Attention-deficit/hyperactivity Disorder Rating Scale Research Articles

Safety and efficacy of guanfacine extended-release in adults with attention-deficit/hyperactivity disorder: an open-label, long-term, phase 3 extension study

BackgroundTo assess the safety and efficacy of long-term administration of guanfacine extended-release (GXR) in adults with attention-deficit/hyperactivity disorder (ADHD).MethodsIn this open-label, long-term, phase 3 extension study in Japan, 150 patients transitioned from a double-blind trial, and 41 newly enrolled patients received once daily GXR (starting dose 2 mg/day, maintenance dose 4–6 mg/day) for 50 weeks. Primary outcome measures were the frequency and nature of treatment-emergent adverse events (TEAEs); secondary outcome measures included the change from week 0 in ADHD Rating Scale IV with Adult Prompts (ADHD-RS-IV; Japanese version) total and subscale scores, Conners’ Adult ADHD Rating Scales (CAARS), Clinical Global Impression-Improvement (CGI-I) and Patient Global Impression-Improvement (PGI-I) scales, and quality of life (QoL) and executive functioning measures.ResultsOf all patients, 94.2% (180/191) reported ≥1 TEAE and 19.9% (38/191) discontinued because of a TEAE. Most TEAEs were mild to moderate in severity; there were two serious TEAEs and no deaths. Commonly reported TEAEs (≥10% of patients) were somnolence, thirst, nasopharyngitis, decreased blood pressure, postural dizziness, bradycardia, malaise, constipation, and dizziness. Mean changes from week 0 in ADHD-RS-IV total and subscale scores and CAARS subscale scores were significantly improved in former placebo or GXR patients and new patients at last observation (p < .0001), and the percentage of patients with very much or much improved CGI-I and PGI-I scores increased.ConclusionsThere were no major safety concerns during long-term GXR administration in adults with ADHD. After long-term treatment, patients had significant improvements from baseline in ADHD symptoms, QoL, and executive functioning.Trial registrationJapan Primary Registries Network (https://rctportal.niph.go.jp/en/): JapicCTI-163232, registered 04/21/2016.

Application of Attention-Deficit/Hyperactivity Disorder Diagnostic Tools: Strengths and Weaknesses of the Korean ADHD Rating Scale and Continuous Performance Test.

PurposeWe aimed to compare the Korean version of the ADHD Rating Scale (K-ARS) and Integrated Visual and Auditory Plus (IVA+Plus), a continuous performance test, by analyzing their abilities to distinguish different groups (attention-deficit/hyperactivity disorder [ADHD], ADHD-not otherwise specified [NOS], and normal control [NC]).Patients and MethodsIndividuals of 7–12 years of age who visited our child and adolescent psychiatric clinic were recruited. Seventy-four participants (58 males, 16 females) were classified into three groups according to results from the Korean Version of Diagnostic Interview Schedule for Children Version IV. The K-ARS and IVA+Plus were administered. An analysis of covariance (ANCOVA) was conducted. The tools’ accuracy in discriminating patients with ADHD or NOS from NCs was evaluated using a receiver operating characteristic (ROC) curve analysis.ResultsANCOVA revealed significant differences in the K-ARS results of the three groups (ADHD [n=29], NOS [n=33], NC [n=12]), whereas a difference in IVA+Plus results was observed only between the ADHD and NC groups. In the ROC curve analysis of the K-ARS, the areas under the curve (AUCs) for each group were 0.960 (ADHD vs NC), 0.885 (NOS vs NC), 0.920 (ADHD+NOS vs NC), and 0.779 (ADHD vs NOS+NC). In the ROC curve analysis for the IVA+Plus hyperactivity-impulsiveness scale, the AUCs for each group were 0.740 (ADHD vs NC), 0.643 (NOS vs NC), 0.688 (ADHD+NOS vs NC), and 0.626 (ADHD vs NOS+NC); those for the inattention scale were 0.731 (ADHD vs NC), 0.658 (NOS vs NC), 0.692 (ADHD+NOS vs NC), and 0.625 (ADHD+NOS vs NC).ConclusionThe K-ARS was useful to distinguish the ADHD and NOS groups from the NC group, while the IVA+Plus was useful to distinguish the ADHD group from the NC group. Clinicians should ensure they understand the properties of each tool and apply them appropriately in the diagnosis of ADHD.

