Continuous Performance Test Scores Research Articles

Enhancing pilot vigilance assessment: The role of flight data and continuous performance test in detecting random attention loss in short IFR flights

Situational awareness (SA) and fatigue management are crucial aspects of aviation safety, particularly during demanding flight phases. This study introduces an innovative approach employing flight data, machine learning, and Continuous Performance Test (CPT) metrics to predict pilot performance and SA during instrument approaches under Instrument Meteorological Conditions (IMC). Data were collected from over 10 pilots across more than 40 flights in a high-fidelity Cessna 172 analog flight simulator.Significant correlations were observed between dynamic cognitive performance parameters and the exceedance shape factor, a novel measure of pilot sustained attention introduced in this research. Key variables identified through correlation analysis included variability, interstimulus change, and reaction time standard deviation.Importantly, commission scores and reaction time standard deviation emerged as key predictors in the machine learning model, specifically the Optimizable Gaussian Process Regression (GPR) model with a radial basis function kernel. The model achieved a validation R-squared of 0.90 and a test R-squared of 0.70. These systems could incorporate additional data sources, such as eye-tracking and scan pattern analysis, for a better assessment of pilot SA and fatigue levels. While post-flight measurements are inherently reactive, they are effective for monitoring the degradation of pilot CPT scores after each leg of high-frequency, short-duration flights.Notable limitations include the need to understand individual cognitive differences among pilots, such as age, experience, and cognitive style. The predictive model also requires validation in actual flight conditions to determine its ecological validity. Future research should aim to address these limitations, generalize the findings, and integrate CPT data with other sensor inputs to provide a more comprehensive understanding of pilot performance.

Clinical characteristics and cognitive function in bipolar disorder patients with different onset symptom.

In recent years, studies on the clinical features and cognitive impairment of patients with different first-episode types of bipolar disorder have received increasing attention. The patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to assess the cognitive functions of a patient's index episode of bipolar disorder, depression or mania, on risk factors of effecting on cognitive functions. One hundred sixty eight patients with bipolar disorder diagnosed for the first time were enrolled in the study. All patients were divided into two groups according to their index episode of bipolar disorder, either depression or mania. Seventy three patients of the cohort had an index episode mania and 95 patients had initial symptoms of depression. Demographic and clinical disease characteristic data of all enrolled patients were collected. Meanwhile, 75 healthy controls were included. Demographic data of controls were collected. The cognitive functions of all patients and controls were detected by continuous performance test (CPT), digital span test (DST) and Wisconsin card sorting test (WCST). The main cognitive functions data were compared among the mania group, depression group and control group. The relevant risk factors affecting cognitive function were analyzed. (1) Most patients with bipolar disorder had an index episode depression (56.55% vs. 43.45%). Compared with the depression group, the mania group had later age of onset [(24.01 ± 4.254) vs. (22.25 ± 6.472), t = 2. 122, p = 0.035]. The education level of patient groups was lower than control group (p < 0.001). (2) The healthy control group's DST, WCST and CPT scores were better than the patient groups (All p < 0.05). The mania group's DST (forward, reverse, sum), WCST (total responses, completed classifications, correct responses, incorrect responses, percentage of correct responses, completed the number of responses required for classification, the percentage of conceptualization level, the number of persistent responses, non-persistent errors), CPT (2 digit score, 3 digit score, 4 digit score) was better than the depression group (p < 0.05). (3) In mania group, correlation analysis showed that all CPT parameter, inverse digit span, and the sum of DST was negatively correlated with the education level (All p < 0.05). The CPT-4 digit score was negatively correlated with onset age (p < 0.05). In the WCST, the number of correct responses, the percentage of correct responses and the percentage of conceptualization level were positively correlated with the BRMS score (All p < 0.05). The number of false responses and persistent responses were negatively correlated with the BRMS score (All p < 0.05). The number of persistent errors and percentage of persistent errors was positively correlated with education years (All p < 0.05). In depression group, there was a positive correlation between inverse digit span and the education level (p < 0.05). In our study, there were cognitive impairments in attention, memory, and executive function of patients with different onset syndromes of bipolar disorder. Compared with the mania group, the degree of cognitive impairments in bipolar patients with the depressive episode was more severe. The risk factors affecting cognitive impairments included the age of onset, education level, number of hospitalizations and severity of illness.

