Attention-deficit/hyperactivity Disorder Individuals Research Articles

Increase in Occurrence of Attention Deficit Hyperactivity Disorder Differs by Age Group and Gender-Finnish Nationwide Register Study.

This study describes epidemiology of attention deficit hyperactivity disorder (ADHD) and use of ADHD medication across all age groups in Finland. This retrospective study is based on nationwide registers in Finland. The study population included individuals with ADHD diagnosis and/or an ADHD medication record at least once during 2015-2020. The yearly prevalence of ADHD was higher in males than in females and was highest in the age groups of 6- to 12- and 13- to 17-year-old males. In 2020, the yearly prevalence was 4.2% in ≤12-year-old, 6.7% in 13- to 17-year-old, 0.7% in ≥18-year-old males, and 1.1%, 2.6%, and 0.6%, respectively, in females. The gender-related differences were greatest among 6- to 12- and 13- to 17-year-olds, after which the differences evened out. During the study period from 2015 to 2020, the yearly prevalence more than doubled in each of the five Finnish administrative university hospital areas. The prevalence was higher in males, but the relative growth was higher in females compared to males. The incidence per 100,000 inhabitants was the highest in ≤12-year-old males and increased in all age groups and in both genders. The use of medication was more common in males than in females, and the overall proportion of prevalent ADHD patients on medication remained around 80%. Decrease in medication use was observed in connection with the transition from adolescence to adulthood, in both genders. Both prevalence and incidence of ADHD more than doubled in Finland during the study period 2015-2020. This study presents the most comprehensive analysis of national register data at personal-level linkage in Finland, since it included all age groups, and both diagnosed ADHD patients and individuals receiving medication, not limited to reimbursed medication.

Vision-related quality of life and near-work visual symptoms in patients with attention-deficit/hyperactivity disorder

ABSTRACT Clinical relevance Attention-deficit/hyperactivity disorder (ADHD) has been associated with visual symptoms that may impact daily activities such as near-work tasks and social interactions. Addressing these visual issues is important for improving the overall quality of life and functional outcomes in individuals with ADHD, particularly in academic and social settings. Purpose To investigate the relationship between vision-related quality of life and near-work visual symptoms in patients with ADHD patients. Methods A cohort of 37 individuals with ADHD was compared to age- and sex-matched healthy controls (n = 37). The 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Convergence Insufficiency Symptoms Survey (CISS) were used to assess vision-related quality of life and near-work visual symptoms. Results Mean NEI VFQ-25 scores were not significantly different between the ADHD and control groups. However, individuals with ADHD scored lower on the near activities (p = 0.032; Cohen’s d = −0.511), social functioning (p = 0.045; Cohen’s d = −0.481) and driving (p = 0.007; Cohen’s d = −0.124) subscales. The CISS scores were significantly higher in the ADHD group (23.43 ± 11.22) than in the control group (14.02 ± 9.36; p < 0.001; Cohen’s d = 0.910), indicating a significant relationship between ADHD and the presence of symptomatic subjects (p < 0.001; Cramer’s V = 0.541). Medication did not affect NEI VFQ-25 or CISS scores. Female gender was associated with an increased number of symptomatic subjects based on their CISS scores (p = 0.043; Cramer’s V = 0.396). Symptomatic ADHD individuals had lower NEI VFQ-25 scores (85.02 ± 12.68 vs. 96.02 ± 4.63, p = 0.008; Cohen’s d = −0.969), indicating compromised vision-related quality of life. Conclusions Patients with ADHD experienced a reduced vision-related quality of life and increased near-work visual symptoms, suggesting potential repercussions on academic performance and social adaptability. This study underscores the importance of addressing visual issues in the ADHD population to enhance their overall well-being and functional outcomes.