Comparing the prevalence of attention deficit hyperactivity disorder in hearing-impaired children with normal-hearing peers

ObjectivesThe most important aspect of hearing loss is its effect on the communication abilities of individuals. The aim of this study was to compare the prevalence of attention deficit hyperactivity disorder (ADHD) in hearing-impaired (HI) children with normal-hearing (NH) peers. MethodsA total of 130 children (65 children with severe-to-profound hearing loss and 65 NH peers) participated in this cross-sectional study from November 2013 to May 2014. ADHD Rating Scale IV questionnaires were given to children's parents to collect data. Descriptive and analytical analyses were used in order to achieve the objectives of the study. ResultsThe mean age of the HI children and NH peers was 14.1 and 13.3 years, respectively. In the case group, 52 children suffered from congenital hearing loss and 10 children had acquired hearing loss. In total, 19 cases (29.2%) and eight controls (12.3%) were diagnosed with ADHD. This difference was statistically significant (P=0.017). The prevalence of ADHD in children with hereditary or acquired hearing loss was 30.7% and 20.0%, respectively. However, this difference was not significant (P=0.71). ConclusionThe prevalence of ADHD in school-aged children with hearing loss is higher than that in the general population of the same age. We could not find significant differences between the different subgroups due to the small sample size. Therefore, we recommend a further larger study to determine the interaction between hearing loss and ADHD.

Population pharmacokinetic and exposure-response analyses of d-amphetamine after administration of lisdexamfetamine dimesylate in Japanese pediatric ADHD patients

Lisdexamfetamine dimesylate, a prodrug of d-amphetamine, has been approved for treatment of attention-deficit/hyperactivity disorder (ADHD). The purposes of this study were constructing a population pharmacokinetic model of d-amphetamine after dosing of lisdexamfetamine dimesylate and assessing influential factors on the pharmacokinetics of d-amphetamine in Japanese pediatric patients with ADHD. Additionally, the exposure-response relationship was evaluated for Japanese pediatric patients with ADHD using a clinical rating scale, the ADHD Rating Scale IV (ADHD RS-IV, efficacy endpoint) total score as a response index. A total of 1365 points of plasma d-amphetamine concentrations from pediatric patients (6–17 years) with ADHD in clinical studies conducted in Japan and the US were employed for the population pharmacokinetic analysis. The plasma concentrations of d-amphetamine in pediatric patients with ADHD were well described by a one-compartment model with first-order absorption and lag time. The effects of body weight and ethnicity (Japanese or non-Japanese) on apparent total body clearance and the effect of body weight on apparent volume of distribution were incorporated into the final model. No clear exposure-dependent reduction was evident from the ADHD RS-IV total score, whereas the reductions were greater for the lisdexamfetamine dimesylate treatment groups compared with the placebo group regardless of exposure to d-amphetamine.

Parental age at childbirth and risk for attention-deficit/hyperactivity disorder in offspring

This study investigated the association between parental age at birth and attention-deficit/hyperactivity disorder (ADHD) symptoms in their children. A total of 30,552 children aged 6–12 years participated in the study. ADHD symptoms were rated using the Korean version of the ADHD Rating Scale (K-ARS) by parents. K-ARS scores and odds ratio (OR) for children with high-risk ADHD presented a U-shape curve depending on the age of both parents at birth. The total K-ARS scores and OR for high-risk ADHD were highest in children of fathers and mothers belonging to the youngest age group (aged ≤20) (K-ARS = 12.33, OR = 2.89 vs K-ARS = 10.98, OR = 2.63) and second highest in children whose father's or mother's age at birth was the oldest (K-ARS = 9.63, OR = 1.65 vs K-ARS = 9.95, OR = 1.95). Our study identified that both spectrums of age—young and old of either parent—were associated with ADHD in children. These are new findings considering that old age of parents as the correlates of offspring ADHD is the inconsistent finding with previous studies and warrant future studies in other cultures that include more detailed information on ADHD symptoms of children and their parents are needed to confirm the present findings.

