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  1. Improvement with Duloxetine in an Adult ADHD Patient

    ERIC Educational Resources Information Center

    Tourjman, Smadar Valerie; Bilodeau, Mathieu

    2009-01-01

    Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common and disabling disorder among adults and is treated with stimulant and non stimulant medication. Objective: To report the case of a patient with ADHD showing good clinical response to duloxetine, a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). Case…

  2. ADHD

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD KidsHealth > For Teens > ADHD Print A A A ... doesn't involve hyperactivity. Symptoms and Signs of ADHD Because ADHD covers lots of different things — attention, ...

  3. Medications Do Not Necessarily Normalize Cognition in ADHD Patients

    ERIC Educational Resources Information Center

    Gualtieri, C. Thomas; Johnson, Lynda G.

    2008-01-01

    Objective: Although ADHD medications are effective for the behavioral components of the disorder, little information exists concerning their effects on cognition, especially in community samples. Method: A cross-sectional study of ADHD patients treated with three different ADHD drugs was conducted. Patients' performance on a computerized…

  4. ADHD

    MedlinePlus

    ADHD FACT SHEET What is ADHD? Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It is sometimes referred to as Attention Deficit Disorder (ADD). It ...

  5. The complexity of ADHD: diagnosis and treatment of the adult patient with comorbidities.

    PubMed

    Newcorn, Jeffrey H; Weiss, Margaret; Stein, Mark A

    2007-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is an impairing but usually treatable condition. Popular culture propagates the myth that ADHD recedes with age; this is not the case. Although it is common, <20% of adults with ADHD are diagnosed or treated. Adults with ADHD show significant comorbidities with depressive disorders, anxiety disorders, substance use, oppositional defiant disorder, personality disorders, sleep problems, and learning disabilities. However, symptoms that result from ADHD, such as mood symptoms or lability, are often mistaken for comorbid disorders. Comorbidity with ADHD impacts treatment compliance, treatment response, and patient insight. Insufficient data on the interaction between ADHD and comorbidities impedes proper diagnosis and treatment. Better clinical tools for assessing these conditions are needed. Food and Drug Administration-approved pharmacologic treatments for adult ADHD include stimulants, dexmethylphenidate, and the nonstimulant atomoxetine. Effect sizes of approved medicines at approved doses are half those seen in children. Adults may also need longer duration of medication effects than children. Short-acting stimulants are likely to result in poorer adherence and have a higher risk for diversion or abuse. Risk of abuse is a major concern; stimulant treatments are controlled substances, and children with ADHD show increased risk of substance abuse. Psychosocial interventions may be beneficial in treating both ADHD and comorbidities.In this expert roundtable supplement, Margaret Weiss, MD, PhD, presents a comprehensive overview of complications surrounding differential diagnosis in adults with ADHD. Next, Mark A. Stein, PhD, reviews evaluation, comorbidity, and development of a treatment plan in this population. Finally, Jeffrey H. Newcorn, MD, provides a discussion on the pharmacologic options available for adults with ADHD, considering dosages specific to adults and common comorbidities. PMID:17667893

  6. Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS)

    PubMed Central

    Breitling, Carolin; Zaehle, Tino; Dannhauer, Moritz; Bonath, Björn; Tegelbeckers, Jana; Flechtner, Hans-Henning; Krauel, Kerstin

    2016-01-01

    The use of transcranial direct current stimulation (tDCS) in patients with attention deficit hyperactivity disorder (ADHD) has been suggested as a promising alternative to psychopharmacological treatment approaches due to its local and network effects on brain activation. In the current study, we investigated the impact of tDCS over the right inferior frontal gyrus (rIFG) on interference control in 21 male adolescents with ADHD and 21 age matched healthy controls aged 13–17 years, who underwent three separate sessions of tDCS (anodal, cathodal, and sham) while completing a Flanker task. Even though anodal stimulation appeared to diminish commission errors in the ADHD group, the overall analysis revealed no significant effect of tDCS. Since participants showed a considerable learning effect from the first to the second session, performance in the first session was separately analyzed. ADHD patients receiving sham stimulation in the first session showed impaired interference control compared to healthy control participants whereas ADHD patients who were exposed to anodal stimulation, showed comparable performance levels (commission errors, reaction time variability) to the control group. These results suggest that anodal tDCS of the right inferior frontal gyrus could improve interference control in patients with ADHD. PMID:27147964

  7. Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS).

    PubMed

    Breitling, Carolin; Zaehle, Tino; Dannhauer, Moritz; Bonath, Björn; Tegelbeckers, Jana; Flechtner, Hans-Henning; Krauel, Kerstin

    2016-01-01

    The use of transcranial direct current stimulation (tDCS) in patients with attention deficit hyperactivity disorder (ADHD) has been suggested as a promising alternative to psychopharmacological treatment approaches due to its local and network effects on brain activation. In the current study, we investigated the impact of tDCS over the right inferior frontal gyrus (rIFG) on interference control in 21 male adolescents with ADHD and 21 age matched healthy controls aged 13-17 years, who underwent three separate sessions of tDCS (anodal, cathodal, and sham) while completing a Flanker task. Even though anodal stimulation appeared to diminish commission errors in the ADHD group, the overall analysis revealed no significant effect of tDCS. Since participants showed a considerable learning effect from the first to the second session, performance in the first session was separately analyzed. ADHD patients receiving sham stimulation in the first session showed impaired interference control compared to healthy control participants whereas ADHD patients who were exposed to anodal stimulation, showed comparable performance levels (commission errors, reaction time variability) to the control group. These results suggest that anodal tDCS of the right inferior frontal gyrus could improve interference control in patients with ADHD. PMID:27147964

  8. Efficient Allocation of Attentional Resources in Patients with ADHD: Maturational Changes from Age 10 to 29

    ERIC Educational Resources Information Center

    Gualtieri, C. Thomas; Johnson, Lynda G.

    2006-01-01

    Background: It has been proposed that ADHD is an executive control disorder. Little is known however about the maturation of executive control in ADHD. Method: A cross-sectional study of ADHD patients compared to normal controls tested on a computerized neurocognitive test battery. Participants: 175 patients with ADHD, age 10 to 29, compared to…

  9. Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders (SUD). The combination of ADHD and SUD is associated with a negative prognosis of both SUD and ADHD. Pharmacological treatments of comorbid ADHD in adult patients with SUD have not been very successful. Recent studies show positive effects of cognitive behavioral therapy (CBT) in ADHD patients without SUD, but CBT has not been studied in ADHD patients with comorbid SUD. Methods/design This paper presents the protocol of a randomized controlled trial to test the efficacy of an integrated CBT protocol aimed at reducing SUD as well as ADHD symptoms in SUD patients with a comorbid diagnosis of ADHD. The experimental group receives 15 CBT sessions directed at symptom reduction of SUD as well as ADHD. The control group receives treatment as usual, i.e. 10 CBT sessions directed at symptom reduction of SUD only. The primary outcome is the level of self-reported ADHD symptoms. Secondary outcomes include measures of substance use, depression and anxiety, quality of life, health care consumption and neuropsychological functions. Discussion This is the first randomized controlled trial to test the efficacy of an integrated CBT protocol for adult SUD patients with a comorbid diagnosis of ADHD. The rationale for the trial, the design, and the strengths and limitations of the study are discussed. Trial registration This trial is registered in http://www.clinicaltrials.gov as NCT01431235. PMID:23663651

  10. Patient education. Behaviour management strategies in ADHD.

    PubMed

    Mitchell, G; Shaw, K

    2000-12-01

    Attention deficit hyperactivity disorder or ADHD is a condition characterised by inattention, hyperactivity and impulsiveness. It is often managed by a combination of medication and behaviour modification techniques. This sheet outlines some useful strategies parents and teachers may undertake. PMID:11140223

  11. Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment--A Cross-Sectional Study of 414 Clinically Diagnosed Adult ADHD Patients

    ERIC Educational Resources Information Center

    Halmoy, Anne; Fasmer, Ole Bernt; Gillberg, Christopher; Haavik, Jan

    2009-01-01

    Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24%…

  12. Pharmacological interventions for ADHD: how do adolescent and adult patient beliefs and attitudes impact treatment adherence?

    PubMed Central

    McCarthy, Suzanne

    2014-01-01

    Adherence to medication can be problematic for patients, especially so for patients with attention deficit hyperactivity disorder (ADHD). Effective medications are available for the treatment of ADHD; however, nonadherence rates for ADHD medication range from 13.2%–64%. The reasons for nonadherence can be complex. This review aims to look at how the beliefs and attitudes of adolescents and adults impact ADHD treatment adherence. PMID:25284990

  13. Case Report: "ADHD Trainer": the mobile application that enhances cognitive skills in ADHD patients.

    PubMed

    Ruiz-Manrique, Gonzalo; Tajima-Pozo, Kazuhiro; Montañes-Rada, Francisco

    2014-01-01

    We report the case of a 10 year old patient diagnosed with attention deficit hyperactivity disorder (ADHD) and comorbid video game addiction, who was treated with medication combined with a novel cognitive training method based on video games called TCT method. A great risk of developing video game or internet addiction has been reported in children, especially in children with ADHD. Despite this risk, we hypothesize that the good use of these new technologies might be useful to develop new methods of cognitive training. The cognitive areas in which a greater improvement was observed through the use of video games were visuospatial working memory and fine motor skills. TCT method is a cognitive training method that enhances cognitive skills such as attention, working memory, processing speed, calculation ability, reasoning, and visuomotor coordination. The purpose of reviewing this case is to highlight that regular cognitive computerized training in ADHD patients may improve some of their cognitive symptoms and might be helpful for treating video game addiction. PMID:26962432

  14. Case Report: "ADHD Trainer": the mobile application that enhances cognitive skills in ADHD patients

    PubMed Central

    Ruiz-Manrique, Gonzalo; Tajima-Pozo, Kazuhiro; Montañes-Rada, Francisco

    2015-01-01

    We report the case of a 10 year old patient diagnosed with attention deficit hyperactivity disorder (ADHD) and comorbid video game addiction, who was treated with medication combined with a novel cognitive training method based on video games called TCT method. A great risk of developing video game or internet addiction has been reported in children, especially in children with ADHD. Despite this risk, we hypothesize that the good use of these new technologies might be useful to develop new methods of cognitive training. The cognitive areas in which a greater improvement was observed through the use of video games were visuospatial working memory and fine motor skills. TCT method is a cognitive training method that enhances cognitive skills such as attention, working memory, processing speed, calculation ability, reasoning, and visuomotor coordination. The purpose of reviewing this case is to highlight that regular cognitive computerized training in ADHD patients may improve some of their cognitive symptoms and might be helpful for treating video game addiction. PMID:26962432

  15. Electrophysiological Correlates of Semantic Processing during Encoding of Neutral and Emotional Pictures in Patients with ADHD

    ERIC Educational Resources Information Center

    Krauel, Kerstin; Duzel, Emrah; Hinrichs, Hermann; Lenz, Daniel; Herrmann, Christoph S.; Santel, Stephanie; Rellum, Thomas; Baving, Lioba

    2009-01-01

    The current study investigated the relevance of semantic processing and stimulus salience for memory performance in young ADHD patients and healthy control participants. 18 male ADHD patients and 15 healthy control children and adolescents participated in an ERP study during a visual memory paradigm with two different encoding tasks requiring…

  16. Addition of methylphenidate to intensive dialectical behaviour therapy for patients suffering from comorbid borderline personality disorder and ADHD: a naturalistic study.

