Continuous Performance Test Research Articles

A Network Analysis of Depression and Cognitive Impairments in Fibromyalgia: A Secondary Analysis Study.

Fibromyalgia is a chronic condition often accompanied by cognitive impairments, such as difficulties with sustained attention, and emotional disturbances, particularly depression and anxiety. Understanding how these emotional and cognitive factors interact is crucial to improving treatment for fibromyalgia patients. This study aimed to investigate the network structure of these interactions, focusing on the relationship between depression, anxiety, and cognitive performance. A total of one hundred ten participants diagnosed with fibromyalgia completed self-reported assessments of depression and anxiety, alongside cognitive performance tests. Key measures included Continuous Performance Tasks (CPT) for impulsivity and sustained attention, the Stroop Interference Index (StI), Stroop Color Naming (StC), and Stroop Word Reading (StW). Network analysis was conducted to estimate the relationships between emotional and cognitive variables and assess their centrality within the network. Errors in CPT emerged as the most significant indicators of the relationship between depression and cognitive performance, with high centrality values observed for the Stroop tasks (StI, StC, and StW). Additionally, Trait Anxiety (A_T) and Beck Depression Inventory (BDI) measures showed high centrality, underscoring the critical role of emotional states in the network of cognitive and emotional variables. The centrality values for cognitive flexibility, processing speed, and inhibitory control were found to be 0.85, 0.78, and 0.72, respectively. This study highlights the strong association between depression symptoms and deficits in cognitive domains, emphasizing the need for integrated care approaches that address both cognitive and emotional health. Multidisciplinary treatment programs, including cognitive rehabilitation and psychological support, could improve patient outcomes by targeting the most influential variables in the cognitive-emotional network.

Transdiagnostic Attentional Deficits Are Associated with Depressive and Externalizing Symptoms in Children and Adolescents with Neuropsychiatric Disorders.

Although inattention, impulsivity, and impairments to vigilance are most associated with attention-deficit/hyperactivity disorder (ADHD), transdiagnostic attentional deficits are prevalent across all psychiatric disorders. To further elucidate this relationship, the present study investigated parent-reported neuropsychiatric symptom correlates of attention deficits using the factor structure of the Conners' Continuous Performance Test (CPT-II), a neuropsychological test of attention. Two-hundred and eighteen children and adolescents (7-21years old) completed the CPT-II as part of standard clinical protocol during outpatient pediatric neuropsychology visits. The factor structure of the CPT-II was determined with a principal component analysis (PCA) using Promax rotation. Pearson correlation analyses and regression models examined the relationship between the generated factor structure, parent-reported clinical symptoms, and pre-determined clinical diagnoses. Results from the PCA suggested a three-factor model best supported the structure of the CPT-II, and were subsequently defined as inattention, impulsivity, and vigilance. Performance-based inattention was significantly correlated with parent-reported hyperactivity, aggression, conduct problems, and depression. Parent-reported depressive symptoms and conduct problems were the strongest correlates of performance-based inattention, not hyperactivity or aggression. Performance-based inattention was significantly associated with an ADHD diagnosis but not a depression or anxiety diagnosis. Findings suggest attentional deficits are not specific to any one disorder. To enhance the identification, classification, and treatment of neuropsychiatric disorders, both researchers and clinicians alike must diminish the importance of categorical approaches to child/adolescent psychopathology and continue to consider the dimensionality of transdiagnostic characteristics such as inattention.

Enhancing cognitive abilities in young adults with ADHD through instrumental music training: a comparative analysis of musicians and non-musicians.