Adult ADHD screening scores and hospitalization due to pedestrian injuries: a case-control study.

sBackgroundThe aim of this study was to investigate the association between adult ADHD screening scores and hospitalization due to pedestrian injuries in a sample of Iranian pedestrians.MethodsThrough a case-control study, a case population of 177 pedestrians injured by the vehicles in road traffic crashes were compared with 177 controls who lacked a record of intentional or unintentional injuries enrolled from various wards of Imam Reza University Hospital which is a specialty teaching hospital located in the same city with similar referral level. The cases and controls had an age range of 18–65 years and were matched on gender and age. ADHD symptom profile was assessed using the Persian Self-report Screening Version of the Conner’s Adult ADHD Rating Scales (CAARS-S:SV). The association of ADHD screening score and pedestrian injuries was investigated using multiple binary logistic regression to investigate the independent effect of ADHD index score on belonging to case group. Both crude and adjusted odds ratios were reported.ResultsMen comprised 86.4% of the study subjects. The crude odds ratios for all the four ADHD subscales to be associated with pedestrian injuries were 1.05, 1.08, and 1.04 for the subscales A (attention deficit), B (hyperactivity/impulsiveness) and ADHD index respectively. However, the association for subscale A was not statistically significant with a borderline p-value. The final multivariate analysis showed that variables associated with pedestrian injuries in the road traffic crashes were ADHD Index score (OR = 1.06, 95% CI: 1.01–1.12); economic status (including household income and expenditure capacity); educational level and total walking time per 24 h.ConclusionsAdult ADHD screening score can predict pedestrian injuries leading to hospitalization independently from sex, age, economic status, educational level and pedestrian exposure to traffic environment (average walking time).

Elevated thalamic glutamate levels and reduced water diffusivity in alcohol use disorder: Association with impulsivity

Alcohol induces neuroinflammation but its role in cognitive impairment and impulsivity in alcohol use disorder (AUD) has been poorly investigated. We used proton magnetic resonance spectroscopy to measure brain glutamate (Glu) levels and diffusion-weighted imaging to measure functional anisotropy (FA) in the thalamus and ventral anterior cingulate cortex (vACC) in 15 recently detoxified patients with AUD and 14 matched controls. Compared to controls, AUD patients showed higher Glu levels (p = 0.04) and lower FA in the thalamus (p = 0.04) but not in the vACC. In AUD, thalamic Glu levels (r = 0.62, p = 0.019) and FA (r=-0.55, p = 0.034) were associated with severity of drinking (drinks/week). Compared to controls, AUD patients showed higher scores on Conners’ Adult ADHD Rating Scale for impulsivity (p = 0.03), which correlated with glutamate levels in the thalamus (r = 0.58, p = 0.03) and vACC (r = 0.55, p = 0.036). In a second cohort of AUD patients (n = 32), Glu in dorsal ACC (dACC) also correlated with Barrett Impulsiveness Scale total score (r = 0.43, p = 0.014). We interpret the elevated thalamic Glu levels and the parallel reduction in FA in AUD—which correlated with drinking severity—as possible evidence of neurotoxicity from neuroinflammation. The association of Glu with impulsivity suggests that neurotoxic effects of chronic alcohol exposure in the thalamus and dACC may contribute to impulsivity.

The Dynamic Properties of a Brain Network During Spatial Working Memory Tasks in College Students With ADHD Traits.

This study investigated deficits of spatial working memory in college students with attention-deficit/hyperactivity disorder (ADHD) traits using event-related potentials (ERPs) and the spatial 2-back task. We also computed sensory-level activity using EEG data and investigated theta and alpha neural oscillations, phase-locking values (PLV), and brain networks. Based on the scores from the Adult ADHD Self-Report Scale (ASRS) and Conners’ Adult ADHD Rating Scales (CAARS), an ADHD-trait group (n = 40) and a normal control group (n = 41) were selected. Participants were required to respond to whether the presented stimulus was at the same location as that presented two trials earlier. The ADHD-trait group showed significantly slower response times than the control group in the spatial 2-back task. In terms of spectrum, the ADHD-trait group showed significantly reduced theta power than the control group. In contrast, the ADHD-trait group exhibited an increased alpha power compared to the control group with the 250–1000 ms interval after stimulus onset. In terms of the PLV, the ADHD-trait group showed significantly weaker theta phase synchrony and fewer connection numbers in frontal-occipital areas than the control group. In terms of the theta brain network, the ADHD-trait group showed a significantly lower clustering coefficient and longer characteristic path length than the control group for the theta band. The present results indicate that college students with ADHD traits have deficits in spatial working memory and that these abnormal activities in neural oscillation, functional connectivity, and the network may contribute to spatial working memory deficits.

