Attention Deficit Hyperactivity Disorder Subtypes Research Articles

Intelligibility of degraded speech and the relationship between symptoms of inattention, hyperactivity/impulsivity and language impairment in children with suspected auditory processing disorder

ObjectivesTo compare the sensitivity and specificity of Auditory Figure Ground sub-tests of the SCAN-3 battery, using signal to noise ratio (SNR) of +8 dB (AFG+8) and 0 dB (AFG0), in identifying auditory processing disorder (APD). A secondary objective was to evaluate any difference in auditory processing (AP) between children with symptoms of inattention versus combined sub-types of Attention Deficit Hyperactivity Disorder (ADHD). MethodsData from 201 children, aged 6 to 16 years (mean: 10 years 6 months, SD: 2 years 8 months), who were assessed for suspected APD were reviewed retrospectively. The outcomes of the SCAN-3 APD test battery, Swanson Nolan and Pelham-IV parental rating (SNAP-IV) and Children's Communication Checklist-2 (CCC-2) were analysed. ResultsAFG0 had a sensitivity of 56.3% and specificity of 100% in identifying children performing poorly in at least two of six SCAN-3 sub-tests or one of the two questionnaires, in contrast to 42.1% and 80% respectively for AFG+8. Impaired AP was mostly associated with symptoms of ADHD and /or language impairment (LI). LI was present in 92.9% of children with ADHD symptoms. Children with symptoms of combined ADHD plus LI performed significantly poorly (p < 0.05) compared to inattention ADHD plus LI in Filtered Words (FW) sub-test, but not in the rest of the SCAN-3 sub-tests. ConclusionSpeech in noise tests using SNR of 0 dB is better than +8 dB in assessing APD. The better FW performance of the inattention ADHD plus LI group can be speculated to be related to known difference in activity in a neural network between different sub-types of ADHD. The findings of the study and existing literature suggest that neural networks connecting the cerebral hemispheres, basal ganglia and cerebellum are involved in APD, ADHD and LI.

Serum brain-derived neurotrophic factor levels in treatment-naïve boys with attention-deficit/hyperactivity disorder treated with methylphenidate: an 8-week, observational pretest-posttest study.

Brain-derived neurotrophic factor (BDNF) is an important neurotrophin in the brain that modulates dopaminergic neurons. In this study, we aimed to investigate the changes in serum BDNF levels of children with attention-deficit/hyperactivity disorder (ADHD) in response to OROS methylphenidate treatment. We also aimed to determine whether there were any pre-post-differences between ADHD subtypes and comorbid psychiatric disorders in serum BDNF levels. Fifty male children with ADHD and 50 male healthy controls within the age range of 6-12years were recruited to the study. The psychiatric diagnoses were determined by applying a structured interview with Kiddie schedule for affective disorders and schizophrenia for school-age children-present and lifetime version. The symptom severity of ADHD was measured using the Clinical Global Impression ADHD Severity Scale (CGI-S). Physicians completed Du Paul ADHD questionnaires. The levels of serum BDNF were assessed before and after 8weeks of treatment with effective dosages of OROS methylphenidate. In the present study, the mean serum BDNF levels of boys with ADHD and of the healthy controls were 2626.33±1528.05 and 2989.11±1420.08pg/mL, respectively. Although there were no statistically significant difference between the ADHD group and healthy controls at baseline (p=0.22), the increase of serum BDNF was statistically significant from baseline to endpoint in the ADHD group (p=0.04). The mean serum BDNF levels at baseline and endpoint of the ADHD group were 2626.33±1528.05 and 3255.80±1908.79pg/mL, respectively. The serum BDNF levels of ADHD-inattentive subtype were significantly lower at baseline (p=0.02), whereas BDNF levels post-treatment showed no significant difference. The increase of serum BDNF levels with methylphenidate treatment after 8weeks was significantly higher in the inattentive group (p=0.005). The increase of serum BDNF levels with methylphenidate treatment after 8weeks in boys with ADHD may support the potential role of BDNF in the pathophysiology of ADHD. The role of BDNF in ADHD subtypes in particular should be evaluated with further, larger studies.