Contributions of brain regions to machine learning-based classifications of attention deficit hyperactivity disorder (ADHD) utilizing EEG signals

Objective The study presented focuses on the creation of a machine learning (ML) model that uses electrophysiological (EEG) data to identify kids with attention deficit hyperactivity disorder (ADHD) from healthy controls. The EEG signals are acquired during cognitive tasks to distinguish children with ADHD from their counterparts. Methodology The EEG data recorded in cognitive exercises was filtered using low pass Bessel filter and notch filters to remove artifacts, by the data set owners. To identify unique EEG patterns, we used many well-known classifiers, including Naïve Bayes (NB), Random Forest, Decision Tree (DT), K-Nearest Neighbors (KNN), Support Vector Machine (SVM), AdaBoost and Linear Discriminant Analysis (LDA), to identify distinct EEG patterns. Input features comprised EEG data from nineteen channels, individually and in combination. Findings Study indicates that EEG-based categorization can differentiate between individuals with ADHD and healthy individuals with accuracy of 84%. The RF classifier achieved a maximum accuracy of 0.84 when particular region combinations were used. Evaluation of classification performance utilizing hemisphere-specific EEG data yielded promising outcomes, particularly in the right hemisphere channels. Novelty The study goes beyond traditional methodologies by investigating the effect of regional data on categorization results. The contributions of various brain regions to these classifications are being extensively researched. Understanding the role of different brain regions in ADHD can lead to better diagnosis and treatment options for individuals with ADHD. The study of categorization ability, utilizing EEG data specific to each hemisphere, particularly channels in the right hemisphere region, provides further granularity to the findings.

Effect of Low-intensity Transcranial Magnetic Stimulation on Response Inhibition of Adults With Attention-deficit/Hyperactivity Disorder.

Response inhibition is an impaired cognitive function in attention-deficit/hyperactivity disorder (ADHD) individuals. This primary deficit during the cancelation of an intended movement is observed even in the minimal demanding cognitive tasks. Studies have shown that transcranial magnetic stimulation (TMS), especially on the dorsolateral prefrontal cortex (DLPFC), can improve response inhibition. Nevertheless, TMS has a low spatial resolution, and its effect may not be observed in a single-session intervention. Studies show that low-intensity TMS has higher spatial resolution. Therefore, in this study, we aimed to evaluate the effectiveness of this method for intervention of response inhibition in ADHD individuals. In a double-blind paradigm, the performance of the adults with ADHD while executing a Stroop color and word test (SCWT) was measured during a sham or a real stimulation of the DLPFC. Subsequently, the response inhibitions of the participants were measured before and after the stimulation. The number of correct, wrong, and missed answers to 96 computerized trials and the response times of the answers were measured. In addition, changes in electro-cortical activities during the rest phase before and after the stimulation were also evaluated. After checking for data normality, the paired t-test between behavioral data showed that low-intensity magnetic stimulation of the DLPFC can improve response inhibition (reduce errors) even in a single-session intervention of ADHD individuals. The answering times did not change significantly. The behavioral changes were associated with significant changes in the power of EEG in delta and beta frequency bands at the frontal areas. The proposed stimulation protocol with low-intensity TMS had a fair effect on the response inhibition in adults with ADHD. Therefore, it could be suggested as a treatment protocol for response inhibition in ADHD individuals.

Experience of CBT in adults with ADHD: a mixed methods study.

The National Institute for Health and Care Excellence (NICE) recommends Cognitive-Behavioural therapy (CBT) as the psychotherapeutic treatment of choice for adults with Attention Deficit Hyperactivity Disorder (ADHD) in the UK. However, the literature often refers to adapted CBT programs tailored for ADHD and provides limited insight into how adults with ADHD experience and perceive this form of treatment in routine clinical practice. This mixed-methods study aims to explore ADHD individuals' experience and perception of CBT delivered in routine clinical practice, to gain a better understanding of this treatment's helpfulness and perceived effectiveness. A survey (n=46) and semi-structured in-depth interviews (n=10) were conducted to explore the experience of CBT and its perceived effectiveness in managing ADHD. The interviews were analysed using thematic analysis and the survey was synthesised using descriptive narratives. The thematic analysis highlighted three key themes: difficulties with the CBT framework, difficulties with CBT therapists, and consequences of CBT. The survey highlighted similar findings. Participants described the CBT framework as, generic, rigid, and too short, and described the CBT therapist as unspecialised, unempathetic, and not sufficiently adapting CBT to ADHD-related difficulties. Overall, participants found non-adapted, generic CBT in the UK to be unhelpful, overwhelming, and at times harmful to their mental well-being. Therefore, it is necessary for clinical bodies in the UK, while following the indicated NICE guidelines, to be mindful of adapting CBT delivery of CBT, to be most effective for people with ADHD and to mitigate potential harm.