    PubMed

    Prada, Paco; Nicastro, Rosetta; Zimmermann, Julien; Hasler, Roland; Aubry, Jean-Michel; Perroud, Nader

    2015-09-01

    Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with borderline personality disorder (BPD). However, few studies have examined how comorbid BPD-ADHD patients, treated or not with methylphenidate (MPH), respond to psychotherapy compared to non-comorbid BPD patients. In this perspective, we used a naturalistic study to compare, during a month-long intensive dialectical behaviour therapy (DBT), the clinical course of BPD patients and comorbid BPD-ADHD patients who were treated or untreated with MPH. Out of the 158 BPD patients recruited, 59 had adult ADHD as a comorbidity; among these, 29 underwent a treatment with MPH or des-methylphenidate, while the 30 others did not. MPH treatment was given non-randomly and only when ADHD was considered to be hampering the capacity of the subjects to follow the therapy. Patients completed the following forms upon admission and after 1 month of treatment: the adult ADHD Self-Report Scale (ASRS v.1.1), the Barratt Impulsiveness Scale (BIS-10), the State-Trait Anger Expression (STAXI), the Beck Depression Inventory II (BDI-II), and the Beck Hopelessness Scale. At baseline, comorbid BPD-ADHD patients showed significantly higher impulsiveness than BPD patients. In the entire sample, there was a significant decrease in all dimensions ranging from small to large effect sizes during the 4-week intensive DBT. BPD-ADHD patients who were undergoing MPH treatment showed a significantly improved response to DBT treatment for Trait-State Anger scores, motor impulsiveness, depression severity, and ADHD severity, when compared to those without stimulant medication. This study outlines the importance of systematically screening BPD patients for ADHD, since a MPH-based treatment will improve the symptoms of patients who are comorbid for BPD and ADHD. Due to the non-random allocation of subjects, more severely affected patients were more readily placed on MPH; this suggests that the more severe the ADHD symptoms, the greater

  17. Reduced Capacity in a Dichotic Memory Test for Adult Patients with ADHD

    ERIC Educational Resources Information Center

    Dige, Niels; Maahr, Eija; Backenroth-Ohsako, Gunnel

    2010-01-01

    Objective: To evaluate whether a dichotic memory test would reveal deficits in short-term working-memory recall and long-term memory recall in a group of adult patients with ADHD. Methods: A dichotic memory test with ipsilateral backward speech distraction in an adult ADHD group (n = 69) and a control group (n = 66) is used to compare performance…

  18. Functional Properties of Rare Missense Variants of Human CDH13 Found in Adult Attention Deficit/Hyperactivity Disorder (ADHD) Patients

    PubMed Central

    Mavroconstanti, Thegna; Johansson, Stefan; Winge, Ingeborg; Knappskog, Per M.; Haavik, Jan

    2013-01-01

    The CDH13 gene codes for T-cadherin, a GPI-anchored protein with cell adhesion properties that is highly expressed in the brain and cardiovascular system. Previous studies have suggested that CDH13 may be a promising candidate gene for Attention Deficit/Hyperactivity Disorder (ADHD). The aims of this study were to identify, functionally characterize, and estimate the frequency of coding CDH13 variants in adult ADHD patients and controls. We performed sequencing of the CDH13 gene in 169 Norwegian adult ADHD patients and 63 controls and genotyping of the identified variants in 641 patients and 668 controls. Native and green fluorescent protein tagged wild type and variant CDH13 proteins were expressed and studied in CHO and HEK293 cells, respectively. Sequencing identified seven rare missense CDH13 variants, one of which was novel. By genotyping, we found a cumulative frequency of these rare variants of 2.9% in controls and 3.2% in ADHD patients, implying that much larger samples are needed to obtain adequate power to study the genetic association between ADHD and rare CDH13 variants. Protein expression and localization studies in CHO cells and HEK293 cells showed that the wild type and mutant proteins were processed according to the canonical processing of GPI-anchored proteins. Although some of the mutations were predicted to severely affect protein secondary structure and stability, no significant differences were observed between the expression levels and distribution of the wild type and mutant proteins in either HEK293 or CHO cells. This is the first study where the frequency of coding CDH13 variants in patients and controls is reported and also where the functional properties of these variants are examined. Further investigations are needed to conclude whether CDH13 is involved in the pathogenesis of ADHD or other conditions. PMID:23936508

  19. Functional properties of rare missense variants of human CDH13 found in adult attention deficit/hyperactivity disorder (ADHD) patients.

    PubMed

    Mavroconstanti, Thegna; Johansson, Stefan; Winge, Ingeborg; Knappskog, Per M; Haavik, Jan

    2013-01-01

    The CDH13 gene codes for T-cadherin, a GPI-anchored protein with cell adhesion properties that is highly expressed in the brain and cardiovascular system. Previous studies have suggested that CDH13 may be a promising candidate gene for Attention Deficit/Hyperactivity Disorder (ADHD). The aims of this study were to identify, functionally characterize, and estimate the frequency of coding CDH13 variants in adult ADHD patients and controls. We performed sequencing of the CDH13 gene in 169 Norwegian adult ADHD patients and 63 controls and genotyping of the identified variants in 641 patients and 668 controls. Native and green fluorescent protein tagged wild type and variant CDH13 proteins were expressed and studied in CHO and HEK293 cells, respectively. Sequencing identified seven rare missense CDH13 variants, one of which was novel. By genotyping, we found a cumulative frequency of these rare variants of 2.9% in controls and 3.2% in ADHD patients, implying that much larger samples are needed to obtain adequate power to study the genetic association between ADHD and rare CDH13 variants. Protein expression and localization studies in CHO cells and HEK293 cells showed that the wild type and mutant proteins were processed according to the canonical processing of GPI-anchored proteins. Although some of the mutations were predicted to severely affect protein secondary structure and stability, no significant differences were observed between the expression levels and distribution of the wild type and mutant proteins in either HEK293 or CHO cells. This is the first study where the frequency of coding CDH13 variants in patients and controls is reported and also where the functional properties of these variants are examined. Further investigations are needed to conclude whether CDH13 is involved in the pathogenesis of ADHD or other conditions. PMID:23936508

  20. Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.

    PubMed

    Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

    2014-05-01

    There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account. PMID:24311027

  1. Impact of head models in N170 component source imaging: results in control subjects and ADHD patients

    NASA Astrophysics Data System (ADS)

    Beltrachini, L.; Blenkmann, A.; von Ellenrieder, N.; Petroni, A.; Urquina, H.; Manes, F.; Ibáñez, A.; Muravchik, C. H.

    2011-12-01

    The major goal of evoked related potential studies arise in source localization techniques to identify the loci of neural activity that give rise to a particular voltage distribution measured on the surface of the scalp. In this paper we evaluate the effect of the head model adopted in order to estimate the N170 component source in attention deficit hyperactivity disorder (ADHD) patients and control subjects, considering faces and words stimuli. The standardized low resolution brain electromagnetic tomography algorithm (sLORETA) is used to compare between the three shell spherical head model and a fully realistic model based on the ICBM-152 atlas. We compare their variance on source estimation and analyze the impact on the N170 source localization. Results show that the often used three shell spherical model may lead to erroneous solutions, specially on ADHD patients, so its use is not recommended. Our results also suggest that N170 sources are mainly located in the right occipital fusiform gyrus for faces stimuli and in the left occipital fusiform gyrus for words stimuli, for both control subjects and ADHD patients. We also found a notable decrease on the N170 estimated source amplitude on ADHD patients, resulting in a plausible marker of the disease.

  2. Individual classification of ADHD patients by integrating multiscale neuroimaging markers and advanced pattern recognition techniques.

    PubMed

    Cheng, Wei; Ji, Xiaoxi; Zhang, Jie; Feng, Jianfeng

    2012-01-01

    Accurate classification or prediction of the brain state across individual subject, i.e., healthy, or with brain disorders, is generally a more difficult task than merely finding group differences. The former must be approached with highly informative and sensitive biomarkers as well as effective pattern classification/feature selection approaches. In this paper, we propose a systematic methodology to discriminate attention deficit hyperactivity disorder (ADHD) patients from healthy controls on the individual level. Multiple neuroimaging markers that are proved to be sensitive features are identified, which include multiscale characteristics extracted from blood oxygenation level dependent (BOLD) signals, such as regional homogeneity (ReHo) and amplitude of low-frequency fluctuations. Functional connectivity derived from Pearson, partial, and spatial correlation is also utilized to reflect the abnormal patterns of functional integration, or, dysconnectivity syndromes in the brain. These neuroimaging markers are calculated on either voxel or regional level. Advanced feature selection approach is then designed, including a brain-wise association study (BWAS). Using identified features and proper feature integration, a support vector machine (SVM) classifier can achieve a cross-validated classification accuracy of 76.15% across individuals from a large dataset consisting of 141 healthy controls and 98 ADHD patients, with the sensitivity being 63.27% and the specificity being 85.11%. Our results show that the most discriminative features for classification are primarily associated with the frontal and cerebellar regions. The proposed methodology is expected to improve clinical diagnosis and evaluation of treatment for ADHD patient, and to have wider applications in diagnosis of general neuropsychiatric disorders. PMID:22888314

  3. Long-Term Treatment of ADHD with Stimulants: A Large Observational Study of Real-Life Patients

    ERIC Educational Resources Information Center

    Powell, Shelagh G.; Thomsen, Per Hove; Frydenberg, Morten; Rasmussen, Helle

    2011-01-01

    Objective: To evaluate 410 real-life patients treated with stimulants and assessed systematically over several years. Method: Naturalistic observational study. A database was compiled on the basis of a review of the medical charts of patients attending a specialized ADHD clinic. Results: The diversity of ADHD patients was evident from the…

  4. Omega-6 to Omega-3 Fatty Acid Ratio in Patients with ADHD: A Meta-Analysis

    PubMed Central

    LaChance, Laura; McKenzie, Kwame; Taylor, Valerie H.; Vigod, Simone N.

    2016-01-01

    Objective: Omega-3 and omega-6 fatty acids have been shown to be deficient in individuals with attention deficit/hyperactivity disorder compared to controls (Hawkey & Nigg, 2014). Clinical trials of omega-3 and omega-6 supplements as treatment for ADHD have demonstrated minimal efficacy (Bloch & Qawasmi, 2011; Gillies, Sinn, Lad, Leach, & Ross, 2011; Hawkey & Nigg, 2014; Puri & Martins, 2014; Sonuga-Barke et al., 2013). Existing trials have analyzed omega-3 and omega-6 separately although the tissue ratio of these fatty acids (n6/n3) may be more important than absolute levels of either. The objective of this study was to determine the relationship between blood n6/n3 and arachidonic acid to eicosapentaenoic acid (AA/EPA), to ADHD symptoms. Method: A systematic literature review identified original articles measuring blood n6/n3 or AA/EPA ratio in children and youth with ADHD, compared to controls without ADHD. Three databases were searched. Blood n6/n3, and AA/EPA ratios were compared between individuals with ADHD and controls. Results were pooled across studies using quantitative synthesis. Results: Five articles met inclusion criteria for the meta-analysis. The pooled mean difference between patients with ADHD and controls was 1.97 (0.90–3.04) for n6/n3 (n=5 studies, I2 83%) and 8.25 (5.94–10.56) for AA/EPA (n=3 studies, I2 0%). Conclusions: Children and youth with ADHD have elevated ratios of both blood n6/n3 and AA/EPA fatty acids compared to controls. Thus an elevated n6/n3, and more specifically AA/EPA, ratio may represent the underlying disturbance in essential fatty acid levels in patients with ADHD. These findings have implications for the development of future interventions using essential fatty acids to treat ADHD, and for the use of these ratios as biomarkers for titrating and monitoring ADHD treatment with essential fatty acids. PMID:27274744

  5. Adults with ADHD. An overview.

    PubMed

    Wender, P H; Wolf, L E; Wasserstein, J

    2001-06-01

    Attention-Deficit Hyperactivity Disorder (ADHD) is a common, genetically transmitted neurological disorder, with onset in childhood, probably mediated by decreased brain dopaminergic functioning. The first author was one of the earliest to describe the persistence of symptoms into adulthood. Prevalence and natural history data suggest that of the 3 to 10% of children diagnosed with ADHD, one- to two-thirds (somewhere between 1 and 6% of the general population) continue to manifest appreciable ADHD symptoms into adult life. This paper describes how ADHD in adults can be readily diagnosed and treated, despite resembling or coexisting with other psychiatric disorders. The Wender Utah diagnostic criteria address adult characteristics of the disorder. Informant and patient interviews and rating scales are used to determine the psychiatric status of the patient as a child, make a retroactive diagnosis of childhood ADHD, and establish the current diagnosis of the adult. Stringent diagnosis is key to determining effective treatment. Dopamine agonist stimulant medications appear to be the most effective in treating ADHD. About 60% of patients receiving stimulant medication showed moderate-to-marked improvement, as compared with 10% of those receiving placebo. The core symptoms of hyperactivity, inattention, mood lability, temper, disorganization, stress sensitivity, and impulsivity have been shown to respond to treatment with stimulant medications. Non-dopaminergic medications, such as the tricyclic antidepressants and SSRIs have generally not been useful in adults with ADHD in the absence of depression or dysthymia. Pemoline is no longer approved for use in these patients, despite early favorable reports. Appropriate management of adult patients with ADHD is multimodal. Psychoeducation, counseling, supportive problem-directed therapy, behavioral intervention, coaching, cognitive remediation, and couples and family therapy are useful adjuncts to medication management

  6. Methylphenidate significantly reduces lapses of attention during on-road highway driving in patients with ADHD.

    PubMed

    Verster, Joris C; Roth, Thomas

    2014-10-01

    Lapses of attention are characteristic for attention-deficit/hyperactivity disorder (ADHD) and as such may impair performance of daily activities. Data from an on-road driving study were reanalyzed to determine lapses in patients with ADHD after treatment with methylphenidate and placebo.A total of 18 adult ADHD patients performed a 100-km on-road driving test and were instructed to drive with a steady lateral position and constant speed. The SD of lateral position (SDLP), that is, the weaving of the car, lapses, and alertness, was assessed.Driving was significantly better (P = 0.006) with methylphenidate (SDLP, 18.8 cm) when compared with placebo (SDLP, 21.2 cm). Both the reduction in SDLP and the number of lapses (P = 0.003) confirm this significant improvement, which is further supported by subjective assessments of perceived driving performance. Although lapses were common in the placebo condition (11/18 patients), they were much less frequently observed (5/18 patients) after treatment with methylphenidate. Postdriving assessments suggest that lapses often go unnoticed by drivers.In conclusion, methylphenidate significantly improves driving of patients with ADHD by significantly reducing the number of lapses. PMID:24978156