Primary School Children's Self-Reports of Attention Deficit Hyperactivity Disorder-Related Symptoms and Their Associations With Subjective and Objective Measures of Attention Deficit Hyperactivity Disorder.

BackgroundThe diagnosis of Attention deficit hyperactivity disorder (ADHD) is primarily dependent on parents’ and teachers’ reports, while children’s own perspectives on their difficulties and strengths are often overlooked.GoalTo further increase our insight into children’s ability to reliably report about their ADHD-related symptoms, the current study examined the associations between children’s self-reports, parents’ and teachers’ reports, and standardized continuous performance test (CPT) data. We also examined whether the addition of children’s perceptions of ADHD-symptoms to parents’ and teachers’ reports would be reflected by objective and standardized data.MethodsThe study included 190 children with ADHD, aged 7–10 years, who were referred to a pediatric neurologic clinic. A retrospective analysis was conducted using records of a clinical database. Obtained data included children’s self-reports of their attention level and ADHD-related symptoms, parent, and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist (CBCL), Teacher’s Report Form (TRF), and CPT scores.ResultsChildren’s self-evaluations of their functioning were globally associated with their teachers’ and parents’ evaluations, but not uniquely. Children’s self-reports of ADHD symptoms were not uniquely linked to a specific CPT impairment index, but to a general likelihood of having an impaired CPT. The CPT performance successfully distinguished between the group of children who defined themselves as inattentive and those who did not.ConclusionPrimary school children with ADHD are able to identify their limitations and needs difficulties and that their perspectives should inform clinical practice and research. The clinical and ethical imperative of taking children’s perspectives into account during ADHD diagnosis and treatment is highlighted.

Influence of alcohol and acetaldehyde on cognitive function: findings from an alcohol clamp study in healthy young adults.

To investigate the acute effects of intravenous alcohol and its metabolite acetaldehyde on cognitive function in healthy individuals. Experimental pre-test/post-test design. Kurihama Medical and Addiction Center, Japan. A total of 298 healthy Japanese people age 20 to 24 years. Participants underwent an intravenous alcohol infusion with a target blood alcohol concentration (BAC) of 0.50 mg/mL for 180 minutes. Participants completed the continuous performance test (CPT) for sustained attention, the paced auditory serial addition test (PASAT) for working memory, and the reaction time test (RTT) for speed/accuracy, along with the blood test for BAC and blood acetaldehyde concentration (BAAC) at baseline, 60 and 180 minutes. Although the target BAC was maintained during the infusion, BAAC peaked at 30 minutes and then gradually declined (η2 = 0.18, P < 0.01). The CPT scores worsened, and the changes between 0 and 60 minutes were correlated with BAAC (correct detection, η2 = 0.09, P < 0.01; r = -0.34, P < 0.01; omission errors, η2 = 0.08, P < 0.01; r = 0.34, P < 0.01). PASAT scores improved through 180 minutes, whereas the changes between 0 and 60 minutes were negatively correlated with BAAC (task one, η2 = 0.02, P < 0.01; r = -0.25, P < 0.01; task two, η2 = 0.03, P < 0.01; r = -0.28, P < 0.01). Although RTTs worsened, they were not associated with BAC or BAAC. None of these comparisons maintained the time effect after controlling for body height. Acetaldehyde exposure following acute intravenous alcohol appears to have a negative impact on sustained attention and working memory, whereas there seems to be only a minor effect of moderate alcohol concentration on speed and accuracy.

Inflammatory cytokines, cognition, and response to antidepressant treatment in patients with major depressive disorder

BackgroundInflammation and cognition are related to major depressive disorder (MDD), but the role in treatment response remains unclear. In this study, we investigated correlation between inflammatory cytokines and cognition in MDD patients treated with antidepressant medication. MethodsThe participants were 149 MDD patients. Cytokines before therapy, cognitive assessments and severity of depression before and after therapy were tested. Logistic regression was used to explore underlying risks treatment response. ResultsThere were significant differences in smoking, alcohol drinking, and Stroop Color Test(SCT), Stroop Color-Word Test (SCWT), and Continuous Performance Test(CPT) scores between response group (RG) and non-response group (NRG) at baseline. Performance of patients in RG improved more in Brief Assessment of Cognition in Schizophrenia (BACS), Color Trial Test-I (CTT-I), SCT and SCWT after treatment. Levels of baseline IL-18 were associated with baseline learning and memory, and executive function. Treatment response was associated with drinking, performance of CPT and SCT. ConclusionMDD patients with different treatment responses have different cognitive defects, especially in speed of processing and executive function. Expression of cytokines is associated with cognition and may influence treatment response. Better speed of processing and executive function, and poorer attention at baseline may respond better to antidepressant treatment.