Effects of Practicing Closed- vs. Open-Skill Exercises on Executive Functions in Individuals with Attention Deficit Hyperactivity Disorder (ADHD)-A Meta-Analysis and Systematic Review.

(1) Background: Previous studies have identified discrepancies in improvements in executive functioning in typically developing children when comparing closed- and open-skill exercise interventions. However, there is limited research on executive functioning in attention deficit hyperactivity disorder (ADHD). This study aims to conduct a systematic review and meta-analysis to explore the impact of closed- and open-skill exercises on ADHD populations. (2) Methods: The PRISMA guidelines for systematic reviews were followed to search seven databases to evaluate and analyze studies published from 2013 to 2023. Prospero: CRD42023460452. (3) Results: A meta-analysis of 578 subjects with ADHD in 11 RCTs (Randomized control trial) and 3 NRS (Non-randomized studies) revealed that closed-skill exercise significantly improved executive function subdomains, including inhibitory control (standardized mean differences (SMD) = -1.00), cognitive flexibility (SMD = -1.33), and working memory (SMD = -0.85). Furthermore, open-skill exercise was found to have a positive effect on inhibitory control (SMD = -1.98) and cognitive flexibility (SMD = -0.97) in ADHD patients. Both types of exercise interventions demonstrated an improvement in executive function compared to controls, with open-skill exercises exhibiting superior effects (Qb = 6.26). (4) Conclusions: The review recommends a 12-week intervention cycle with exercise at least twice a week of moderate or higher intensity as suitable for ADHD individuals. This review also encourages individuals with ADHD to engage in exercises involving multiple motor skill types.

Paraphilic fantasies and behavior in attention deficit/hyperactivity disorder and their association with hypersexuality.

Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ2 = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ2 = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.

Adult Attention-Deficit/Hyperactivity Disorder and Borderline Personality Disorder: diagnostic and management challenges

IntroductionBorderline Personality Disorder (BPD) and Attention-Deficit/Hyperactivity Disorder (ADHD), relatively common psychiatric pathologies (5% and 1-2% respectively), share several characteristics, specially impulsivity and emotional dysregulation. With different therapeutic approaches, it is therefore important to distinguish the entities for a correct approach to the patient. Clinical evidence has also demonstrated high comorbidity between two entities, and therefore this recognition is of equal relevance.ObjectivesAnalyze the clinical evidence, in order to better understand the dynamics between the two pathologies as comorbid or differential diagnosis, for an appropriate approach to the patient.MethodsAuthors used the Medline database through the Pubmed search engine, with the keywords: “PBP”, “PHDA”.ResultsThese two pathologies share impulsive and spontaneous actions with poor thinking about the consequences; nonetheless, ADHD individuals tend to show this impulsivity by being more impatiente when they have to wait, talking over other people, interrupting others; on the contrary, in BPD impulsivity can be showed more as self-harm behaviors.As for the emotional dysregulation, that both entities share, in the comorbid case it is known that it is the most severe form. This characteristic is part of the central characteristics of BPD where these individuals experience intense and unstable emotions. They have difficulty regulating their emotions which can lead to rapid changes in mood, and they report feelings of emotional emptiness and difficulty in establishing stable relationships. As for ADHD individuals, despite present, it’s not a core symptom, as they have more control over their emotions, and have more adaptative cognitive strategies.Attention deficit can be a core symptom of a subtype of ADHD and has not yet been reported in patients with PBP, except in comorbid situations. According to studies, 30-60% of patients with PBP report and score on attention deficit scales. Truth is both entities have intelectual disfunctionalities.Results of genetic studies are very inconsistent, however epigenetic research and reseach focusing on hypothetized vulnerability genes or sites have been promising.ConclusionsA complete clinical history is particularly important in these cases and sometimes difficult, as so, clinicians should be aware to prevent misdiagnosis and provide the best care for both disorders and the comorbidity. Given that treatment differs between both pathologies, psychotherapy in BPD, and the multimodal approach in ADHD, it is imperative to distinguish the two entities. In comorbid cases, a combination of the two therapies has demonstrated effectiveness but much more studies are needed.Disclosure of InterestNone Declared

A novel self-rating instrument designed for long-term, app-based monitoring of ADHD symptoms: A mixed-methods development and validation study.