Motor Performance of Children With Attention Deficit Hyperactivity Disorder in Fourth to Sixth Grades: Differences Among Subtypes

Abstract Date Presented 3/30/2017 The aim of this study is to investigate motor performance in children with attention deficit hyperactivity disorder (ADHD). The findings regarding specific challenges in motor skills among children with different subtypes of ADHD will assist therapists to better understand and address these deficits in providing precise intervention. Primary Author and Speaker: Chien-Ying Yang Contributing Authors: Tsu-Hsin Howe

Neuronal Intra-Individual Variability Masks Response Selection Differences between ADHD Subtypes-A Need to Change Perspectives.

Due to the high intra-individual variability in attention deficit/hyperactivity disorder (ADHD), there may be considerable bias in knowledge about altered neurophysiological processes underlying executive dysfunctions in patients with different ADHD subtypes. When aiming to establish dimensional cognitive-neurophysiological constructs representing symptoms of ADHD as suggested by the initiative for Research Domain Criteria, it is crucial to consider such processes independent of variability. We examined patients with the predominantly inattentive subtype (attention deficit disorder, ADD) and the combined subtype of ADHD (ADHD-C) in a flanker task measuring conflict control. Groups were matched for task performance. Besides using classic event-related potential (ERP) techniques and source localization, neurophysiological data was also analyzed using residue iteration decomposition (RIDE) to statistically account for intra-individual variability and S-LORETA to estimate the sources of the activations. The analysis of classic ERPs related to conflict monitoring revealed no differences between patients with ADD and ADHD-C. When individual variability was accounted for, clear differences became apparent in the RIDE C-cluster (analog to the P3 ERP-component). While patients with ADD distinguished between compatible and incompatible flanker trials early on, patients with ADHD-C seemed to employ more cognitive resources overall. These differences are reflected in inferior parietal areas. The study demonstrates differences in neuronal mechanisms related to response selection processes between ADD and ADHD-C which, according to source localization, arise from the inferior parietal cortex. Importantly, these differences could only be detected when accounting for intra-individual variability. The results imply that it is very likely that differences in neurophysiological processes between ADHD subtypes are underestimated and have not been recognized because intra-individual variability in neurophysiological data has not sufficiently been taken into account.

RANZCP 2017 Book of Abstracts

Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental health disorders in children. Limitations of behavioural interventions and pharmacological treatment have led to the development of other novel interventions. Neurofeedback has shown promise in improving not only inattention symptoms but also impulsivity/hyperactivity symptoms. A feed-forward mechanism has been proposed to be more feasible in the treatment of ADHD as it trains individuals to harness their ability to pay attention and also shows promise in improving impulsivity symptoms. Objectives: The aim of the current study is to investigate the impact of a novel intervention using (feed-forward) brain-to-computer interface (BCI) technology on an objective measure of attention and impulsivity in children with ADHD. Methods: A total of 172 children aged 6 to 12 years (mean = 8.63, standard deviation = 1.51) with a clinical diagnosis of ADHD, inattentive or combined subtype were recruited. Participants were randomized into the waitlist-control or intervention group. Participants in the intervention group underwent 24 sessions of brain-to-computer interface technology (BCI) intervention over a period of 8 weeks, whereas participants in the control group did not receive any intervention. The Conners’ Continuous Performance Test, second edition (CPT-II) was administered to the participants before and after the treatment. Findings: Analysis was conducted for the intervention and control groups at weeks 1 and 8.Conclusions: Results will be discussed with a view to inform future research.

Sleep problems in pediatric epilepsy and ADHD: The impact of comorbidity.

Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ). Neurology clinic charts were reviewed for the epilepsy-related variables. ADHD subtypes were diagnosed according to the DSM-IV. Children with epilepsy-ADHD had the highest CSHQ total scores, while children with primary ADHD had higher scores than those with epilepsy. Besides the total score, epilepsy-ADHD group differed from the primary ADHD and epilepsy groups with higher CSHQ subscores on sleep onset delay and sleep anxiety. The frequency of moderate-severe sleep problems (CSHQ>56) was 62.9% in children with epilepsy-ADHD, while it was 40.4% and 26.4% in children with primary ADHD and epilepsy, respectively. CSHQ total scores were not different between ADHD subtypes in both children with epilepsy-ADHD and those with primary ADHD. None of the epilepsy-related variables were found to be associated with CSHQ scores. Epilepsy-ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy.

Relationship between attention-deficit/hyperactivity disorder and sedentary behavior in adolescence: a cross-sectional study.

