ADHD-C Group Research Articles

Motor proficiency of persons with attention deficit hyperactivity disorder or autism spectrum disorder diagnosed in adulthood

Purpose To compare (1) motor proficiency of persons diagnosed in adulthood with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) with normative values of motor proficiency, and (2) motor proficiency between persons with ADHD and those with ASD diagnosed in adulthood. Methods A total of 153 adults (median age 32 years, 36% women) participated in this cross-sectional study. Fifty-three persons with predominately inattentive presentation (ADHD-I), 67 persons with combined presentation (ADHD-C), and 33 persons with ASD performed the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). One-sample binominal tests were used to compare motor proficiency against standardized norms of BOT-2 for young adults. One-way ANOVAs and Kruskal-Wallis tests were used to compare test outcomes between the groups. Results The total sample showed significantly impaired motor proficiency in comparison to norms in all test domains (p < 0.001–0.006), except for fine motor skills. The ASD group showed significantly poorer body coordination compared with the ADHD-I and ADHD-C groups, with a moderate effect size (p = 0.003–0.02, η2 = 0.061). Conclusions Motor proficiency is impaired in most persons with ADHD or ASD diagnosed in adulthood, suggesting that motor assessment should be included in clinical examinations of adults with suspected neurodevelopment disorders.

Frequency characteristics of temporal and spatial concordance among dynamic indices in inattentive and combined subtypes of attention deficit hyperactivity disorder.

Numerous voxel-based resting-state functional magnetic resonance imaging (rs-fMRI) measurements have been used to characterize spontaneous brain activity in attention deficit hyperactivity disorder (ADHD). However, the practical distinctions and commonalities among these intrinsic brain activity measures remain to be fully explored, and whether the functional concordance is related to frequency is still unknown. The study included 25 ADHD, combined type (ADHD-C); 26 ADHD, inattentive type (ADHD-I); and 28 typically developing (TD) children. We calculated the voxel-wise (temporal) and volume-wise (spatial) concordance among dynamic rs-fMRI indices in the slow-5 (0.01-0.027 Hz) and slow-4 (0.027-0.073 Hz) frequency bands, respectively. The spatiotemporal concordance within the slow-4 and slow-5 bands among the ADHD-C, ADHD-I, and TD groups was compared. Although the ADHD-C and ADHD-I groups showed similar volume-wise concordance, comparison analysis revealed that compared with ADHD-C patients, ADHD-I patients exhibited decreased voxel-wise concordance in the right median cingulate and paracingulate gyrus (MCC) and right supplementary motor area (SMA) in the slow-5 band. In addition, the voxel-wise concordance was negatively correlated with the diagnostic scores of ADHD subtypes. Our results suggest that functional concordance is frequency dependent, and dynamic concordance analysis based on specific frequency bands may provide a novel approach for investigating the pathophysiological differences among ADHD subtypes.

The clinical, neuropsychological, and brain functional characteristics of the ADHD restrictive inattentive presentation.

There is an ongoing debate about the restrictive inattentive (RI) presentation of attention deficit hyperactivity disorder (ADHD). The current study aimed to systematically investigate the clinical, neuropsychological, and brain functional characteristics of children with ADHD restrictive inattentive presentation. A clinical sample of 789 children with or without ADHD participated in the current study and finished clinical interviews, questionnaires, and neuropsychological tests. Those individuals with a diagnosis of ADHD were further divided into three subgroups according to the presentation of inattentive and/or hyperactive/impulsive symptoms, the ADHD-RI, the ADHD-I (inattentive), and the ADHD-C (combined) groups. Between-group comparisons were carried out on each clinical and neuropsychological measure using ANCOVA, with age and sex as covariates. Bonferroni corrections were applied to correct for multiple comparisons. Two hundred twenty-seven of the subjects also went through resting-state functional magnetic resonance imaging scans. Five ADHD-related brain functional networks, including the default mode network (DMN), the dorsal attention network (DAN), the ventral attention network, the executive control network, and the salience network, were built using predefined regions of interest (ROIs). Voxel-based group-wise comparisons were performed. Compared with healthy controls, all ADHD groups presented more clinical problems and weaker cognitive function. Among the ADHD groups, the ADHD-C group had the most clinical problems, especially delinquent and aggressive behaviors. Regarding cognitive function, the ADHD-RI group displayed the most impaired sustained attention, and the ADHD-C group had the worst response inhibition function. In terms of brain functional connectivity (FC), reduced FC in the DMN was identified in the ADHD-C and the ADHD-I groups but not the ADHD-RI group, compared to the healthy controls. Subjects with ADHD-I also presented decreased FC in the DAN in contrast to the control group. The ADHD-RI displayed marginally significantly lower FC in the salience network compared to the ADHD-I and the control groups. The ADHD-RI group is distinguishable from the ADHD-I and the ADHD-C groups. It is characterized by fewer externalizing behaviors, worse sustained attention, and better response inhibition function. The absence of abnormally high hyperactive/impulsive symptoms in ADHD-RI might be related to less impaired brain function in DMN, but potentially more impairment in the salience network.

