Attention Deficit Hyperactivity Disorder Patients Research Articles

Neural and Cognitive Predictors of Stimulant Treatment Efficacy in Medication-Naïve ADHD Adults: A Pilot Diffusion Tensor Imaging Study

Objective: Stimulant medications are the main treatment for Attention Deficit Hyperactivity Disorder (ADHD), but overall treatment efficacy in adults has less than a 60% response rate. This study aimed to identify neural and cognitive markers predictive of longitudinal improvement in response to stimulant treatment in drug-naïve adults with ADHD. Method: We used diffusion tensor imaging (DTI) and executive function measures with 36 drug-naïve adult ADHD patients in a prospective study design. Results: Structural connectivity (measured by fractional anisotropy, FA) in striatal regions correlated with ADHD clinical symptom improvement following stimulant treatment (amphetamine or methylphenidate) in better medication responders. A significant positive correlation was also found between working memory performance and stimulant-related symptom improvement. Higher pre-treatment working memory scores correlated with greater response. Conclusion: These findings provide evidence of pre-treatment neural and behavioral markers predictive of longitudinal treatment response to stimulant medications in adults with ADHD.

Internet Gaming Disorder in Children and Adolescents with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have been related to an increased risk for behavioral addictions including online gaming. However, the relationship between these two conditions and Internet gaming disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ASD youth and ADHD youth, compared with a normal control group, and by assessing selected psychopathological and neuropsychological features in ASD and ADHD patients with and without IGD. This study included 77 ASD patients (67 males, mean age 13.58 ± 2.75 years), 94 ADHD patients (79 males, mean age 11.46 ± 2.47 years), and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) that received structured measures for IGD (IAT, IGDS9-SF, and UADI). In the ADHD group, 72.34% of the sample were above the IGD cut-off, compared with 45.45% in the ASD group and 9.5% in the NC group. ASD patients with IGD presented with greater severity and more severe attention problems, with no difference in the ASD core symptoms between patients with and without IGD. In the comparison between the ASD and ADHD groups according to the presence of IGD, ASD patients with IGD were the most severe group according to the CGI (Clinical Global Impression) scale. The follow-up, conducted on 45 patients affected by ASD, showed an improvement in CGI and CGAS (Children's Global Assessment Scale) scores, but not in the IGD symptoms. These findings could place the diagnosis of ASD as a negative prognostic factor in the follow-up of aspects of video game addiction compared with ADHD.

Efficacy of Methylphenidate for Internet Gaming Disorder and Internet Addiction in Patients with Attention-Deficit/Hyperactivity Disorder.

Internet Gaming Disorder (IGD) and Internet Addiction (IA) are related clinical conditions often comorbid with Attention-Deficit/Hyperactivity Disorder (ADHD). We evaluated the efficacy of MPH for IGD/IA symptoms in ADHD patients. We enrolled 38 drug-naive patients diagnosed with ADHD (Attention-Deficit/Hyperactivity Disorder) and IGD/IA. At baseline, all patients underwent a clinical assessment for IGD/IA symptoms and then received the most appropriate therapy according to their clinical profile. Twenty-one patients received MPH (methylphenidate) treatment, and 17 patients did not. Patients were re-evaluated after three months of treatment. Findings revealed significant reductions in IGD/IA symptoms over time, while no significant effect of MPH on symptom reduction was found. Clinical predictors of symptom reduction were identified, including IQ (Intelligence Quotient) and comorbid anxiety. This longitudinal prospective study contributes to the understanding of IGD/IA treatment in ADHD patients and highlights the importance of considering individual clinical characteristics when predicting treatment response. However, MPH may not directly impact IGD/IA symptom reduction.

Association of Age and Response to Methylphenidate HCL Treatment in Adult ADHD: A Proton Magnetic Resonance Spectroscopy Study.