Existing studies reveal that high levels of sedentary behavior are associated with more inattention and hyperactivity problems. Since most previous studies used screen time as an indicator of sedentary behavior and assessed symptoms of attention-deficit/hyperactivity disorder (ADHD) by short screening measures which do not allow to distinguish between subtypes of ADHD, the current study aimed to investigate association between different types of sedentary behavior and symptoms and subtypes of ADHD. The current cross-sectional study analyzed data of 913 students (46.1% girls) aged 13-17years (M=15.0, SD=0.6). Using a self-administered questionnaire, screen-based and non-screen-based sedentary behavior and ADHD symptoms were assessed. Linear and logistic regression analyses were conducted. All analyses were adjusted for age, gender, moderate to vigorous physical activity and body mass index. Screen time was related to the total ADHD score (p<0.001) as well as to the subscales inattention (p≤0.016) and hyperactivity/impulsivity (p≤0.008). Sedentary time without screens was virtually not associated with ADHD. As far as ADHD symptoms are considered as a correlate of sedentary behavior, the type of activity which is pursued sedentarily seems to matter: screen time, but not other non-screen-based sedentary activities should be considered as being a risk factor for ADHD.

Adult ADHD diagnosis and binge eating disorder

The association between attention deficit hyperactivity disorder (ADHD) and eating disorders has not been yet clarified. The presence of ADHD was significantly correlated with more severe binge eating, bulimic behaviors, and depressive symptomatology. The aim of this work is to study the relationship between ADHD subtypes in adults and the risk of food addiction (binge eating disorder).The sample was collected on a specific program for adults with ADHD diagnosis in Madrid (Spain). In total, the sample was 110 patients, and we collected information about socio-demographic factors. All patients met DSM-5 criteria for ADHD in different subtypes. We used the conner's Adult ADHD rating scales and the Barrat impulsiveness scale. Also we used the Shorter Promise Questionnaire. This is a 16 scale self-report instrument to measure an individual's level of addictive tendency.The 36.4% were at high risk of developing a food addiction. For binge eating disorder (BE), no statistically significant differences were found by gender within patients with ADHD.Binge eating was significantly related to the impulsivity and emotional liability subscale of the CAARS (P &lt; 0.05). The risk of develop BE in ADHD was 4.7 (CI 95% 1.8–12.07). Binge eating was significantly related to the total score on the Barrat scale (P &lt; 0.05) Risk of 3,5 (CI 95% 1.5–7.9) and within the subtypes of impulsivity, motor impulsiveness was the one that was significantly related to BE (P &lt; 0.001)There is a clear relationship between impulsiveness symptoms and BE in patients with ADHD. It's important to note that there are no gender differences within ADHA patients to develop a BE disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Impact of Pharmacotherapy on Substance Use in Adolescents With Attention-Deficit/Hyperactivity Disorder: Variations Across Subtypes

ABSTRACTObjective: The primary purpose of this study was to investigate the impact of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy on the risk of substance use within each ADHD subtype. Methods: The study used data from the National Comorbidity Survey-Adolescent supplement, a nationally representative sample of US adolescents (ages 13–18) collected from 6,483 adolescent-parent interviews conducted between 2001 and 2004. ADHD was categorized into three subtypes: ADHD-predominantly hyperactive-impulsive type (ADHD-H); ADHD-predominantly inattentive type (ADHD-I); and ADHD-combined type (ADHD-C) using Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Substance use information was obtained from the adolescents’ interview. The impact of ADHD-pharmacotherapy on substance use was examined using multivariable logistic regression analysis. Results: Among the adolescents with ADHD, ADHD pharmacotherapy significantly associated with reduced risk of substance use (OR = 0.53, 95%CI [0.31–0.90]); with regards to ADHD subtypes, ADHD pharmacotherapy is negatively associated with substance use in adolescents with ADHD-C (OR = 0.53, 95%CI [0.24–0.97]) and those with ADHD-H (OR = 0.23, 95% CI [0.07–0.78]), but it did not have statistically significant effect on risk of substance use in those with ADHD-I subtype (OR = 0.49, 95%CI [0.17–1.39]). Among the group who never received ADHD-pharmacotherapy before the interview, individuals with ADHD-H and ADHD-C had a similar risk of substance use compared to adolescents with ADHD-I (ADHD-C: OR = 1.5, 95%CI [0.77–2.95] and ADHD-H: OR = 2.10, 95%CI [0.87–4.95]). Conclusions: Adolescents with ADHD were equally susceptible to future substance use disregard their ADHD subtypes. Receipt of pharmacotherapy could decrease risk of substance use in adolescents with ADHD-H and ADHD-C, but it may not affect risk of substance use among individuals with ADHD-I.