Distinguishing different types of attention deficit hyperactivity disorder in children using artificial neural network with clinical intelligent test.

Attention deficit hyperactivity disorder (ADHD) is a well-studied topic in child and adolescent psychiatry. ADHD diagnosis relies on information from an assessment scale used by teachers and parents and psychological assessment by physicians; however, the assessment results can be inconsistent. To construct models that automatically distinguish between children with predominantly inattentive-type ADHD (ADHD-I), with combined-type ADHD (ADHD-C), and without ADHD. Clinical records with age 6-17 years-old, for January 2011-September 2020 were collected from local general hospitals in northern Taiwan; the data were based on the SNAP-IV scale, the second and third editions of Conners' Continuous Performance Test (CPT), and various intelligence tests. This study used an artificial neural network to construct the models. In addition, k-fold cross-validation was applied to ensure the consistency of the machine learning results. We collected 328 records using CPT-3 and 239 records using CPT-2. With regard to distinguishing between ADHD-I and ADHD-C, a combination of demographic information, SNAP-IV scale results, and CPT-2 results yielded overall accuracies of 88.75 and 85.56% in the training and testing sets, respectively. The replacement of CPT-2 with CPT-3 results in this model yielded an overall accuracy of 90.46% in the training set and 89.44% in the testing set. With regard to distinguishing between ADHD-I, ADHD-C, and the absence of ADHD, a combination of demographic information, SNAP-IV scale results, and CPT-2 results yielded overall accuracies of 86.74 and 77.43% in the training and testing sets, respectively. This proposed model distinguished between the ADHD-I and ADHD-C groups with 85-90% accuracy, and it distinguished between the ADHD-I, ADHD-C, and control groups with 77-86% accuracy. The machine learning model helps clinicians identify patients with ADHD in a timely manner.

Comparison of the Cognitive Disengagement and Hypoactivity Components of Sluggish Cognitive Tempo in Autism, ADHD, and Population-Based Samples of Children.

An international Sluggish Cognitive Tempo (SCT) Work Group proposed a new term for SCT, "cognitive disengagement syndrome," that more accurately describes the syndrome than does SCT. According to the Work Group, symptoms of SCT represent a cognitive dimension (cognitive disengagement) and a motor dimension (hypoactivity). Our study determined (1) if distinct factors representing cognitive disengagement and hypoactivity emerged when SCT items were factor analyzed and (2) the degree of differences in cognitive disengagement and hypoactivity within diagnostic groups. Mothers rated 1,177 children with autism, 725 with ADHD-Combined, and 307 with ADHD-Inattentive (4-17years) and 665 elementary school children (6-12years) on the Pediatric Behavior Scale (PBS). SCT prevalence rates were autism 32%, ADHD-Inattentive 27%, ADHD-Combined 18%, and elementary school students 7%. Factor analysis of the SCT items yielded two factors reflecting cognitive disengagement (in a fog/confused and stares/preoccupied/in own world) and hypoactivity (sluggish/slow moving/low energy, drowsy/sleepy/not alert, and tires easily) in all diagnostic groups. Cognitive disengagement prevalence rates and scores were significantly higher than hypoactivity in the autism and ADHD-C groups and in the autism and ADHD-C subgroups of children with SCT (but not in the ADHD-I and elementary school total groups and SCT subgroups). Our findings factor analyzing five SCT items support two SCT subfactors: cognitive disengagement and hypoactivity.