Gestational and peripubertal phthalate exposure in relation to attention performance in childhood and adolescence

The prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) has been increasing. Research suggests that exposure to endocrine disrupting chemicals such as phthalates may play a role, but studies of in utero phthalate exposure and ADHD-related symptoms beyond early childhood are limited. We investigated associations between measures of in utero phthalate exposure and ADHD symptoms, such as inattention and impulsivity, in childhood (age 6–11 years, n = 221) and in adolescence (age 9–18 years, n = 200), as well as cross-sectional relationships between phthalate exposure and ADHD symptoms in adolescence (n = 491) among participants in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort. Women provided urine samples up to three times during pregnancy and adolescents provided a urine sample at 9–18 years of age for phthalate metabolite measurement. We administered the Conners’ Continuous Performance Test (CPT) when children were age 6–11 years and again at 9–18 years of age. We used multivariable linear regression to examine associations between the geometric mean of phthalate metabolite levels across pregnancy and CPT scores in childhood or adolescence separately, adjusting for age, years schooling (at 9–18 only), maternal education, and specific gravity. Although average in utero phthalate concentrations were not associated with CPT scores in childhood, interquartile range (IQR) increases of in utero MBzP, MCPP, and MBP were associated with 4.2%, 4.7%, and 4.5% (p < 0.05) higher Omissions scores in adolescence, respectively, indicating higher inattention. In utero MiBP levels were also associated with higher Inter-Stimulus Interval (ISI) and Variability scores (5.4% and 5.5% per IQR, p < 0.05) in adolescence. In addition, urinary DEHP metabolite levels during adolescence were cross-sectionally associated with poorer scores on several CPT indices indicating greater inattention. These findings suggest that in utero phthalate exposure may have adverse effects on attention, but these effects may not appear until adolescence, a period of extensive neurodevelopment. Future research investigating the long-term effects of in utero phthalate exposure on attention and ADHD in adolescence, as well as identification of potential mechanisms involved, is needed.

Neural Dynamics for Facilitating ADHD Diagnosis in Preschoolers: Central and Parietal Delta Synchronization in the Kiddie Continuous Performance Test

The present study aimed to characterize children at risk of attention-deficit/hyperactivity disorder (ADHD) during preschool age and provide early intervention. The continuous performance test (CPT) and electroencephalography (EEG) can contribute additional valuable information to facilitate diagnosis. This study measured brain dynamics at slow and fast task rates in the CPT using a wireless wearable EEG and identified correlations between the EEG and CPT data in preschool children with ADHD. Forty-nine preschool children participated in this study, of which 29 were diagnosed with ADHD and 20 exhibited typical development (TD). The Conners Kiddie Continuous Performance Test (K-CPT) and wireless wearable EEG recordings were employed simultaneously. Significant differences were observed between the groups with ADHD and TD in task-related EEG spectral powers (central as well as parietal delta, P <; 0.01), which were distinct only in the slow-rate task condition. A shift from resting to the CPT task condition induced overall alpha powers decrease in the ADHD group. In the task condition, the delta powers were positively correlated with the CPT perseveration scores, whereas the alpha powers were negatively correlated with specific CPT scores mainly on perseveration and detectability (P <; 0.05). These results, which complement the findings of other sparse studies that have investigated within-task-related brain dynamics, particularly in preschool children, can assist specialists working in early intervention to plan training and educational programs for preschoolers with ADHD.