Attention-deficit hyperactivity disorder in elementary school students in Shantou, China: prevalence, subtypes, and influencing factors.

Attention-deficit hyperactivity disorder (ADHD) is a frequent childhood-onset psychiatric condition and categorized into three subtypes of predominantly inattentive (ADHD-I), hyperactive impulsive (ADHD-H), and combined (ADHD-C). The prevalence and subtypes of ADHD vary considerably. The primary aim of this study was to provide a prevalence estimate of ADHD in elementary school students living in Shantou, a district of China, and in addition to examine the influence of informants, age, and gender on the prevalence. A total of 3,497 students aged 7–12 years were enrolled by random and stratified sampling. In stage I, teachers and parents of all participating students in randomly selected schools were asked to complete Chinese versions of the Conners’ 10-item scale. In stage II, students with high scores (>15) were interviewed by a psychiatrist for a diagnosis with or without ADHD. Parents rated many more students with high scores than teachers did in stage I. The prevalence of ADHD determined by Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) was 5.91% (5.27%–6.55%), which is comparable to the rates reported in previous studies with Chinese children. This hits the low border of the ADHD prevalence range from 5.9 to 7.1% worldwide, and is lower than that of Chinese children living in Hong Kong, suggesting an important influence of Chinese culture on the diagnosis of ADHD. The constituent ratios of ADHD-I, ADHD-C, and ADHD-H subtypes were 67.43, 24.57, and 8.00%, respectively. The rate of ADHD-H decreased with age, whereas that of ADHD-I remained at the highest levels in all age groups, suggesting that symptoms in the inattention domain are the most persistent and refractory.

Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms

BackgroundAbnormal sensory sensitivity is a feature of autism-spectrum disorder (ASD), but is also reported in attention-deficit/hyperactivity disorder (ADHD). In many cases, ADHD and ASD are comorbid. This study investigated the prevalence of sensory hyper- and hyposensitivity among adults with ADHD, controlling for autistic symptoms. MethodOne hundred and sixteen adults diagnosed with ADHD completed the Adolescent/Adult Sensory Profile-NL (AASP-NL) and the Autism-spectrum Quotient (AQ) questionnaires. Prevalences of hyper- and hyposensitivity and autism-spectrum symptoms were compared to norm values. Multivariate binary logistic regressions were used to determine the association of autistic symptoms, age, gender, ADHD subtype, self-reported severity of ADHD symptoms, comorbid disorders, and use of medication on the sensory hypo- and hypersensitivity in adults with ADHD. ResultsAdults with ADHD had more autistic symptoms, and they had both more hyper- and hyposensitivity compared to norm groups. This was especially apparent in the Activity level and Auditory sensory modalities. Sensory hypo- and hypersensitivity were both related to an increased ADHD score, even showing a dose-response relationship, but not to any autistic symptom or comorbid disorder. As much as 43% of the females with ADHD reported sensory hypo- and/or hypersensitivity, compared to 22% of the men. ConclusionsSensory hypo- and hypersensitivity may be viewed as key features of adult ADHD, especially in females, regardless of any autistic symptoms. Future research should be directed at the implications of this sensory dysregulation for the understanding of the pathophysiology of (female) ADHD, and on the usefulness of assessment of atypical sensory profiles in the diagnostic procedure of ADHD in adults.

Regional brain network organization distinguishes the combined and inattentive subtypes of Attention Deficit Hyperactivity Disorder.

