Attention Deficits In Adults Research Articles

Sulfonylurea for improving neurological features in neonatal diabetes: A systematic review and meta-analyses.

In monogenic diabetes due to KCNJ11 and ABCC8 mutations that impair KATP- channel function, sulfonylureas improve long-term glycemic control. Although KATP channels are extensively expressed in the brain, the effect of sulfonylureas on neurological function has varied widely. We evaluated published evidence about potential effects of sulfonylureas on neurological features, especially epilepsy, cognition, motor function and muscular tone, visuo-motor integration, and attention deficits in children and adults with KCNJ11 and ABCC8-related neonatal-onset diabetes mellitus. We conducted a systematic review and meta-analyses of the literature (PROSPERO, CRD42021254782), including individual-patient data, according to PRISMA, using RevMan software. We also graded the level of evidence. We selected 34 of 776 publications. The evaluation of global neurological function before and after sulfonylurea (glibenclamide) treatment in 114 patients yielded a risk difference (RD) of 58% (95%CI, 43%-74%; I2 = 54%) overall and 73% (95%CI, 32%-113%; I2 = 0%) in the subgroup younger than 4 years; the level of evidence was moderate and high, respectively. EEG studies of epilepsy showed a RD of 56% (95%CI, 23%-89%; I2 = 34%) in patients with KCNJ11 mutations, with a high quality of evidence. For hypotonia and motor function, the RDs were 90% (95%CI, 69%-111%; I2 = 0%) and 73% (95%CI, 35%-111%; I2 = 0%), respectively, with a high level of evidence. Glibenclamide significantly improved neurological abnormalities in patients with neonatal-onset diabetes due to KCNJ11 or ABCC8 mutations. Hypotonia was the symptom that responded best. Earlier treatment initiation was associated with greater benefits.

Regional Topological Aberrances of White Matter- and Gray Matter-Based Functional Networks for Attention Processing May Foster Traumatic Brain Injury-Related Attention Deficits in Adults.

Traumatic brain injury (TBI) is highly prevalent in adults. TBI-related functional brain alterations have been linked with common post-TBI neurobehavioral sequelae, with unknown neural substrates. This study examined the systems-level functional brain alterations in white matter (WM) and gray matter (GM) for visual sustained-attention processing, and their interactions and contributions to post-TBI attention deficits. Task-based functional MRI data were collected from 42 adults with TBI and 43 group-matched normal controls (NCs), and analyzed using the graph theoretic technique. Global and nodal topological properties were calculated and compared between the two groups. Correlation analyses were conducted between the neuroimaging measures that showed significant between-group differences and the behavioral symptom measures in attention domain in the groups of TBI and NCs, respectively. Significantly altered nodal efficiencies and/or degrees in several WM and GM nodes were reported in the TBI group, including the posterior corona radiata (PCR), posterior thalamic radiation (PTR), postcentral gyrus (PoG), and superior temporal sulcus (STS). Subjects with TBI also demonstrated abnormal systems-level functional synchronization between the PTR and STS in the right hemisphere, hypo-interaction between the PCR and PoG in the left hemisphere, as well as the involvement of systems-level functional aberrances in the PCR in TBI-related behavioral impairments in the attention domain. The findings of the current study suggest that TBI-related systems-level functional alterations associated with these two major-association WM tracts, and their anatomically connected GM regions may play critical role in TBI-related behavioral deficits in attention domains.

Sustained Attention Deficits in Adults With Juvenile-Onset Type 1 Diabetes Mellitus.