Extensive research highlights the multifaceted benefits of active musical engagement across all ages, from childhood to the elderly. The practice of a musical instrument activates numerous brain regions, enhancing a range of neurocognitive skills. Despite accumulating evidence from various clinical populations, research on the effects of musical training in individuals with ADHD is scarce, with virtually no studies focusing on adults. This study aims to fill the gap by evaluating the impact of long-term instrumental music training on cognitive abilities in young adults (18-35 years) diagnosed with ADHD. Cognitive abilities were compared across groups of 48 musicians (experienced guitar or piano players) and 46 matched non-musicians, all confirmed to have ADHD. The assessments covered cognitive domains such as sustained attention, visuospatial processing, processing speed, graphomotor speed, working memory, auditory recall, response inhibition, and executive function. Evaluation tools included the Digit-Symbol Coding Test, Digit Span Test, Symbol Search Test, Switching Task, and Continuous Performance Test (CPT). Collectively, the results indicated a notable enhancement in cognitive performance in the musician group compared to the non-musician group, including in functions central to the disorder, such as sustained attention and impulse control. Musicians scored higher on the Digit-Symbol Coding, Digit Span, and Symbol Search tests, showed lower error rates and greater consistency in reaction times in the Switching Task, and had fewer commission errors in the CPT. The findings support the integration of specialized musical training in therapeutic and support programs for ADHD, suggesting benefits that may extend into adulthood.

Impact of Nutritional Minerals Biomarkers on Cognitive Performance Among Bangladeshi Rural Adolescents-A Pilot Study.

Background: Nutritional metals (NM) are essential for neurodevelopment and cognitive performance during growth. Nevertheless, epidemiological evidence regarding the associations between NM and brain function remains understudied, particularly among adolescents. Therefore, the objective of this pilot study was to examine the effects of NM biomarkers such as iron (Fe), selenium (Se), zinc (Zn), magnesium (Mg), and copper (Cu) on neurobehavioral functions among a group of rural Bangladeshi adolescents. Methodology: We conducted a cross-sectional study involving 105 adolescents aged 13-17 from Araihazar, Bangladesh. Cognitive function was assessed using the computer-based Behavioral Assessment and Research System (BARS), focusing attention, memory, and executive function, and blood NM levels (Fe, Se, Zn, Mg, and Cu) were measured. Associations between individual minerals, NM composite scores, and cognition were analyzed using multiple linear regressions. Results: This study included 47 boys and 58 girls with an average age of 15 years. Fe levels were correlated with Continuous Performance Test (CPT) latency (r = -0.42, p < 0.05) and Se levels correlated with Match-to-Sample (MTS) correct count (r = 0.32, p < 0.01). Linear regressions showed that Se was associated with MTS correct count (b = 0.02, 95%CI: 0.01, -0.04), reflecting visual memory, and Fe was associated with CPT latency (b = -0.68, 95%CI: -1.11, -0.26), reflecting improved attention. The same BARS measures were also significantly associated with the 3-NM composite score. Conclusions: Our findings suggest that NM, particularly Fe, Se, and NM mixtures, could play a crucial role in brain development and neurocognitive function during adolescence. Further studies will help design national public health policies and strategies to address and mitigate brain health deficiencies among adolescents.

The utility of wearable electroencephalography combined with behavioral measures to establish a practical multi-domain model for facilitating the diagnosis of young children with attention-deficit/hyperactivity disorder

BackgroundA multi-method, multi-informant approach is crucial for evaluating attention-deficit/hyperactivity disorders (ADHD) in preschool children due to the diagnostic complexities and challenges at this developmental stage. However, most artificial intelligence (AI) studies on the automated detection of ADHD have relied on using a single datatype. This study aims to develop a reliable multimodal AI-detection system to facilitate the diagnosis of ADHD in young children.Methods78 young children were recruited, including 43 diagnosed with ADHD (mean age: 68.07 ± 6.19 months) and 35 with typical development (mean age: 67.40 ± 5.44 months). Machine learning and deep learning methods were adopted to develop three individual predictive models using electroencephalography (EEG) data recorded with a wearable wireless device, scores from the computerized attention assessment via Conners’ Kiddie Continuous Performance Test Second Edition (K-CPT-2), and ratings from ADHD-related symptom scales. Finally, these models were combined to form a single ensemble model.ResultsThe ensemble model achieved an accuracy of 0.974. While individual modality provided the optimal classification with an accuracy rate of 0.909, 0.922, and 0.950 using the ADHD-related symptom rating scale, the K-CPT-2 score, and the EEG measure, respectively. Moreover, the findings suggest that teacher ratings, K-CPT-2 reaction time, and occipital high-frequency EEG band power values are significant features in identifying young children with ADHD.ConclusionsThis study addresses three common issues in ADHD-related AI research: the utility of wearable technologies, integrating databases from diverse ADHD diagnostic instruments, and appropriately interpreting the models. This established multimodal system is potentially reliable and practical for distinguishing ADHD from TD, thus further facilitating the clinical diagnosis of ADHD in preschool young children.