Effect of a visual tracking intervention on attention and behavior of children with Attention Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder is characterized by several cognitive and behavioral problems such as inattention and impulsivity, abnormal control of eye movements and relocation, visual fixation and visuospatial perception. There is a link between core motor functions such as oculomotor function and cognition to the extent that the oculomotor system acts as a mediator between the motor and cognitive functions. Therefore, the effects of eye-tracking intervention were investigated on attention in these children. Thirty - nine boys with ADHD, 6 to 10 years of age were recruited and randomized to receive current occupational therapy (control group), or occupational therapy accompanied with eye-tracking exercises (experimental group). They were evaluated using the Conner's Parent Rating Scale, the Continuous Performance Task-2, and the Test of Visual-Motor Skills-Revised before and after the intervention. Significant improvements in the mean scores of cognitive problems (F=9/22), coping behavior (F=6.03) and hyperactivity (F=9.77) were detected in the posttest between the two groups (p<0.05). Furthermore, in the Continuous Performance Test scores, detectability (F=5.68), omission errors (F=17.89), commission errors (F=19.45), reaction time (F=8.95), variability (F=7.07), and preservation (F=6.33) showed significant differences between control and experimental groups (p<0.01). It appears that eye-tracking interventions designed based on the isolation of neck and eye movement might have an important role in improving cognitive function and coping behaviors in these children. It seems that these exercises could increase eye movement control; improve cognitive function and response inhibition.

Attentional and neurophysiologic effects of repetitive transcranial magnetic stimulation.

Twenty-seven healthy subjects were randomly assigned to 1 of 2 equal groups : (1) experimental group (active stimulation) and (2) control group (sham stimulation). A total of 10 Hz repetitive transcranial magnetic stimulation was delivered to the left dorsolateral prefrontal cortex at 80% of the resting motor threshold. The reaction time of the correct response, omission error, and commission error of the auditory and visual continuous performance test scores were measured. The motor evoked potentials, resting motor threshold, short-interval intracortical inhibition, and intracortical facilitation was recorded in the right first dorsal interosseous muscle to determine motor cortex excitability. The reaction time and commission error of the auditory continuous performance test were reduced significantly after 10 Hz repetitive transcranial magnetic stimulation (P < 0.05). Resting motor threshold and short-interval intracortical inhibition was significantly decreased after active repetitive transcranial magnetic stimulation (P < 0.05), with no changes in the latency and amplitude of the motor evoked potentials and intracortical facilitation. In conclusion, high-frequency repetitive transcranial magnetic stimulation to the left dorsolateral prefrontal cortex is shown to improve the attentional function and may be simultaneously associated with changes in neurophysiological activity.

Comparison of the Effect of Cognitive Rehabilitation and Neurofeedback on Sustained Attention Among Elementary School Students With Specific Learning Disorder: A Preliminary Randomized Controlled Clinical Trial

Introduction:Sustained Attention (SA) failure is one of the main characteristics of Specific Learning Disorders (SLD). Recent studies have reported a positive effect of Cognitive Rehabilitation (CR) and Neurofeedback (NFB) on SA in SLD. Thus, the effectiveness of CR and NFB is well understood. This preliminary study aimed to compare the effects of CR and NFB on SA among the elementary school students with SLD, using a randomized controlled clinical trial.Methods:In this preliminary randomized controlled clinical trial, 53 eligible students with SLD (based on DSM-5) within the age range of 7 to 10 years were randomly assigned in the NFB (n=18), CR (n=18), and control group (n=17). All the participants were evaluated for SA using the Continuous Performance Test (CPT), at the time of entry to the study, and one month later. The intervention groups participated in 20 sessions of CR and 20 sessions of NFB, while the control group was evaluated without any intervention.Results:A total number of 24 boys and 36 girls in four groups (n=15) completed the study. The Mean±SD age of the participants in the CR, NFB, and control groups were 8.66±1.48 years, 8.40±1.73 years, and 8.53±1.63 years, respectively. Results showed a significant difference in the variables of the CPT between the study groups (P<0.05). Also, the CPT scores of the CR group were higher than that of the NFB group (P<0.001).Conclusion:This study supports that CR is more effective than NFB on SA in students with SLD.

Gender Differences in Objective and Subjective Measures of ADHD Among Clinic-Referred Children.