Attention Deficit Hyperactivity Disorder (ADHD) is characterized clinically by hyperactive/impulsive and/or inattentive symptoms which determine diagnostic subtypes as Predominantly Hyperactive-Impulsive (ADHD-HI), Predominantly Inattentive (ADHD-I), and Combined (ADHD-C). Neuroanatomically though we do not yet know if these clinical subtypes reflect distinct aberrations in underlying brain organization.We imaged 34 ADHD participants defined using DSM-IV criteria as ADHD-I (n = 16) or as ADHD-C (n = 18) and 28 matched typically developing controls, aged 8–17 years, using high-resolution T1 MRI. To quantify neuroanatomical organization we used graph theoretical analysis to assess properties of structural covariance between ADHD subtypes and controls (global network measures: path length, clustering coefficient, and regional network measures: nodal degree). As a context for interpreting network organization differences, we also quantified gray matter volume using voxel-based morphometry.Each ADHD subtype was distinguished by a different organizational profile of the degree to which specific regions were anatomically connected with other regions (i.e., in “nodal degree”). For ADHD-I (compared to both ADHD-C and controls) the nodal degree was higher in the hippocampus. ADHD-I also had a higher nodal degree in the supramarginal gyrus, calcarine sulcus, and superior occipital cortex compared to ADHD-C and in the amygdala compared to controls. By contrast, the nodal degree was higher in the cerebellum for ADHD-C compared to ADHD-I and in the anterior cingulate, middle frontal gyrus and putamen compared to controls. ADHD-C also had reduced nodal degree in the rolandic operculum and middle temporal pole compared to controls. These regional profiles were observed in the context of no differences in gray matter volume or global network organization.Our results suggest that the clinical distinction between the Inattentive and Combined subtypes of ADHD may also be reflected in distinct aberrations in underlying brain organization.

Assessment of electronic media use in children and adolescents with attention deficit hyperactivity disorder

Objective: Electronic media use is an emerging area of research interest and its relationship with Attention Deficit hyperactivity disorder (ADHD) is neglected in Turkish literature. We therefore aimed to examine its relationship with certain variables and ADHD subtypes. Methods: A total of 360 participants aged between 6-18 years, who attended Bezmialem University, Child and Adolescent Psychiatry outpatient clinic between January 2016 and October 2016, were screened with The Schedule for Affective Disorders and Schizophrenia for School Age Children (KSADS) interview to ascertain diagnosis and a sociodemographic information tool was used to collect the relevant data. Results: The mean age was 9.47±2.67, and 81.9% majority of the sample consisted of males. Exposure to total media (TV, cell phone, tablet, computer) between 2 and 4 hours was reported in 20.6% of the sample, whilst 4-6 hours exposure was reported in 15.8%, 6-8 hours was reported in %11.4, 8-10 hours was stated by 9.4% of the participants and more than 10 hours of exposure to electronic media was reported in 18.2 % of the total sample. More than 2 hours/day computer/tablet use, and more than 4 hours/day cell phone use were significantly associated with academic underachievement, which also became more significant as the time spent with total media gadgets increased. Electronic media use significantly decreased as the household income increased. TV viewing before 2 years of age was significantly associated with heavy use of electronic media, whilst this significance was lost when the age threshold was dropped to 1 year. Total TV viewing in the household was significantly higher among the heavy electronic media users. Regression analysis revealed that exposure to electronic media for 10 hours and above was significantly and independently associated with current family psychiatric illness and low academic achievement. Conclusion: To the best of our knowledge, this is the first study reporting exposure to electronic media in a Turkish clinical sample of children and adolescents with ADHD. Results are in line with the existing international literature and highlights the excessive electronic media use in this clinical population. We recommend a routine screening for electronic media exposure in ADHD minors and increase awareness in their families and education system.

Comorbilidades asociadas al déficit de atención con hiperactividad

Introducción. Para diagnosticar trastorno por déficit de atención con hiperactividad (TDAH) en niños y adolescentes, es necesario identificar la coexistencia de comorbilidades afectivo-comportamentales que complejizan la evaluación y los procesos terapéuticos requeridos.Objetivo. Describir la comorbilidad afectivo-comportamental asociada a los diferentes subtipos del TDAH en niños y adolescentes de Manizales.Materiales y métodos. Muestra conformada por 141 participantes entre los 5 y 15 años de edad, escolarizados, diagnosticados con TDAH y coeficiente intelectual mayor o igual a 85. Estudio exploratorio-descriptivo, donde se analizaron registros de la entrevista neuropsiquiátrica internacional (MINI-KID).Resultados. El rango de edad con mayor asociación comórbida está entre los 8 y 11 años. El subtipo de TDAH predominante es el combinado. El 32% de la muestra presenta asociación comórbida afectivo-comportamental y los trastornos internalizantes tienen una representación del 68.8%, siendo la fobia simple específica la comorbilidad más preponderante en 80.6% de los casos.Conclusiones. La fobia simple específica es el trastorno internalizante más frecuente en el estudio en rangos de edad y subtipos de TDAH. El trastorno oposicionista desafiante es la comorbilidad externalizante predominante y exclusiva del subtipo de TDAH combinado.