Mind wandering is associated with worsening attentional vigilance.

The tendency for our minds to wander is a pervasive and disruptive influence on continued task performance. Models of sustained attention have implicated mind wandering, moments when attention has turned inwards toward task-unrelated thought, in characteristic patterns of worsening performance with greater time-on-task, known as the vigilance decrement. Despite their theoretical connection, associations between mind wandering and the vigilance decrement have not been investigated systematically. Across two studies (N = 730), we evaluated covariance between within-task change in rates of probe-caught mind wandering and patterns of worsening behavioral task performance that characterize the vigilance decrement. Bivariate growth curve models characterized patterns of intraindividual linear change in mind wandering alongside concomitant changes in task accuracy, response time (RT), and RT variability. Importantly, models assessing the covariance between intraindividual change in mind wandering and behavioral outcome measures confirmed that increases in mind wandering are associated with patterns of worsening behavioral performance with greater time-on-task. In addition, we investigated the role of several moderating factors associated with patterns of within-task change: self-reported task interest and motivation, and individuals' propensity for mind wandering, and mindfulness in their daily lives. These factors moderated either the overall level or rate of within-task change in mind wandering. Our results provide support for models of sustained attention that directly implicate mind wandering in worsening behavioral performance with greater time-on-task in continuous performance tasks requiring sustained attention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of urinary organophosphate flame retardants in susceptibility to attention-deficit/hyperactivity disorder in school-age children

Our previous studies have revealed a correlation between urinary phthalates (PAE) metabolites and parabens and PM2.5 exposure and susceptibility to attention-deficit/hyperactivity disorder (ADHD) in school-age children. Our goal was to examine the relationships between urinary organophosphate flame retardants (OPFRs) and their metabolites and the susceptibility to ADHD in the same cohort of children. We recruited 186 school children, including 132 with ADHD and 54 normal controls, living in southern Taiwan to investigate five OPFRs (1,3-dichloro-2-propyl phosphate (TDCPP), tri-n-butyl phosphate (TnBP), tris (2-chloroethyl) phosphate (TCEP), tris(2-butoxyethyl) phosphate (TBEP), and triphenyl phosphate (TPHP)) and five OPFR metabolites (bis(1,3-dichloro-2-propyl) phosphate (BDCPP), di-n-butyl phosphate (DNBP), bis(2-chloroethyl) hydrogen phosphate (BCEP), di-(2-butoxyethyl) phosphate (DBEP), and diphenyl phosphate (DPHP)) in urine. ADHD patients’ behavioral symptoms and neuropsychological function were assessed using the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV) and the Conners’ Continuous Performance Test 3rd Edition (Conners CPT3), respectively. BCEP was predominant among urinary OPFRs and the metabolites in both the ADHD and control groups. ADHD children had significantly higher levels of urinary BDCPP, BCEP, DBEP, DPHP, TCEP, TBEP, TNBP, TPHP, and Σ10OPFR compared to the controls. After controlling for age, gender, body mass index, PM2.5 exposure scenarios, and urinary phthalate metabolites, parabens, bisphenol-A and creatinine, levels of urinary BDCPP, TDCPP, and TBEP in ADHD children showed significant and dose-dependent effects on core behavioral symptoms of inattention. DNBP levels were positively correlated with neuropsychological deficits (CPT detectability, omission, and commission), while urinary DPHP in ADHD children were negatively related to CPT detectability and commission. Hyperactivity and impulsivity were not correlated with urinary OPFRs and their metabolites in ADHD children. In conclusion, the ADHD symptom of inattention and CPT performance may be closely associated with certain urinary OPFRs and their metabolites, independent of urinary PAE metabolites, parabens, and bisphenol-A in school-age-ADHD children.