This study aimed to investigate whether patients with juvenile-onset type 1 diabetes mellitus (T1DM) have poorer sustained attention than their counterparts with adult-onset T1DM, and whether there is a relationship between diabetes-related variables and sustained attention. This study included 76 participants with juvenile-onset T1DM, 68 participants with adult-onset T1DM, and 85 healthy controls (HCs). All participants completed the Sustained Attention to Response Task, Beck Depression Inventory-II, and the Chinese version of the Wechsler Adult Intelligence Scale. The juvenile-onset group showed more omission errors (p = .007) than the adult-onset group and shorter reaction time (p = .005) than HCs, whereas the adult-onset group showed no significant differences compared with HCs. Hierarchical linear regression analysis revealed that the age of onset was associated with omission errors in T1DM participants (β = -0.275, t = -2.002, p = .047). In the juvenile-onset group, the omission error rate were associated with the history of severe hypoglycemia (β = 0.225, t = 1.996, p = .050), whereas reaction time was associated with the age of onset (β = -0.251, t = -2.271, p = .026). Fasting blood glucose levels were significantly associated with reaction time in both the juvenile-onset and adult-onset groups (β = -0.236, t = -2.117, p = .038, and β = 0.259, t = 2.041, p = .046, respectively). Adults with juvenile-onset T1DM have sustained attention deficits in contrast to their adult-onset counterparts, suggesting that the disease adversely affects the developing brain. Both the history of severe hypoglycemia and fasting blood glucose levels are factors associated with sustained attention impairment. Early diagnosis and treatment in juvenile patients are required to prevent the detrimental effects of diabetes.

Attention deficits in adults with Major depressive disorder: A systematic review and meta-analysis.

Attention deficits have been proven in patients with major depressive disorder (MDD). However, a detailed characterization of attention deficits in MDD was unclear. The aim of current study was to explore the specific deficits of attention in different sub-domains of attention so as to produce an overall picture of contemporary research on this field. We performed a systematic review and meta-analysis of published researches. PubMed, EMBASE, Cochrane Library and review of references were searched up to October 2019. Studies using at least one objective measurement to assess attention performances of MDD patients were included. Effect sizes were calculated using random-effects models for attention outcomes. Publication bias was evaluated using Egger's test. Twenty-three eligible studies including 1371 MDD patients were enrolled in this meta-analysis. Significant deficit of global attention was observed. For the specific outcomes, MDD patients showed significant deficits in psychomotor speed/attention, auditory attention, visuo-spatial attention, sustained visual attention, ranging from small to moderate, but not in selective attention. Larger sample sizes and more detailed subgroup analyses based on features of patients should be conducted to produce a more accurate conclusion.

The neural correlations of spatial attention and working memory deficits in adults with ADHD.

Working memory impairment is a typical cognitive abnormality in patients with attention-deficit/hyperactivity disorder (ADHD) and is closely related to attention. Exploring the interaction between working memory and attention in patients with ADHD is of great significance for studying the pathological mechanism of this disease. In this study, electrophysiological markers of attention, posterior contralateral N2 (N2pc), and working memory, contralateral delay activity (CDA), were used to explore the relationship between these two cognitive abilities in patients with ADHD. EEG data were collected from adults with ADHD and age-, sex-, and IQ-matched normal controls while performing a classical visuospatial working memory task that consisted of low-load and high-load memory conditions. In different memory load conditions, the memory array elicited a smaller N2pc (220–260 ms) and a smaller CDA (400–800 ms) in adults with ADHD than in normal controls. Further analysis revealed that the reduced CDA amplitude could be significantly predicted by the earlier and reduced N2pc amplitude in adults with ADHD. Moreover, when the number of memory items increased, the increase in N2pc highly predicted the increases in CDA. Our findings illustrate the relationship between spatial working memory and attention ability in ADHD adults from the neurophysiological aspect that reduced working memory is closely related to insufficient attention ability and provide a potential physiological basis for the pathological mechanism of ADHD.

Transcranial Doppler sonography reveals sustained attention deficits in young adults diagnosed with ADHD.