Attention deficit hyperactivity disorder (ADHD), one of the most prevalent childhood disorders today, is generally more likely to be diagnosed and treated in boys than in girls. However, gender differences in ADHD are currently poorly understood, partly because previous research included only a limited proportion of girls and relied mainly on subjective measures of ADHD, which are highly vulnerable to reporter’s bias. To further examine gender differences in ADHD and to address some of the shortcomings of previous studies, this study examined gender differences in subjective and objective measures of ADHD among clinic-referred children with ADHD. Participants were 204 children aged 6–17 years-old with ADHD (129 boys, 75 girls). A retrospective analysis was conducted using records of a clinical database. Obtained data included parent and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist (CBCL), Teacher’s Report Form (TRF), and child’s continuous performance test (CPT) scores. Results showed that according to parents’ and teachers’ reports of ADHD-related symptoms (Conners ADHD rating scales), girls had more inattention problems than boys, but no differences were identified in the level of hyperactivity and impulsivity symptoms. CPT data, however, revealed higher impulsivity among boys. We did not find gender differences in the level of distractibility during CPT performance. Specifically, the effects of distractors type (visual environmental stimuli, auditory stimuli, or a combination of them) and distractors load (one or two distracting stimuli at a time) on CPT performance did not differ between boys and girls with ADHD. These findings suggest that gender effects on ADHD symptoms may differ between subjective and objective measures. Understanding gender differences in ADHD may lead to improved identification of girls with the disorder, helping to reduce the gender gap in diagnosis and treatment.

Investigation of the effects of transcranial direct current stimulation and neurofeedback by continuous performance test

Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique based on weak direct current stimulation through the scalp. Neurofeedback (NFB) is a learning strategy that may help alter to brain wave parameters, by monitoring electroencephalography (EEG) feedback via special programs. We aimed to investigate the supportive effects of tDCS in addition to NFB training. 16 healthy volunteers were divided equally into two groups. One of the groups was trained by NFB with the sensorimotor rhythm (SMR) protocol; 2 days per week, 10 sessions of 30 min, the other group received 10 min of tDCS before each NFB sessions. Continuous Performance Test (CPT) was used to measure, response time and suppression and to determine selective attention condition. Also, Beck Depression and Anxiety Inventories were used to exclude people with depression and anxiety. Depression scores of NFB + tDCS group were decreased significantly. CPT scores were better at last sessions for both groups compared to the first sessions. Sessions were analyzed by comparing 1st, 2nd, 5th and 10th sessions. While the NFB + tDCS group had statistically significant changes at theta/beta ratios with SMR and alpha band amplitudes, NFB group statistics had changed at theta/SMR ratios. NFB training shows its effects at the end of 10 sessions. Despite an increase in the latencies of correct and commission responses on the task of CPT, additional use of tDCS improves cognitive performance. Also, tDCS has a supportive effect on the healthy participants who have mild anxiety and depression; also inhibition deficits of subjects were clear.

The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors

ObjectiveWe investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. MethodsFrom patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). ResultsAt baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. ConclusionQuality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

Effect of Aerobic Exercise on Cognitive Function and Symptoms in Patients with Depression

In the present study, an effort was made to explore the effect of aerobic exercise on cognitive function and symptoms in patients with depression. One hundred and twenty-five cases of patients with cognitive function were divided into experimental group (n = 63) and control group (n = 62). In the experimental group, aerobic exercise was carried out combined with coexisting drug therapy, while in the control group, patients received drug therapy only. All patients received the Hamilton Depression Scale (HAMD) assessing and the neuropsychological testing three times (0, 4th and 8th week). The neuropsychological testing included the following tests: trail making test (TMT), continuous performance test (CPT), digit span test, visual reproduction test and verbal fluency test (VFT). The differences in cognitive function and HAMD score between the two groups were compared. At 0 week, the cognitive function and HAMD score were not significantly different between the two groups (P > 0.05). After 4 weeks of aerobic exercise training, the VF, TMT-B and HAMD score were improved in the experimental group than in the control group (P < 0.05). After 8 weeks, the VFT, CPT, TMT and HAMD score were significantly improved in the experimental group than in the control group (P < 0.01). Aerobic exercise might could improve the cognitive function and symptoms in patients with depression.

Do Neuropsychological Deficits Predict Anger Dysregulation in Adults with ADHD?