Regular outcome monitoring is essential for effective attention deficit hyperactivity disorder (ADHD) treatment, yet routine care often limits long-term contacts to annual visits. Smartphone apps can complement current practice by offering low-threshold, long-term sustainable monitoring capabilities. However, special considerations apply for such measurement which should be anchored in stakeholder preferences. This mixed-methods study engaged 13 experienced clinicians from Region Stockholm in iterative qualitative interviews to inform development of an instrument for app-based ADHD monitoring: the mHealth scale for Continuous ADHD Symptom Self-monitoring (mCASS). A subsequent survey, including the mCASS and addressing app-based monitoring preferences, was administered to 397 individuals with self-reported ADHD. Psychometric properties of the mCASS were explored through exploratory factor analysis and examinations of internal consistency. Concurrent validity was calculated between the mCASS and the Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1). Additional quantitative analyses included summary statistics and repeated-measures ANOVAs. Clinicians identified properties influencing willingness to use and adherence including content validity, clinical relevance, respondent burden, tone, wording and preferences for in-app results presentation. The final 12-item mCASS version demonstrated four factors covering everyday tasks, productivity, rest and recovery and interactions with others, explaining 47.4% of variance. Preliminary psychometric assessment indicated satisfactory concurrent validity (r = .595) and internal consistency (α = .826). The mCASS, informed by clinician and patient experiences, appears to be valid for app-based assessment of ADHD symptoms. Furthermore, insights are presented regarding important considerations when developing mobile health (mHealth) instruments for ADHD individuals. These can be of value for future, similar endeavours.

Bipolar-ADHD comorbidity: screening for differences in neurocognition and virtual reality-based cognitive performance

Objectives Identification of comorbid attention-deficit/hyperactivity disorder (ADHD) in patients with bipolar disorder (BD) is complicated by overlapping cognitive symptoms and methodological challenges. This cross-sectional study investigated whether virtual reality (VR)-based cognitive assessment that mimics daily life cognitive challenges can aid in the detection of sustained attention impairment in BD individuals with comorbid ADHD (BD + ADHD). Methods Forty-nine fully or partially remitted outpatients with BD, of whom 14 (24%) had BD + ADHD, were assessed with the Cognition Assessment in Virtual Reality (CAVIR) test, including a sustained attention test that involves distractions, and the Screen for Cognitive Impairment in Psychiatry (SCIP). Patients were also rated for mood symptoms and functioning and completed questionnaires assessing subjective cognition and quality of life. Patients’ cognitive impairment on the SCIP was estimated with reference to n = 100 demographically comparable healthy control participants. Results BD + ADHD participants exhibited more pronounced performance deficits on the CAVIR sustained attention test (t(48) = 2.15, p = .037, d = .66). Notably, deficits on this test were proportional to self-reported daily life concentration difficulties in BD + ADHD individuals. Exploratory analyses revealed that BD + ADHD participants also displayed greater impairment on the SCIP working memory- and delayed verbal learning subtests and greater subjective cognitive complaints than BD patients without this comorbidity (p-levels < .001), but only the difference in subjective cognition survived correction for multiple comparisons (F(1,47) = 14.13, p = .005, np2 = 0.24). Conclusion Screening for deficits in sustained attention with an ecologically valid VR test involving distracting stimuli may be useful for identifying BD + ADHD individuals.

The Chinese Version of the Compensatory ADHD Behaviors Scale (CABS): A Study on Reliability, Validity, and Clinical Utility.