A New Objective Diagnostic Tool for Attention-Deficit Hyper-Activity Disorder (ADHD): Development of the Distractor-Embedded Auditory Continuous Performance Test.

Background/Objectives: Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Traditional diagnostic methods, which depend on subjective assessments, often lack precision. This study evaluates the validity and reliability of a newly developed diagnostic tool, the Distractor-Embedded Auditory Continuous Performance Test (da-CPT), which integrates auditory stimuli with distractors to enhance the clinical utility of ADHD diagnosis. Methods: The study included 160 children aged 6-12 years, comprising 80 with a confirmed ADHD diagnosis and 80 controls. All participants completed the da-CPT, a web-based tool designed to assess inattention, hyperactivity, impulsivity, and timing via an auditory-based task. To validate the da-CPT, participants also completed the Conners' Parent Rating Scale-Revised Short Form (CPRS-R) and either the MOXO or IVA-2 tests. Data were analyzed using ROC curves and statistical correlations to assess sensitivity, specificity, and overall diagnostic accuracy. Results: The da-CPT demonstrated high diagnostic accuracy, with a sensitivity of 91.25% and specificity of 83.75%. ROC analysis indicated that the inattention index had the highest discriminatory power (AUC = 0.881), followed by timing, impulsivity, and hyperactivity (all p < 0.01). Furthermore, the da-CPT scores were strongly correlated with ADHD severity (p < 0.01). Conclusions: This study confirms that the da-CPT is a valid and reliable tool for diagnosing ADHD in children aged 6-12. By incorporating auditory stimuli and distractors, the tool offers a more ecologically valid assessment of ADHD symptoms in clinical settings, improving diagnostic precision and utility.

Validity of specific CPT indices in differentiating school-aged children previously diagnosed with attention deficit/hyperactivity disorder from school-aged children with non-attention deficit/hyperactivity disorder in general education classrooms: a case control study

BackgroundContinuous performance tests (CPTs) are a popular tool for evaluating the symptoms of attention-deficit/hyperactivity disorder (ADHD). Performance measurements are typically linked to the biological features and cognitive functions of individuals. To determine the validity of specific CPT indices in differentiating between school-aged children with ADHD from with non-ADHD, each student’s sex, chronological age, and cognitive abilities should be considered.MethodsIn this prospective case–control study, a total of 30 non-ADHD students and 26 with ADHD who were aged 6 to 12 years were from general education classrooms. All students completed the Continuous Performance Tests (CPTs) and the Peabody Picture Vocabulary Test-revised (Mandarin-Chinese version). Demographic data were collected from the students’ parents.ResultsDetectability, Omissions, Commissions, and Hit Reaction Time Standard Deviation (HRT SD) yielded higher T-scores in children with ADHD than those without. Compared with non-ADHD students, those with ADHD had higher classification scores for Detectability, Omissions, Perseverations, and HRT SD. For each CPT index, after individual factors were controlled for, logistic regression revealed that only students with positive scores for Detectability, Omission, and HRT SD (adjusted odds ratios = 4.627, 9.977, and 3.908, Ps < 0.05) were likely to receive a diagnosis of ADHD. Furthermore, after individual characteristics were controlled for, Logistic regression also revealed that the cumulative positive scores of the Detectability, Omission, or and HRT SD remained associated with an increased risk of ADHD (adjusted odds ratio = 3.116, P < 0.01).ConclusionsCompared with school-aged children with non-ADHD in general education classrooms, those with ADHD exhibited significantly lower performance in inattention-related CPT indices. To reach an accurate diagnosis through CPTs, clinicians should pay attention to Detectability, Omission, and HRT SD. Compared with other CPT indices, Detectability, Omission, and HRT SD may function as more suitable indicators for distinguishing between school-aged children with and non-ADHD in general education classrooms. These indicators are robust and unobscured by individual characteristics.