Objective: To examine the relationship between anger and neuropsychological functioning in adults with ADHD.Method: Seventy adults with ADHD were assessed. Correlational and hierarchical multiple regression analyses were performed using neurocognitive tasks and subscales of the State Trait Anger Expression Inventory (STAXI)-trait anger, anger out, anger control, while controlling for anxiety and depression (HADS), and full-scale IQ (WASI). Selective, divided, and shifting attention were assessed using the Test of Everyday Attention (TEA) subscales. Sustained attention was measured using Continuous Performance Test (CPT) scores. Response inhibition was measured using scores from the CPT and Matching Familiar Figures test (MFFT).Results: Trait anger and anger out were both found to have a significant relationship to shifting attention (TEA - visual elevator task) and anxiety. Anger control was found to have a significant relationship to response inhibition (MFFT).Conclusion: Anger was significantly related to two measures of neuropsychological functioning, and anxiety. Shifting attention was more significantly associated with trait anger and anger out than response inhibition, which was significantly related to anger control. These findings have the potential to inform targeted interventions in forensic psychiatry and may have implications regarding which model of ADHD best accounts for anger dysregulation.

Comparing Attention and Cognitive Function in School Children across Noise Conditions: A Quasi-Experimental Study.

Objective The effect of acute noise on cognitive function has long been a topic of study, yet these effects remain a serious problem for learning performance in school children. Methods From November 15, 2010 to December 8, 2010, we enrolled 268 students from three elementary schools (135 boys and 133 girls, 10–12 years old) in Ulsan, Korea. The study subjects were divided into two groups according to their test conditions (background versus additional noise), and tests were conducted using psychological examination tools. Chi-square tests and general linear models were used to assess the differences of impacts on cognition between the two groups. Results After adjusting for socio-demographic covariates, the noise significantly affected the results of full-scale IQ, verbal IQ, Continuous Performance Test scores, and Children’s Color Trails Test and Stroop test scores. The groups at high risk of learning difficulties were more affected by noise than low-risk groups. Conclusion These findings suggest that noise is hazardous to the attention and performance of elementary school students, particularly for groups at greater risk for poor academic achievement. Additional studies are needed to identify subject-specific levels of noise that can affect attention and cognitive function.

Effects of Interaction Between DRD4 Methylation and Prenatal Maternal Stress on Methylphenidate-Induced Changes in Continuous Performance Test Performance in Youth with Attention-Deficit/Hyperactivity Disorder.

Environmental factors may interact with genetic factors via the epigenetic process, and this interaction can contribute to inter-individual variability in the treatment response. The purpose of this study was to investigate the interaction effects between dopamine receptor D4 (DRD4) methylation and prenatal maternal stress on the methylphenidate (MPH) response of youth with attention-deficit/hyperactivity disorder (ADHD). This study was an 8-week open-label trial of MPH that included 74 ADHD youth. We investigated the associations between MPH treatment response, which was defined as a score ≤2 on the Clinical Global Impressions-Improvement (CGI-I) scale, and the methylation of 28 cytosine-guanine dinucleotide (CpG) sites of DRD4. Additionally, the interaction effects between DRD4 methylation and prenatal maternal stress on changes in Continuous Performance Test (CPT) scores after MPH treatment were investigated. Although there were no significant sites that showed significant association with treatment response, there was a significant interaction effect of the methylation of CpG7 and prenatal maternal stress on changes in omission errors of the CPT following treatment (p = 0.0001). The present findings indicate that the interaction between methylation of CpG7 of DRD4 and prenatal maternal stress may be predictive of the treatment response to MPH in youth with ADHD.

F160. Investigation of the effects of transcranial direct current stimulation and neurofeedback by continuous performance test and beck inventories