The National Institute of Mental Health has recently launched the Research Domain Criteria framework that seeks to inform clinical classification schemes by elevating the status of neuroscience research in the diagnosis of mental disorders. The current research seeks to contribute to that initiative by using a neurophysiological measure, transcranial Doppler sonography that has been shown to be sensitive to decrements in sustained attention and may provide an additional biomarker of executive dysfunction in ADHD. Twenty-seven participants performed a 12-min vigilance task while cerebral blood flow velocity (CBFV) was recorded. Thirteen participants were included in an ADHD condition if they had been formally diagnosed with ADHD. The remaining 14 participants who had never been formally diagnosed with ADHD were included in the control condition. Participants that had been diagnosed with ADHD demonstrated a steeper decrement in performance accuracy, a steeper decrement in perceptual sensitivity, and employed a more liberal response bias over time as compared to the control participants. Critically, the decrement in CBFV was steeper for participants previously diagnosed with ADHD than those who were not. Moreover, CBFV was found to better predict decreases in sensitivity and hit rate, as well as increases in liberal responding above and beyond self-reported ADHD symptoms. Results suggest that CBFV can be used to index failures of executive control in ADHD and can predict response strategy, and that the measure may provide an additional index of the sustained attention deficits associated with ADHD compared to traditional diagnostic methods.

Decoding selective attention to context memory: An aging study

Emerging evidence has suggested that the tendency for older adults to bind too much contextual information during encoding (i.e., hyper-binding) may contribute to poorer memory for relevant contextual information during retrieval. While these findings are consistent with theories of age-related declines in selective attention and inhibitory control, the degree to which older adults are able to selectively attend to relevant contextual information during encoding is unknown. To better understand the neural dynamics associated with selective attention during encoding, the current study applied multivariate pattern analyses (MVPA) to oscillatory EEG in order to track moment-to-moment shifts of attention between relevant and irrelevant contextual information during encoding. Young and older adults studied pictures of objects in the presence of two contextual features: a color and a scene, and their attention was directed to the object's relationship with one of those contexts (i.e., target context). Results showed that patterns of oscillatory power successfully predicted whether selective attention was directed to a scene or color, across age groups. Individual differences in overall classification performance were associated with individual differences in target context memory accuracy during retrieval. However, changes in classification performance within a trial, suggestive of fluctuations in selective attention, predicted individual differences in hyper-binding. To the best of our knowledge, this is the first study to use MPVA techniques to decode attention during episodic encoding and the impact of attentional shifts toward distracting information on age-related context memory impairments and hyper-binding. These results are consistent with the as-of-yet unsubstantiated theory that age-related declines in context memory may be attributable to poorer selective attention and/or greater inhibitory deficits in older adults.

Neurocognitive performances of visuospatial attention and the correlations with metabolic and inflammatory biomarkers in adults with obesity.

What is the central question of this study? Obesity is linked to cognitive deficits, elevated energy metabolic indices and low-grade systemic inflammation. Do the relationships between neurocognitive performance and the biochemical markers (e.g. energy metabolic indices and inflammatory cytokines) occur independently of factors known to be associated with neurocognitive dysfunction (i.e. cardiorespiratory fitness) in young adults? What is the main finding and its importance? Young obese adults showed poorer neuropsychological performances, aberrant neural activity and higher C-reactive protein and energy metabolic indices. The higher leptin and C-reactive protein concentrations showed a significant negative association with lower P3 amplitudes. However, leptin was the sole predictive factor, implicating hyperleptinaemia in the altered neurocognitive function observed in obesity. The present study was designed to explore the neurophysiological mechanism of visuospatial attention deficits in obese adults and to examine the relationships between neurocognitive (neuropsychological and neurophysiological) performances and the biochemical markers. Thirty obese adults and 30 healthy-weight control subjects, categorized by body mass index and percentage fat as measured with dual-energy X-ray absorptiometry, provided a fasting blood sample and performed a visuospatial attention protocol with concomitant electrophysiological recording. The obese group showed slower reaction times and smaller P3 amplitudes when performing the cognitive task. Even when controlling for the covariable of cardiorespiratory fitness, the results remained. In addition, the serum concentrations of insulin, glucose, leptin and C-reactive protein were significantly higher in the obese group relative to the control group, but not those of interleukin-6, interleukin-1β and tumour necrosis factor-α. Partial correlations adjusting for cardiorespiratory fitness showed that leptin and C-reactive protein concentrations in the obese group were negatively associated with poorer neurophysiological (i.e. P3 amplitude) performance. However, the regression analysis showed that leptin was the sole predictor of P3 amplitude in the obese group. These findings indicate that the individuals with obesity exhibited neurocognitive deficits when performing the visuospatial attention task, and serum leptin concentrations could be one of the influential factors.