With the further development of attention-deficit/hyperactivity disorder (ADHD) research, more and more assessment tools related to ADHD have been used. However, there is still no measurement instrument to evaluate the compensatory behavior of ADHD in China. This study aimed to examine the reliability and validity of the Compensatory ADHD Behaviors Scale (CABS) adapted in Chinese and explore ecological characteristics in adults with ADHD using the CABS. Data were collected from a sample of 306 adults (Mage = 26.43 years, SD = 5.32; 46.08% male). The original version CABS was translated into Chinese using the forward and backward translation procedures. Participants completed the CABS and questionnaires assessing ADHD symptoms and executive function. We utilized content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion validity to test the validity. Internal consistency and test-retest reliability were employed to test the reliability. Analysis of variance (ANOVA) was employed to compare ADHD subgroups based on gender, ADHD subtype, comorbidities, and medication status, while controlling for demographic variables as covariates. CABS exhibited good construct validity (two factors: present-oriented and future-oriented), content validity (content validity index: 0.98), internal consistency reliability (Cronbach's alpha coefficient: 0.85 to 0.87) and test-retest reliability (intraclass correlation coefficient: 0.59 to 0.88). The results of CFA showed acceptable fitness for each subscale. CABS demonstrated significant associations with inattention symptoms and plan/organizational abilities. Medicated ADHD individuals scored higher on future-oriented effectiveness subscale of CABS than non-medicated (F = 6.106, p = 0.014). The results indicate that the Chinese CABS exhibited good validity and reliability. It can be considered a valid tool for assessing compensatory behaviors in Chinese adults with ADHD. Further research is needed to explore the connection between medication and compensatory behavior.

Interpretative Phenomenological Analysis of Attention Deficit Hyperactivity Disorder in Adolescents

Current research on attention deficit hyperactivity disorder (ADHD) is generally based on quantitative methodology. This indicates a lack of information on how ADHD individuals explain this phenomenon, and what they experience. The aim of this research is to reveal how attention deficit hyperactivity disorder is experienced in adolescents and how adolescents explain this phenomenon. The participants in this study were ten adolescents aged 11-18 who were diagnosed with ADHD and did not have a comorbid diagnosis. Participants were interviewed through a semi-structured interview form. The interviews were conducted and recorded on an online platform, and a transcript of the voice recording of each participant was then created. The texts obtained from the transcripts were analyzed with an interpretative phenomenological analysis. As a result of the analysis, the following themes were found: Academic difficulty, normalizing and affirming the diagnosis, living with undesirable emotions and behaviors, and negative social experiences. The findings reveal that the ADHD-related experiences of adolescents and their explanations for the ADHD diagnosis are not of a single nature. Instead, they were also perceived in a positive light as well as negative. The results reveal that the awareness of professionals and families who have contact with ADHD-diagnosed adolescents should be raised, and interventional and motivational programs directed at ADHD treatment-related negative experiences of adolescents can be organized.

Risky driving behavior among individuals with Autism, ADHD, and typically developing persons

IntroductionMany individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) often experience difficulty with driving, including difficulty with obtaining a driver’s license as well as driving safely and efficiently. Such difficulties negatively impact their ability to function independently and participate in daily activities that require driving. ASD and ADHD commonly occur co-morbidly and share many overlapping clinical features. Few studies have directly compared the nature of difficulties in driving safety outcomes between ASD and ADHD. The overarching goal of the current study was to characterize and compare self-reported driving behavior among young autistic drivers, ADHD drivers, and typically developing (TD) drivers. MethodFifty-four participants (14 ASD, 20 ADHD, 20 TD); ages 16–30) completed the Autism Spectrum Quotient and ADHD Adult Rating scale as a method of screening of symptoms. All three groups then completed the Driving Behavior Questionnaire (DBQ), which measured self-reported driving violations, driving errors, and overall risky driving behavior. The three groups of ASD, ADHD, and TD individuals were then compared regarding symptomology and driving behavior differences. ResultsOne-way ANOVAs indicated group differences in DBQ total scores and DBQ errors. Drivers with ADHD reported significantly greater overall risky driving behaviors and driving errors compared to ASD and TD drivers. There were no significant differences between ASD and TD drivers in reported risky driving behaviors and errors. Linear regressions indicated that among all drivers, self-reported ADHD symptoms were significantly associated with higher levels of self-reported overall risky driving and driving errors, regardless of diagnostic group. DiscussionRisky driving and driving errors may be more closely related to symptoms that are characteristic of ADHD. This has implications for individuals with ADHD and autistic individuals who often show or report higher rates of ADHD symptoms. Future studies should compare driving skills of ASD and ADHD drivers using objective measures of driving performance, such as driving simulators or on-road tests.