Biomarkers of Organophosphate Pesticides and Attention-Deficit/ Hyperactivity Disorder in Children: A Case-Control Study

Children are frequently exposed to significant hazard for organophosphate poisoning (OP) in their environment; since the brain is growing during this period and it is extra liable to neurotoxicants. The aim of this work was to determine the relationship between urinary concentrations of dialkylphosphates (DAP) metabolites, which are biomarkers of OP pesticide exposure, and attention-deficit/hyperactivity disorder (ADHD) in Egyptian children ages seven to twelve years. A case-control study was conducted at Alzhraa University hospital. We recruited 40 children diagnosed as ADHD according to “the diagnostic and statistical manual of mental disorder (DSM-5) criteria” by psychiatrist. Control group of 40 healthy children who did not have any psychiatric or neurologic disorders, age and sex matched. Exposure was determined by analyzing six urinary metabolites of DAP. We investigated the association between ADHD subtypes, coincidence of epilepsy and OP exposure. Significant increase in urinary level of all DAP metabolites for children with ADHD in comparison to control group except Diethyl-dithio-phosphate. ADHD children with epilepsy had statistically significant elevated level of urinary Dimethyl-dithio-phosphate, Diethyl- phosphate and Dimethyl-phosphate metabolites in comparison to those without epilepsy. By logistic regression analysis, Children with high level of urinary Dimethyldithio- phosphate (OR=2.29), Diethyl-phosphate (OR=2.40), Dimethyl-phosphate (OR =2.02), and Dimethyl-thiophosphate (OR=1.82) have two fold increased risk of developing ADHD than those having lower concentration of these metabolites. Our findings back up the theory that existing environmental concentration of organophosphate pesticide exposure may lead to the development of ADHD and increase the risk of epilepsy in ADHD children.

Early diagnosis and treatment of ADHD are important for a secure transition to adolescence

Objective: Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders that begins in childhood. By using self-esteem and loneliness scales, our aim was to compare the adolescents who were diagnosed “early” and are currently receiving treatment with the ones with “late” diagnoses. By examining loneliness and self-esteem directly, we wish to emphasize a possibility of positive impact of early diagnosis and treatment. We hypothesized that the duration of treatment is an important factor in reducing several negative psychosocial impacts of ADHD. Methods: The study included 62 adolescent patients with a “late” ADHD diagnosis between the ages of 12 and 14 years, and 55 adolescent patients with “early” diagnosis between the ages of 6 and 8 years who have been followed up regularly with appropriate treatment for nearly 6 years. These groups were compared with regard to self-esteem and feelings of loneliness. Results: The UCLA Loneliness Scale scores were higher, but the Rosenberg Self-esteem Scale scores were lower in the late-diagnosed group. These results did not change with regard to ADHD subtypes and gender. Conclusion: The late-diagnosed adolescents with ADHD feel they are alone more than the early-diagnosed adolescents, and they like themselves less compared to the early-diagnosed group.

An ADHD Diagnostic Approach Based on Binary-Coded Genetic Algorithm and Extreme Learning Machine

An accurate approach for diagnosis of attention deficit hyperactivity disorder (ADHD) is presented in this paper. The presented technique efficiently classifies three subtypes of ADHD (ADHD-C, ADHD-H, ADHD-I) and typically developing control (TDC) by using only structural magnetic resonance imaging (MRI). The research examines structural MRI of the hippocampus from the ADHD-200 database. Each available MRI has been processed by a region-of-interest (ROI) to build a set of features for further analysis. The presented ADHD diagnostic approach unifies feature selection and classification techniques. The feature selection technique based on the proposed binary-coded genetic algorithm searches for an optimal subset of features extracted from the hippocampus. The classification technique uses a chosen optimal subset of features for accurate classification of three subtypes of ADHD and TDC. In this study, the famous Extreme Learning Machine is used as a classification technique. Experimental results clearly indicate that the presented BCGA-ELM (binary-coded genetic algorithm coupled with Extreme Learning Machine) efficiently classifies TDC and three subtypes of ADHD and outperforms existing techniques.