Dietary patterns are associated with attention-deficit hyperactivity disorder (ADHD) symptoms among preschoolers in South Korea: a prospective cohort study

ABSTRACT Objectives: Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder in children. There are limited studies for diet or dietary supplement effects on ADHD in preschool children in Asia. This study aimed to determine the association between dietary patterns in 4-year-old children and ADHD symptoms in 6-year-old children. Methods: We estimated dietary intake in 4-year-old children using a food frequency questionnaire. Using 33 food groups, major dietary patterns were identified in relation to the consumption of sweets, vegetables, meats, and carbohydrates. Parents of 6-year-old children used the Korean version of the ADHD Rating Scale for ADHD symptom assessment. Results: A sweet dietary pattern was associated with a higher risk of attention deficit (AD) (relative risk [RR], 1.34; confidence interval [CI], 1.17–1.55), hyperactivity (RR, 1.40; CI, 1.19–1.64), and ADHD symptoms (RR, 1.37; CI, 1.23–1.52). A vegetable dietary pattern was associated with a lower risk of ADHD symptoms (RR, 0.81; CI, 0.72–0.90). Food item analysis of the sweet dietary pattern showed that intake scores for chocolate, chips, and fruit jams positively correlated with AD, hyperactivity, and ADHD symptoms. Discussion: These findings can be useful to further understand the roles of dietary factors in ADHD.

Neuropsychological characteristics of adults with attention-deficit/hyperactivity disorder without intellectual disability.

AimsWhile several studies have reported various cognitive impairments in children with attention‐deficit/hyperactivity disorder, the neuropsychological profiles of adults with this disorder are understudied. Here, the intelligence and memory functions of adults with attention‐deficit/hyperactivity disorder without intellectual disability were evaluated.MethodsThe Wechsler Adult Intelligence Scale—Third Edition and Wechsler Memory Scale—Revised were administered to 30 adults with attention‐deficit/hyperactivity disorder whose full‐scale intelligence quotients were >85. Diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders‐IV criteria. Conners' Adult ADHD Rating Scales—Self‐Report—screening version and the Autism Spectrum Quotient were also evaluated.ResultsIn the Wechsler Adult Intelligence Scale—Third Edition, the verbal intelligence quotient was significantly higher than the performance intelligence quotient and the verbal comprehension score was the highest among the secondary indices. In the Wechsler Memory Scale—Revised, the visual memory score was the highest measure. Although the verbal intelligence quotient had no correlation with any Wechsler Memory Scale—Revised measures, the performance intelligence quotient was significantly correlated with the visual memory and attention scores of the Wechsler Memory Scale—Revised. Conners' Adult ADHD Rating Scales hyperactive‐impulsive score was significantly correlated with the verbal intelligence quotient, whereas the inattention score was not correlated with any measures of the Wechsler Adult Intelligence Scale—Third Edition or Wechsler Memory Scale—Revised.ConclusionsThe results suggest that while adults with normal‐intelligence attention‐deficit/hyperactivity disorder have comparatively high verbal comprehension and social knowledge, their ability of information processing and visual‐motor coordination are relatively weak.

Post hoc Responder and Remission Analyses from Two Studies of SHP465 Mixed Amphetamine Salts Extended-Release Among Adults with Attention-Deficit/Hyperactivity Disorder.