This study investigated the age-dependent effects of methylphenidate (MPH) on brain metabolites including choline (Cho), N-acetyl aspartate (NAA) and creatine (Cr) levels in the dorsolateral prefrontal cortex (DLPFC), striatum, cerebellum, and anterior cingulate cortex (ACC) regions of the brain in adult patients with attention deficit hyperactivity disorder (ADHD). The study was included 60 patients with ADHD between the ages of 18 and 60 years. The patients were grouped with respect to their ages as follows: 18-24 years, 25-30 years, and 31 and over years. Levels of NAA, Cr and Cho in DLPFC, ACC, cerebellum and striatum were measured with magnetic resonance spectroscopy (MRS). Subjects were then given 10 mg of oral MPH and the same metabolite levels were measured 30 minutes apart. Twelve (20%) of the cases were female and 48 (80%) were male. The age distribution of the cases is as follows: 15 subjects between the ages of 18-24, 26 subjects between the ages of 25-30 and 19 subjects over the age of 30. NAA levels were higher after MPH in the DLPFC of the 18-24 age group (p = 0.016) and in the cerebellum of the 25-30 age group (p = 0.041). No increase in Cho and Cr levels was observed after treatment compared to before (p > 0.05). It is thought that treatment of MPH can be effective on metabolites in different brain regions and this effect can vary upon age adult ADHD patients. After MPH treatment, both the 18-24 age group (in the DLPFC) and the 25-30 age group (in the cerebellum) was detected significantly higher NAA levels compared to pre-treatment levels. This increase in NAA levels suggested that pharmacotherapy, especially at early ages, may be effective on neuronal damage.

Treatment Adherence and Related Factors Among Children with Attention-Deficit/Hyperactivity Disorder in Saudi Arabia.

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder. It frequently persists into adulthood and is a risk factor for other mental disorders and adverse outcomes, mainly if not managed optimally. This study aimed to assess ADHD treatment adherence and explore the underlying causes of non-adherence in ADHD children in Saudi Arabia. A cross-sectional study of a convenience sample of 221 participants. The survey included demographic characteristics of the child and parents, the child's medical history, quality of services evaluation, as well as medication adherence assessment by Medication Adherence Report Scale (MARS), the general beliefs about medicines questionnaire (General-BMQ), in addition to assessing the parents' beliefs about ADHD and provided/recommended treatment. The sample was primarily 6 to 8-year-old children (32.81%) and males (78.52%). Most subjects were prescribed extended-release agents (45.7%), and overall, high-quality services were provided to the patients. The adherence rate of ADHD patients to their medication was 89.77%. The mother's education correlated significantly with patient adherence (p=0.029), and the mother's age correlated significantly with their beliefs (p=0.021), in addition to the family income (0.033). Children on Methylphenidate Immediate Release had good compliance with the medication (p=0.008). Moreover, Methylphenidate Extended Release has shown continuity results, increasing the adherence rates (p=0.035). ADHD medication adherence was high and associated with older age, educational status, and type of medication used. Physicians should consider these factors to improve adherence in their patients.

Alpha modulation via transcranial alternating current stimulation in adults with attention-deficit hyperactivity disorder.

One potential therapy treating attention-deficit/hyperactivity disorder (ADHD) is to modulate dysfunctional brain activations using brain stimulation techniques. While the number of studies investigating the effect of transcranial direct current stimulation on ADHD symptoms continues to increase, transcranial alternating current stimulation (tACS) is poorly examined. Previous studies reported impaired alpha brain oscillation (8-12 Hz) that may be associated with increased attention deficits in ADHD. Our aim was to enhance alpha power in adult ADHD patients via tACS, using different methods to explore potential therapeutic effects. Undergoing a crossover design, adults with ADHD received active and sham stimulation on distinct days. Before and after each intervention, mean alpha power, attention performance, subjective symptom ratings, as well as head and gaze movement were examined. Frequency analyses revealed a significant power increase in the alpha band after both interventions. Despite a trend toward an interaction effect, this alpha power increase was, however, not significantly higher after active stimulation compared to sham stimulation. For the other measures, some additional pre-post effects were found, which were not intervention-related. Our study cannot provide clear evidence for a tACS-induced increase in alpha power in adult ADHD patients, and thus no stimulation related improvement of attention parameters. We provide further recommendations for the future investigation of tACS as a potential ADHD treatment.

Unraveling the Role of miR-200b-3p in Attention-Deficit/Hyperactivity Disorder (ADHD) and Its Therapeutic Potential in Spontaneously Hypertensive Rats (SHR).

