) blindly assessed using Wender-Reimherr interview ratings, Structured Clinical Interview for DSM-IV Disorders and DSM-IV criteria. Infrared motion capture systems tracked head and leg movements during performance of a No-4’s cognitive control task. Subjects also completed the Conners’ CPT-II.ResultsADHD and controls differed significantly in activity and attention. Effect sizes for activity measures (d’ = 0.7–1.6) were, on average, two-fold larger than differences in attention or impulsivity, correlated more strongly with executive function ratings and were more discriminatory (ROC area = 0.83 for activity composite, 0.65 for No-4’s distraction composite, 0.63 for Conners’ CPT-II confidence index, 0.96 for the combined activity and attention diagnostic index). This finding was true for subjects with the predominantly inattentive subtype as well as subjects with combined or predominantly hyperactive/impulsive subtype. Males and females with ADHD were equally active. The superior accuracy of activity measures was confirmed using Random Forest and predictive modeling techniques.ConclusionsObjectively measured hyperactivity persists in adults with ADHD and is a more discriminative feature of the disorder than computerized measures of inattention or impulsivity. This finding supports the hypothesis that a deficient ability to sit still remains a defining feature of the disorder in adults when it is measured objectively.
Highlights
Symptoms of hyperactivity are believed to fade with age leaving Attention-Deficit/Hyperactivity Disorder (ADHD) adults mostly inattentive and impulsive
Objectively measured hyperactivity persists in adults with ADHD and is a more discriminative feature of the disorder than computerized measures of inattention or impulsivity
Conclusions it is widely believed that hyperactivity in individuals with ADHD abates with age we found, using objective measures, that adults with ADHD moved their head and legs to a markedly greater degree than healthy controls during performance of a computerized attention test
Summary
Symptoms of hyperactivity are believed to fade with age leaving ADHD adults mostly inattentive and impulsive. A widely held belief exists that hyperactivity fades with age or becomes merely a subjective sensation, leaving adults with ADHD to manifest primarily inattentive and impulsive symptoms [1]. This observation is interesting as it suggests that neural maturational events occur in individuals with ADHD that predominantly normalize motor activity but fail to Hyperactivity is a sign rather than a symptom [3] and can be quantified using instruments. Levels of hyperactivity correlated with an indirect measure of blood flow in the putamen [6] and with dopamine D2 receptor density in the caudate [7]
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