Incidental Physical Activity and Physical Fitness Associate with Sustained Attention and Impulse Control in Older Adults

Age-related changes have been observed in sustained attention and impulse control. Deficits in these functions are related to pathological aging. However, research suggests that an active lifestyle may exert a protective effect on cognition in aging. While the association between physical activity and cognitive functioning in older adults has been previously described, few studies have explored the relationship between incidental physical activity and fitness with sustained attention and impulse control in this population. Therefore, this study aimed to evaluate the association between incidental physical activity and various components of fitness and sustained attention and impulsivity in older adults. Fifty-four older adults were recruited (41 females and 13 males) with a mean age of 76.76 years (SD = 8.94). Physical activity levels were assessed using the Yale Physical Activity Survey (YPAS), physical function in healthy older adults was evaluated with the Senior Fitness Test, and sustained attention and impulsivity were measured using a computerized continuous performance task. Significant correlations were found between higher energy expenditure during housework and yardwork activities, and fewer commission errors and shorter reaction times during sustained attention task, and higher sensitivity during impulse control task (rho between 0.35 and 0.40, p < .01, β = 0.80). Additionally, higher scores between agility and balance were associated with better accuracy during the sustained attention task, and faster speed processing correlated to better performance impulse control task (rho between 0.33 and 0.36, p < .05, β = 0.80). Our study highlights the importance of incidental physical activity and various components of fitness on sustained attention and impulse control in aging.

A study into the fluid power control characteristics of a hydrostatic transmission for mobile machinery

In response to improve the quality and level of hydrostatic transmission (HST) products for modern mobile machineries, the closed-loop transfer functions of a HST are established by mathematical modeling, a comprehensive testing equipment is developed employing a proportional relief valve for automatic program loading and fuzzy-PID oil temperature control, the testing equipment is capable of conducting various performance tests for various models of HST integrated pump-motor products, including factory and type tests, especially continuous impact and endurance performance tests under high temperature and high-speed conditions. Comprehensive performance test of the above test sample is carried out using the developed equipment, that the test results agree well with the previous simulation results verifies the correctness of the established theoretical analysis model. The obtained theory and equipment from this work provide theoretical and experimental technical support for improving design and development of high-end fluid components for modern mobile machinery HST.

Adverse childhood experiences, brain function, and psychiatric diagnoses in a large adult clinical cohort.

Adverse childhood experiences (ACEs) are linked to higher rates of psychiatric disorders in adults. Previous neuroimaging studies with small samples have shown associations between ACEs and alterations in brain volume, connectivity, and blood flow. However, no study has explored these associations in a large clinical population to identify brain regions that may mediate the relationship between ACEs and psychiatric diagnoses. This study aims to evaluate how patient-reported ACEs are associated with brain function in adults, across diagnoses. We analyzed 7,275 adults using HMPAO SPECT scans at rest and during a continuous performance task (CPT). We assessed the impact of ACEs on brain function across psychiatric diagnoses and performed mediation analyses where brain functional regions of interest acted as mediators between patient-reported ACEs and specific psychiatric diagnoses. We further evaluated the risk of being diagnosed with specific classes of mental illnesses as a function of increasing ACEs and identified which specific ACE questions were statistically related to each diagnosis in this cohort. Increased ACEs were associated with higher activity in cognitive control and default mode networks and decreased activity in the dorsal striatum and cerebellum. Higher ACEs increased the risk of anxiety-related disorders, substance abuse, and depression. Several brain regions were identified as potential mediators between ACEs and adult psychiatric diagnoses. This study, utilizing a large clinical cohort, provides new insights into the neurobiological mechanisms linking ACEs to adult psychiatric conditions. The findings suggest that specific brain regions mediate the effects of ACEs on the risk of developing mental health disorders, highlighting potential targets for therapeutic interventions.

Memory augmentation with an adaptive cognitive interface.