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children with unknown etiology. Impaired learning ability was commonly reported in ADHD patients and has been associated with dopamine uptake in the striatum of an animal model. Another evidence also indicated that micro-RNA (miR)-200b-3p is associated with learning ability in various animal models. However, the association between miR-200b-3p and ADHD-related symptoms remains unclear. Therefore, the current study investigated the role of miR-200b-3p in ADHD-related symptoms such as inattention and striatal inflammatory cytokines. To verify the influence of miR-200b-3p in ADHD-related symptoms, striatal stereotaxic injection of miR-200b-3p antagomir (AT) was performed on spontaneously hypertensive rats (SHR). The antioxidant activity and expressions of miR-200b-3p, slit guidance ligand 2 (Slit2), and inflammatory cytokines in the striatum of SHR were measured using quantitative real-time polymerase chain reaction (RT-qPCR), immunohistochemistry (IHC), immunoblotting, and enzyme-linked immunosorbent assay (ELISA). The spontaneous alternation of SHR was tested using a three-arm Y-shaped maze. The administration of miR-200b-3p AT or taurine significantly decreased striatal tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in SHR, along with increased super-oxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and significantly higher spontaneous alternation. In this paper, we show that miR-200b-3p AT and taurine alleviates ADHD-related symptoms in SHR. These findings provide insights into ADHD's molecular basis and suggest miR-200b-3p as a potential therapeutic target. Concurrently, this study also suggests broad implications for treating neurodevelopmental disorders affecting learning activity such as ADHD.

P2X4 signalling contributes to hyperactivity but not pain sensitization comorbidity in a mouse model of attention deficit/hyperactivity disorder.

Introduction: Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by hyperactivity, inattention, and impulsivity that often persist until adulthood. Frequent comorbid disorders accompany ADHD and two thirds of children diagnosed with ADHD also suffer from behavioural disorders and from alteration of sensory processing. We recently characterized the comorbidity between ADHD-like symptoms and pain sensitisation in a pharmacological mouse model of ADHD, and we demonstrated the implication of the anterior cingulate cortex and posterior insula. However, few studies have explored the causal mechanisms underlying the interactions between ADHD and pain. The implication of inflammatory mechanisms has been suggested but the signalling pathways involved have not been explored. Methods: We investigated the roles of purinergic signalling, at the crossroad of pain and neuroinflammatory pathways, by using a transgenic mouse line that carries a total deletion of the P2X4 receptor. Results: We demonstrated that P2X4 deletion prevents hyperactivity in the mouse model of ADHD. In contrast, the absence of P2X4 lowered thermal pain thresholds in sham conditions and did not affect pain sensitization in ADHD-like conditions. We further analysed microglia reactivity and the expression of inflammatory markers in wild type and P2X4KO mice. Our results revealed that P2X4 deletion limits microglia reactivity but at the same time exerts proinflammatory effects in the anterior cingulate cortex and posterior insula. Conclusion: This dual role of P2X4 could be responsible for the differential effects noted on ADHD-like symptoms and pain sensitization and calls for further studies to investigate the therapeutic benefit of targeting the P2X4 receptor in ADHD patients.

The diagnostic effect of integrated visual and auditory continuous performance and event-related potentials in ADHD.

The development of objective assessment tools for attention deficit hyperactivity disorder (ADHD) has become a hot research topic. The aim was to explore the value of the P300 wave and integrated visual and auditory continuous performance test (IVA-CPT) in diagnosing ADHD. We enrolled 30 patients with ADHD and 30 age-matched healthy volunteers in a prospective study to evaluate differences in IVA-CPT and P300 indexes using student t test. These tools' accuracy in identifying ADHD patients was evaluated using receiver operating characteristic curve analysis. Additionally, the correlation between P300 and IVA-CPT in ADHD patients was evaluated using Pearson correlation analysis. Compared with healthy volunteers, ADHD patients showed longer latency and lower amplitude, and had lower scores of IVA-CPT (P<0.01). There was no significant difference of latency, amplitude, and area below the amplitude of the P300 wave and in the score of IVA-CPT for age and gender within-ADHD groups (P>0.05). Moreover, receiver operating characteristic (ROC) curve showed high accuracy of P300 and IVA-CPT in identifying ADHD patients. Furthermore, both P300 index and IVA-CPT had high accuracy and performance in identification of ADHDin, ADHDhi, and ADHDcom. However, for different subtypes of ADHD, no significant differences were observed of ROC curves between subgroups (P>0.05). In addition, the performance in IVA-CPT was positively correlated with the amplitude, and negatively correlated with the latency of P300. These results support the discriminant validity of P300 and IVA-CPT in distinguishing ADHD patients, providing a theoretical basis for P300 and IVA-CPT testing in the clinical diagnosis of ADHD.

