Deficits In Attention-deficit/hyperactivity Disorder Research Articles

Methylphenidate does not improve interference control during a working memory task in young patients with attention-deficit hyperactivity disorder

Patients with attention-deficit/hyperactivity disorder (ADHD) show deficits in working memory (WM) which may be related to prefrontal dysfunction. Methylphenidate (MPH) can restore WM deficits in ADHD by enhancing prefrontal activity. At the same time, changes in striatal activation could cause ADHD patients to be more interference-sensitive during working memory tasks. However, it is unclear whether MPH reduces WM distractibility in ADHD. In this fMRI study, 12 ADHD patients and 12 healthy controls participated on two separate days in a delayed-match-to-sample test. During the delay interval, a distractor stimulus was presented in half of the trials. Children and adolescents with ADHD received MPH only on one of the two sessions. Behavioral data analyses revealed that MPH normalized WM in ADHD. However, MPH did not improve WM performance when a distractor was presented during the delay interval. Functional images showed that MPH enhanced prefrontal activity during the delay in ADHD patients when no distractor was present. If the delay was interrupted by a distractor, only healthy controls showed activation of the caudate. In patients with ADHD, however, in line with behavioral data, MPH did not enhance caudate activity. In healthy youth, caudate activity is involved in interference control allowing the successful maintenance of information in working memory even in the presence of distraction. Our findings suggest that interference control, linked to caudate activity, is not adequately enhanced by MPH in ADHD.

Discriminant validity of the Behavior Rating Inventory of Executive Function Parent Form for children with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, with concomitant executive function deficits often being the focus of empirical and clinical investigation. This study explored the validity of the Behavior Rating Inventory of Executive Function Parent Form (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000) for children with ADHD and a matched control sample. Fifty-eight children with ADHD (69% with comorbidity) and 58 matched controls were found to exhibit statistically (p .001) and clinically significant group differences on the BRIEF scales. Discriminant function analyses revealed that the Behavior Regulation and Metacognition Indexes accurately classified 82% of the sample (86% of controls and 79% of children with ADHD correctly identified). The Behavior Regulation Index was found to make the most significant contribution overall to the discriminant function, consistent with arguments that response inhibition is the primary deficit in ADHD. Implications and future research are discussed.

Post-error performance may shape behavioral deficits in attention-deficit/hyperactivity disorder

Event Abstract Back to Event Post-error performance may shape behavioral deficits in attention-deficit/hyperactivity disorder Juliana Yordanova1*, Björn Albrecht2, Henrik Uebel2, Tobias Banaschewski3, Aribert Rothenberger2 and Vasil Kolev1 1 Institute of Neurobiology, Bulg. Acad. Sci., Bulgaria 2 University of Göttingen, Germany 3 Central Institute of Mental Health, Germany Although the performance of children with attention-deficit/hyperactivity disorder (ADHD) is impaired in a variety of cognitive tasks, the specific capacity of strategic re-adaptation after errors as a source of behavioral deficits is not sufficiently understood. The present study used an extended and refined behavioral parameterization to assess performance monitoring and post-error adaptation in children with ADHD. Twenty eight healthy controls and 47 ADHD patients (7-16 years of age, all males, matched for age and IQ) performed a visual flanker task, where targets were congruent or incongruent with preceding flankers. Post-error adaptation was measured for response speed (post-error slowing), accuracy, and variability by using normalized individual rates of change. Markers of error detection and general performance were also analyzed. Post-correct response speed and accuracy did not differ between the groups, in contrast to post-error behaviors. While post-error slowing was not evident in any of the groups, the error rate and performance instability (reaction time variance) substantially increased after errors only in ADHD patients, not in controls. No reliable between-group differences were found for error detection and global performance. It is concluded that in healthy children, post-error adaptation preserves performance at its ongoing level. No such adaptation was evident in ADHD leading to consecutive errors and increased behavioral instability. Performance deficits in ADHD were only present after error but not after correct behaviors, which shapes the general profile of performance impairment in ADHD. The findings have practical implications for strategic designs of behavioral therapy in ADHD. Keywords: ADHD, cognitive control Conference: XI International Conference on Cognitive Neuroscience (ICON XI), Palma, Mallorca, Spain, 25 Sep - 29 Sep, 2011. Presentation Type: Poster Presentation Topic: Poster Sessions: Performance Monitoring and Cognitive Control Citation: Yordanova J, Albrecht B, Uebel H, Banaschewski T, Rothenberger A and Kolev V (2011). Post-error performance may shape behavioral deficits in attention-deficit/hyperactivity disorder. Conference Abstract: XI International Conference on Cognitive Neuroscience (ICON XI). doi: 10.3389/conf.fnhum.2011.207.00253 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 21 Nov 2011; Published Online: 28 Nov 2011. * Correspondence: Prof. Juliana Yordanova, Institute of Neurobiology, Bulg. Acad. Sci., Sofia, Bulgaria, jyord@yahoo.de Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Juliana Yordanova Björn Albrecht Henrik Uebel Tobias Banaschewski Aribert Rothenberger Vasil Kolev Google Juliana Yordanova Björn Albrecht Henrik Uebel Tobias Banaschewski Aribert Rothenberger Vasil Kolev Google Scholar Juliana Yordanova Björn Albrecht Henrik Uebel Tobias Banaschewski Aribert Rothenberger Vasil Kolev PubMed Juliana Yordanova Björn Albrecht Henrik Uebel Tobias Banaschewski Aribert Rothenberger Vasil Kolev Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway

ADHD is typically characterized as a disorder of inattention and hyperactivity/impulsivity but there is increasing evidence of deficits in motivation. Using PET we showed decreased function in the brain dopamine reward pathway in adults with ADHD, which we hypothesized could underlie the motivation deficits in this disorder. To evaluate this hypothesis we performed secondary analyses to assess the correlation between the PET measures of dopamine D2/D3 receptor and dopamine transporter availability (obtained with [11C]raclopride and [11C]cocaine, respectively) in the dopamine reward pathway (midbrain and nucleus accumbens), and a surrogate measures of trait motivation (assessed using the Achievement scale on the Multidimensional Personality Questionnaire or MPQ) in 45 ADHD participants and 41 controls. The Achievement scale was lower in ADHD participants than in controls (11±5 vs 14±3, p<0.001) and was significantly correlated with D2/D3 receptors (accumbens: r=0.39, p<0.008; midbrain: r=0.41, p<0.005) and transporters (accumbens: r=0.35, p < 0.02) in ADHD participants, but not in controls. ADHD participants also had lower values in the Constraint factor and higher values in the Negative Emotionality factor of the MPQ but did not differ in the Positive Emotionality factor - and none of these were correlated with the dopamine measures. In ADHD participants scores in the Achievement scale were also negatively correlated with symptoms of inattention (CAARS A, E and SWAN-I). These findings provide evidence that disruption of the dopamine reward pathway is associated with motivation deficits in ADHD adults, which may contribute to attention deficits and supports the use of therapeutic interventions to enhance motivation in ADHD.

Inhibitory control and psychopathology: A meta-analysis of studies using the stop signal task

The Stop Signal Task (SST) is a measure that has been used widely to assess response inhibition. We conducted a meta-analysis of studies that examined SST performance in patients with various psychiatric disorders to determine the magnitude and generality of deficient inhibition. A five-item instrument was used to assess the methodological quality of studies. We found medium deficits in stop signal reaction time (SSRT), reflecting the speed of the inhibitory process, for attention-deficit hyperactivity disorder (ADHD) (g = 0.62), obsessive compulsive disorder (OCD) (g = 0.77) and schizophrenia (SCZ) (g = 0.69). SSRT was less impaired or normal for anxiety disorder (ANX), autism, major depressive disorder (MDD), oppositional defiant disorder/conduct disorder (ODD/CD), pathological gambling, reading disability (RD), substance dependence, and Tourette syndrome. We observed a large SSRT deficit for comorbid ADHD + RD (g = 0.82). SSRT was less than moderately impaired for ADHD + ANX and ADHD + ODD/CD. Study quality did not significantly affect SSRT across ADHD studies. This confirms an inhibition deficit in ADHD, and suggests that comorbid ADHD has different effects on inhibition in patients with ANX, ODD/CD, and RD. Further studies are needed to firmly establish an inhibition deficit in OCD and SCZ.