A-204 Exploring Memory Functioning in an Adult ADHD Population Using the Rey Auditory Verbal Learning Test

Abstract Objective: This study analyzed differences in learning/acquisition and delayed recall between adult patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) Predominantly Inattentive and Combined subtypes and a control group using the Rey Auditory Verbal Learning Test (RAVLT). Method: This cross-sectional study analyzed data from a consecutive series of patients referred specifically for purposes of ADHD diagnostic clarification. Each was administered the RAVLT, as part of an extensive evaluation, to assess for verbal learning and memory. 155 patients (40.8%) met DSM-5 criteria for ADHD-Inattentive subtype and 165 (43.4%) for ADHD-Combined subtype. Sixty (15.8%) who did not meet criteria for ADHD, but who were diagnosed with a primary depressive/anxiety disorder or received no diagnosis served as a control group. Results: There were significant main effects found between the three groups on all trials analyzed on the RAVLT (Trial 1, p=.016; Trial 5, p=.003; Total Trials, p=.000; Trial 6, p=.001; Trial 7, p=.000). Effect sizes ranged from .022-.042. Posthoc analysis revealed that the ADHD-C group performed significantly worse than both the control group and ADHD-I group in both acquisition and delayed memory. Frequency distributions of impaired performance revealed the ADHD-C group had the largest rate of impairments (12-23%) on this measure. The ADHD-I group demonstrated 6-19% impairments. The control group ranged from 3-10% impairments. Conclusion: Verbal memory impairments are much more likely in adult patients diagnosed with ADHD than those without the diagnosis. While the inattentive and combined subtypes of ADHD both demonstrate deficiencies in verbal memory performance, the rate of likely impairments is much greater amongst the combined subtype.

Static and Dynamic Assessment of Intelligence in ADHD Subtypes.

There is a debate about the measure of IQ in children with ADHD. Some studies report that, compared to static assessment procedures, dynamic assessment of intelligence can better measure cognitive modifiability and plasticity. The present study was designed to examine children belonging to different ADHD subtypes (inattentive, hyperactive/impulsive, and combined) in terms of both static (WISC scores) and dynamic measures (Modifiability index). Thirty-four children (12 ADHD-I, 10 ADHD-H, and 12 ADHD-C) were compared to a sample of 27 typically developing children. Results indicate that only the inattentive and the combined subtypes, compared with the normative sample, show lower IQ scores. The ADHD-I group presents generally low WISC scores and ADHD-H presents generally high WISC scores. Moreover, the ADHD-C group shows a low static score and a high dynamic score, indicating a wide breadth of Vygotskian children’s zone of proximal development. Static and dynamic measurements together can indeed be considered a comprehensive examination of intelligence levels in ADHD children and may be essential in predicting learning capacities.

ADHD-inattentive versus ADHD-Combined subtypes: A severity continuum or two distinct entities? A comprehensive analysis of clinical, cognitive and neuroimaging data

The current study aimed to explore the multimodal differences between the inattentive ADHD (ADHD-I) subtype and the combined ADHD (ADHD-C) subtype. A large sample of medication-naïve children with pure ADHD (i.e., without any comorbidity) (145 with ADHD-I, 132 with ADHD-C) and healthy controls (n = 98) were recruited. A battery of multiple scales and cognitive tests were utilized to assess the clinical and cognitive profiles of each individual. In addition, structural and diffusion magnetic resonance imaging (MRI) were acquired for 120 subjects with ADHD and 85 controls. Regional gray matter volume, white matter volume, and diffusion tensors, e.g., axial diffusivity (AD), were compared among the three groups in a whole-brain voxel-wise manner. Compared with healthy controls, both ADHD groups exhibited elevated levels of behavioral and emotional problems. The ADHD-C group had more behavioral problems and emotional liability, as well as less anxiety, than the ADHD-I group. The two ADHD groups were equally impaired in most cognitive domains, with the exception of sustained attention. Compared with healthy controls, the ADHD-C group showed a high gray matter volume (GMV) in the bilateral thalamus and a high white matter volume in the body of the corpus callosum, while the ADHD-I group presented an elevated GMV mainly in the left precentral gyrus and posterior cingulate cortex. Compared with participants with ADHD-C and healthy controls, subjects with ADHD-I showed increased AD in widespread brain regions. Our study has revealed a distinct, interconnected pattern of behavioral, cognitive, and brain structural characteristics in children with different ADHD subtypes.