Evaluation of the Relationship between Brain-Derived Neurotropic Factor Levels and the Stroop Interference Effect in Children with Attention-Deficit Hyperactivity Disorder.

Brain-derived neurotropic factor (BDNF) has been suggested to play a role in the pathogenesis of attention-deficit hyperactivity disorder (ADHD). In addition, impairment in executive functions has been reported in children with ADHD. This study investigated the presence of a relationship between Stroop test scores and BDNF levels in children with ADHD. The study was conducted in the Department of Child Psychiatry at Dicle University. The study included 49 children between 6 and 15 years of age (M/F: 42/7), who were diagnosed with ADHD according to DSM-IV, and who did not receive previous therapy. Similar in terms of age and gender to the ADHD group, 40 children were selected in the control group. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version was administered to all participants. Parents and teachers were administered Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening and Rating Scale to measure symptom severity in children with ADHD. Children with ADHD underwent the Stroop test. BDNF levels were evaluated in serum by ELISA. The ADHD and control groups did not differ in terms of BDNF levels. BDNF levels did not differ between ADHD subtypes. There was also no relationship between the Stroop test interference scores and BDNF levels. The findings of the present study are in line with those in studies that demonstrated no significant role of BDNF in the pathogenesis of ADHD.

BDNF concentrations and daily fluctuations differ among ADHD children and respond differently to methylphenidate with no relationship with depressive symptomatology.

Brain-derived neurotrophic factor (BDNF) enhances the growth and maintenance of several monoamine neuronal systems, serves as a neurotransmitter modulator and participates in the mechanisms of neuronal plasticity. Therefore, BDNF is a good candidate for interventions in the pathogenesis and/or treatment response of attention deficit hyperactivity disorder (ADHD). We quantified the basal concentration and daily fluctuation of serum BDNF, as well as changes after methylphenidate treatment. A total of 148 children, 4-5years old, were classified into groups as follows: ADHD group (n=107, DSM-IV-TR criteria) and a control group (CG, n=41). Blood samples were drawn at 2000 and 0900 hours from both groups, and after 4.63±2.3months of treatment, blood was drawn only from the ADHD group for BDNF measurements. Factorial analysis was performed (Stata software, version 12.0). Morning BDNF (36.36±11.62ng/ml) in the CG was very similar to that in the predominantly inattentive children (PAD), although the evening concentration in the CG was higher (CG 31.78±11.92 vs PAD 26.41±11.55ng/ml). The hyperactive-impulsive group, including patients with comorbid conduct disorder (PHI/CD), had lower concentrations. Methylphenidate (MPH) did not modify the concentration or the absence of daily BDNF fluctuations in the PHI/CD children; however, MPH induced a significant decrease in BDNF in PAD and basal day/night fluctuations disappeared in this ADHD subtype. This profile was not altered by the presence of depressive symptoms. Our data support a reduction in BDNF in untreated ADHD due to the lower concentrations in PHI/CD children, which is similar to other psychopathologic and cognitive disorders. MPH decreased BDNF only in the PAD group, which might indicate that BDNF is not directly implicated in the methylphenidate-induced amelioration of the neuropsychological and organic immaturity of ADHD patients.

P.1.a.018 - Gene expression in the brain of adult rats with behavioural alterations caused by neonatal exposure to the dipeptidyl peptidase-IV inhibitors diprotin A and sitagliptin

Attention deficit hyperactivity disorder (ADHD) is much more frequent in males than females, so several genes on the X chromosome (e.g., MAOA and MAOB) have been pursued as candidates for influencing risk for the disorder. HTR2C is also located on the X chromosome. In the current study, we examined the relationship between the C-759T and G-697C polymorphisms of HTR2C and ADHD in 488 Han Chinese families. Transmission Disequilibrium Test (TDT) analysis showed that the −759C allele, the −697G allele, and haplotype −759C/−697G were significantly over-transmitted to affected probands, while haplotypes −759C/−697C and −759T/−697C were under-transmitted. When families were divided into three subtypes according to the diagnosis of probands, the −697G allele and haplotype −759C/−697G were significantly over transmitted to ADHD-C probands, while haplotype −759T/−697C was under-transmitted to these individuals; however, no biased transmission of any allele or haplotype was observed for probands with ADHD-I, suggesting that different subtypes of ADHD have different genetic influences. Our findings highlight the need to explore the role of 5-HT2C receptor dysfunction in the pathogenesis of ADHD.