Neuronal correlates of ADHD in adults with evidence for compensation strategies--a functional MRI study with a Go/No-Go paradigm.

Objective: Response inhibition impairment is one of the most characteristic symptoms of attention-deficit/hyperactivity disorder (ADHD). Thus functional magnetic resonance imaging (fMRI) during a Go/No-Go task seems to be an ideal tool for examining neuronal correlates of inhibitory control deficits in ADHD. Prior studies have shown frontostriatal abnormalities in children and adolescents. The aim of our study was to investigate whether adults with ADHD would still show abnormal brain activation in prefrontal brain regions during motor response inhibition tasks. Methods: fMRI was used to compare brain activation in 15 untreated adult patients with ADHD and 15 healthy reference volunteers during performance of a Go/No-Go task. Results: In contrast to various other studies with children and adolescents with ADHD, we found no significant difference in the activity of anterior cingulate cortex (ACC) or other frontostriatal structures between ADHD and healthy adults. Significantly enhanced activity was found in the parietal cortex, which is known to play an important role in building up attention. Conclusion: We hypothesize that the enhanced activity is due to the ability of adult ADHD patients to compensate their deficits for a short time, which is demonstrated in our study by equal task performance in both groups.

Working memory demands impair skill acquisition in children with ADHD.

This study examined the process of cognitive skill acquisition under differential working memory (WM) load conditions in children with the primarily inattentive (n = 21) and the combined (n = 32) subtypes of childhood attention-deficit/hyperactivity disorder (ADHD) and compared the results with those of non-ADHD controls (n = 48). Children completed 2 tasks of cognitive skill acquisition: alphabet arithmetic and finger math. The tasks differed in the amount of WM required for execution (alphabet arithmetic required more) but were otherwise matched with respect to logical structure, design, and discriminatory power. As would be predicted if the WM of the to-be-learned task affected the ability of children with ADHD to develop automaticity for a complex cognitive skill, ADHD-related impairments in the development of automaticity were seen for alphabet arithmetic but not for finger math. Results not only are relevant to ongoing debate regarding the presence of effortful versus automatic cognitive deficits in ADHD but also have implications for the development of new psychoeducational interventions for children with ADHD.

Electrophysiological evidence for abnormal preparatory states and inhibitory processing in adult ADHD

BackgroundAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that starts in childhood and frequently persists in adults. Several theories postulate deficits in ADHD that have effects across many executive functions or in more narrowly defined aspects, such as response inhibition. Electrophysiological studies on children, however, indicate that ADHD is not associated with a core deficit of response inhibition, as abnormal inhibitory processing is typically preceded or accompanied by other processing deficits. It is not yet known if this pattern of abnormal processing is evident in adult ADHD.MethodsThe objective of this paper was to investigate event-related potential indices of preparatory states and subsequent response inhibition processing in adults with ADHD. Two cued continuous performance tasks were presented to 21 adults meeting current criteria for adult ADHD and combined type ADHD in childhood, and 20 controls.ResultsThe ADHD group exhibited significantly weaker orienting attention to cues, cognitive preparation processes and inhibitory processing. In addition, we observed a strong correlation between the resources allocated to orienting to cues and the strength of the subsequent response strength control processes, suggesting that orienting deficits partly predict and determine response control deficits in ADHD.ConclusionsThese findings closely resemble those previously found in children with ADHD, which indicate that there is not a core response inhibition deficit in ADHD. These findings therefore suggest the possibility of developmental stability into adulthood of the underlying abnormal processes in ADHD.