  7. A Combined Treatment Approach for Adults with ADHD--Results of an Open Study of 43 Patients

    ERIC Educational Resources Information Center

    Rostain, Anthony L.; Ramsay, J. Russell

    2006-01-01

    Objective: Increasing numbers of adults are seeking treatment for ADHD. Pharmacotherapy is well established as the first line treatment for adult ADHD, although medications alone may be insufficient treatment for the myriad problems experienced by these patients. Few studies have examined the clinical outcomes of a combination of pharmacotherapy…

  8. No Clear Association between Impaired Short-Term or Working Memory Storage and Time Reproduction Capacity in Adult ADHD Patients

    PubMed Central

    Mette, Christian; Grabemann, Marco; Zimmermann, Marco; Strunz, Laura; Scherbaum, Norbert; Wiltfang, Jens; Kis, Bernhard

    2015-01-01

    Objective Altered time reproduction is exhibited by patients with adult attention deficit hyperactivity disorder (ADHD). It remains unclear whether memory capacity influences the ability of adults with ADHD to reproduce time intervals. Method We conducted a behavioral study on 30 ADHD patients who were medicated with methylphenidate, 29 unmedicated adult ADHD patients and 32 healthy controls (HCs). We assessed time reproduction using six time intervals (1 s, 4 s, 6 s, 10 s, 24 s and 60 s) and assessed memory performance using the Wechsler memory scale. Results The patients with ADHD exhibited lower memory performance scores than the HCs. No significant differences in the raw scores for any of the time intervals (p > .05), with the exception of the variability at the short time intervals (1 s, 4 s and 6 s) (p < .01), were found between the groups. The overall analyses failed to reveal any significant correlations between time reproduction at any of the time intervals examined in the time reproduction task and working memory performance (p > .05). Conclusion We detected no findings indicating that working memory might influence time reproduction in adult patients with ADHD. Therefore, further studies concerning time reproduction and memory capacity among adult patients with ADHD must be performed to verify and replicate the present findings. PMID:26221955

  9. How 'core' are motor timing difficulties in ADHD? A latent class comparison of pure and comorbid ADHD classes.

    PubMed

    van der Meer, Jolanda M J; Hartman, Catharina A; Thissen, Andrieke J A M; Oerlemans, Anoek M; Luman, Marjolein; Buitelaar, Jan K; Rommelse, Nanda N J

    2016-04-01

    Children with attention-deficit/hyperactivity disorder (ADHD) have motor timing difficulties. This study examined whether affected motor timing accuracy and variability are specific for ADHD, or that comorbidity with autism spectrum disorders (ASD) contributes to these motor timing difficulties. An 80-trial motor timing task measuring accuracy (μ), variability (σ) and infrequent long response times (τ) in estimating a 1-s interval was administered to 283 children and adolescents (8-17 years) from both a clinic and population based sample. They were divided into four latent classes based on the SCQ and CPRS-R:L data. These classes were: without behavioral problems 'Normal-class' (n = 154), with only ADHD symptoms 'ADHD-class' (n = 49), and two classes with both ASD and ADHD symptoms; ADHD(+ASD)-class (n = 39) and ASD(+ADHD)-class (n = 41). The pure ADHD-class did not deviate from the Normal class on any of the motor timing measures (mean RTs 916 and 925 ms, respectively). The comorbid ADHD(+ASD) and ASD(+ADHD) classes were significantly less accurate (more time underestimations) compared to the Normal class (mean RTs 847 and 870 ms, respectively). Variability in motor timing was reduced in the younger children in the ADHD(+ASD) class, which may reflect a tendency to rush the tedious task. Only patients with more severe behavioral symptoms show motor timing deficiencies. This cannot merely be explained by high ADHD severity with ASD playing no role, as ADHD symptom severity in the pure ADHD-class and the ASD(+ADHD) class was highly similar, with the former class showing no motor timing deficits. PMID:26154019

  10. Children with ADHD Show No Deficits in Plantar Foot Sensitivity and Static Balance Compared to Healthy Controls

    ERIC Educational Resources Information Center

    Schlee, Gunther; Neubert, Tom; Worenz, Andreas; Milani, Thomas L.

    2012-01-01

    The goal of this study was to investigate plantar foot sensitivity and balance control of ADHD (n = 21) impaired children compared to age-matched healthy controls (n = 25). Thresholds were measured at 200 Hz at three anatomical locations of the plantar foot area of both feet (hallux, first metatarsal head (METI) and heel). Body balance was…

  11. ADHD Medications

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD Medicines KidsHealth > For Teens > ADHD Medicines Print A ... Medicación para el tratamiento del TDAH (ADHD) Managing ADHD With Medicine Just about everyone has trouble concentrating ...

  12. Treating enuresis in a patient with ADHD: application of a novel behavioural modification therapy.

    PubMed

    Tajima-Pozo, Kazuhiro; Ruiz-Manrique, Gonzalo; Montañes, Francisco

    2014-01-01

    We report the case of a 6-year-old patient diagnosed with attention-deficit hyperactivity disorder (ADHD) and comorbid enuresis disorder, who was treated with methylphenidate for the past 3 months and a novel behavioural modification therapy by using an application called 'Enuresis Trainer'. This therapeutic application is basically an interactive 'Bedwetting Calendar', based on traditional cognitive behavioural modification therapies and positive reinforcement systems. Enuresis is defined as the failure of voluntary control of the urethral sphincter. The prevalence of enuresis is 15-20% in the child population; however, children with ADHD had a 2.7 times higher incidence of nocturnal enuresis. Bedwetting is a common cause of isolation in children as well as loss of self-esteem and other psychological distress for the child and the family. PMID:24916977

  13. Treating enuresis in a patient with ADHD: application of a novel behavioural modification therapy

    PubMed Central

    Tajima-Pozo, Kazuhiro; Ruiz-Manrique, Gonzalo; Montañes, Francisco

    2014-01-01

    We report the case of a 6-year-old patient diagnosed with attention-deficit hyperactivity disorder (ADHD) and comorbid enuresis disorder, who was treated with methylphenidate for the past 3 months and a novel behavioural modification therapy by using an application called ‘Enuresis Trainer’. This therapeutic application is basically an interactive ‘Bedwetting Calendar’, based on traditional cognitive behavioural modification therapies and positive reinforcement systems. Enuresis is defined as the failure of voluntary control of the urethral sphincter. The prevalence of enuresis is 15–20% in the child population; however, children with ADHD had a 2.7 times higher incidence of nocturnal enuresis. Bedwetting is a common cause of isolation in children as well as loss of self-esteem and other psychological distress for the child and the family. PMID:24916977

  14. IPI-145 shows promise in CLL patients.

    PubMed

    2014-02-01

    Results from a phase I study of Infinity Pharmaceuticals' IPI-145, which inhibits both δ and γ isoforms of phosphoinositide3-kinase, suggest the drug is safe and effective in patients with advanced chronic lymphocytic leukemia. PMID:24501284

  15. Duplications in ADHD patients harbour neurobehavioural genes that are co‐expressed with genes associated with hyperactivity in the mouse

    PubMed Central

    Taylor, Avigail; Steinberg, Julia

    2015-01-01

    Attention deficit/hyperactivity disorder (ADHD) is a childhood onset disorder, prevalent in 5.3% of children and 1–4% of adults. ADHD is highly heritable, with a burden of large (>500 Kb) copy number variants (CNVs) identified among individuals with ADHD. However, how such CNVs exert their effects is poorly understood. We examined the genes affected by 71 large, rare, and predominantly inherited CNVs identified among 902 individuals with ADHD. We applied both mouse‐knockout functional enrichment analyses, exploiting behavioral phenotypes arising from the determined disruption of 1:1 mouse orthologues, and human brain‐specific spatio‐temporal expression data to uncover molecular pathways common among genes contributing to enriched phenotypes. Twenty‐two percent of genes duplicated in individuals with ADHD that had mouse phenotypic information were associated with abnormal learning/memory/conditioning (“l/m/c”) phenotypes. Although not observed in a second ADHD‐cohort, we identified a similar enrichment among genes duplicated by eight de novo CNVs present in eight individuals with Hyperactivity and/or Short attention span (“Hyperactivity/SAS”, the ontologically‐derived phenotypic components of ADHD). In the brain, genes duplicated in patients with ADHD and Hyperactivity/SAS and whose orthologues’ disruption yields l/m/c phenotypes in mouse (“candidate‐genes”), were co‐expressed with one another and with genes whose orthologues’ mouse models exhibit hyperactivity. Moreover, genes associated with hyperactivity in the mouse were significantly more co‐expressed with ADHD candidate‐genes than with similarly identified genes from individuals with intellectual disability. Our findings support an etiology for ADHD distinct from intellectual disability, and mechanistically related to genes associated with hyperactivity phenotypes in other mammalian species. © 2015 The Authors. American Journal of Medical Genetics Part B

  16. Role of ADHD symptoms as a contributing factor to obesity in patients with MC4R mutations.

    PubMed

    Porfirio, Maria-Cristina; Giovinazzo, Silvia; Cortese, Samuele; Giana, Grazia; Lo-Castro, Adriana; Mouren, Marie-Christine; Curatolo, Paolo; Purper-Ouakil, Diane

    2015-01-01

    Besides the crucial role of genetic susceptibility in the development of early-onset obesity, it has been shown that feeding behavior could contribute to increased body weight. A significant association between obesity/overweight and ADHD has been reported, suggesting that these two conditions, despite their heterogeneity, might share common molecular pathways. Although the co-occurrence of obesity and ADHD is increasingly supported by empirical evidence, the complex pathogenetic link between these two conditions is still unclear. Here, we focus on the relationship between MC4R gene mutations and ADHD in children with early-onset obesity. Mutations in the gene MC4R lead to the most common form of monogenic obesity. We hypothesize that dysregulated eating behavior in a subset of patients with MC4R mutation might be due to comorbid ADHD symptoms, underpinned by abnormal reward mechanisms. Therefore, we speculate that it is possible to prevent obesity in a subset of patients with MC4R mutation, even if these patients are genetically programmed to "be fat", via an appropriate treatment of ADHD symptoms. We hope that our paper will stimulate further studies testing if the early screening for ADHD symptoms and their appropriate treatment may be an effective way to prevent obesity in a subset of children with MC4R mutation. PMID:25466298

  17. Proposing an adaptive mutation to improve XCSF performance to classify ADHD and BMD patients.

    PubMed

    Sadatnezhad, Khadijeh; Boostani, Reza; Ghanizadeh, Ahmad

    2010-12-01

    There is extensive overlap of clinical symptoms observed among children with bipolar mood disorder (BMD) and those with attention deficit hyperactivity disorder (ADHD). Thus, diagnosis according to clinical symptoms cannot be very accurate. It is therefore desirable to develop quantitative criteria for automatic discrimination between these disorders. This study is aimed at designing an efficient decision maker to accurately classify ADHD and BMD patients by analyzing their electroencephalogram (EEG) signals. In this study, 22 channels of EEGs have been recorded from 21 subjects with ADHD and 22 individuals with BMD. Several informative features, such as fractal dimension, band power and autoregressive coefficients, were extracted from the recorded signals. Considering the multimodal overlapping distribution of the obtained features, linear discriminant analysis (LDA) was used to reduce the input dimension in a more separable space to make it more appropriate for the proposed classifier. A piecewise linear classifier based on the extended classifier system for function approximation (XCSF) was modified by developing an adaptive mutation rate, which was proportional to the genotypic content of best individuals and their fitness in each generation. The proposed operator controlled the trade-off between exploration and exploitation while maintaining the diversity in the classifier's population to avoid premature convergence. To assess the effectiveness of the proposed scheme, the extracted features were applied to support vector machine, LDA, nearest neighbor and XCSF classifiers. To evaluate the method, a noisy environment was simulated with different noise amplitudes. It is shown that the results of the proposed technique are more robust as compared to conventional classifiers. Statistical tests demonstrate that the proposed classifier is a promising method for discriminating between ADHD and BMD patients. PMID:21048285

  18. Proposing an adaptive mutation to improve XCSF performance to classify ADHD and BMD patients

    NASA Astrophysics Data System (ADS)

    Sadatnezhad, Khadijeh; Boostani, Reza; Ghanizadeh, Ahmad

    2010-12-01

    There is extensive overlap of clinical symptoms observed among children with bipolar mood disorder (BMD) and those with attention deficit hyperactivity disorder (ADHD). Thus, diagnosis according to clinical symptoms cannot be very accurate. It is therefore desirable to develop quantitative criteria for automatic discrimination between these disorders. This study is aimed at designing an efficient decision maker to accurately classify ADHD and BMD patients by analyzing their electroencephalogram (EEG) signals. In this study, 22 channels of EEGs have been recorded from 21 subjects with ADHD and 22 individuals with BMD. Several informative features, such as fractal dimension, band power and autoregressive coefficients, were extracted from the recorded signals. Considering the multimodal overlapping distribution of the obtained features, linear discriminant analysis (LDA) was used to reduce the input dimension in a more separable space to make it more appropriate for the proposed classifier. A piecewise linear classifier based on the extended classifier system for function approximation (XCSF) was modified by developing an adaptive mutation rate, which was proportional to the genotypic content of best individuals and their fitness in each generation. The proposed operator controlled the trade-off between exploration and exploitation while maintaining the diversity in the classifier's population to avoid premature convergence. To assess the effectiveness of the proposed scheme, the extracted features were applied to support vector machine, LDA, nearest neighbor and XCSF classifiers. To evaluate the method, a noisy environment was simulated with different noise amplitudes. It is shown that the results of the proposed technique are more robust as compared to conventional classifiers. Statistical tests demonstrate that the proposed classifier is a promising method for discriminating between ADHD and BMD patients.