Impaired flexible reward learning in ADHD patients is associated with blunted reinforcement sensitivity and neural signals in ventral striatum and parietal cortex

Reward-based learning and decision-making are prime candidates to understand symptoms of attention deficit hyperactivity disorder (ADHD). However, only limited evidence is available regarding the neurocomputational underpinnings of the alterations seen in ADHD. This concerns flexible behavioral adaption in dynamically changing environments, which is challenging for individuals with ADHD. One previous study points to elevated choice switching in adolescent ADHD, which was accompanied by disrupted learning signals in medial prefrontal cortex.Here, we investigated young adults with ADHD (n = 17) as compared to age- and sex-matched controls (n = 17) using a probabilistic reversal learning experiment during functional magnetic resonance imaging (fMRI). The task requires continuous learning to guide flexible behavioral adaptation to changing reward contingencies. To disentangle the neurocomputational underpinnings of the behavioral data, we used reinforcement learning (RL) models, which informed the analysis of fMRI data.ADHD patients performed worse than controls particularly in trials before reversals, i.e., when reward contingencies were stable. This pattern resulted from ‘noisy’ choice switching regardless of previous feedback. RL modelling showed decreased reinforcement sensitivity and enhanced learning rates for negative feedback in ADHD patients. At the neural level, this was reflected in a diminished representation of choice probability in the left posterior parietal cortex in ADHD. Moreover, modelling showed a marginal reduction of learning about the unchosen option, which was paralleled by a marginal reduction in learning signals incorporating the unchosen option in the left ventral striatum.Taken together, we show that impaired flexible behavior in ADHD is due to excessive choice switching (‘hyper-flexibility’), which can be detrimental or beneficial depending on the learning environment. Computationally, this resulted from blunted sensitivity to reinforcement of which we detected neural correlates in the attention-control network, specifically in the parietal cortex. These neurocomputational findings remain preliminary due to the relatively small sample size.

Acoustic and Text Features Analysis for Adult ADHD Screening: A Data-Driven Approach Utilizing DIVA Interview.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder commonly seen in childhood that leads to behavioural changes in social development and communication patterns, often continues into undiagnosed adulthood due to a global shortage of psychiatrists, resulting in delayed diagnoses with lasting consequences on individual's well-being and the societal impact. Recently, machine learning methodologies have been incorporated into healthcare systems to facilitate the diagnosis and enhance the potential prediction of treatment outcomes for mental health conditions. In ADHD detection, the previous research focused on utilizing functional magnetic resonance imaging (fMRI) or Electroencephalography (EEG) signals, which require costly equipment and trained personnel for data collection. In recent years, speech and text modalities have garnered increasing attention due to their cost-effectiveness and non-wearable sensing in data collection. In this research, conducted in collaboration with the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, we gathered audio data from both ADHD patients and normal controls based on the clinically popular Diagnostic Interview for ADHD in adults (DIVA). Subsequently, we transformed the speech data into text modalities through the utilization of the Google Cloud Speech API. We extracted both acoustic and text features from the data, encompassing traditional acoustic features (e.g., MFCC), specialized feature sets (e.g., eGeMAPS), as well as deep-learned linguistic and semantic features derived from pre-trained deep learning models. These features are employed in conjunction with a support vector machine for ADHD classification, yielding promising outcomes in the utilization of audio and text data for effective adult ADHD screening. Clinical impact: This research introduces a transformative approach in ADHD diagnosis, employing speech and text analysis to facilitate early and more accessible detection, particularly beneficial in areas with limited psychiatric resources. Clinical and Translational Impact Statement: The successful application of machine learning techniques in analyzing audio and text data for ADHD screening represents a significant advancement in mental health diagnostics, paving the way for its integration into clinical settings and potentially improving patient outcomes on a broader scale.

Psychiatric comorbidities of attention deficit/hyperactivity disorder in Japan: a nationwide population-based study.