What we remember reflects both what we encounter, such as the intrinsic memorability of a stimulus, and our internal attentional state when we encounter that stimulus. Our memories are better for memorable images and images encountered in an engaged attentional state. Here, in an effort to modulate long-term memory performance, we manipulated these factors in combination by selecting the memorability of presented images contingent on individuals' natural fluctuations in sustained attention. Can image memorability and attentional state be strategically combined to improve memory? Are memorable images still well remembered during lapses in sustained attention, and conversely, can attentive states rescue memory performance for forgettable images? We designed a procedure to monitor participants' sustained attention dynamics on the fly via their response time fluctuations during a continuous performance task with trial-unique scene images. When high- or low-attentional states were detected, our algorithm triggered the presentation of high- or low-memorability images. Afterwards, participants completed a surprise recognition memory test for the attention-triggered images. Results demonstrated that memory performance for memorable items is not only resistant to lapses in sustained attention but also that memory cannot be further improved by encoding memorable items in engaged attentional states. On the other hand, memory performance for low-memorability images can be rescued by attentive encoding states. In sum, we show that both memorability and sustained attention can be leveraged in real time to maximize memory performance. This approach suggests that adaptive cognitive interfaces can tailor what information appears when to best support overall memory.

Exploring correlations between Conners' Continuous Performance Test and subjective measures of attention deficit hyperactivity disorder symptoms in a paediatric clinical sample.

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental condition characterised by inattention and/or hyperactivity-impulsivity. The ADHD symptoms are often evaluated and quantified using various assessment tools, such as the Conners' Continuous Performance Test II (CCPT-II), ADHD Rating Scale (ADHD-RS), Child Behaviour Checklist (CBCL), Clinical Global Assessment Scale (CGAS) and Clinical Global Impression Scale (CGIS). This study sought to compare CCPT-II with parent- and clinician-rated rating scales (ADHD-RS, CBCL, CGAS and CGIS) in measuring the core ADHD symptoms within the paediatric ADHD population. The data, gathered from a large-scale randomised controlled trial involving 172 children aged 6-12 years with ADHD, was pooled, and a Pearson correlation analysis was conducted. No significant correlations were observed between CCPT-II and ADHD-RS, as well as the various subscales of CBCL, CGAS and CGIS. While CCPT-II may offer insights into ADHD symptomatology, its relationship with parent- and clinician-rated rating scales such as ADHD-RS, CBCL, CGAS and CGIS appears limited. Further research is warranted to elucidate the nuances of these assessment tools and their roles in evaluating ADHD.

Peripheral Brain-Derived Neurotrophic Factor (BDNF) and Its Regulatory miRNAs as Biological Correlates of Impulsivity in Young Adults.

Background: Impulsivity assessment may serve as a valuable clinical tool in the stratification of suicide risk. Acting without forethought is a crucial feature in the psychopathology of many psychiatric disturbances and corresponds with suicidal ideations, behaviors, and attempts. Methods: We present data on biological and psychological correlates of impulsivity among young adults (n = 47). Psychological analysis included both the self-description questionnaire-Barratt Impulsiveness Scale (BIS-11)-and neuropsychological behavioral tests, including the Iowa Gambling Task (IGT), the Simple Response Time task (SRT), and the Continuous Performance Test (CPT). mRNA and micro-RNA were isolated from peripheral blood mononuclear cells (PBMC). Expression levels of Brain-Derived Neurotrophic Factor (BDNF) mRNA and its regulatory micro RNAs, mir-1-3p, mir-15a-5p, mir-26a-5p, mir-26b-5p, and mir-195-5p, were analyzed using the quantitative reverse transcription polymerase chain reaction (RT-qPCR) method. proBDNF and BDNF plasma protein levels were quantified using enzyme-linked immunosorbent assay (ELISA). Results: Significant correlations between BDNF mRNA and mir-15a-5p as well as proBDNF levels and mir-1-3p were detected. proBDNF protein levels correlated with motor and perseverance, while mir-26b correlated with cognitive complexity subdimensions of the BIS-11 scale. Correlations between BDNF, miRNAs, and the results of neuropsychological tests were also detected. Conclusions: The BDNF pathway shows a clinical potential in searching for biomarkers of impulse-control impairment. BDNF-regulatory micro-RNAs are detectable and related to clinical parameters in the studied population, which needs further research.