  19. Alzheimer’s Model Develops Early ADHD Syndrome

    PubMed Central

    Zhang, Qiang; Du, Guiping; John, V; Kapahi, Pankaj; Bredesen, Dale E.

    2016-01-01

    We describe the first invertebrate model of attention deficit hyperactivity disorder (ADHD) that reproduces its major features, including hyperactivity, male predominance, marked exacerbation by simple carbohydrates, reversible response to dextroamphetamine, and a “paradoxical response” to stimulants. This model may offer new insight into ADHD pathogenesis and treatment. Furthermore, these findings are of particular interest in light of the recent epidemiological evidence showing that patients with dementia have a high frequency of antecedent ADHD symptoms. PMID:26753104

  20. Migraine patients show increased platelet vasopressin receptors.

    PubMed

    Buschmann, J; Leppla-Wollsiffer, G; Nemeth, N; Nelson, K; Kirsten, R

    1996-01-01

    This study was designed to investigate vasopressin receptor status (Bmax and Kd) on platelets, vasopressin plasma levels, and vasopressin-induced platelet aggregation in migraine patients (21 females and 6 males) during a headache-free interval and in a matched control group. In the migraine group, Bmax was significantly higher (P = 0.02) at 53.9 +/- 20.6 fmol/mg than in the control group (36.8 +/- 21.0 fmol/mg). A correlation between Bmax and high or low sensitivity to vasopressin as an aggregator was evident in the control group, but not in the migraine group. No differences in Kd or in plasma levels of vasopressin between the migraine and control group were apparent. Men in both groups were much less sensitive to vasopressin as a platelet aggregator than were women (P < 0.01). Whether the higher Bmax in the migraine group is a reflection of temporarily higher vasopressin levels during headache or reflects a primary increase in sensitivity to vasopressin, remains to be clarified. The higher sensitivity of platelets (as a model for vessel wall receptors) from women may indicate why many more women than men suffer from migraine. Since the Bmax of the vasopressin receptor on platelets from migraine patients is increased compared to controls, treating migraine headache with vasopressin may deserve more attention. PMID:8990597

  1. Do patients with different mental disorders show specific aspects of shame?

    PubMed

    Scheel, Corinna N; Bender, Caroline; Tuschen-Caffier, Brunna; Brodführer, Anne; Matthies, Swantje; Hermann, Christiane; Geisse, Eva K; Svaldi, Jennifer; Brakemeier, Eva-Lotta; Philipsen, Alexandra; Jacob, Gitta A

    2014-12-15

    Shame is related to several mental disorders. We assume that facets of shame, namely bodily, cognitive and existential shame, may occur in typical patterns in mental and personality disorders. An excessive level of shame may lead to psychopathological symptoms. However, a lack of shame may also lead to distress, for instance as it may facilitate violation of social norms and thus may promote interpersonal problems. In this study we investigated facets of shame in females suffering from various mental disorders and personality disorders presumably associated with specific aspects of shame. Women suffering from borderline personality disorder (BPD, n=92), attention deficit hyperactivity disorder (ADHD, n=86), major depressive disorder (MDD, n=17), social anxiety disorder (SAD, n=33), and a community sample (COM, n=290) completed the SHAME questionnaire, which is a newly developed instrument to assess adaptive and maladaptive aspects of shame. BPD patients reported the highest level of existential shame compared to all other groups. Compared to the controls, SAD patients displayed stronger bodily and cognitive shame, and ADHD showed lower bodily shame. As assumed, specific aspects of shame were found in different patient groups. It may be important to specifically address these specific aspects of shame in psychotherapy. PMID:25219613

  2. Prevalence of Restless Legs Syndrome in Adult ADHD and Its Subtypes.

    PubMed

    Snitselaar, Mark A; Smits, Marcel G; Spijker, Jan

    2016-01-01

    In this observational cross-sectional study, 49 subjects were assessed for sleep disorders and for ADHD symptoms. Thirty-six received an ADHD diagnosis (29: combined type (ADHD-C); 7: inattentive type). An RLS and RLS symptoms prevalence of 34.5% was found, with a higher prevalence rate in the ADHD-C subgroup, although not significantly (p = 0.066). RLS symptoms were correlated with particularly hyperactivity-impulsivity (ρ = 0.742; p: 0.000). ADHD patients with positive RLS scores reported higher scores on the ADHD-Rating scale compared with patients with negative RLS scores (Z: -2.968, p = 0.003), mainly due to higher hyperactivity-impulsivity scores (Z: -3.145; p = 0.002). Our findings show that clinicians need to be aware of RLS among adult ADHD patients, particularly those with severe hyperactivity-impulsivity symptoms. PMID:26418664

  3. Pattern classification of response inhibition in ADHD: Toward the development of neurobiological markers for ADHD

    PubMed Central

    Hart, Heledd; Chantiluke, Kaylita; Cubillo, Ana I; Smith, Anna B; Simmons, Andrew; Brammer, Michael J; Marquand, Andre F; Rubia, Katya

    2014-01-01

    The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is based on subjective measures despite evidence for multisystemic structural and functional deficits. ADHD patients have consistent neurofunctional deficits in motor response inhibition. The aim of this study was to apply pattern classification to task-based functional magnetic resonance imaging (fMRI) of inhibition, to accurately predict the diagnostic status of ADHD. Thirty adolescent ADHD and thirty age-matched healthy boys underwent fMRI while performing a Stop task. fMRI data were analyzed with Gaussian process classifiers (GPC), a machine learning approach, to predict individual ADHD diagnosis based on task-based activation patterns. Traditional univariate case-control analyses were also performed to replicate previous findings in a relatively large dataset. The pattern of brain activation correctly classified up to 90% of patients and 63% of controls, achieving an overall classification accuracy of 77%. The regions of the discriminative network most predictive of controls included later developing lateral prefrontal, striatal, and temporo-parietal areas that mediate inhibition, while regions most predictive of ADHD were in earlier developing ventromedial fronto-limbic regions, which furthermore correlated with symptom severity. Univariate analysis showed reduced activation in ADHD in bilateral ventrolateral prefrontal, striatal, and temporo-parietal regions that overlapped with areas predictive of controls, suggesting the latter are dysfunctional areas in ADHD. We show that significant individual classification of ADHD patients of 77% can be achieved using whole brain pattern analysis of task-based fMRI inhibition data, suggesting that multivariate pattern recognition analyses of inhibition networks can provide objective diagnostic neuroimaging biomarkers of ADHD. Hum Brain Mapp 35:3083–3094, 2014. © 2013 Wiley Periodicals, Inc. PMID:24123508

  4. Pattern classification of response inhibition in ADHD: toward the development of neurobiological markers for ADHD.

    PubMed

    Hart, Heledd; Chantiluke, Kaylita; Cubillo, Ana I; Smith, Anna B; Simmons, Andrew; Brammer, Michael J; Marquand, Andre F; Rubia, Katya

    2014-07-01

    The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is based on subjective measures despite evidence for multisystemic structural and functional deficits. ADHD patients have consistent neurofunctional deficits in motor response inhibition. The aim of this study was to apply pattern classification to task-based functional magnetic resonance imaging (fMRI) of inhibition, to accurately predict the diagnostic status of ADHD. Thirty adolescent ADHD and thirty age-matched healthy boys underwent fMRI while performing a Stop task. fMRI data were analyzed with Gaussian process classifiers (GPC), a machine learning approach, to predict individual ADHD diagnosis based on task-based activation patterns. Traditional univariate case-control analyses were also performed to replicate previous findings in a relatively large dataset. The pattern of brain activation correctly classified up to 90% of patients and 63% of controls, achieving an overall classification accuracy of 77%. The regions of the discriminative network most predictive of controls included later developing lateral prefrontal, striatal, and temporo-parietal areas that mediate inhibition, while regions most predictive of ADHD were in earlier developing ventromedial fronto-limbic regions, which furthermore correlated with symptom severity. Univariate analysis showed reduced activation in ADHD in bilateral ventrolateral prefrontal, striatal, and temporo-parietal regions that overlapped with areas predictive of controls, suggesting the latter are dysfunctional areas in ADHD. We show that significant individual classification of ADHD patients of 77% can be achieved using whole brain pattern analysis of task-based fMRI inhibition data, suggesting that multivariate pattern recognition analyses of inhibition networks can provide objective diagnostic neuroimaging biomarkers of ADHD. PMID:24123508

  5. Growing out of ADHD: The Relationship between Functioning and Symptoms

    ERIC Educational Resources Information Center

    Young, Susan; Gudjonsson, Gisli H.

    2008-01-01

    Objective: The objective is to ascertain whether people in partial remission (IPR) or in full remission (IR) of their ADHD symptoms continue to have neuropsychological deficits and clinical and psychosocial problems. Method: IPR and IR groups are compared with fully symptomatic ADHD patients and normal controls. Results: The results show a decline…

  6. A Linguistic Analysis of In-Office Dialogue among Psychiatrists, Parents, and Child and Adolescent Patients with ADHD

    ERIC Educational Resources Information Center

    Findling, Robert L.; Connor, Daniel F.; Wigal, Timothy; Eagan, Corey; Onofrey, Meaghan Nelson

    2009-01-01

    Objective: The aim was to evaluate in-office discussions of ADHD and psychiatric comorbidities. Method: Naturally occurring interactions among 11 psychiatrists, 32 patients and their parents were recorded, with a focus on "complicated" patients (i.e., having or suspected to have [greater than or equal to] 1 psychiatric comorbidities and/or…

  7. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network.

    PubMed

    Young, Susan; Adamou, Marios; Asherson, Philip; Coghill, David; Colley, Bill; Gudjonsson, Gisli; Hollis, Chris; McCarthy, Jane; Müller, Ulrich; Paul, Moli; Pitts, Mark; Arif, Muhammad

    2016-01-01

    The aim of this consensus statement was to discuss transition of patients with ADHD from child to adult healthcare services, and formulate recommendations to facilitate successful transition. An expert workshop was convened in June 2012 by the UK Adult ADHD Network (UKAAN), attended by a multidisciplinary team of mental health professionals, allied professionals and patients. It was concluded that transitions must be planned through joint meetings involving referring/receiving services, patients and their families. Negotiation may be required to balance parental desire for continued involvement in their child's care, and the child's growing autonomy. Clear transition protocols can maintain standards of care, detailing relevant timeframes, responsibilities of agencies and preparing contingencies. Transition should be viewed as a process not an event, and should normally occur by the age of 18, however flexibility is required to accommodate individual needs. Transition is often poorly experienced, and adherence to clear recommendations is necessary to ensure effective transition and prevent drop-out from services. PMID:27561259

  8. Lack of Association between a 3'UTR VNTR Polymorphism of Dopamine Transporter Gene (SLC6A3) and ADHD in a Brazilian Sample of Adult Patients

    ERIC Educational Resources Information Center

    Aperecida da Silva, Maria; Cordeiro, Quirino; Louza, Mario; Vallada, Homero

    2011-01-01

    Objective: To investigate a possible association between a 3'UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients. Method: Study Case-control with 102 ADHD adult outpatients ("DSM-IV" criteria) and 479 healthy controls. The primers' sequence used were: 3'UTR-Forward: 5' TGT GGT GAT GGG…

  9. Isochromosome 13 in a patient with childhood-onset schizophrenia, ADHD, and motor tic disorder

    PubMed Central

    2012-01-01

    Background A small percentage of all cases of schizophrenia have a childhood onset. The impact on the individual and family can be devastating. We report the results of genetic analyses from a patient with onset of visual hallucinations at 5 years, and a subsequent diagnosis at 9 years of schizophrenia, attention deficit hyperactivity disorder (ADHD) with hyperactivity and impulsivity, and chronic motor tic disorder. Results Karyotypic analysis found 45,XX,i(13)(q10) in all cells examined. Alpha satellite FISH of isochromosome 13 revealed a large unsplit centromeric region, interpreted as two centromeres separated by minimal or undetectable short-arm material or as a single monocentric centromere, indicating that the isochromosome likely formed post-zygotically by a short arm U-type or centromeric exchange. Characterization of chromosome 13 simple tandem repeats and Affymetrix whole-genome 6.0 SNP array hybridization found homozygosity for all markers, and the presence of only a single paternal allele in informative markers, consistent with an isodisomic isochromosome of paternal origin. Analysis of two chromosome 13 schizophrenia candidate genes, D-amino acid oxidase activator (DAOA) and 5-hydroxytryptamine (serotonin) receptor 2A (5-HTR2A), failed to identify non-synonymous coding mutations but did identify homozygous risk polymorphisms. Conclusions We report a female patient with childhood-onset schizophrenia, ADHD, and motor tic disorder associated with an isodisomic isochromosome 13 of paternal origin and a 45,XX,i(13)(q10q10) karyotype. We examined two potential mechanisms to explain chromosome 13 involvement in the patient's pathology, including reduction to homozygosity of a paternal mutation and reduction to homozygosity of a paternal copy number variation, but were unable to identify any overtly pathogenic abnormality. Future studies may consider whether epigenetic mechanisms resulting from uniparental disomy (UPD) and the lack of chromosome 13 maternal