This study aimed to estimate prevalence and incidence of attention deficit/hyperactivity disorder (ADHD) and comorbid relationships between ADHD and other psychiatric disorders in Japan. Using the real-world JMDC Claims Database, we conducted a cross-sectional study (analysis years 2017-2021) and retrospective cohort study (observation 2 years before/after the initial ADHD diagnosis; data collection 2005-2021; enrollment 2017-2019). Patients were male or female, aged 0-57 years. Cross-sectional study patients had an ADHD or other psychiatric disorder diagnosis (with or without medication) and were continuously registered in each analysis year; retrospective study patients had an ADHD diagnosis and ≥2 years' observation before and after diagnosis. Endpoints were annual prevalence and incidence of ADHD in Japan, prevalence and risk ratio of each psychiatric comorbidity in patients with ADHD, prevalence and risk ratios of ADHD in patients with each psychiatric comorbidity, and prevalence of psychiatric disorders before/after the initial ADHD diagnosis. ADHD prevalence in children/adolescents and adults increased each year from 2017 to 2021. Prevalence in boys was 3.5-4.1 times higher than in girls. Prevalence in adults was lower than in children/adolescents, with a small sex difference. ADHD was highly comorbid with various psychiatric disorders. In 2019, the most common comorbidity in children/adolescents with ADHD was autism spectrum disorder (ASD; 54.4%); in adults, it was mood disorders (60.9%). ADHD prevalence in patients with various psychiatric disorders was higher than in the control population. ADHD prevalence was highest in patients with oppositional defiance disorder among both children/adolescents and adults (77.2% and 69.2%, respectively). In the retrospective cohort study (N = 14,940), the most common psychiatric disorders diagnosed prior to ADHD diagnosis were ASD in children/adolescents (33.9% of patients), and mood disorders and sleep disorders in adults (36.9% and 23.8% of patients, respectively). ADHD was comorbid with various psychiatric disorders in Japan. In children and adolescents with ADHD, ASD was often diagnosed prior to ADHD. Psychiatric disorders, especially mood disorders and sleep disorders, were frequently diagnosed prior to the initial ADHD diagnosis in adults. The likelihood of comorbid ADHD should be considered when diagnosing adult patients with psychiatric disorders.

An investigation on the alterations in Wnt signaling in ADHD across developmental stages

The canonical Wnt signaling pathway plays a vital role in the developmental processes of the Central Nervous System throughout both prenatal and postnatal stages, as well as in maintaining homeostasis during adulthood. Its complex intracellular cascade involves the participation of key proteins (i.e., GSK3β and β-catenin) to activate the transcription of Wnt target genes. These genes subsequently control processes like cell proliferation, maturation, and the determination of cell fate. Previous studies suggest that this pathway can also be associated with Attention-Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder with multifactorial etiology. This study aimed to clarify if and at what developmental stage the Wnt pathway is altered in ADHD. Accordingly, we carried out proteomic and functional assessments of the Wnt pathway using Western Blot and reporter assays, respectively. These assessments were performed at the induced pluripotent stem cell (iPSC), neural stem cell (NSC), and neuronal phases. IPSCs were generated from somatic cells retrieved from 5 controls and 5 patients diagnosed with ADHD. As opposed to the developmental stage of iPSCs, ADHD NSCs showed alterations in the protein expression of both GSK3β and β-catenin, suggesting increased Wnt activity in the ADHD group. Moreover, Wnt reporter assays confirmed higher Wnt activity in ADHD NSCs. Our molecular findings in NSCs correlated with genetic predisposition to ADHD and clinical traits displayed by their respective donors. In conclusion, these results suggest that a crucial cellular pathway is disrupted in patient-specific NSCs, potentially explaining the developmental deficits clinically exhibited by ADHD patients.

Precuneal hyperperfusion in patients with attention-deficit/hyperactivity disorder-comorbid nociplastic pain.