The importance of involving experts-by-experience with different psychiatric diagnoses when revising diagnostic criteria

Philosophers of science have recently called for experts-by-experience to be involved in revising psychiatric diagnoses. They argue that experts-by-experience can have relevant knowledge which is important for considering potential modifications to psychiatric diagnoses. I show how altering one diagnosis can impact individuals with a different diagnosis. For example, altering autism can impact individuals diagnosed with Attention Deficit Hyperactivity Disorder and Schizoid Personality Disorder through co-morbidity and differential diagnostic criteria. Altering autism can impact the population making up the diagnosis of Attention Deficit Hyperactivity Disorder and Schizoid Personality Disorder which can then influence which behaviour each diagnosis covers and which parts of the causal structure each diagnosis covers. Expanding one diagnosis can mean, if differential diagnostic criteria are present, that individuals who have a different diagnosis, or would one day have been diagnosed with that different diagnosis, are instead now diagnosed with the expanded diagnosis. Alternatively, if two diagnoses can be co-morbid then expanding one diagnosis can mean individuals who have a different diagnosis can now also receive the expanded diagnosis. Changing these can then impact the adequacy of symptoms formulated to cover behaviour and causal mechanisms formulated to cover the causal structure. This means experts-by-experience representing a range of diagnoses should be involved in decisions over modifying diagnoses they do not have. For example, Attention Deficit Hyperactivity Disorder individuals should be involved in decisions to modify autism. I discuss practical issues relating to how much say people with a range of diagnoses should have in relation to modifying a diagnosis which they do not have. We should employ a principle of equality whereby the level of say individuals with one diagnosis should have on another diagnosis should be equally reciprocated.

44 Functional Connectivity In The Default Mode Network Of ASD and ADHD

Objective:Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are neurodevelopmental disorders with overlapping symptomatology and shared genetic makeup. Numerous previous studies have investigated ASD and ADHD using resting state functional networks. One functional network of particular interest is the Default Mode Network (DMN), as it has been shown to be abnormal in several mental disorders. Previous studies have investigated the DMN in ASD and ADHD separately but reported mixed trends of increased and decreased functional connectivity (FC) in the DMN in ASD and increased FC in ADHD. Additionally, little studies have investigated executive and attentional network dysfunction in the DMN for ASD and ADHD populations. To better understand the shared characteristics between ASD and ADHD, this study analyzed the DMN FC in children with ASD and ADHD.Participants and Methods:Archival datasets from Autism Brain Imaging Data Exchange (ABIDE)-I and ADHD-200 datasets were used, with 33 ADHD, 35 ASD, and 32 typically developing (TD) males (ages = 7-17 years). After applying a standard pre-processing pipeline, 11 regions of interest (ROIs) from the Dosenbach-160 atlas were examined with 55 ROI pairs generated for the 100 subjects.Results:Significant differences were noted between ASD-ADHD groups in attentional networks and executive functioning networks. Specifically, significant Group x VIQ interactions were noted for FC between the following pairs of regions: medial prefrontal cortex - ventromedial prefrontal cortex, anterior cingulate cortex -ventromedial prefrontal cortex, inferior temporal lobe - ventromedial prefrontal cortex, angular -ventromedial prefrontal cortex, angular -anterior cingulate cortex, inferior temporal lobe -ventrolateral prefrontal cortex, angular -superior frontal lobe, and intraparietal sulcus -superior frontal lobe. In the above FC pairs, FC in ADHD was negatively correlated with VIQ, with no correlation for ASD and positive correlation for TD. Previous literature has indicated that ADHD individuals demonstrate increased executive functioning deficits compared to ASD individuals. This study provides evidence at a neural level for these findings by demonstrating decreased FC trends in ADHD in attentional and executive functioning networks compared to ASD individuals. Group and VIQ main effects demonstrated mixed patterns across the three groups, as well as shared decreased FC in attention/executive networks for both ASD and ADHD groups.Conclusions:In summary, this study found similar findings from previous studies regarding mixed connectivity patterns, as well as shared dysfunction between ASD and ADHD groups. These results help in solidifying the theory that ASD and ADHD share clinical and neural patterns which need to be examined further. Future directions include utilizing more ASD+ADHD comorbid individuals in studies comparing ASD and ADHD FC trends as well as seeking to further understand the neuropsychological and neuroimaging profiles in ASD and ADHD.