  10. Gently restless: association of ADHD-like traits with response inhibition and interference control.

    PubMed

    Polner, Bertalan; Aichert, Désirée; Macare, Christine; Costa, Anna; Ettinger, Ulrich

    2015-12-01

    Impairment of inhibition-related functions is one of the most pronounced cognitive deficits found in attention-deficit/hyperactivity disorder (ADHD). Compelling evidence from studies of unaffected relatives of patients with ADHD and of ADHD-like traits in healthy subjects suggest the continuous distribution of ADHD symptoms in the population. A more subtle inhibitory deficit can also be found in healthy relatives of patients and in subjects with high ADHD-like traits. Here, we examined the relationship between inhibitory performance and ADHD-like traits, for the first time, in a large sample of healthy adults by applying multiple, widely used tests of inhibition-related functions. ADHD-like traits, in general, were independently predicted by Stroop interference score and, at trend level, by go/no-go commission error rate while controlling for socio-demographic factors, verbal intelligence and neuroticism. Additionally, higher inattentive traits were related to worse Stroop performance at trend level, and higher hyperactive/impulsive traits were significantly associated with more go/no-go commission errors. ADHD-like traits were strongly related to neuroticism. The study shows that individual differences in ADHD-like traits are related to variance in fundamental inhibition-related functions over and above effects of negative affect regulation, but the relationships tend to be small. The results suggest the quasi-dimensionality of ADHD and raise further questions about the relationship between genetic factors and the deficit of inhibition-related functions in the ADHD spectrum. PMID:25209569

  11. ADHD symptomatology in eating disorders: a secondary psychopathological measure of severity?

    PubMed Central

    2013-01-01

    Background Attention-deficit/hyperactivity disorder (ADHD) has commonly been described in psychiatric disorders. Although several studies have found positive associations between abnormal eating patterns during childhood and ADHD, there is a lack of studies on ADHD and Eating Disorders (ED). The aims of this exploratory study were 1) to assess the ADHD symptoms level in ED and to ascertain whether there are differences among ED subtypes; 2) to analyze whether the presence of ADHD symptoms is associated with more severe eating disorder symptoms and greater general psychopathology; and 3) to assess whether the ADHD symptoms level is associated with specific temperament and character traits. Methods 191 female ED patients were included. Assessment was carried out with the EDI-2, ASRS-v1.1, the SCL-90-R and the TCI-R. Results The ADHD symptoms level was similar in bulimia, eating disorder not otherwise specified and binge eating subtypes, and lower in anorexic patients. Obsessiveness and Hostility were significantly positively associated with ADHD symptoms. A path model showed that ADHD was associated with high Novelty Seeking and low Self-Directedness, whereas ED severity was influenced by ADHD severity and low Self-Directedness. Conclusions Bingeing/purging ED subtypes have a high ADHD symptoms level, also related with more severe eating, general and personality psychopathology. PMID:23758944

  12. Stimulant Dosing for Children with ADHD: A Medical Claims Analysis

    ERIC Educational Resources Information Center

    Olfson, Mark; Marcus, Steven; Wan, George

    2009-01-01

    Analysis of the claims data for patients aged six to 12 years who are being treated for attention deficit hyperactivity disorder shows that dosing in the community treatment of ADHD tends to be lower than those used in clinical trials.

  13. Language Deficits in ADHD Preschoolers

    ERIC Educational Resources Information Center

    Agapitou, Paraskevi; Andreou, Georgia

    2008-01-01

    The present study examined the impact of preschool ADHD on linguistic and metalinguistic awareness and mental ability. Eight subscales of the Athina Test were administered to ADHD preschoolers and a control group. Results showed that ADHD preschoolers performed significantly lower than the control group in all tasks. The greatest difficulty for…

  14. Time dependent patient no-show predictive modelling development.

    PubMed

    Huang, Yu-Li; Hanauer, David A

    2016-05-01

    Purpose - The purpose of this paper is to develop evident-based predictive no-show models considering patients' each past appointment status, a time-dependent component, as an independent predictor to improve predictability. Design/methodology/approach - A ten-year retrospective data set was extracted from a pediatric clinic. It consisted of 7,291 distinct patients who had at least two visits along with their appointment characteristics, patient demographics, and insurance information. Logistic regression was adopted to develop no-show models using two-thirds of the data for training and the remaining data for validation. The no-show threshold was then determined based on minimizing the misclassification of show/no-show assignments. There were a total of 26 predictive model developed based on the number of available past appointments. Simulation was employed to test the effective of each model on costs of patient wait time, physician idle time, and overtime. Findings - The results demonstrated the misclassification rate and the area under the curve of the receiver operating characteristic gradually improved as more appointment history was included until around the 20th predictive model. The overbooking method with no-show predictive models suggested incorporating up to the 16th model and outperformed other overbooking methods by as much as 9.4 per cent in the cost per patient while allowing two additional patients in a clinic day. Research limitations/implications - The challenge now is to actually implement the no-show predictive model systematically to further demonstrate its robustness and simplicity in various scheduling systems. Originality/value - This paper provides examples of how to build the no-show predictive models with time-dependent components to improve the overbooking policy. Accurately identifying scheduled patients' show/no-show status allows clinics to proactively schedule patients to reduce the negative impact of patient no-shows. PMID:27142954

  15. [The potential role of childhood ADHD in the development of heroin dependence at a young age].

    PubMed

    Szilágyi, Agnes; Barta, Csaba; Boór, Krisztina; Székely, Anna; Demetrovics, Zsolt; Csorba, József; Kalász, Huba; Sasvári-Székely, Mária

    2007-06-01

    Several studies suggested a possible link between substance use disorder and attention deficit hyperactivity syndrome (ADHD). The ADHD Rating Scale (ADHD-RS) completed by parents is a tool for diagnosing ADHD in childhood. We adapted this questionnaire for a self-report retrospective scale to estimate the presence of childhood ADHD symptoms in adults. This retrospective questionnaire was completed by 121 heroin dependent patients and 85 age- and sex-matched healthy controls. The ADHD Rating Scale Retrospective Questionnaire is a novel tool for assessing ADHD symptoms that demonstrated high validity. Our results showed strong gender difference in the prevalence of ADHD symptoms, since male subjects obtained higher mean scores of both attention-deficit and hyperactivity scales than females in both the control and the heroin dependent population. Besides, mean score of both scales were higher in the clinical population as a higher portion of substance abusers reported symptoms of childhood ADHD than controls. These results support the hypothesis that untreated childhood ADHD could be a risk factor for developing substance use disorder. PMID:17970529

  16. Advances in understanding and treating ADHD

    PubMed Central

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is a neurocognitive behavioral developmental disorder most commonly seen in childhood and adolescence, which often extends to the adult years. Relative to a decade ago, there has been extensive research into understanding the factors underlying ADHD, leading to far more treatment options available for both adolescents and adults with this disorder. Novel stimulant formulations have made it possible to tailor treatment to the duration of efficacy required by patients, and to help mitigate the potential for abuse, misuse and diversion. Several new non-stimulant options have also emerged in the past few years. Among these, cognitive behavioral interventions have proven popular in the treatment of adult ADHD, especially within the adult population who cannot or will not use medications, along with the many medication-treated patients who continue to show residual disability. PMID:21658285

  17. Impact of ADHD symptoms on autism spectrum disorder symptom severity.

    PubMed

    Sprenger, Linda; Bühler, Eva; Poustka, Luise; Bach, Christiane; Heinzel-Gutenbrunner, Monika; Kamp-Becker, Inge; Bachmann, Christian

    2013-10-01

    Despite the official exclusion criteria for autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) in the DSM-IV and ICD-10, patients with ASD often show ADHD symptoms. We aimed to examine the potential influence of ADHD symptoms on autistic psychopathology in a large sample of patients with ASD. We tested the hypothesis that patients with ASD and an additional ADHD (ASD+) would show a higher severity of autistic symptoms than those with ASD only (ASD-). We measured autistic symptoms using the autism diagnostic observation schedule (ADOS-G), the autism diagnostic interview (ADI-R), and the social responsiveness scale (SRS). To measure overall psychopathology and ADHD symptoms, we used the child behavior checklist (CBCL) and the ADHD rating scale (FBB-ADHS), respectively. Group differences between the ASD+ and the ASD- group (group division was conducted according to the results of the FBB-ADHS) were calculated using a univariate analysis of variance (ANOVA). The ASD+ group showed a greater severity of autistic symptoms than the ASD- group, measured by the SRS and the ADI-R. Especially in the social interaction subscale (ADI-R), a significantly higher symptom severity was found in the ASD+ group. No significant group differences were found regarding autistic symptoms measured by the ADOS-G. Patients with ASD and an additional ADHD expressed a stronger severity of autistic symptoms than patients with ASD only. According to our results, the possibility of a co-diagnosis of ADS and ADHD, as is being planned in the DSM-5, is in line with earlier studies, is highly reasonable, will simplify research, and have therapeutic implications. PMID:23973801

  18. EEG correlates of visual short-term memory as neuro-cognitive endophenotypes of ADHD.

    PubMed

    Wiegand, Iris; Hennig-Fast, Kristina; Kilian, Beate; Müller, Hermann J; Töllner, Thomas; Möller, Hans-Jürgen; Engel, Rolf R; Finke, Kathrin

    2016-05-01

    Attention deficit hyperactivity disorder (ADHD) frequently persists into adulthood. A reduction in visual short-term memory (vSTM) storage capacity was recently suggested as a potential neuro-cognitive endophenotype, i.e., a testable marker of an individual's liability for developing ADHD. This study aimed at identifying markers of the brain abnormalities underlying vSTM reductions in adult ADHD. We combined behavioral parameter-based assessment with electrophysiology in groups of adult ADHD patients and healthy age-matched controls. Amplitudes of ERP markers of vSTM storage capacity, the contralateral delay activity (CDA) and the P3b, were analyzed according to (i) differences between individuals with higher vs. lower storage capacity K and (ii) differences between ADHD patients and control participants. We replicated the finding of reduced storage capacity in adult ADHD. Across groups, individuals with higher relative to lower storage capacity showed a larger CDA and P3b. We further found differences between the patient and control groups in the ERPs: The CDA amplitude was attenuated in an early time window for ADHD patients compared to control participants, and was negatively correlated with ADHD patients' symptom severity ratings. Furthermore, the P3b was larger in ADHD patients relative to control participants. These electrophysiological findings indicate altered brain mechanisms underlying visual storage capacity in ADHD, which are characterized by deficient encoding and maintenance, and increased recruitment of control processes. Accordingly, (quantifiable) ERP markers of vSTM in adult ADHD bear candidacy as neuro-cognitive endophenotypes of the disease. PMID:26972967

  19. A Twin Study of ADHD Symptoms in Early Adolescence: Hyperactivity-Impulsivity and Inattentiveness Show Substantial Genetic Overlap but Also Genetic Specificity

    ERIC Educational Resources Information Center

    Greven, Corina U.; Rijsdijk, Fruhling V.; Plomin, Robert

    2011-01-01

    A previous paper in this journal revealed substantial genetic overlap between the ADHD dimensions of hyperactivity-impulsivity and inattentiveness in a sample of 8-year old twins drawn from a UK-representative population sample. Four years later, when the twins were 12 years old, more than 5,500 pairs drawn from the same sample were rated again on…

  20. ADHD More Often Missed in Minority Kids

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160571.html ADHD More Often Missed in Minority Kids Study found ... percentage of black children show the symptoms of attention-deficit/hyperactivity disorder (ADHD) than white kids, they are less likely ...

  1. Test-Retest Reliability of Two Patient-Report Measures for Use in Adults with ADHD

    ERIC Educational Resources Information Center

    Matza, Louis S.; Van Brunt, David L.; Cates, Charlotte; Murray, Lindsey T.

    2011-01-01

    Aims: Childhood attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and continues to impair health-related quality of life (HRQL). Thus, it is important to have validated symptom and HRQL measures for assessing treatment outcomes in this population. The purpose of the current analysis was to assess test-retest…

  2. Behavioral and Movement Disorders due to Long-Lasting Myoclonic Status Epilepticus Misdiagnosed as ADHD in a Patient With Juvenile Myoclonic Epilepsy: Electroclinical Findings and Related Hemodynamic Changes.