Nociplastic pain (NP), a third category of chronic pain, offers a framework for elucidating its pathophysiology and treatment strategies. One of the characteristics of NP is comorbidity of symptoms other than pain, such as psychological and cognitive problems; therefore, these can be clues to understanding NP. Recently, we reported several cases with comorbid symptoms of attention-deficit/hyperactivity disorder (ADHD). Notably, ADHD medications, including methylphenidate (MP) and atomoxetine, improved chronic pain as well as the symptoms of ADHD. However, in clinical settings, identifying comorbid ADHD in patients with chronic pain is challenging, and underlying mechanisms have not been elucidated. To explore the common characteristics of brain function in patients with ADHD-comorbid NP, we identified brain regions where cerebral blood flow (CBF) distributions changed between pre- and post-treatment using single-photon emission computed tomography (SPECT). Additionally, we examined brain regions where CBF values correlated with clinical scores. We retrospectively studied 65 patients (mean age 53 ± 14years; 30 males and 35 females) with ADHD-comorbid NP who underwent CBF-SPECT before and after ADHD medication initiation. Clinical scores included the clinical global impression severity (CGI-S), pain numerical rating scale, hospital anxiety and depression scale, pain catastrophizing scale, and Conners' adult ADHD rating scale-self report scores. Voxel-based statistical methods were used to compare pre- and post-treatment CBF-SPECT images to identify significant differences and investigate brain regions correlated with clinical scores. The CBF was higher in the precuneus, insular gyrus, and thalamus before treatment than after treatment (paired t-test, cluster-definition p < 0.001, cluster-extent threshold p < 0.05, with family-wise error [FWE] correction). The hyperperfusion in the precuneus was positively correlated with the CGI-S score and significantly reduced after treatment with MP (paired t-test, cluster-definition p < 0.005, cluster-extent threshold p < 0.05, with FWE correction). The finding of precuneal hyperperfusion may provide insight into the mechanisms of NP and help identify patients who would benefit most from ADHD medications.

Major Visual Impairment in Special Children

Objective: This study aims to identify the major visual impairment among special children. Methods: This cross-sectional study was conducted among 120 children within 3-15 years of age group at a vision therapy centre between April-June of 2023. Results: Low visual acuity was seen in children who had a development delay of 0.79%. In 15.7% of cases of autism spectrum disorder (ASD), astigmatism was present. Nystagmus was seen in 5.8% of cases of cortical visual impairment (CVI). 9.9% of those with attention-deficit/hyperactivity disorder (ADHD) were unable to both accommodate and converge. In 14.0% of cases, the stereo acuity was poor. Ocular mobility was impaired in 9.1% of developmental delay cases, 14.0% of CVI cases, and 25.6% of ASD cases. Fusion was not performed well by 9.9% of ADHD patients. Suppression and diplopia were present in 25.6% of ASD cases, 14.0% of CVI cases, and 9.1% of developmental delay cases. 7.4% of ADHD patients and 12.4% of CVI patients had photophobia. 9.9% of ADHD patients and 14.0% of CVI patients were unable to perform spatial orientation. Children with developmental delays, ASD, ADHD, and CVI were more likely to be impacted and had abnormal visual function.

Classification of attention deficit hyperactivity disorder using machine learning on an EEG dataset

The neurodevelopmental disorder, Attention Deficit Hyperactivity Disorder (ADHD), frequently affecting youngsters, is characterized by persistent patterns of inattention, hyperactivity, and impulsivity, the etiology of which may involve a variety of genetic, environmental, and neurological factors. Electroencephalography (EEG) measures the electrical activity in the brain through neuronal activity, which is a function of cognitive processes. In this study, a previously recorded sample set of 121 children containing unbiased data from both ADHD and control group classes and EEG signals were analyzed to classify the ADHD patients. The samples were tested under different cognitive conditions, and multiple features were extracted using Euclidean distance. Many machine learning algorithms use Euclidean distance as their default distance metric to compare two recorded data points. The extracted features were trained using four supervised machine learning algorithms (linear regression, random forest, extreme gradient boosting, and K nearest neighbor (KNN)) based on the results of various frequency bands. The results suggest that the KNN algorithm produces the highest accuracy over other machine learning approaches, and results can be further improved with the application of hyperparameter tuning and used for classifying sub-groups of ADHD to identify the severity of the disorder.

BOLD Activation During the Application of MOXO-CPT in School Patients With and Without Attention Deficit Hyperactivity Disorder

Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 3% of children in the world. Objective: In this work, we seek to compare the different brain activations of pediatric patients with and without ADHD. Methods: A functional resonance examination with BOLD contrast was applied using the MOXO-CPT test (Continuous Performance test with single and double visual-auditory distractors). Results: Differences in BOLD activation were observed indicating that control children regularly presented negative BOLD activations that were not found in children with ADHD. Inhibitory activity in audiovisual association zones in control patients was greater than in patients with ADHD. The inhibition in the frontal and motor regions in the controls contrasted with the overactivation of the motor areas in patients with ADHD, this, together with the detection of cerebellar activation which attempted to modulate the responses of the different areas that lead to executive failure in patients with ADHD. Conclusions: In view of these results, it can be argued that the lack of inhibition of ADHD patients in their executive functions led to a disorganization of the different brain systems.