Objectives: In two studies of adult attention-deficit/hyperactivity disorder (ADHD), SHP465 mixed amphetamine salts (MAS) extended-release significantly reduced ADHD-Rating Scale, 4th Edition total score (ADHD-RS-IV-TS) versus placebo (PBO). This report describes post hoc analyses of SHP465 MAS treatment response and remission rates from those studies.Methods: Adults with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision–defined ADHD were randomized to SHP465 MAS (12.5–75 mg) or PBO in a 7-week dose-optimization study and to SHP465 MAS (25, 50, or 75 mg) or PBO in a 6-week fixed-dose study. Response was examined using three definitions (definition 1: ≥30% ADHD-RS-IV-TS reduction + Clinical Global Impressions-Improvement [CGI-I] rating of 1 or 2; definition 2: ≥50% ADHD-RS-IV-TS reduction + CGI-I rating of 1 or 2; definition 3: ADHD-RS-IV-TS ≤18). Remission was defined as ADHD-RS-IV-TS ≤12. The Kaplan–Meier analyses assessed time to response or remission.Results: The intent-to-treat populations included 136 SHP465 MAS and 132 PBO participants in the dose-optimization study and 302 SHP465 MAS and 103 PBO participants in the fixed-dose study. Percentages of participants meeting response criteria (SHP465 MAS vs. PBO) at the final treatment week in the dose-optimization and fixed-dose studies, respectively, were 66.0% versus 31.6% and 72.7% versus 28.3% (definition 1); 47.9% versus 27.6% and 60.6% versus 16.7% (definition 2); and 54.3% versus 30.3% and 52.6% versus 18.3% (definition 3). The remission criterion (SHP465 MAS vs. PBO) at the final treatment week was met by 37.2% versus 19.7% of participants in the dose-optimization study and 39.7% versus 10.0% of participants in the fixed-dose study. Times to response and remission favored SHP465 MAS over PBO in both studies (all nominal log-rank p < 0.0001).Conclusion: These post hoc analyses indicate that SHP465 MAS was associated with greater response and remission rates than PBO in adults with ADHD, with times to response and remission also nominally favoring SHP465 MAS.

Efficacy of Omega-3 and Korean Red Ginseng in Children with Subthreshold ADHD: A Double-Blind, Randomized, Placebo-Controlled Trial

Objective: The purpose of the present study was to investigate the efficacy of combined omega-3 and Korean red ginseng supplementation on ADHD symptoms and cognitive function in children with subthreshold ADHD. Method: 120 children from 6 to 12 years with subthreshold ADHD were enrolled in this 12-week, double-blind, randomized, placebocontrolled study. The primary outcome was measured by Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Children Behavior Check List (CBCL), and neuropsychological tests assessing attention, memory, and executive function were included as secondary primary outcome measures. Results: Significant effects on the scores of ADHDRS, as well as several subscales of CBCL including ADHD and attention problem subscales were revealed. Conclusion: The combination of omega-3 and Korean red ginseng may have beneficial effects in children with subthreshold ADHD. Increased clinical awareness of ADHD symptoms even at a subthreshold level is needed.

FDA OKs ADHD Video Game Therapy

FDA OKs ADHD Video Game Therapy

Oligoantigenic Diet Improves Children's ADHD Rating Scale Scores Reliably in Added Video-Rating.

ObjectivesThe influence of food intake on behavioural disorders was already described in the early 20th century. Elimination of individually allergenic food items from individual diets [“oligoantigenic diet” (OD)] showed promise to improve attention-deficit/hyperactivity disorder (ADHD) symptoms. However, only few of the positive results were evaluated by blinded symptom rating. Therefore the present study’s purpose was to evaluate the reliability of a non-blinded rating of the ADHD Rating Scale IV (ARS) for the assessment of OD effects in comparison to a blinded rating of the ARS based on pseudonymized video recordings.MethodsTen children (8m/2f) aged 8 to 14 with ADHD according to ICD-10 participated in an uncontrolled, open-label dietary intervention study. Food items, commonly related to intolerances, were eliminated for four weeks. Participants with > 40% improvement in the ARS between T1 (before the diet) and T2 (after the diet) were defined as responders. Nutrients with individual relevance to ADHD symptoms were identified in a following reintroduction phase (T3–T4) lasting 8–16 weeks. The ARS was completed by a non-blinded child and adolescent psychiatrist (T0-T4). Sessions were recorded on video, pseudonymized, and evaluated by three blinded raters. Complete data were captured for eight children. The inter-rater reliability between the non-blinded therapist and every blinded rater was determined by the intra-class correlation coefficient (ICC). Correlations according to Pearson and Spearman between the non-blinded and blinded rating were calculated for each rater.ResultsTwo blinded raters and the non-blinded rater considered 5 of 8 (62.5%) children as responders, whereas one blinded rater disagreed as to the success of one case thus considering only 4 of 8 children as responders to the diet. Inter-rater reliability was assessed after each rater having scored 33 videos: The intra-class coefficients were >.9 for all raters (rater 1: ICC=.997, rater 2: ICC=.996, rater 3: ICC=.996) and the Spearman rho between the raters were high (n=33; rater 1: rho =.989, p<.0001, rater 2: rho=.987, p<.0001, rater 3: rho=.984, p<.0001), respectively.DiscussionAs both, blinded and non-blinded ratings of the ARS, revealed relevant significant improvement of ADHD scores in children following an OD in this uncontrolled trial, Randomized controlled trials appear as highly desirable in order to replicate these improvements and to establish reliable and unbiased effect sizes thereby fostering further more objective confirmatory measurements.