    PubMed

    Fanella, Martina; Carnì, Marco; Morano, Alessandra; Albini, Mariarita; Lapenta, Leonardo; Casciato, Sara; Fattouch, Jinane; Di Castro, Elisabetta; Colonnese, Claudio; Vaudano, Anna Elisabetta; Giallonardo, Anna Teresa; Di Bonaventura, Carlo

    2016-01-01

    Epilepsy and attention-deficit/hyperactivity disorder (ADHD) likely share common underlying neural mechanisms, as often suggested by both the evidence of electroencephalography (EEG) abnormalities in ADHD patients without epilepsy and the coexistence of these 2 conditions. The differential diagnosis between epilepsy and ADHD may consequently be challenging. In this report, we describe a patient presenting with a clinical association of "tics" and behavioral disorders that appeared 6 months before our first observation and had previously been interpreted as ADHD. A video-EEG evaluation documented an electroclinical pattern of myoclonic status epilepticus. On the basis of the revised clinical data, the EEG findings, the good response to valproate, the long-lasting myoclonic status epilepticus, and the enduring epileptic abnormalities likely causing behavioral disturbances, the patient's symptoms were interpreted as being the expression of untreated juvenile myoclonic epilepsy. The EEG-functional magnetic resonance imaging study revealed, during clinical generalized spike-and-wave and polyspike-and-wave discharges, positive blood oxygen level-dependent (BOLD) signal changes bilaterally in the thalamus, the prefrontal cortex (Brodmann area 6, supplementary motor area) and the cerebellum, and negative BOLD signal changes in the regions of the default mode network. Such findings, which are typical of BOLD changes observed in idiopathic generalized epilepsy, may also shed light on the anatomofunctional network underlying ADHD. PMID:25733678

  3. Demographic Characteristics and Psychiatric Comorbidity of Children and Adolescents Diagnosed with ADHD in Specialized Healthcare.

    PubMed

    Joelsson, Petteri; Chudal, Roshan; Gyllenberg, David; Kesti, Anna-Kaisa; Hinkka-Yli-Salomäki, Susanna; Virtanen, Juha-Pekka; Huttunen, Jukka; Ristkari, Terja; Parkkola, Kai; Gissler, Mika; Sourander, Andre

    2016-08-01

    Recent studies have shown an increasing incidence of attention-deficit/hyperactivity disorder (ADHD) among children diagnosed in specialized services. This study aims to describe children with ADHD in Finnish specialized healthcare by reporting the demographic characteristics, time trends in diagnosis, psychiatric comorbidity, and the validity of register-based diagnoses. All the singletons born in Finland between 1991 and 2005 and diagnosed with ADHD by 2011 were identified and their psychiatric comorbidity data was obtained from the Finnish Hospital Discharge Register (FHDR). Parents of 69 patients were interviewed via telephone for a diagnostic validation. A total of 10,409 children were identified with ADHD, with a male: female ratio of 5.3:1 and a psychiatric comorbidity rate of 76.7 %. Of the validation sample 88 % met the diagnostic criteria of ADHD for DSM-IV. There is an increasing trend of ADHD diagnosis among both males and females. Psychiatric comorbidity is common and includes a wide range of disorders among children with ADHD. There was an increase of ADHD diagnoses especially among boys. More attention is needed to detect ADHD among girls in health services. Diagnoses in the FHDR show diagnostic validity and their sociodemographic patterns are in line with previous studies. PMID:26399420

  4. A critical appraisal of atomoxetine in the management of ADHD

    PubMed Central

    Childress, Ann C

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera®, [ATX]) by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed. PMID:26730199

  5. A critical appraisal of atomoxetine in the management of ADHD.

    PubMed

    Childress, Ann C

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera(®), [ATX]) by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed. PMID:26730199

  6. PARK2 patient neuroprogenitors show increased mitochondrial sensitivity to copper.

    PubMed

    Aboud, Asad A; Tidball, Andrew M; Kumar, Kevin K; Neely, M Diana; Han, Bingying; Ess, Kevin C; Hong, Charles C; Erikson, Keith M; Hedera, Peter; Bowman, Aaron B

    2015-01-01

    Poorly-defined interactions between environmental and genetic risk factors underlie Parkinson's disease (PD) etiology. Here we tested the hypothesis that human stem cell derived forebrain neuroprogenitors from patients with known familial risk for early onset PD will exhibit enhanced sensitivity to PD environmental risk factors compared to healthy control subjects without a family history of PD. Two male siblings (SM and PM) with biallelic loss-of-function mutations in PARK2 were identified. Human induced pluripotent stem cells (hiPSCs) from SM, PM, and four control subjects with no known family histories of PD or related neurodegenerative diseases were utilized. We tested the hypothesis that hiPSC-derived neuroprogenitors from patients with PARK2 mutations would show heightened cell death, mitochondrial dysfunction, and reactive oxygen species generation compared to control cells as a result of exposure to heavy metals (PD environmental risk factors). We report that PARK2 mutant neuroprogenitors showed increased cytotoxicity with copper (Cu) and cadmium (Cd) exposure but not manganese (Mn) or methyl mercury (MeHg) relative to control neuroprogenitors. PARK2 mutant neuroprogenitors also showed a substantial increase in mitochondrial fragmentation, initial ROS generation, and loss of mitochondrial membrane potential following Cu exposure. Our data substantiate Cu exposure as an environmental risk factor for PD. Furthermore, we report a shift in the lowest observable effect level (LOEL) for greater sensitivity to Cu-dependent mitochondrial dysfunction in patients SM and PM relative to controls, correlating with their increased genetic risk for PD. PMID:25315681

  7. Increased prefrontal oxygenation related to distractor-resistant working memory in children with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Tsujimoto, Satoshi; Yasumura, Akira; Yamashita, Yushiro; Torii, Miyuki; Kaga, Makiko; Inagaki, Masumi

    2013-10-01

    This study aimed at investigating the effect of distraction on working memory and its underlying neural mechanisms in children with attention-deficit/hyperactivity disorder (ADHD). To this end, we studied hemodynamic activity in the prefrontal cortex using near-infrared spectroscopy while 16 children with ADHD and 10 typically developing (TD) children performed a working memory task. This task had two conditions: one involved a distraction during the memory delay interval, whereas the other had no systematic distraction. The ADHD patients showed significantly poorer behavioral performance compared with the TD group, particularly under the distraction. The ADHD group exhibited significantly higher level of prefrontal activation than did TD children. The activity level was positively correlated with the severity of ADHD symptoms. These results suggest that the impairment in the inhibition of distraction is responsible for the working memory deficits observed in ADHD children. Inefficient processing in the prefrontal cortex appears to underlie such deficits. PMID:23385518

  8. The Energetic Brain: Understanding and Managing ADHD

    ERIC Educational Resources Information Center

    Reynolds, Cecil R.; Vannest, Kimberly J.; Harrison, Judith R.

    2012-01-01

    ADHD affects millions of people-some 3 to 5% of the general population. Written by a neuroscientist who has studied ADHD, a clinician who has diagnosed and treated it for 30 years, and a special educator who sees it daily, "The Energetic Brain" provides the latest information from neuroscience on how the ADHD brain works and shows how to harness…

  9. DIRAS2 is Associated with Adult ADHD, Related Traits, and Co-Morbid Disorders

    PubMed Central

    Reif, Andreas; Nguyen, T Trang; Weißflog, Lena; Jacob, Christian P; Romanos, Marcel; Renner, Tobias J; Buttenschon, Henriette N; Kittel-Schneider, Sarah; Gessner, Alexandra; Weber, Heike; Neuner, Maria; Gross-Lesch, Silke; Zamzow, Karin; Kreiker, Susanne; Walitza, Susanne; Meyer, Jobst; Freitag, Christine M; Bosch, Rosa; Casas, Miquel; Gómez, Nuria; Ribasès, Marta; Bayès, Mónica; Buitelaar, Jan K; Kiemeney, Lambertus A L M; Kooij, J J Sandra; Kan, Cees C; Hoogman, Martine; Johansson, Stefan; Jacobsen, Kaya K; Knappskog, Per M; Fasmer, Ole B; Asherson, Phil; Warnke, Andreas; Grabe, Hans-Jörgen; Mahler, Jessie; Teumer, Alexander; Völzke, Henry; Mors, Ole N; Schäfer, Helmut; Ramos-Quiroga, Josep Antoni; Cormand, Bru; Haavik, Jan; Franke, Barbara; Lesch, Klaus-Peter

    2011-01-01

    Several linkage analyses implicated the chromosome 9q22 region in attention deficit/hyperactivity disorder (ADHD), a neurodevelopmental disease with remarkable persistence into adulthood. This locus contains the brain-expressed GTP-binding RAS-like 2 gene (DIRAS2) thought to regulate neurogenesis. As DIRAS2 is a positional and functional ADHD candidate gene, we conducted an association study in 600 patients suffering from adult ADHD (aADHD) and 420 controls. Replication samples consisted of 1035 aADHD patients and 1381 controls, as well as 166 families with a child affected from childhood ADHD. Given the high degree of co-morbidity with ADHD, we also investigated patients suffering from bipolar disorder (BD) (n=336) or personality disorders (PDs) (n=622). Twelve single-nucleotide polymorphisms (SNPs) covering the structural gene and the transcriptional control region of DIRAS2 were analyzed. Four SNPs and two haplotype blocks showed evidence of association with ADHD, with nominal p-values ranging from p=0.006 to p=0.05. In the adult replication samples, we obtained a consistent effect of rs1412005 and of a risk haplotype containing the promoter region (p=0.026). Meta-analysis resulted in a significant common OR of 1.12 (p=0.04) for rs1412005 and confirmed association with the promoter risk haplotype (OR=1.45, p=0.0003). Subsequent analysis in nuclear families with childhood ADHD again showed an association of the promoter haplotype block (p=0.02). rs1412005 also increased risk toward BD (p=0.026) and cluster B PD (p=0.031). Additional SNPs showed association with personality scores (p=0.008–0.048). Converging lines of evidence implicate genetic variance in the promoter region of DIRAS2 in the etiology of ADHD and co-morbid impulsive disorders. PMID:21750579

  10. Variations in EEG discharges predict ADHD severity within individual Smith-Lemli-Opitz patients

    PubMed Central

    Schreiber, John M.; Lanham, Diane C.; Trescher, William H.; Sparks, Susan E.; Wassif, Christopher A.; Caffo, Brian S.; Porter, Forbes D.; Tierney, Elaine; Gropman, Andrea L.

    2014-01-01

    Objective: We sought to examine the prevalence of EEG abnormalities in Smith-Lemli-Opitz syndrome (SLOS) as well as the relationship between interictal epileptiform discharges (IEDs) and within-subject variations in attentional symptom severity. Methods: In the context of a clinical trial for SLOS, we performed cross-sectional and repeated-measure observational studies of the relationship between EEG findings and cognitive/behavioral factors on 23 children (aged 4–17 years). EEGs were reviewed for clinical abnormalities, including IEDs, by readers blinded to participants' behavioral symptoms. Between-group differences in baseline characteristics of participants with and without IEDs were analyzed. Within-subject analyses examined the association between the presence of IEDs and changes in attention-deficit/hyperactivity disorder (ADHD) symptoms. Results: Of 85 EEGs, 43 (51%) were abnormal, predominantly because of IEDs. Only one subject had documented clinical seizures. IEDs clustered in 13 subjects (57%), whereas 9 subjects (39%) had EEGs consistently free of IEDs. While there were no significant group differences in sex, age, intellectual disability, language level, or baseline ADHD symptoms, autistic symptoms tended to be more prevalent in the “IED” group (according to Autism Diagnostic Observation Schedule–2 criteria). Within individuals, the presence of IEDs on a particular EEG predicted, on average, a 27% increase in ADHD symptom severity. Conclusions: Epileptiform discharges are common in SLOS, despite a relatively low prevalence of epilepsy. Fluctuations in the presence of epileptiform discharges within individual children with a developmental disability syndrome may be associated with fluctuations in ADHD symptomatology, even in the absence of clinical seizures. PMID:24920862

  11. An Asymmetric Stroop/Reverse-Stroop Interference Phenomenon in ADHD

    ERIC Educational Resources Information Center

    Song, Yongning; Hakoda, Yuji

    2011-01-01

    Objective: To examine whether participants with ADHD showed a deficit in Stroop/reverse-Stroop interference by comparing them to non-ADHD participants. Method: A group with ADHD, primarily inattentive type (n = 15), and a paired non-ADHD group (n = 15) completed the group version of the Stroop/reverse-Stroop test. Results: Asymmetric interference…

  12. Attention-related EEG markers in adult ADHD.

    PubMed

    Hasler, Roland; Perroud, Nader; Meziane, Hadj Boumediene; Herrmann, François; Prada, Paco; Giannakopoulos, Panteleimon; Deiber, Marie-Pierre