Use of eye-tracker device to detect attention deficits in adults with ADHD

IntroductionAdult patients with ADHD may go unrecognized. This can result in psychosocial and functional decline.ObjectivesTo investigate the use of objective testing, with an eye-tracker device in the diagnosis of adult patients with ADHD.MethodsCase control study. Inclusion criteria were aged 18–65, minimum 5 years of education and literate in English. Exclusion criteria were visual impairment, amnesia and learning difficulties. ADHD was diagnosed with Conners’ adult ADHD diagnostic interview (group A, n = 15) and were matched for gender and age against normal controls (group B, n = 33). Participants completed four computer-based tasks while their eye movements were recorded. The tests included (i) Stroop effect test, (ii) Stroop effect test with visual aid, (iii) perceptual selectivity test and (iv) Saccadic interference. accuracy (%) and response time (msec) for tests (i–iii) measured while for test (iv), saccade count, average saccade amplitude and average fixation duration.ResultsStroop test accuracy showed a statistically significant difference between group A and group B (P = 0.004). Stroop response time also showed a statistically significant difference between the two groups (t = 3.228, df: 46, P = 0.001). For test (ii), there was a significant difference for response time (t = 2.326, df: 46, P = 0.024) but not for accuracy. For test (iii), the results were statistically significant for accuracy; (t = 2.682, df: 46, P = 0.010) and for response time (t = 4.028, df: 46, P = 0.001). There were no significant differences in the saccadic interference test.ConclusionAdults with ADHD have a longer response time and perform less accurately than controls. Thus, these data demonstrate that there is a use for objective tests (tests i–iii) in the diagnosis of adult ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cognitive rehabilitation of attention deficits in traumatic brain injury using action video games: A controlled trial

AbstractThis paper investigates the utility and efficacy of a novel eight-week cognitive rehabilitation programme developed to remediate attention deficits in adults who have sustained a traumatic brain injury (TBI), incorporating the use of both action video game playing and a compensatory skills programme. Thirty-one male TBI patients, aged 18–65 years, were recruited from 2 Australian brain injury units and allocated to either a treatment or waitlist (treatment as usual) control group. Results showed improvements in the treatment group, but not the waitlist control group, for performance on the immediate trained task (i.e. the video game) and in non-trained measures of attention and quality of life. Neither group showed changes to executive behaviours or self-efficacy. The strengths and limitations of the study are discussed, as are the potential applications and future implications of the research.

The role of visual spatial attention in adult developmental dyslexia

The present study investigated the nature of visual spatial attention deficits in adults with developmental dyslexia, using a partial report task with five-letter, digit, and symbol strings. Participants responded by a manual key press to one of nine alternatives, which included other characters in the string, allowing an assessment of position errors as well as intrusion errors. The results showed that the dyslexic adults performed significantly worse than age-matched controls with letter and digit strings but not with symbol strings. Both groups produced W-shaped serial position functions with letter and digit strings. The dyslexics' deficits with letter string stimuli were limited to position errors, specifically at the string-interior positions 2 and 4. These errors correlated with letter transposition reading errors (e.g., reading slat as "salt"), but not with the Rapid Automatized Naming (RAN) task. Overall, these results suggest that the dyslexic adults have a visual spatial attention deficit; however, the deficit does not reflect a reduced span in visual-spatial attention, but a deficit in processing a string of letters in parallel, probably due to difficulty in the coding of letter position.

Attention deficits in adults with ADHD tendency using Change Blindness Tasks

Attention deficits in adults with ADHD tendency using Change Blindness Tasks

Frontal Atrophy and Attention Deficits in Older Adults with a History of Elevated Depressive Symptoms

Studies of older adults with depressive disorders indicate greater cognitive deficits and brain alterations than would be expected for their age. There is some evidence that these findings are present after a single episode of depression, but this work has been cross-sectional in nature. We investigated both cross-sectional and longitudinal associations between a history of elevated depressive symptoms (HDS), frontal lobe volumes, and cognitive performance within the context of normal age-related changes over time in the Baltimore Longitudinal Study of Aging. After controlling for age, HDS was associated with smaller total frontal gray matter volumes and with smaller regional volumes in the cingulate gyrus and orbitofrontal cortex. Men, but not women, with HDS showed deficits in auditory attention span at older ages. Results confirm previous reports that even a single episode of depression is associated with adverse outcomes in older adults but suggest that HDS does not affect longitudinal trajectories of cognitive and brain volume change.