Analysis of neurodevelopmental outcomes of preadolescents born with extremely low weight revealed impairments in multiple developmental domains despite absence of cognitive impairment.

Background and aimsChildren with extremely low‐birth weight (ELBW) have a high risk for cognitive, motor, and attention impairments and learning disabilities. Longitudinal follow‐up studies to a later age are needed in order to increase understanding of the changes in neurodevelopmental trajectories in targeting timely intervention. The aims of this study were to investigate cognitive and motor outcomes, attention‐deficit hyperactivity (ADHD) behaviour, school performance, and overall outcomes in a national cohort of ELBW children at preadolescence, and minor neuromotor impairments in a subpopulation of these children and to compare the results with those of full‐term controls. The additional aim was to report the overall outcome in all ELBW infants born at 22 to 26 gestational weeks.MethodsThis longitudinal prospective national cohort study included all surviving ELBW (birth weight <1000 g) children born in Finland in 1996 to 1997. No children were excluded from the study. Perinatal, neonatal, and follow‐up data up to the age of 5 years of these children were registered in the national birth register. According to birth register, the study population included all infants born at the age under 27 gestational weeks. At 11 years of age general cognitive ability was tested with the Wechsler Intelligence Scale for Children, ADHD behavior evaluated with a report from each child's own teacher (ADHD Rating Scale IV), and school performance with a parental questionnaire. An ELBW subpopulation consisting of a cohort representative children from the two university hospitals from two regions (n = 63) and the age‐matched full‐term born controls born in Helsinki university hospital (n = 30) underwent Movement Assessment Battery for Children and Touwen neurological examination comprising developmental coordination disorder (DCD) and minor neurological dysfunction (MND), respectively.ResultsOf 206 ELBW survivors 122 (73% of eligible) children and 30 (100%) full‐term control children participated in assessments. ELBW children had lower full‐scale intellectual quotient than controls (t‐test, 90 vs 112, P < .001), elevated teacher‐ reported inattention scores (median = 4.0 vs 1.0, P = .021, r = .20) and needed more educational support (47% vs 17%, OR 4.5, 95% CI 1.6‐12.4, P = .02). In the subpopulation, the incidences of DCD were 30% in ELBW and 7% in control children (P = .012, OR 6.0 CI 1.3‐27.9), and complex MND 12.5% and 0%, (P = .052; RR 1.1 95% CI 1.04‐1.25), respectively. Of survivors born in 24 to 26 gestational weeks, 29% had normal outcome.ConclusionAs the majority of the extremely preterm born children had some problems, long‐term follow‐up is warranted to identify those with special needs and to design individual multidisciplinary support programs.

The Effect of Convergence Vision Therapy on Symptoms and Visual Perception in Children with ADHD tendency

The purpose of this study is to determine whether vision therapy improves symptom and visual perceptual skills in children with attention deficit hyperactivity disorder tendency who have visual problems. The subjects of this study were 10 children. Before and after vision therapy, the visual function test, developmental test of visual-motor integration, test of visual perceptual skills, and ADHD rating scale test were performed. Vision therapy was conducted twice a week for a period of 6 months to 1 year. After vision therapy, all subjects achieved normal ranges of visual function, sensory fusion, stereoacuity, vergence function, and convergence. The visual function and visual perceptual skill were improved and the score for ADHD symptoms was reduced. Therefore, it seems that vision therapy can be used to improve the symptoms and visual perception of children with ADHD.

A Deep Learning Approach for Missing Data Imputation of Rating Scales Assessing Attention-Deficit Hyperactivity Disorder.