    2016-07-01

    ADHD status affects both bottom-up sensory processing and top-down attentional selection, impairing professional and social functioning. The objective of the study was to investigate the functional mechanisms of attention deficits in adult ADHD by examining the electrophysiological activities associated with bottom-up attentional cueing (temporal and spatial orienting of attention) and top-down control (conflict resolution). Continuous EEG was recorded in 21 adult ADHD patients (40.05±9.5 years) and 20 healthy adults (25.5±4 years) during performance of the Attention Network Test (ANT). We examined the cue and target-related P1, N1 and P3 components as well as the contingent negative variation (CNV) developing between cue and target. Oscillatory responses were analyzed in the alpha (8-13Hz) and beta (14-19Hz) frequency bands. ADHD patients performed similarly to controls but showed reduced P3 amplitude, larger early CNV decrementing over time, reduced preparatory activation in both alpha and beta bands, as well as flattened target-related posterior alpha and beta responses. As compared to controls, the inverted CNV pattern suggested peculiar preparatory processing in ADHD patients. The singular pattern of target-related beta response indicated increased inhibitory processes in the case of easier task resolution and more generally, the lack of association between conflict resolution speed and beta activity supported alternative executive processing in ADHD patients. Overall, the reduced activation of the functional networks devoted to bottom-up and top-down attention suggests that adult ADHD patients engage reduced cortical resources in this composite task, compatible with the cortical hypoarousal model. PMID:27178310

  13. Efficacy of Atomoxetine for the Treatment of ADHD Symptoms in Patients with Pervasive Developmental Disorders: A Prospective, Open-Label Study

    ERIC Educational Resources Information Center

    Fernandez-Jaen, Alberto; Fernandez-Mayoralas, Daniel Martin; Calleja-Perez, Beatriz; Munoz-Jareno, Nuria; Campos Diaz, Maria del Rosario; Lopez-Arribas, Sonia

    2013-01-01

    Objective: Atomoxetine's tolerance and efficacy were studied in 24 patients with pervasive developmental disorder and symptoms of ADHD. Method: Prospective, open-label, 16-week study was performed, using the variables of the Clinical Global Impression Scale and the Conners' Scale, among others. Results: A significant difference was found…

  14. EEG theta and beta power spectra in adolescents with ADHD versus adolescents with ASD + ADHD.

    PubMed

    Bink, M; van Boxtel, G J M; Popma, A; Bongers, I L; Denissen, A J M; van Nieuwenhuizen, Ch

    2015-08-01

    Attention problems are common in youngsters with attention deficit hyperactivity disorder (ADHD) as well as in adolescents with combined autism spectrum disorder (ASD) and ADHD. However, it is unknown whether there is psychophysiological overlap and/or a difference in electroencephalogram (EEG) power spectra between ADHD and comorbid ASD and ADHD (ASD + ADHD), on and off stimulant medication. To explore potential differences and overlap, measures of theta and beta power in adolescents diagnosed with ADHD (n = 33) versus adolescents with combined ASD + ADHD (n = 20), categorized by stimulant medication use (57 % of the total sample), were compared. EEG measures were acquired in three conditions: (1) resting state, eyes closed (2) resting state, eyes open and (3) during an oddball task. In addition, performance on the d2 attention test was analyzed. Adolescents with ADHD displayed more absolute theta activity than adolescents with ASD + ADHD during the eyes open and task conditions, independent of stimulant medication use. In addition, only the adolescents with ADHD showed an association between diminished attention test performance and increased theta in the eyes open condition. Results of the current study suggest that although there is behavioral overlap between ADHD characteristics in adolescents with ADHD and adolescents with combined ASD + ADHD, the underlying psychophysiological mechanisms may be different. Adolescents with ASD + ADHD exhibited fewer of the EEG physiological signs usually associated with ADHD, although there was an overlap in attentional problems between the groups. This may indicate that treatments developed for ADHD work differently in some adolescents with ASD + ADHD and adolescents with ADHD only. PMID:25374034

  15. Modeling and simulation of the exposure-response and dropout pattern of guanfacine extended-release in pediatric patients with ADHD.

    PubMed

    Knebel, William; Rogers, Jim; Polhamus, Dan; Ermer, James; Gastonguay, Marc R

    2015-02-01

    Guanfacine extended-release (GXR) is a selective α2A-adrenergic receptor agonist approved in the United States for once-daily administration for the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents ages 6-17 years old either as monotherapy or adjunctive to stimulant medications. This analysis integrates exposure-response, placebo, and dropout data from 10 clinical trials that used GXR in adolescents and children with ADHD. In these trials, the ADHD Rating Scale-IV (ADHD RS-IV) score was collected longitudinally within patients over the course of 6-13 weeks. Non-linear mixed effects models were developed and used to describe the exposure-response of the GXR and placebo time course. The OpenBUGS program was utilized to describe the dropout time course across the trials. Placebo time course was best described by an inverse Bateman function with a 3-group mixture model that allowed for the onset and offset of the placebo response. Dropout time modeling indicated a missing at random mechanism for dropouts which was best described by a Weibull distribution with an estimated percentage of non-dropout patients. A linear exposure-response model with an adolescent effect on maximum slope (SLPmax), and a time delay for reaching SLPmax, provided the best description of the GXR exposure-response time course. The GXR exposure-response model indicated that the typical (95 % confidence interval) decrease in ADHD RS-IV score from the placebo-response trajectory would be 37.1 % (32.2, 42.0 %) per 0.1 mg/kg of GXR exposure. There was little noticeable difference between the exposure-response in adolescents and children or across ADHD subtypes. PMID:25373474

  16. The Effect of Methylphenidate on Neurological Soft Signs in ADHD

    PubMed Central

    Hrtanek, Igor; Tonhajzerova, Ingrid; Snircova, Eva; Kulhan, Tomas; Farsky, Ivan; Nosalova, Gabriela

    2015-01-01

    Objective Neurological soft signs are very common in children with the attention deficit hyperactivity disorder (ADHD), and the first line medication of this disorder is methylphenidate. The aim of the study was to assess the effect of methylphenidate on the neurological soft signs in children and adolescents suffering from ADHD depending on the dose of methylphenidate. Methods Thirty five patients with ADHD were investigated by the ADHD RS-IV parent version questionnaire and the Revised Neurological Examination for Subtle Signs before treatment adjustment and after four weeks of methylphenidate medication. The changes in hyperactivity symptomatology, neurological soft signs during therapy and the influence of the methylphenidate dose were statistically analyzed. Results A significant decrease in hyperactivity symptomatology was found after one month of methylphenidate medication (p=0.0001) and significant decrease in neurological soft signs was demonstrated in 21 from a total of 26 items (p<0.05). Correlation analysis showed no relationship between the dose of methylphenidate and the improvement of neurological soft signs. Similarly, the improvement of ADHD symptomatology had not correlation with the improvement of neurological soft signs. Conclusion The study demonstrated the positive effect of methylphenidate on neurological soft signs in which improvement occurred independently of the dose, indicating that their progress may be due to methylphenidate treatment of any dose. The unrelated effect of methylphenidate on the attention deficit hyperactivity disorder and neurological soft signs suggest that methylphenidate might be useful in the therapy of clumsy child syndrome and in ADHD treatment of non-responders. PMID:26508967

  17. The relationship between tics, OC, ADHD and autism symptoms: A cross- disorder symptom analysis in Gilles de la Tourette syndrome patients and family-members.

    PubMed

    Huisman-van Dijk, Hilde M; Schoot, Rens van de; Rijkeboer, Marleen M; Mathews, Carol A; Cath, Daniëlle C

    2016-03-30

    Gilles de la Tourette's syndrome (GTS) is a disorder in which obsessive-compulsive (OC), Attention Deficit Hyperactivity Disorder (ADHD) and autism symptoms occur in up to 60% of patients, suggesting shared etiology. We explored the phenotypic structure of tic, OC, ADHD, and autism symptoms as measured by the YGTSS,Y-BOCS,CAARS and AQ, in 225 GTS patients and 371 family members. First, Confirmatory Factor Analyses (CFA) were performed on the symptom structure of each separate symptom scale. Second, the symptom dimensions derived from each scale were combined in one model, and correlations between them were calculated. Using the correlation matrix, Exploratory Factor Analyses (EFA) were performed on the symptom dimensions across the scales. EFA revealed a five factor structure: tic/aggression/symmetry; OC symptoms/compulsive tics/ numbers and patterns; ADHD symptoms; autism symptoms; and hoarding/inattention symptoms. The results are partly in line with the traditional categorical boundaries of the symptom scales used, and partly reveal a symptom structure that cuts through the diagnostic categories. This phenotypic structure might more closely reflect underlying etiologies than a structure that classically describes GTS patients according to absence or presence of comorbid OCD, ADHD and autism, and might inform both future genetic and treatment studies. PMID:26826899

  18. Voxel-based morphometry analysis reveals frontal brain differences in participants with ADHD and their unaffected siblings

    PubMed Central

    Bralten, Janita; Greven, Corina U.; Franke, Barbara; Mennes, Maarten; Zwiers, Marcel P.; Rommelse, Nanda N.J.; Hartman, Catharina; van der Meer, Dennis; O’Dwyer, Laurence; Oosterlaan, Jaap; Hoekstra, Pieter J.; Heslenfeld, Dirk; Arias-Vasquez, Alejandro; Buitelaar, Jan K.

    2016-01-01

    Background Data on structural brain alterations in patients with attention-deficit/hyperactivity disorder (ADHD) have been inconsistent. Both ADHD and brain volumes have a strong genetic loading, but whether brain alterations in patients with ADHD are familial has been underexplored. We aimed to detect structural brain alterations in adolescents and young adults with ADHD compared with healthy controls. We examined whether these alterations were also found in their unaffected siblings, using a uniquely large sample. Methods We performed voxel-based morphometry analyses on MRI scans of patients with ADHD, their unaffected siblings and typically developing controls. We identified brain areas that differed between participants with ADHD and controls and investigated whether these areas were different in unaffected siblings. Influences of medication use, age, sex and IQ were considered. Results Our sample included 307 patients with ADHD, 169 unaffected siblings and 196 typically developing controls (mean age 17.2 [range 8–30] yr). Compared with controls, participants with ADHD had significantly smaller grey matter volume in 5 clusters located in the precentral gyrus, medial and orbitofrontal cortex, and (para)cingulate cortices. Unaffected siblings showed intermediate volumes significantly different from controls in 4 of these clusters (all except the precentral gyrus). Medication use, age, sex and IQ did not have an undue influence on the results. Limitations Our sample was heterogeneous, most participants with ADHD were taking medication, and the comparison was cross-sectional. Conclusion Brain areas involved in decision making, motivation, cognitive control and motor functioning were smaller in participants with ADHD than in controls. Investigation of unaffected siblings indicated familiality of 4 of the structural brain differences, supporting their potential in molecular genetic analyses in ADHD research. PMID:26679925

  19. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD

    PubMed Central

    2010-01-01

    Background Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. Methods The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. Results Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? Conclusions ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group. PMID:20815868

  20. Personality Traits and Comorbidity in Adults With ADHD.

    PubMed

    Instanes, Johanne Telnes; Haavik, Jan; Halmøy, Anne

    2013-11-22

    Objective: To assess personality traits using the Temperament and Character Inventory (TCI) in a group of 63 previously diagnosed ADHD patients and 68 population controls and investigate the impact of common comorbid psychiatric disorders on these personality measures. Method: Psychiatric comorbidity was assessed with the Mini International Neuropsychiatric Interview Plus and personality traits by the TCI. Results: The patient group had significantly higher scores on the TCI dimensions Harm avoidance and Novelty seeking compared with the control group. However, when adjusting for comorbid anxiety and depressive disorder, the ADHD group no longer showed higher Harm avoidance than the control group. The difference in Novelty seeking between the patient and control groups was correlated with lifetime diagnosis of antisocial personality disorder (ASPD). Conclusion: It is important to take comorbid psychiatric disorders into account while investigating personality traits in ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24271945

  1. Patient Experience Shows Little Relationship with Hospital Quality Management Strategies

    PubMed Central

    Groene, Oliver; Arah, Onyebuchi A.; Klazinga, Niek S.; Wagner, Cordula; Bartels, Paul D.; Kristensen, Solvejg; Saillour, Florence; Thompson, Andrew; Thompson, Caroline A.; Pfaff, Holger; DerSarkissian, Maral; Sunol, Rosa

    2015-01-01

    Objectives Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. Materials and Methods We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. Results Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute

  2. A four-year follow-up controlled study of stress response and symptom persistence in Brazilian children and adolescents with attention deficit disorder and hyperactivity (ADHD).