Visual-motor attention in children with ADHD: The role of automatic and controlled processes

Backgroundthere are evidence that children with ADHD exhibit a deficit both in automatic and controlled processes. Aimsthe present study aimed to examine the visual-motor attention and the influence of cognitive load through a dual task paradigm in children with ADHD compared with typical developing children (TD). Methods and procedures113 children with ADHD: 40 with subtype inattentive (ADHD- I group), 16 with subtype hyperactive (ADHD-H group), 57 with subtype combined (ADHD-C group), and 113 TD children (TD group) were recruited. We used a dual-task paradigm in which the primary task was a figure-tracing test whereas the second task was a digit span test. A figure-tracing test was used to evaluate visual motor attention. Based on the length and intersection of the lines, the figures of the primary task were categorized into simple and complex. Outcomes and resultsthe ADHD groups compared to the TD group showed a worse accuracy of performance in both condition with and without cognitive load. Conclusions and implicationsThe findings were discussed in light of the relationship between automatic and controlled processes involved in the visual-motor attention.

Differential structure-function network coupling in the inattentive and combined types of attention deficit hyperactivity disorder.

The heterogeneous presentation of inattentive and hyperactive-impulsive core symptoms in attention deficit hyperactivity disorder (ADHD) warrants further investigation into brain network connectivity as a basis for subtype divisions in this prevalent disorder. With diffusion and resting-state functional magnetic resonance imaging data from the Healthy Brain Network database, we analyzed both structural and functional network efficiency and structure-functional network (SC-FC) coupling at the default mode (DMN), executive control (ECN), and salience (SAN) intrinsic networks in 201 children diagnosed with the inattentive subtype (ADHD-I), the combined subtype (ADHD-C), and typically developing children (TDC) to characterize ADHD symptoms relative to TDC and to test differences between ADHD subtypes. Relative to TDC, children with ADHD had lower structural connectivity and network efficiency in the DMN, without significant group differences in functional networks. Children with ADHD-C had higher SC-FC coupling, a finding consistent with diminished cognitive flexibility, for all subnetworks compared to TDC. The ADHD-C group also demonstrated increased SC-FC coupling in the DMN compared to the ADHD-I group. The correlation between SC-FC coupling and hyperactivity scores was negative in the ADHD-I, but not in the ADHD-C group. The current study suggests that ADHD-C and ADHD-I may differ with respect to their underlying neuronal connectivity and that the added dimensionality of hyperactivity may not explain this distinction.

Link Between Topographic Memory and the Combined Presentation of ADHD (ADHD-C): A Pilot Study.

Background: Topographic memory is the ability to reach various places by recognizing spatial layouts and getting oriented in familiar environments. It involves several different cognitive abilities, in particular executive functions (EF), such as attention, working memory, and planning. Children with attention deficit hyperactivity disorder (ADHD) show impairments in inhibitory control, regulation of attention, planning, and working memory.Aim: The aim of this study was to evaluate the topographic memory in children with ADHD-combined subtype (ADHD-C).Method: Fifteen children (8–10 years) with a diagnosis of ADHD-C (DSM-5) (ADHD-C group) were compared to 15 children with typical development (TD group) of the same age. All children performed Raven's colored progressive matrices (CPM) test to obtain a measure related with cognitive functioning. The walking Corsi test (WalCT), a large-scale version of the Corsi block-tapping test, was used to assess topographic memory in experimental environment.Results: A higher impairment was observed in ADHD-C than TD with significant differences in the WalCT, in particular on the topographic short-term memory (TSTM) task, on the topographic learning (TL) task, and on the repetition number (RN) task during the TL task. Perseverative errors were reported in performing the square-sequence in the WalCT. Zero-order correlations showed a positive correlation between TSTM and auditory attention, and memory of design of NEPSY-II and digit span of WISC-IV. No statistically significant differences were found between the ADHD-C group and TD group in the TL task in the WalCT condition.Conclusion: In ADHD-C, initial topographic learning was compromised whereas the long-term retention of learned topographical material seemed to not be impaired. In particular, these impairments seem to be linked with difficulties in sustained attention, in spatial memory for novel visual materials, in a poor working memory, and in perseverative behaviors.