Cross-sectional evaluation of cognitive functioning in children, adolescents and young adults with ADHD

Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, albeit with changes in clinical symptoms throughout the life span. Although effect sizes of neuropsychological deficits in ADHD are well established, developmental approaches have rarely been explored and little is yet known about age-dependent changes in cognitive dysfunction from childhood to adulthood. In this cross-sectional study, 20 male children (8-12 years), 20 adolescents (13-16 years), and 20 adults (18-40 years) with ADHD and a matched control group were investigated using six experimental paradigms tapping into different domains of cognitive dysfunction. Subjects with ADHD were more delay-aversive and showed deficits in time discrimination and time reproduction, but they were not impaired in working memory, interference control or time production. Independent of age, the most robust group differences were observed with respect to delay aversion and time reproduction, pointing to persistent dysfunction in the mesolimbic reward circuitry and in the frontal-striatal-cerebellar timing system in subjects with ADHD. Across all tasks, effect sizes were lowest for adolescents with ADHD compared to age-matched controls. Developmental dissociations were found only for simple stimuli comparison, which was particularly impaired in ADHD children. Thus, in line with current multiple-pathway approaches to ADHD, our data suggest that deficits in different cognitive domains are persistent across the lifespan, albeit less pronounced in adolescents with ADHD.

Mapping Attention-Deficit/Hyperactivity Disorder from Childhood to Adolescence—No Neurophysiologic Evidence for a Developmental Lag of Attention but Some for Inhibition

The role of a developmental lag for deficits of higher brain functions in attention-deficit/hyperactivity disorder (ADHD) has not yet been tested in longitudinal studies. We examined the development of neurophysiological markers of attention (Cue P300; contingent negative variation [CNV]) and inhibition (NoGo P300) in ADHD and control groups from childhood to adolescence for support of the developmental lag hypothesis of ADHD. ADHD (n = 28/3 girls) and control (n = 22/5 girls) subjects were assessed at baseline (Time 1; ADHD age 10.8 +/- 1.8 years, controls 10.4 +/- 1.1 years) and at two follow-up examinations (Time 2 after 1.2 years, Time 3 after 2.5 years). Event-related potential maps were recorded during a cued Continuous Performance Test (CPT) at all assessments and analyzed using scalp and source (sLORETA) measures. CPT performance showed common effects of ADHD and younger age, consistent with (but not specific to) developmental lag. The NoGo P300 developed earlier and became stronger in control subjects than in the ADHD group, again consistent with an initial developmental lag. In contrast, the attenuation of the Cue P300 and the CNV with ADHD at all assessments was opposite to the enhancement with younger age and thus inconsistent with developmental lag. The sLORETA source localization also differed between ADHD and developmental effects. These results provide strong evidence for multiple and persistent neural processing deficits in ADHD. They do not support the developmental lag hypothesis for attentional dysfunction in ADHD despite partial evidence that developmental lag contributes to inhibitory brain dysfunction during early adolescence.

Dopaminergic Haplotype as a Predictor of Spatial Inattention in Children With Attention-Deficit/Hyperactivity Disorder

A distinct pattern of selective attention deficits in attention-deficit/hyperactivity disorder (ADHD) has been difficult to identify. Heterogeneity may reflect differences in underlying genetics. To document an objective deficit of selective attention in a large sample of children with and without ADHD using spatial orienting paradigms. By stratifying samples according to the gene dosage of a risk haplotype of the dopamine transporter gene (DAT1), we could determine whether genetic factors predict spatial inattention in ADHD. A case-control design was used. Children with ADHD were recruited from clinics or support groups in Ireland. Typically developing children were recruited from schools in and around Dublin, Ireland. One hundred fifteen children were recruited (ADHD = 50, control = 65). Groups were matched for age but differed in estimated intelligence. Two versions of a visual spatial orienting task in which attention was directed by valid, neutral, or invalid cues to target locations. Sudden-onset peripheral cues (exogenous) and centrally presented predictive cues (endogenous) were used. To isolate an attention deficit in ADHD, groups were first compared using analysis of variance on the spatial orienting tasks. Multiple regression was used to assess the main effect of DAT1 haplotype status (heterozygous vs homozygous) and the interaction of diagnosis and genotype on those variables that discriminated children with and without ADHD. Children with ADHD displayed deficits in reorienting attention from invalidly cued spatial locations, particularly for targets in the left visual field. DAT1 haplotype status predicted spatial reorienting deficits for left visual field targets (P = .007) but there was also a significant interaction of diagnosis and genotype (P = .02), which revealed the greatest impairment in children with ADHD homozygous for the DAT1 haplotype. Heterogeneity in selective attention in ADHD can be explained by a replicated genetic risk factor for ADHD, the 10/3 DAT1 haplotype.