Analysis of the therapeutic effect of pestle needle and EEG biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder.

This research aimed to analyze the therapeutic effect of the pestle needle combined with electroencephalogram (EEG) biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. Seventy-eight children with ADHD were selected and randomized into a control group and an observation group (n = 39 each). The control group received EEG biofeedback and methylphenidate treatment, whereas the observation group received pestle needle therapy on this basis. Both groups received continuous treatment for 3 mo. The clinical efficacy, scores of Conners Parents Symptom Questionnaire (PSQ), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), and Pittsburgh Sleep Quality Index (PSQI), EEG θ/β changes in values, serum indicators such as adrenocorticotropic hormone (ACTH) and cortisol (CORT), and incidence of adverse reactions were compared in the two groups. The total effective rate of the observation group was 92.31% (36/39), which was higher than the control group's 69.23% (27/39) (P < 0.05). After treatment, reduced PSQ scores, PSQI scores, EEG θ/β values, and ACTH levels and elevated IVA-CPT and CORT levels were observed in both groups; the observation group had the best improvement effect after treatment (P < 0.05). Pestle needle combined with EEG biofeedback and methylphenidate in the treatment of ADHD children can elevate the IVA-CPT score, improve EEG waves and sleep quality, regulate serum indicators such as ACTH and CORT, reduce behavioral problem scores, and have high efficacy and safety.NEW & NOTEWORTHY The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can elevate the IVA-CPT score. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve EEG waves. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve sleep quality. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can regulate serum indicators.

Nurturing attention through nature

BackgroundPrevious research suggests an association between exposure to nature and improved attention. However, no observational studies explored the underlying mechanisms or considered bluespace, and none used Polish data. We investigated the association between exposure to nature and attention, and whether it was mediated by nature perception, physical activity and sleep duration. MethodsData derived from the case-control NeuroSmog study comprised 195 participants with attention deficit hyperactivity disorder (ADHD) and 457 participants without ADHD, all aged 10 to 13. Attention was evaluated using the computerized attention network test and the continuous performance test. Lifelong and current exposure to nature, determined by percentage of grass and tree cover and water presence within 500m buffer around residences, as well as domestic garden, were examined through linear, log-linear and negative binomial regressions. Potential pathways were explored using structural equation modelling. ResultsParticipants with ADHD with higher exposure to tree cover tended to have improved orienting ability, shorter reaction time and fewer correct rejections, while participants without ADHD tended to show decreased alertness and improved orienting ability. Participants with ADHD with higher exposure to grass cover tended to have longer reaction time, decreased alertness, improved orienting ability, reduced target discrimination ability, fewer correct rejections and less risky response style, while participants without ADHD tended to show decreased orienting ability, more mistakes, longer reaction time, better hit rate and more risky response style. Participants without ADHD with water in their neighbourhood tended to have improved orienting ability, fewer mistakes and better hit rate. Participants without ADHD with a garden tended to show improved target discrimination ability, better hit rate and more risky response style. No mediating pathways were revealed. ConclusionTree cover and presence of garden and water tended to be associated with improved attention in Polish adolescents while grass tended to have negative impact.

Characteristics of Speech Auditory Brainstem Response in Preschool Children With Attention-Deficit/Hyperactivity Disorder.

This study aimed to investigate the characteristics of auditory processing (AP) in preschool children with attention-deficit/hyperactivity disorder (ADHD) using the speech auditory brainstem response (speech-ABR), which provides insights into the AP of speech signals in the central auditory nervous system (CANS). A total of 84 preschool children diagnosed with ADHD, aged 4-6 years, were matched with 84 typically developing (TD) children based on gender and age. All children underwent speech-ABR testing, cognitive assessment using the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition or the Wechsler Intelligence Scale for Children-Fourth Edition, and a continuous performance test. Children with ADHD exhibited significantly longer latencies of speech-ABR waveforms V, A, and D compared to TD children. Multiple linear regression analysis showed that the latencies of speech-ABR waves V, A, and D were affected by the presence of ADHD, but not by the full-scale intelligence quotient. This study revealed that preschool children with ADHD exhibited abnormal AP of speech signals in their CANS. The findings suggest that speech-ABR can be utilized as a reliable measure to evaluate AP ability in this population, as it remains unaffected by cognitive or attentional factors. The transient response (V, A) of speech-ABR was found to be a significant predictor of ADHD in a clinical setting. Early assessment of AP abnormalities via speech-ABR is recommended in preschool-age children to develop targeted interventions for ADHD. https://doi.org/10.23641/asha.26376502.