Asymmetry in Cortical and Subcortical Structures of the Brain in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

BackgroundHuman cognitive and emotional functions are asymmetrical between the left and right hemispheres. In neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) patients, the absence of aberrant asymmetry might serve as a neuroanatomical marker of ADHD. However, few studies have estimated abnormalities in cortical and subcortical asymmetry in children and adolescents of different ADHD subtypes.MethodsData were from the results collected by the Peking University site in the “ADHD-200 sample” dataset, which comprised 31 eligible ADHD (20 inattentive ADHD (ADHD-I), 11 combined ADHD (ADHD-C)) and 31 matched typically developing (TD) individuals. The Asymmetry Indexes (AIs) in cortical thickness, cortical gray-matter volume and subcortical nucleus (SN) volume were calculated based on an automated surface-based approach. The differences in cortical thickness, cortical gray-matter volume, and SN volume AIs were evaluated among groups. We also analyzed the correlation between AIs and the severity of ADHD symptoms.ResultsCompared with the TD group, SN asymmetry in ADHD group did not reveal significant differences. Altered cortical asymmetry of different subtypes in ADHD groups was located in the orbitofrontal and anterior cingulate circuits, including the medial orbitofrontal, paracentral, pars triangularis, caudal anterior cingulate, isthmus cingulate, and superior frontal regions. In the comparisons, cortical gray-matter volume AIs were significantly different in the caudal anterior cingulate, isthmus cingulate, and superior frontal regions between ADHD-I and ADHD-C groups. There were significant correlations between the severity of ADHD symptoms and asymmetric measurements in medial orbitofrontal, paracentral and isthmus cingulate regions.ConclusionThese findings provide further evidence for the altered cortical morphological asymmetry in children and adolescents with ADHD, and these differences are associated (at least in part) with the severity of ADHD symptoms. Brain asymmetry could be an appropriate precursor of morphological alterations in neurodevelopmental disorders.

The role of tryptophan metabolic pathway in children with attention deficit hyperactivity disorder with and without comorbid oppositional defiant disorder and conduct disorder

Accumulating data presented that tryptophan metabolic pathway (TMP) may play a role in attention-deficit/hyperactivity disorder (ADHD). However, no study have investigated potential role of TMP in disruptive behavior disorders coexisting with ADHD. This study compared serum levels of tryptophan, kynurenine, kynurenic acid, 3-hydroxykynurenine and 3-hydroxyantranilic acid in medication-free children with ADHD combined presentation (ADHD-C), with ADHD-C and oppositional defiant disorder (ODD), and with ADHD-C and conduct disorder (CD) versus healthy controls. The study also compared several ratios that are previously suggested to reflect the activities of the KP enzymes (kynurenine/tryptophan, kynurenic acid/kynurenine, 3-hydroxykynurenine/kynurenine) or neuroprotective activity (kynurenic acid/3-hydroxykynurenine) among groups. A total of 122 patients were enrolled: 46 children with ADHD-C alone, 43 children with ADHD-C+ODD, 33 children with ADHD-C+CD and 50 healthy controls. Targeted biochemical molecules were assessed by liquid chromatography-mass spectrometry/mass spectrometry. Compared to control group, serum kynurenine levels were significantly higher in the ADHD-C group, serum 3-hydroxykynurenine levels were significantly lower in the ADHD-C and ADHD-C+ODD groups, the serum kynurenic acid/kynurenine ratio was significantly higher in the ADHD-C, ADHD-C+ODD and ADHD-C+CD groups, and the serum 3-hydroxykynurenine/kynurenine ratio was significantly lower in the ADHD-C group. These findings suggest that TMP may play a role in the pathophysiology of ADHD-C.

Effects of the dopamine transporter gene on neuroimaging findings in different attention deficit hyperactivity disorder presentations.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a phenotipically and neurobiologically heterogeneous disorder. Deficiencies at different levels in response inhibition, differences in dopamine transporter genotype (DAT1) and various symptomatic presentations contribute to ADHD heterogeneity. Integrating these three aspects into a functional neuroimaging research could help unreval specific neurobiological components of more phenotipically homogeneous groups of patients with ADHD. During the Go-NoGo trial, we investigated the effect of the DAT1 gene using 3T MRI in 72 ADHD cases and 24 (TD) controls that typically developed between the ages 8 and 15years. In the total ADHD group, DAT1 predicted homozygosity for the 10R allele and hypoactivation in the anterior cingulate cortex and paracingulate cortex. There were no significant activation differences between DAT1 10R/10R homozygotes and 9R carriers in TD controls. Subjects with predominantly inattentive ADHD (ADHD-I) presentation with DAT1 10R/10R homozygous reduced neuronal activation during Go trial particularly in the frontal regions and insular cortex, and in the parietal regions during NoGo trial (brain regions reported as part of Default Mode Network- DMN). Additionally, DAT1 10R/10R homozygousness was associated with increased occipital zone activation during only the Go trial in the ADHD combined presentation (ADHD-C) group. Our results point the three main findings: 1) The DAT1 gene is 10R homozygous for differentiated brain activation in ADHD cases but not in the TD controls, supporting the DAT1 gene as a potential marker for ADHD, 2) The relationship between the DAT1 gene and the occipital regions in ADHD-C group which may reflect compensatory mechanisms, 3) The relationship between DAT1 gene and the reduced DMN suppression for 9R carriers probabaly stems from the ADHD-I group.