Effects of oral methylphenidate on [18F]fallypride binding in healthy volunteers and adults with attention-deficit hyperactivity disorder (ADHD)

Methylphenidate (MPH) improves performance on tests of prefrontal cognitive functioning in healthy volunteers and adults with ADHD. This study assessed increases of dopamine following a single dose of oral MPH, dopamine D2/D3 receptor availability in adult ADHD patients compared to healthy controls and relationships between dopamine activity, ADHD symptom severity and prefrontal cognitive functioning. 16 adults with ADHD and 16 matched controls were scanned with positron emission tomography (PET) and [18F]fallypride, a high-affinity D2/D3 receptor radiotracer, after a single oral dose of MPH (0.5mg/kg) or placebo in counter-blanaced order. [18F]fallypride binding potentials (BPs) in regions manually defined on magnetic resonance images were calculated using a reference tissue model. Selected CANTAB tasks were administered on both sessions. MPH displaced [18F]fallypride in all striatal sub-regions, globus pallidus and substantia nigra (SN). This effect was similar in patients and controls. Baseline BP in the pre-commissural caudate correlated negatively with attention deficit symptoms and total errors in SWM. BP changes in the SN following MPH correlated positively with baseline performance on RVIP and SWM, and with improved SWM performance following MPH. (All results p&lt;0.01). Our results support a continuum model of dysregulations of the dopamine system and cognitive deficits in ADHD and a specific role of the SN in mediating cognitive enhancing effects of MPH.

Choline transporter gene variation is associated with attention-deficit hyperactivity disorder

The neurotransmitter acetylcholine (ACh) plays a critical role in brain circuits mediating motor control, attention, learning and memory. Cholinergic dysfunction is associated with multiple brain disorders including Alzheimer’s Disease, addiction, schizophrenia and Attention-Deficit Hyperactivity Disorder (ADHD). The presynaptic choline transporter (CHT, SLC5A7) is the major, rate-limiting determinant of ACh production in the brain and periphery and is consequently upregulated during tasks that require sustained attention. Given the contribution of central cholinergic circuits to the control of movement and attention, we hypothesized that functional CHT gene variants might impact risk for ADHD. We performed a case-control study, followed by family-based association tests on a separate cohort, of two purportedly functional CHT polymorphisms (coding variant Ile89Val (rs1013940) and a genomic SNP 3’ of the CHT gene (rs333229), affording both a replication sample and opportunities to reduce potential population stratification biases. Initial genotyping of pediatric ADHD subjects for two purportedly functional CHT alleles revealed a 2–3 fold elevation of the Val89 allele (n = 100; P = 0.02) relative to healthy controls, as well as a significant decrease of the 3’SNP minor allele in Caucasian male subjects (n = 60; P = 0.004). In family based association tests, we found significant overtransmission of the Val89 variant to children with a Combined subtype diagnosis (OR = 3.16; P = 0.01), with an increased Odds Ratio for a haplotype comprising both minor alleles. These studies show evidence of cholinergic deficits in ADHD, particularly for subjects with the Combined subtype, and, if replicated, may encourage further consideration of cholinergic agonist therapy in the disorder.Electronic supplementary materialThe online version of this article (doi:10.1007/s11689-009-9033-8) contains supplementary material, which is available to authorized users.