Hold that Thought: Organochlorines May Alter Infant Attention Skills

Vol. 116, No. 5 EnvironewsOpen AccessHold that Thought: Organochlorines May Alter Infant Attention Skills Tanya Tillett Tanya Tillett Search for more papers by this author Published:1 May 2008https://doi.org/10.1289/ehp.116-a215bAboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InRedditEmail From the mid-1940s on, a group of synthetic chemicals known as organochlorines (OCs) were used in industry and as pesticides. Because of evidence of human and environmental risks from exposure to some of these chemicals, the Environmental Protection Agency in the 1970s banned the use of two—the pesticide DDT and a class of industrial chemicals known as polychlorinated biphenyls (PCBs). Despite the ban of more than 30 years, residues of these persistent, bioaccumulative chemicals are still found in human tissue. Now researchers have found evidence of an association between poor attention skills in early infancy and low-level prenatal exposure to PCBs and p,p′-DDE, the chief metabolite of DDT [EHP 116:666–673; Sagiv et al.].Previous studies have shown associations between PCB exposure and attention deficits in adults and school-age children. In the current study, the authors sought to investigate whether these associations could be detected in early infancy using the Neonatal Behavioral Assessment Scale (NBAS) to assess infants’ visual and auditory stimuli responses, motor tone and motor activity levels, and ability to regulate crying, alert, and sleep states. These behavioral items identify the infant’s capacity for attention as well as abilities potentially associated with attention, such as state regulation and motor maturity.The present study included infants born between 1993 and 1998 to mothers who lived near a PCB-contaminated harbor in New Bedford, Massachusetts. The NBAS was administered to infants twice: between 1 and 3 days after birth and between 5 and 22 days after birth. The researchers also administered questionnaires to mothers of the infants to collect demographic data on household income; medical and reproductive histories; drug, alcohol, and tobacco use; race and ethnicity; and occupational and exposure histories pertinent to outcomes of interest.To determine OC levels in the infants, the researchers analyzed infant cord serum samples, taken at birth, for 51 PCB congeners and p,p′-DDE. Of the total serum samples, 96% had detectable DDE levels; depending on the PCB congener, anywhere from fewer than 1% to 91% of the infants had detectable serum levels. For the 542 infants that completed both exams, statistical analysis revealed a decline in scores of attention with increased serum levels of DDE and of PCBs. The exposure-associated declines were less pronounced for abilities associated with attention, including state- and motor-associated outcomes.The authors acknowledge the uncertainty of the NBAS in accurately predicting attention behaviors that may occur later in childhood. Future studies should examine whether the attention deficits observed in the current study in association with organochlorine exposure persist into childhood.Soothability can predict later attention skillsFiguresReferencesRelatedDetails Vol. 116, No. 5 May 2008Metrics About Article Metrics Publication History Originally published1 May 2008Published in print1 May 2008 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact ehponline@niehs.nih.gov. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Auditory spatial localization and attention deficits in autistic adults

The objective of this study was to compare autistic adults and matched control subjects in their ability to focus attention selectively on a sound source in a noisy environment. Event-related brain potentials (ERPs) were recorded while subjects attended to a fast paced sequence of brief noise bursts presented in free-field at a central or peripheral location. Competing sequences of noise bursts at adjacent locations were to be ignored. Both behavioral measures of target detection and auditory ERP amplitudes indicated that control subjects were able to focus their attention more sharply on the relevant sound source than autistic subjects. These findings point to a fundamental deficit in the spatial focusing of auditory attention in autism, which may be a factor that impedes social interactions and sensory-guided behavior, particularly in noisy environments.

Attention Deficits in Adults

Attention Deficits in Adults