A - 39 The Physical and Neurological Examination of Subtle Signs (PANESS) as a Predictor of ADHD

Abstract Objective The Physical and Neurological Examination of Subtle Signs (PANESS) is a pediatric neuromotor exam. Prior research shows children with attention deficit hyperactivity disorder (ADHD) may exhibit neurological soft signs. This study investigates the predictability of PANESS performance on other ADHD measures. Methods Subjects included 52 children aged 8–16 seen clinically for evaluation at Austin Neuropsychology. Dependent variables included Digit Span (DS), Test of Everyday Attention (TeaCh), Conners Continuous Performance Test (CCPT-3), and Delis-Kaplan Executive Function System (DKEFS). The raw scores of PANESS tasks were the independent variables. Results DS was significantly predicted by the foot tap (FT) (p = 0.017), foot heel-toe tap (FH) (p = 0.028), hand pat (HP) (p = 0.018), finger tap (FinT) (p &amp;lt; 0.001), and appose finger succession (AFS) (p = 0.012) tasks on the PANESS. The Category Fluency (CF) subtest on DKEFS Verbal Fluency was also significantly predicted by the FT (p = 0.043), FH (p &amp;lt; 0.001), hand pronate/supinate (HPS) (p = 0.003), FinT (p = 0.003), FA (p &amp;lt; 0.001) tasks. All PANESS tasks significantly predicted performance on Trial 2 of DKEFS Color-Word (FT: p = 0.012; FH: p = 0.015; HP: p = 0.002; HPS: p = 0.009; FinT: p = 0.003; FA: p = 0.002). The FA task was a significant predictor of all trials of CWI (T1: p &amp;lt; 0.001; T2: p = 0.002; T3: p &amp;lt; 0.001; T4: p &amp;lt; 0.001). Conclusion The PANESS predicts performance on some ADHD tasks, though not others. This finding prompts further investigation into how PANESS can be integrated into clinical settings to enhance ADHD diagnosis and understanding.

Time-on-task-related decrements in performance in the rodent continuous performance test are not caused by physical disengagement from the task.

Attention deficits, a hallmark of many neuropsychiatric disorders, significantly impair quality of life and functional outcome for patients. Continuous Performance Tests (CPTs) are widely used to assess attentional function in clinical settings and have been adapted for mice as the rodent Continuous Performance Test (rCPT). In this study, we combined traditional analyses of rCPT performance with markerless pose estimation using DeepLabCut and visual field analysis (VFA) to objectively measure the orientation of mice toward stimuli during rCPT sessions. Additionally, we extended session lengths to assess performance decrements over time. Our findings show that extending rCPT sessions from 45 to 90 minutes results in a significant decline in performance in male mice, which aligns with performance decrements observed in clinical research. Importantly, physical engagement with the task remained relatively stable throughout the session, even as performance deteriorated. This suggests that the performance decline specifically reflects a time-on-task (TOT)-dependent vigilance decrement rather than physical disengagement. We also investigated the effects of amphetamine, an FDA-approved treatment for attention-deficit/hyperactivity disorder (ADHD), on rCPT performance. Amphetamine significantly improved rCPT performance in male mice by reducing false alarms without modulating orientation or physical engagement with the task stimuli. Collectively, these findings validate a behavioral tracking platform for objectively measuring physical engagement in the rCPT and a task modification that accentuates TOT-dependent performance decrements, enhancing the translational value of the rCPT for studies related to human neuropsychiatric disorders.