A variety of tools and methods have been used to measure behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Missing data is a major concern in ADHD behavioral studies. This study used a deep learning method to impute missing data in ADHD rating scales and evaluated the ability of the imputed dataset (i.e., the imputed data replacing the original missing values) to distinguish youths with ADHD from youths without ADHD. The data were collected from 1220 youths, 799 of whom had an ADHD diagnosis, and 421 were typically developing (TD) youths without ADHD, recruited in Northern Taiwan. Participants were assessed using the Conners’ Continuous Performance Test, the Chinese versions of the Conners’ rating scale-revised: short form for parent and teacher reports, and the Swanson, Nolan, and Pelham, version IV scale for parent and teacher reports. We used deep learning, with information from the original complete dataset (referred to as the reference dataset), to perform missing data imputation and generate an imputation order according to the imputed accuracy of each question. We evaluated the effectiveness of imputation using support vector machine to classify the ADHD and TD groups in the imputed dataset. The imputed dataset can classify ADHD vs. TD up to 89% accuracy, which did not differ from the classification accuracy (89%) using the reference dataset. Most of the behaviors related to oppositional behaviors rated by teachers and hyperactivity/impulsivity rated by both parents and teachers showed high discriminatory accuracy to distinguish ADHD from non-ADHD. Our findings support a deep learning solution for missing data imputation without introducing bias to the data.

ADHD Symptoms, Academic and Social Difficulties in Parents of Children with ADHD

Objective: To evaluate the prevalence of ADHD in a group of parents of children with ADHD compared with the general population. To compare academic level, unemployment aid rate and marital separations/divorce of this parents sample. Methodology: The experimental group was formed by the parents of 60 children with ADHD. The control group was formed by the parents of 60 healthy children. To assess the retrospective and current ADHD symptomatology among the parents of the sample the Wender Utah Rating Scale (WURS) and the Attention Deficit Hyperactivity Disorder-rating scale (ADHD.rs) were used. Also, the Hollingshead Four-Factor Index of Socioeconomic status (SES-Child) was used. Results: 20.33% of the mothers in the case group met criteria for a retrospective diagnosis of ADHD, while none of the control group mothers met criteria (p < .01). Regarding fathers, there was a retrospective ADHD diagnosis in 25% of the case group compared to 10% in the control group (p < .01). In terms of the current symptoms, 25.42% of the mothers and 21.43% of fathers in the case group met diagnostic criteria for probable ADHD compared to 1.67% in the control group (p < .01 in both genders). Parents in the case group had a lower academic level (p < .01), received more unemployment aid (p = .02) and reported a higher rate of marital separation or divorce (p = .02). Conclusions: Parents of children with ADHD have a higher incidence of retrospective and current ADHD diagnosis and they also present worse socioeconomic factors.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study.

ObjectivesThis study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS).MethodsThirty-eight patients with Tourette’s disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity.ResultsThe internal consistency of items on the PUTS was high, with a Cronbach’s α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: “presumed functional relationship between the tic and the urge to tic,” “the quality of the premonitory urge,” and “just right phenomena.”ConclusionThe results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

Impaired early information processing in adult ADHD: a high-density ERP study

BackgroundChildren with attention-deficit/hyperactivity disorder (ADHD) often demonstrate sensory processing difficulties in the form of altered sensory modulation, which may contribute to their symptomatology. Our objective was to investigate the neurophysiological correlates of sensory processing deficits and the electrophysiological characteristics of early information processing in adult ADHD, measured by the P1 event-related potential (ERP).MethodsWe obtained ERPs during a Go/NoGo task from 26 adult patients with ADHD and 25 matched controls using a high-density 128-channel BioSemi ActiveTwo recording system.ResultsADHD patients had a significantly reduced P1 component at occipital and inferotemporal scalp areas compared to controls. The reduction was associated with inattention and hyperactivity symptom severity, as measured by the Conners’ Adult ADHD Rating Scale. ADHD patients with higher inattention scores had significantly smaller P1 amplitudes at posterior scalp sites, while higher hyperactivity scores were associated with higher P1 amplitudes.ConclusionsDeficits in early sensory processing, as measured by the P1 ERP component, are present in adult ADHD patients and are associated with symptom severity. These findings are suggestive of bottom-up cognitive deficits in ADHD driven by impairments in early visual processing, and provide evidence that sensory processing problems are present at the neurophysiological level in this population.