Ocular and neural genes jointly regulate the visuospatial working memory in ADHD children

ObjectiveWorking memory (WM) deficits have frequently been linked to attention deficit hyperactivity disorder (ADHD). Despite previous studies suggested its high heritability, its genetic basis, especially in ADHD, remains unclear. The current study aimed to comprehensively explore the genetic basis of visual-spatial working memory (VSWM) in ADHD using wide-ranging genetic analyses.MethodsThe current study recruited a cohort consisted of 802 ADHD individuals, all met DSM-IV ADHD diagnostic criteria. VSWM was assessed by Rey-Osterrieth complex figure test (RCFT), which is a widely used psychological test include four memory indexes: detail delayed (DD), structure delayed (SD), structure immediate (SI), detail immediate (DI). Genetic analyses were conducted at the single nucleotide polymorphism (SNP), gene, pathway, polygenic and protein network levels. Polygenic Risk Scores (PRS) were based on summary statistics of various psychiatric disorders, including ADHD, autism spectrum disorder (ASD), major depressive disorder (MDD), schizophrenia (SCZ), obsessive compulsive disorders (OCD), and substance use disorder (SUD).ResultsAnalyses at the single-marker level did not yield significant results (5E−08). However, the potential signals with P values less than E−05 and their mapped genes suggested the regulation of VSWM involved both ocular and neural system related genes, moreover, ADHD-related genes were also involved. The gene-based analysis found RAB11FIP1, whose encoded protein modulates several neurodevelopment processes and visual system, as significantly associated with DD scores (P = 1.96E−06, Padj = 0.036). Candidate pathway enrichment analyses (N = 53) found that forebrain neuron fate commitment significantly enriched in DD (P = 4.78E−04, Padj = 0.025), and dopamine transport enriched in SD (P = 5.90E-04, Padj = 0.031). We also observed a significant negative relationship between DD scores and ADHD PRS scores (P = 0.0025, Empirical P = 0.048).ConclusionsOur results emphasized the joint contribution of ocular and neural genes in regulating VSWM. The study reveals a shared genetic basis between ADHD and VSWM, with GWAS indicating the involvement of ADHD-related genes in VSWM. Additionally, the PRS analysis identifies a significant relationship between ADHD-PRS and DD scores. Overall, our findings shed light on the genetic basis of VSWM deficits in ADHD, and may have important implications for future research and clinical practice.

Attention-deficit/hyperactivity disorder as a risk factor for being involved in intimate partner violence and sexual violence: a systematic review and meta-analysis.

Intimate partner violence (IPV) and sexual violence (SV) are significant problems world-wide, and they affect women disproportionally. Whether individuals with attention-deficit/hyperactivity disorder (ADHD) are at an increased risk of being involved in these types of violence is unclear. We carried out a systematic review and meta-analysis (PROSPERO registration CRD42022348165) of the associations between ADHD and being the victim or perpetrator of IPV and SV. Ratios of occurrence of violence were pooled in random-effects models and study risk of bias was evaluated using the Newcastle-Ottawa Scale. A search on multiple databases, carried out on 7 October 2022, yielded 14 eligible studies (1 111 557 individuals). Analyses showed a higher risk of ADHD individuals being involved in IPV as perpetrators (six studies, OR 2.5, 95% CI 1.51-4.15) or victims (four studies, OR 1.78, 95% CI 1.06-3.0). Likewise, individuals with ADHD were at increased risk of being perpetrators (three studies, OR 2.73, 95% CI 1.35-5.51) or victims of SV (six studies, OR 1.84, 95% CI 1.51-2.24). Results were overall robust to different analytical choices. Individuals with ADHD are at an increased risk of being involved in cases of violence, namely IPV and SV, either as victims or perpetrators. Although the causal path or mediating variables for these results are still unclear, this increased risk should inform evidence-based psychoeducation with individuals with ADHD, their families, and partners about romantic relationships and sexuality.