Transcranial direct current stimulation (tDCS) method is a noninvasive neuromodulation technique based on weak direct current stimulation through the scalp. Neurofeedback (NFB) is a learning strategy which may help to alter brain wave parameters of a person by giving electroencephalography (EEG) feedback via special developed computer programs. Based on the aforementioned evidence, the study was designed to examine primarily the possible fascinating and supportive effects of tDCS application in addition to NFB training on healthy volunteers. Secondly, we aimed to examine brain wave parameters of by giving EEG feedback alteration by Continuous Performance Test (CPT), Beck Inventories (BI) used in order to measure; the selective attention, response time and suppression. Sixteen healthy volunteers were divided into two groups consisting of eight subjects. One of the groups were trained by sensorimotor rhythm (SMR) NFB training; 2 days per week, 10 sessions of 30 min, other group received 10 min tDCS before each NFB training session. CPT, BI were used in order to measure the selective attention, response time and suppression. Obtained EEG band values and rates were evaluated offline. According to statistical analyses, average of depression scores of NFB + tDCS group (7.000 ± 4.07) was decreased compared to before (9,625 ± 5.60) NFB + tDCS practice, it was significantly decreased when compared with statistical analyze of t-test (t (7) = 2628, p < .05). After trainings, the results of CPT were compared with repeated measure ANOVA.Sessions were analyzed by comparing 1st, 2nd, 5th and 10th practice results. Although there was no significant difference of right answers of the group of NFB (F (4,28) = 2215, p = .093), NFB + tDCS were significantly increased (F (4,28) = 6557, p = .001). Each groups CPT score were compared by repeated measures of ANOVA, statistically significance was found between the correct response latencies of the NFB group (F (4,28) = 3282, p = .025) and NFB + tDCS group (F(4,28) = 3143, p = .030). When the frequency bands were compared between the NFB training group with post hoc Bonferroni pairwise comparisons showed that difference was significant between 1st practice (1.515 ± .39) and at the 10th application (1.996 ± .42 (p = .002). When the inter-application of frequency bands at the group of NFB + tDCS statistically significant between the first 1th stimulation (10.165 ± 1.34) and 10th stimulation (14.128 ± 1.72)(p = .012), The difference on theta/beta band is significant at 2th practice (2.074 ± .098) to 10th practice (1.824 ± .084) (.013). While NFB + tDCS had significance at theta/beta ratios and alpha band amplitudes, NFB group had significance at theta/SMR ratios. Results suggest that NFB training shows its effects at the end of 10 sessions, and additional use of tDCS did not accelerate improvement as expected. However, its therapeutic effect on anxiety and depression scores and inhibition deficits of subjects were clear.

The effects of maternal and children phthalate exposure on the neurocognitive function of 6-year-old children

The primary purpose of this study was to investigate the effects of phthalate exposure on the intelligence and attentional performance of 6-year old children when adjusting each other as covariates. We also investigated the differential effects of phthalate exposure on the intelligence and attention according to exposure period (maternal or children). Urine concentrations of mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-n-butyl phthalate (MBP) were analyzed. Multivariable linear regression models were used to investigate the relationship between exposure to various phthalates with IQ scores and continuous performance test (CPT) variables. There were robust associations between child MEHHP and MEOHP levels with full scale IQ (FSIQ) even after adjusting for demographic variables and CPT scores (MEHHP −9.27, 95% CI: −17.25, −1.29; MEOHP −9.83, 95% CI: −17.44, −2.21). Child MEHHP and MEHOP levels negatively affected omission errors (MEHHP −20.36, 95% CI: −34.17, −6.55; MEOHP −18.93, 95% CI: −32.58, −5.28) and the response time variability (MEHHP −21.07, 95% CI: −39.04, −3.10; MEOHP −20.41, 95% CI −38.14, −2.69) of the CPT after adjusting for demographic variables and IQ. Maternal phthalate exposure had no effects on IQ or CPT variables. These results suggest that children phthalate exposure, but not maternal exposure, has an adverse effect on IQ and attentional performance, and these associations were found to be independent of each other.

How can Continuous Performance Test help to assess inattention when mood and ADHD symptoms coexist?

Depression and attention-deficit/hyperactivity disorder (ADHD) are prevalent, and often comorbid, disorders, with varying severity levels among patients. Inattention is a symptom present in both disorders, which often makes their differential diagnosis difficult in clinical practice (depression only versus comorbidity). This study aimed to investigate the influence of depressive symptoms on attention performance using one of the most common tasks in clinical practice, the continuous performance test (CPT). Ninety-three college students (60 men, 33 women) with a mean age of 24 years old were investigated with self-reports and semi-structured interviews for ADHD; the Beck Depression Inventory (BDI) was used for depression ratings. Attention measures were derived from the CPT. There was no correlation between depression and ADHD symptoms; in addition, depression was not correlated with any of the CPT scores; ADHD symptomatology was the only predictor of changes in those CPT variables (commission and omission errors and d prime). ADHD-associated impairment on the CPT was not augmented by the presence of depressive symptoms, making neuropsychological results on this test helpful for the differential diagnosis. When attention deficits are observed in individuals with mild or moderate depression, they are most likely not attributed to depression.