Priming sentence production in adolescents and adults with attention-deficit/hyper-activity disorder.

Theoretical accounts of attention-deficit/hyperactivity disorder (ADHD) posit a prominent role for problems in response inhibition (Nigg 2006). A key avenue for impulsivity in children with ADHD is inappropriate language expression. In this study, we sought to determine whether poor inhibitory control affects language production in adolescents and adults with ADHD. One hundred and ninety-five participants (13-35 years old; 65% male) were presented with two pictures and a verb, and their task was to form a sentence. If deficits in response inhibition affect language production, then participants with ADHD should be more likely than non-ADHD controls to begin speaking before having formulated a plan that will allow a grammatical continuation. The results showed that the ADHD-combined subtype, in particular, was more likely to produce an ungrammatical sequence. Effects were not moderated by age or gender. These data suggest that response suppression deficits in ADHD adversely affect the basic processes of sentence formation.

Oculomotor Performance Identifies Underlying Cognitive Deficits in Attention-Deficit/Hyperactivity Disorder

ObjectiveTo evaluate cognitive control in children with attention-deficit/hyperactivity disorder (ADHD) using oculomotor tests of executive function. MethodCross-sectional study of children aged 8 to 13 years with ADHD (n = 26) and controls (n = 33) used oculomotor tasks to assess sensorimotor function (visually guided saccades), resistance to peripheral distractors (fixation), response inhibition (antisaccades), and spatial working memory (memory-guided saccades). ResultsAll children had intact sensorimotor function and working memory. Children with ADHD showed susceptibility to peripheral distractors and deficits in response inhibition. Increased interstimulus (IS) fixation periods on the antisaccade task were associated with improved performance and decreased reaction times on correct trials for controls but not for children with ADHD. Attention-deficit/hyperactivity disorder-combined and inattentive subtypes showed different patterns of reaction time as a function of IS periods. ConclusionsResponse inhibition deficits in ADHD on oculomotor tasks are consistent with other studies. The failure of children with ADHD to use IS time to decrease response inhibition errors and reaction time suggests that IS time is not used to prepare a response. These findings highlight the importance of considering cognitive processing components affected by ADHD in addition to core behavioral symptoms, particularly in designing new treatment strategies.

Can Executive Functions Explain the Relationship Between Attention Deficit Hyperactivity Disorder and Social Adjustment?

This study examined the ability of executive functions (EF) to account for the relationship between Attention Deficit Hyperactivity Disorder (ADHD) status and social adjustment as indexed by parent and teacher report and by performance on a standardized observational "chat room" task. Children with the Combined subtype (ADHD-C; n = 23), the Primarily Inattentive Subtype (ADHD-I; n = 33), and non-ADHD controls (n = 36) participated. EF did not mediate the relationship between ADHD status and parent or teacher report of social adjustment. EF accounted for about 40-50% of the variance between ADHD status and the ability of children to detect subtle verbal cues as well as memory for the conversation in the chat room task, but did not mediate the relationship between ADHD and the number of prosocial, hostile, or on-topic statements that were made. Results are consistent with other recent reports, and suggest that the role of EF deficits in the production of social skill deficits in ADHD may not be as prominent as is typically assumed. The implications for the development of intervention programs designed to target core cognitive etiologic factors are discussed.

Contraction of time in attention-deficit hyperactivity disorder.

Attention-deficit hyperactivity disorder (ADHD) has been associated with anomalies in dopamine systems. Recent advances in the understanding of the core cognitive deficits in ADHD suggest that dopamine dysfunction might be expressed through shortened time scales in reward-based learning. Here this perspective is extended by the conjecture that temporal span in working memory systems might generally be shortened. As a test of this conjecture the authors focus on the implicit memory system involved in rhythmic movement, assessing the minimum tempo at which rhythmic feeling can be sustained in adults with diagnosed ADHD and in a control group of normal adults. The authors found that people with ADHD do in fact have a rhythm cut-off that is faster in tempo than those without ADHD. This finding is consistent with the idea that impaired dopamine dynamics have systemic consequences for cognitive function, essentially recalibrating the clock that sets the time scale for the subjective experience of temporal events.