Neuroradiological changes in patients with attention deficit hyperactivity disorder: Presentation of 3 cases and literature update

Introduction: Attention deficit/hyperactivity disorder (ADHD) is thought to be caused by structural and functional abnormalities in the frontal-striatal circuitry of the brain. The dorsolateral prefrontal cortex, caudate, pallidum, corpus callosum, and cerebellum all have significantly smaller volumes in children with ADHD. According to recent reports, other cortical and cerebellar regions generally suffer impairment. Case Series: Multiple nodes of dysfunction at the frontostriatal and mesocorticolimbic networks in attention-deficit/hyperactivity disorder (ADHD) have been identified through functional neuroimaging studies. We present a group of three ADHD patients and review the clinical findings and potential connections to neuroimaging tests. DISCUSSION: Adults with ADHD have different brain volume patterns in the areas of the brain responsible for attention and executive function. Conclusion: Among other neuroradiological findings, the ADHD patients in the current study showed changes in the frontal and prefrontal cortex, thickening of the corpus callosum, and elevated levels of glutamine and glutamate in the cerebellum. New studies are required to understand better the clinical finding with potential neuroanatomical and functional changes. Attention-deficit/hyperactivity disorder, brain, and neuroimage are keywords.

Impaired segregation of the attention deficit hyperactivity disorder related pattern in children

BackgroundInattention is a key characteristic of attention deficit hyperactivity disorder (ADHD). Specific brain abnormalities associated with this symptom form a discernible pattern related with ADHD in children (i.e., ADHD related pattern) in our earlier research. The developmental processes of segregation and integration may be crucial to ADHD. However, how brains reconfigure these processes of the ADHD related pattern in different subtypes of ADHD and across sexes remain unclear. MethodsNested-spectral partition method was applied to identify effects of subtype and sex on segregation and integration of the ADHD related pattern, using 145 ADHD patients and 135 typically developing controls (TDC) aged 7–14. Relationships between the measures and inattention symptoms were also investigated. ResultsChildren with ADHD exhibited lower segregation of the ADHD related pattern (p = 1.17 × 10−8) than TDCs. Only the main effect of subtype was significant (p = 1.14 × 10−5). Both ADHD-C (p = 2.16 × 10−6) and ADHD-I (p = 2.87 × 10−6) patients had lower segregation components relative to the TDC. Moreover, segregation components were negatively correlated with inattention scores. ConclusionsThis study identified impaired segregation in the ADHD related pattern of children with ADHD and found shared neural bases among different subtypes and sexes.

Management of sleep disorders in autism spectrum disorder with co-occurring attention-deficit hyperactivity disorder: update for clinicians.

To update and examine available literature germane to the recognition, assessment and treatment of comorbid autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD) and sleep disruption, with a predominant focus on children, adolescents and emerging adults. Considerable overlaps exist among ASD, ADHD and sleep disruption. Literature and guidance for clinicians, administrators, policy makers and families have been limited, as such deliberations were rarely considered until 2013. This narrative review of the literature addressing sleep disruption issues among those with ASD, ADHD and comorbid ASD and ADHD involved searching multiple databases and use of reverse citations up to the end of September 2022. Emphasis is placed on secondary sources and relevant data for clinical practice. Complex clinical presentations of ASD/ADHD/sleep disruption are frequently encountered in clinical practice. Prior to 2013, prevalence, clinical presentation, pathophysiology, prognosis, other sleep-related factors and interventions were determined separately for each disorder, often with overlapping objective and subjective methods employed in the process. High percentages of ADHD and ASD patients have both disorders and sleep disruption. Here, the extant literature is integrated to provide a multidimensional understanding of the relevant issues and insights, allowing enhanced awareness and better care of this complex clinical population. Database limitations are considered. Assessment of ASD symptomatology in youth with ADHD, and the reverse, in cases with disrupted sleep is critical to address the special challenges for case formulation and treatment. Evidence-based approaches to treatment planning and multi-treatment modalities should consider combining psychosocial and biological interventions to address the complexities of each case.