PSYCHIATRIC COMORBIDITY AND SLEEP PROBLEMS IN CHILDREN AND ADOLESCENTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER IN RELATION TO ATTENTION DEFICIT HYPERACTIVITY DISORDER PRESENTATION, AGE AND GENDER

Objective: This study aimed to investigate psychiatric comorbidity and sleep problems and their relationships with ADHD presentation, age and gender in a clinical sample of children and adolescents with ADHD. Material and Method: One hundred fifty-four subjects aged 6-17 were included in the study. A semi-structured diagnostic interview was conducted to screen psychiatric disorders. The Child Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children’s Sleep Habits Questionnaire (CSHQ) were used to investigate internalizing difficulties and sleep problems. Results: Overall high rates of comorbid disorders (78%) and sleep problems (97%) were found. ADHD-C was significantly more frequent in males and ADHD-I was more frequent in females (p&lt;0.001). While oppositional defiant disorder (ODD), enuresis and encopresis were more frequent in subjects with ADHD-C (p&lt;0.05), generalized anxiety (GAD) and social anxiety (SAD) disorders were more frequent in subjects with ADHD-I (p&lt;0.05). Females, compared to males, had more frequent diagnoses of depression (p=0.021) and SAD (p=0.03). The majority of subjects (96.7%) scored above the cut off score of 41 in CSHQ (50.51±5.86). The ADHD-C group had significantly higher CSHQ total scores than the ADHD-I group (p&lt;0.05). There was a significant positive correlation between CSHQ total scores and the number of lifetime comorbid diagnoses (p=0.006), self-reported anxiety (p=0.009) and depressive (p=0.004) symptoms. Conclusion: Comorbidity and sleep problems may be common in young people with ADHD and may have complex reciprocal relations with several factors including ADHD presentation, age, and gender.

Aberrant functional connectivity in resting state networks of ADHD patients revealed by independent component analysis

BackgroundADHD is one of the most common psychiatric disorders in children and adolescents. Altered functional connectivity has been associated with ADHD symptoms. This study aimed to investigate abnormal changes in the functional connectivity of resting-state brain networks (RSNs) among adolescent patients with different subtypes of ADHD.MethodsThe data were obtained from the ADHD-200 Global Competition, including fMRI data from 88 ADHD patients (56 patients of ADHD-Combined, ADHD-C and 32 patients of ADHD-Inattentive, ADHD-I) and 67 typically developing controls (TD-C). Group ICA was utilized to research aberrant brain functional connectivity within the different subtypes of ADHD.ResultsIn comparison with the TD-C group, the ADHD-C group showed clusters of decreased functional connectivity in the left inferior occipital gyrus (p = 0.0041) and right superior occipital gyrus (p = 0.0011) of the dorsal attention network (DAN), supplementary motor area (p = 0.0036) of the executive control network (ECN), left supramarginal gyrus (p = 0.0081) of the salience network (SN), middle temporal gyrus (p = 0.0041), and superior medial frontal gyrus (p = 0.0055) of the default mode network (DMN), while the ADHD-I group showed decreased functional connectivity in the right superior parietal gyrus (p = 0.0017) of the DAN and left middle temporal gyrus (p = 0.0105) of the DMN. In comparison with the ADHD-I group, the ADHD-C group showed decreased functional connectivity in the superior temporal gyrus (p = 0.0062) of the AN, inferior temporal gyrus (p = 0.0016) of the DAN, and the dorsolateral superior frontal gyrus (p = 0.0082) of the DMN. All the clusters surviving at p < 0.05 (AlphaSim correction).ConclusionThe results suggested that decreased functional connectivity within the DMN and DAN was responsible, at least in part, for the symptom of inattention in ADHD-I patients. Similarly, we believed that the impaired functional connectivity within networks may contribute to the manifestations of ADHD-C patients, including inattention, hyperactivity/impulsivity, and unconscious movements.

Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.

Discrimination of ADHD Subtypes Using Decision Tree on Behavioral, Neuropsychological and Neural Markers

Introduction:Attention-Deficit/Hyperactivity Disorder (ADHD) is a well-known neurodevelopmental disorder. Diagnosis and treatment of ADHD can often lead to a developmental trajectory toward positive results. The present study aimed at implementing the decision tree method to recognize children with and without ADHD, as well as ADHD subtypes.Methods:In the present study, the subjects included 61 children with ADHD (subdivided into ADHD-I (n=25), ADHD-H (n=14), and ADHD-C (n=22) groups) and 43 typically developing controls matched by IQ and age. The Child Behavior Checklist (CBCL), Integrated Visual And Auditory (IVA) test, and quantitative EEG during eyes-closed resting-state were utilized to evaluate the level of behavioral, neuropsychology, and electrophysiology markers using a decision tree algorithm, respectively.Results:Based on the results, excellent classification accuracy (100%) was obtained to discriminate children with ADHD from the control group. Also, the ADHD subtypes, including combined, inattention, and hyperactive/impulsive subtypes were recognized from others with an accuracy of 80.41%, 84.17%, and 71.46%, respectively.Conclusion:Our results showed that children with ADHD can be recognized from the healthy controls based on the neuropsychological data (sensory-motor parameters of IVA). Also, subtypes of ADHD can be distinguished from each other using behavioral, neuropsychiatric and electrophysiological parameters. The findings suggested that the decision tree method may present an efficient and accurate diagnostic tool for the clinicians.

Visual Attention, Orthographic Word Recognition, and Executive Functioning in Children With ADHD, Dyslexia, or ADHD + Dyslexia

Objective: The current study examined the differences in visual selective attention, orthographic word recognition, and executive functioning. Method: One hundred and forty Ecuadorian children in third and fifth grades of elementary school (8-10 years old) participated in the study—35 with only dyslexia (DD), 35 with the combined type of attention deficit and hyperactivity disorder (ADHD-C), 35 with disorders (DD + ADHD-C), and 35 typical development children (TD). Results: The Ecuadorian children with DD and/or ADHD-C in this age range usually have difficulties in visual selective attention, and also in orthographic word recognition. The executive functioning results showed that such functioning was worse in the ADHD-C groups (with or without DD), but not in the DD group, supporting the dissociation between DD and ADHD-C in executive functioning in this population. Conclusion: The DD + ADHD-C comorbidity produces worse deficits compared to DD, but not compared to ADHD-C, supporting the idea that there are common factors in DD and ADHD-C.

Prefrontal Brain Activation in Subtypes of Attention Deficit Hyperactivity Disorder: A Functional Near-Infrared Spectroscopy Study

DOI : 10.26650/electrica.2018.99730 According to clinical symptoms, attention deficit and hyperactivity disorder (ADHD) is categorized into three groups: the predominantly inattentive subtype (ADHD-I), the predominantly hyperactive-impulsive subtype (ADHD-HI), and the combined subtype (ADHD-C). Recent advances in neuroimaging have demonstrated new approaches for assessing the ADHD subtypes with underlying pathophysiology. This study aims to examine the hemodynamic response and reaction time (RT) in healthy children and the ADHD subtypes as measured by functional near-infrared spectroscopy (fNIRS) during an auditory oddball attention task. The sample was made up of 40 children divided into four groups: control group (n=14), ADHD-I group (n=9), ADHD-HI group (n=6), and ADHD-C group (n=11). The target responses were identified and were grand-averaged for each participant. Right prefrontal cortex hemodynamic responses and groups performances on RT were compared between subtypes and between controls and subtypes. Functional near-infrared spectroscopy indicated that while control subjects exhibited higher activation than all ADHD subtypes, the ADHD subtypes did not differ from one another. Relative to control subjects, a longer RT was observed in all ADHD subtypes. The ADHD-I group showed significantly longer RTs compared to the ADHD-HI and ADHD-C groups. This study can bring a new perspective to the continuing controversy about ADHD subtypes, and the findings may help in the evaluation of fNIRS, RT, and RT variability studies in ADHD.