Attention deficit hyperactivity disorder (ADHD): gender- and age-related differences in neurocognition

Despite the growing recognition that the clinical symptom characteristics associated with attention deficit hyperactivity disorder (ADHD) persist into adulthood in a high proportion of subjects, little is known about the persistence of neurocognitive deficits in ADHD. The objective was twofold: (1) to conduct a meta-analysis of neuropsychological studies to characterize attentional performance in subjects with adult ADHD by examining differences in ADHD versus normal control subjects; and (2) to investigate whether these differences vary as a function of age and gender. Twenty-five neuropsychological studies comparing subjects with adult ADHD and healthy controls were evaluated. Statistical effect size was determined to characterize the difference between ADHD and control subjects. Meta-regression analysis was applied to investigate whether the difference between ADHD and control subjects varied as a function of age and gender across studies. Tests measuring focused and sustained attention yielded an effect size with medium to large magnitude whereas tests of simple attention resulted in a small to medium effect size in terms of poorer attention functioning of ADHD subjects versus controls. On some of the measures (e.g. Stroop interference), a lower level of attention functioning in the ADHD group versus the controls was associated with male gender. Adult ADHD subjects display significantly poorer functioning versus healthy controls on complex but not on simple tasks of attention, and the degree of impairment varies with gender, with males displaying a higher level of impairment.

Basic number processing deficits in ADHD: a broad examination of elementary and complex number processing skills in 9‐ to 12‐year‐old children with ADHD‐C

ADHD (attention-deficit hyperactivity disorder) and academic difficulties are frequently associated, but to date this link is poorly understood. In order to explore which components of number processing and calculation skills may be disturbed in children with ADHD we presented a series of respective tasks to 9- to 12-year-old children with ADHD-combined type and matched children without ADHD (of any type) without concomitant dyscalculia and/or dyslexia. Overall, group differences were not significant regarding overlearned and explicitly trained simple and complex calculation skills. More basic number processing skills are - for instance - the ability to compare one-digit numbers according to their magnitude (so-called magnitude comparison), to count or to transcode numbers, i.e. to write down an Arabic number '21' in verbal dictation. Significant differences favouring control children in basic number processing skills were obtained in a number comparison task and in a dot enumeration task. Importantly, our results cannot be explained by group differences regarding specific working memory and executive function components. Thus, number processing skills and in particular the processing of numerical magnitude should be investigated in children diagnosed with ADHD even when no comorbid learning disabilities are reported.

ADHD and Behavioral Inhibition: A Re-examination of the Stop-signal Task

The current study investigates two recently identified threats to the construct validity of behavioral inhibition as a core deficit of attention-deficit/hyperactivity disorder (ADHD) based on the stop-signal task: calculation of mean reaction time from go-trials presented adjacent to intermittent stop-trials, and non-reporting of the stop-signal delay metric. Children with ADHD (n = 12) and typically developing (TD) children (n = 11) were administered the standard stop-signal task and three variant stop-signal conditions. These included a no-tone condition administered without the presentation of an auditory tone; an ignore-tone condition that presented a neutral (i.e., not associated with stopping) auditory tone; and a second ignore-tone condition that presented a neutral auditory tone after the tone had been previously paired with stopping. Children with ADHD exhibited significantly slower and more variable reaction times to go-stimuli, and slower stop-signal reaction times relative to TD controls. Stop-signal delay was not significantly different between groups, and both groups' go-trial reaction times slowed following meaningful tones. Collectively, these findings corroborate recent meta-analyses and indicate that previous findings of stop-signal performance deficits in ADHD reflect slower and more variable responding to visually presented stimuli and concurrent processing of a second stimulus, rather than deficits of motor behavioral inhibition.