Detection of ADHD from EEG signals using new hybrid decomposition and deep learning techniques

Objective. Attention deficit hyperactivity disorder (ADHD) is considered one of the most common psychiatric disorders in childhood. The incidence of this disease in the community draws an increasing graph from the past to the present. While the ADHD diagnosis is basically made with the psychiatric tests, there is no active clinically used objective diagnostic tool. However, some studies in the literature has reported development of an objective diagnostic tool that facilitates the diagnosis of ADHD. Approach. In this study, it was aimed to develop an objective diagnostic tool for ADHD using electroencephalography (EEG) signals. In the proposed method, EEG signals were decomposed into subbands by robust local mode decomposition and variational mode decomposition techniques. These subbands and the EEG signals were fed as input data to the deep learning algorithm designed in the study. Main results. As a result, an algorithm has been put forward that distinguishes over 95% of ADHD and healthy individuals through using a 19-channel EEG signal. In addition, a classification accuracy of over 87% was obtained by the proposed approach of EEG signal decomposition followed by data processing in the designed deep learning algorithm. Significance. The findings of the current research enrich the literature based on originality and proposed method can be used as a clinical diagnostic tool in the near future.

Classifying Children with ADHD Based on Prefrontal Functional Near-infrared Spectroscopy Using Machine Learning.

: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adults characterized by cognitive and emotional self-control deficiencies. Previous functional near-infrared spectroscopy (fNIRS) studies found significant group differences between ADHD children and healthy controls during cognitive flexibility tasks in several brain regions. This study aims to apply a machine learning approach to identify medication-naive ADHD patients and healthy control (HC) groups using task-based fNIRS data. : fNIRS signals from 33 ADHD children and 39 HC during the Stroop task were analyzed. In addition, regularized linear discriminant analysis (RLDA) was used to identify ADHD individuals from healthy controls, and classification performance was evaluated. : We found that participants can be correctly classified in RLDA leave-one-out cross validation, with a sensitivity of 0.67, specificity of 0.93, and accuracy of 0.82. : RLDA using only fNIRS data can effectively discriminate children with ADHD from HC. This study suggests the potential utility of the fNIRS signal as a diagnostic biomarker for ADHD children.

Characterizing the metabolomic signature of attention-deficit hyperactivity disorder in twins

Emerging evidence implicate the gut microbiota as a potential susceptibility factor in attention-deficit hyperactivity disorder (ADHD), a common multifactorial neurodevelopmental condition. However, little is known about the biochemical signature of ADHD, including the metabolic contribution of the microbiota via the gut-brain axis, and the relative contribution of genetics and environmental factors. Here, we perform unbiased metabolomic profiling of urine and fecal samples collected from a well-characterized Swedish twin cohort enriched for ADHD (33 ADHD, 79 non-ADHD), using 1H nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry. Our results highlight sex-specific patterns in the metabolic phenotype of individuals with ADHD. Specifically, the urine profile of males, but not females, with ADHD was characterized by greater excretion of hippurate, a product of microbial-host co-metabolism that can cross the blood-brain-barrier with bioactivity of potential relevance to ADHD. This trans-genomic metabolite was also negatively correlated with IQ in males and was significantly correlated with fecal metabolites associated with gut microbial metabolism. The fecal profile of ADHD individuals was characterized by increased excretion of stearoyl-linoleoyl-glycerol, 3,7-dimethylurate, and FAD and lower amounts of glycerol 3-phosphate, thymine, 2(1H)-quinolinone, aspartate, xanthine, hypoxanthine, and orotate. These changes were independent of ADHD medication, age, and BMI. Furthermore, our specific twins’ models revealed that many of these gut metabolites had a stronger genetic influence than environmental. These findings suggest that metabolic disturbances in ADHD, involving combined gut microbial and host metabolic processes, may largely derive from gene variants previously linked to behavioral symptoms in this disorder.This article is part of the Special Issue on “Microbiome & the Brain: Mechanisms & Maladies”.