    PubMed

    Palma, Sonia Maria Motta; Natale, Ana Carolina Motta Palma; Calil, Helena Maria

    2015-12-15

    This study evaluated children and adolescents with Attention Deficit Disorder andHyperactivity Disorder (ADHD), reassessing them at a four-year follow-up. Their cortisol response to a stress stimulus was measured twice. ADHD symptom persistence, development of comorbidities, and psychostimulant usage were also reassessed. The initial sample consisted of 38 ADHD patients and 38 healthy controls, age ranging 6-14. At the follow-up, there were 37 ADHD patients and 22 healthy controls, age ranging 10-18. ADHD was classified as persistent if the patients fulfilled all DSM IV criteria for syndromic or subthreshold or had functional impairment. Salivary cortisol samples were collected prior to the application of a cognitive stressor (Continuous Performance Test - CPT), and at three time intervals afterwards at baseline and at the follow-up. Their reassessment showed that 75% had persistent symptoms, psychiatric comorbidities (oppositional defiant and behavioral disorders), functional and academic impairement. Only seven patients were on medication. The ADHD group's cortisol levels were lower than those measured four years earlier, but cortisol concentrations were similar for both ADHD and control groups at the four-year follow-up. The cortisol results suggest that HPA axis reactivity could be a marker differentiating ADHD from ADHD with comorbidities. PMID:26365689

  3. Patient navigators show the way to faster flow.

    PubMed

    2007-09-01

    Nurses or physician assistants designated as patient navigators can ease the burden on the rest of the staff, improve relations with outside physicians, and improve patient flow in your ED. Provide them with separate phone numbers that primary care physicians can call to check on the condition of referred patients. Make them an integral part of your bed flow team, and have them serve as liaisons to admitting. Navigators also can be used to check with radiology when test results appear to be delayed. PMID:17894127

  4. Screening for ADHD in an Adult Social Phobia Sample

    ERIC Educational Resources Information Center

    Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne

    2012-01-01

    Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult…

  5. Coaching for ADHD

    ERIC Educational Resources Information Center

    Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.

    2010-01-01

    Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…

  6. Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

    ERIC Educational Resources Information Center

    Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.

    2010-01-01

    In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…

  7. Characterising resting-state functional connectivity in a large sample of adults with ADHD.

    PubMed

    Mostert, Jeanette C; Shumskaya, Elena; Mennes, Maarten; Onnink, A Marten H; Hoogman, Martine; Kan, Cornelis C; Arias Vasquez, Alejandro; Buitelaar, Jan; Franke, Barbara; Norris, David G

    2016-06-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder that often persists into adulthood. While several studies have identified altered functional connectivity in brain networks during rest in children with ADHD, few studies have been performed on adults with ADHD. Existing studies have generally investigated small samples. We therefore investigated aberrant functional connectivity in a large sample of adult patients with childhood-onset ADHD, using a data-driven, whole-brain approach. Adults with a clinical ADHD diagnosis (N=99) and healthy, adult comparison subjects (N=113) underwent a 9-minute resting-state fMRI session in a 1.5T MRI scanner. After elaborate preprocessing including a thorough head-motion correction procedure, group independent component analysis (ICA) was applied from which we identified six networks of interest: cerebellum, executive control, left and right frontoparietal and two default-mode networks. Participant-level network maps were obtained using dual-regression and tested for differences between patients with ADHD and controls using permutation testing. Patients showed significantly stronger connectivity in the anterior cingulate gyrus of the executive control network. Trends were also observed for stronger connectivity in the cerebellum network in ADHD patients compared to controls. However, there was considerable overlap in connectivity values between patients and controls, leading to relatively low effect sizes despite the large sample size. These effect sizes were slightly larger when testing for correlations between hyperactivity/impulsivity symptoms and connectivity strength in the executive control and cerebellum networks. This study provides important insights for studies on the neurobiology of adult ADHD; it shows that resting-state functional connectivity differences between adult patients and controls exist, but have smaller effect sizes than existing literature suggested. PMID:26825495

  8. Brain structural deficits and working memory fMRI dysfunction in young adults who were diagnosed with ADHD in adolescence.

    PubMed

    Roman-Urrestarazu, Andres; Lindholm, Päivi; Moilanen, Irma; Kiviniemi, Vesa; Miettunen, Jouko; Jääskeläinen, Erika; Mäki, Pirjo; Hurtig, Tuula; Ebeling, Hanna; Barnett, Jennifer H; Nikkinen, Juha; Suckling, John; Jones, Peter B; Veijola, Juha; Murray, Graham K

    2016-05-01

    When adolescents with ADHD enter adulthood, some no longer meet disorder diagnostic criteria but it is unknown if biological and cognitive abnorma lities persist. We tested the hypothesis that people diagnosed with ADHD during adolescence present residual brain abnormalities both in brain structure and in working memory brain function. 83 young adults (aged 20-24 years) from the Northern Finland 1986 Birth Cohort were classified as diagnosed with ADHD in adolescence (adolescence ADHD, n = 49) or a control group (n = 34). Only one patient had received medication for ADHD. T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. A sub-sample of both groups (ADHD, n = 21; controls n = 23) also performed a Sternberg working memory task whilst acquiring fMRI data. Areas of structural difference were used as a region of interest to evaluate the implications that structural abnormalities found in the ADHD group might have on working memory function. There was lower grey matter volume bilaterally in adolescence ADHD participants in the caudate (p < 0.05 FWE corrected across the whole brain) at age 20-24. Working memory was poorer in adolescence ADHD participants, with associated failure to show normal load-dependent caudate activation. Young adults diagnosed with ADHD in adolescence have structural and functional deficits in the caudate associated with abnormal working memory function. These findings are not secondary to stimulant treatment, and emphasise the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time. PMID:26307356

  9. Developing ADHD

    ERIC Educational Resources Information Center

    Taylor, Eric

    2009-01-01

    Over the past 50 years the concept of attention deficit/hyperactivity disorder (ADHD) has developed from the notion of a specific form of brain dysfunction to that of a heterogeneous set of related behaviours. The great advances in genetics, neuroimaging and neuropsychiatry have made it one of the best understood forms of complex mental…

  10. Interaction of recalled parental ADHD symptoms and rearing behavior with current attachment and emotional dysfunction in adult offspring with ADHD.

    PubMed

    Edel, Marc-Andreas; Juckel, Georg; Brüne, Martin

    2010-06-30

    Research into attachment and emotion regulation has shown that children with ADHD are at risk of developing attachment disorders and emotion regulation disturbances, which in part may be due to the rearing style of their parents. No such data exists for adults with persistent ADHD. We hypothesized that current attachment style and emotion processing of adult patients with ADHD may be influenced by the presence of parental ADHD symptoms when the now adult patients were children, assuming that ADHD symptoms of parents have an impact on their parenting style. We examined recalled parental ADHD symptoms and rearing style as well as current attachment and emotion regulation abilities in a sample of 73 adults with ADHD using several self-rating instruments. Recalled prevalence of ADHD symptoms in the mother, and less so in the father, of adult patients with ADHD was significantly associated with partly adverse parental rearing styles, current attachment problems in romantic partnerships and emotion regulation disturbances compared with adult ADHD patients without possibly affected parent. ADHD symptoms in parents of children with ADHD may present a risk factor for attachment problems and poor emotion regulation when ADHD children are grown. PMID:20452044

  11. ADHD Medicines (for Kids)

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  12. College Students with ADHD

    MedlinePlus

    ... Families Guide Skip breadcrumb navigation College Students with ADHD Quick Links Facts For Families Guide Facts For ... No. 111; Updated December 2013 Many students with Attention Deficit Hyperactivity Disorder (ADHD) attend college. College students with ADHD face ...

  13. Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Pediatric Narcolepsy: A Cross-Sectional Study

    PubMed Central

    Lecendreux, Michel; Lavault, Sophie; Lopez, Régis; Inocente, Clara Odilia; Konofal, Eric; Cortese, Samuele; Franco, Patricia; Arnulf, Isabelle; Dauvilliers, Yves

    2015-01-01

    Study Objectives: To evaluate the frequency, severity, and associations of symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with narcolepsy with and without cataplexy. Design: Cross-sectional survey. Setting: Four French national reference centers for narcolepsy. Patients: One hundred eight consecutively referred children aged younger than 18 y with narcolepsy, with (NwC, n = 86) or without cataplexy (NwoC, n = 22), and 67 healthy controls. Interventions: The participants, their families, and sleep specialists completed a structured interview and questionnaires about sleep, daytime sleepiness, fatigue, and ADHD symptoms (ADHD-rating scale based upon Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [DSM-IV-TR] symptoms), and use of psychostimulants for the treatment of narcolepsy (administered in 68.2%). Polysomnographic measures were collected. Measurements and Results: Clinically significant levels of ADHD symptoms were found in 4.8% of controls compared with 35.3% in patients with NwoC (P < 0.001) and 19.7% in patients with NwC (P < 0.01). Total ADHD scores were 6.4 (95% confidence interval [CI]: 4.5, 9.0) in controls compared with 14.2 (95% CI: 10.6, 18.9; P < 0.001), in patients with NwoC and 12.2 (95% CI: 9.8, 15.3; P < 0.01) in patients with NwC; subscores of inattention and hyperactivity/impulsivity were also significantly higher in both narcolepsy groups compared with controls. No difference was found between the NwC and NwoC groups for any ADHD measure. ADHD symptom severity was associated with increased levels of sleepiness, fatigue, and insomnia. Compared with the 34 untreated patients, the 73 patients treated with psychostimulants (modafinil in 91%) showed a trend toward lower narcolepsy symptoms but not lower ADHD symptoms. Conclusions: Pediatric patients with narcolepsy have high levels of treatment-resistant attention-deficit/hyperactivity disorder (ADHD) symptoms. The optimal treatment for

  14. Enlarged striatal volume in adults with ADHD carrying the 9-6 haplotype of the dopamine transporter gene DAT1.

    PubMed

    Onnink, A Marten H; Franke, Barbara; van Hulzen, Kimm; Zwiers, Marcel P; Mostert, Jeanette C; Schene, Aart H; Heslenfeld, Dirk J; Oosterlaan, Jaap; Hoekstra, Pieter J; Hartman, Catharina A; Vasquez, Alejandro Arias; Kan, Cornelis C; Buitelaar, Jan; Hoogman, Martine

    2016-08-01

    The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). Different alleles of variable number of tandem repeats (VNTRs) in this gene have been associated with childhood ADHD (10/10 genotype and haplotype 10-6) and adult ADHD (haplotype 9-6). This suggests a differential association depending on age, and a role of DAT1 in modulating the ADHD phenotype over the lifespan. The DAT1 gene may mediate susceptibility to ADHD through effects on striatal volumes, where it is most highly expressed. In an attempt to clarify its mode of action, we examined the effect of three DAT1 alleles (10/10 genotype, and the haplotypes 10-6 and 9-6) on bilateral striatal volumes (nucleus accumbens, caudate nucleus, and putamen) derived from structural magnetic resonance imaging scans using automated tissue segmentation. Analyses were performed separately in three cohorts with cross-sectional MRI data, a childhood/adolescent sample (NeuroIMAGE, 301 patients with ADHD and 186 healthy participants) and two adult samples (IMpACT, 118 patients with ADHD and 111 healthy participants; BIG, 1718 healthy participants). Regression analyses revealed that in the IMpACT cohort, and not in the other cohorts, carriers of the DAT1 adult ADHD risk haplotype 9-6 had 5.9 % larger striatum volume relative to participants not carrying this haplotype. This effect varied by diagnostic status, with the risk haplotype affecting striatal volumes only in patients with ADHD. An explorative analysis in the cohorts combined (N = 2434) showed a significant gene-by-diagnosis-by-age interaction suggesting that carriership of the 9-6 haplotype predisposes to a slower age-related decay of striatal volume specific to the patient group. This study emphasizes the need of a lifespan approach in genetic studies of ADHD. PMID:26935821

  15. Optimal management of ADHD in older adults

    PubMed Central

    Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten

    2016-01-01

    Background The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. Method A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. Results ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. Conclusion It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. PMID:26811680

  16. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data.

    PubMed

    Fair, Damien A; Nigg, Joel T; Iyer, Swathi; Bathula, Deepti; Mills, Kathryn L; Dosenbach, Nico U F; Schlaggar, Bradley L; Mennes, Maarten; Gutman, David; Bangaru, Saroja; Buitelaar, Jan K; Dickstein, Daniel P; Di Martino, Adriana; Kennedy, David N; Kelly, Clare; Luna, Beatriz; Schweitzer, Julie B; Velanova, Katerina; Wang, Yu-Feng; Mostofsky, Stewart; Castellanos, F Xavier; Milham, Michael P

    2012-01-01

    In recent years, there has been growing enthusiasm that functional magnetic resonance imaging (MRI) could achieve clinical utility for a broad range of neuropsychiatric disorders. However, several barriers remain. For example, the acquisition of large-scale datasets capable of clarifying the marked heterogeneity that exists in psychiatric illnesses will need to be realized. In addition, there continues to be a need for the development of image processing and analysis methods capable of separating signal from artifact. As a prototypical hyperkinetic disorder, and movement-related artifact being a significant confound in functional imaging studies, ADHD offers a unique challenge. As part of the ADHD-200 Global Competition and this special edition of Frontiers, the ADHD-200 Consortium demonstrates the utility of an aggregate dataset pooled across five institutions in addressing these challenges. The work aimed to (1) examine the impact of emerging techniques for controlling for "micro-movements," and (2) provide novel insights into the neural correlates of ADHD subtypes. Using support vector machine (SVM)-based multivariate pattern analysis (MVPA) we show that functional connectivity patterns in individuals are capable of differentiating the two most prominent ADHD subtypes. The application of graph-theory revealed that the Combined (ADHD-C) and Inattentive (ADHD-I) subtypes demonstrated some overlapping (particularly sensorimotor systems), but unique patterns of atypical connectivity. For ADHD-C, atypical connectivity was prominent in midline default network components, as well as insular cortex; in contrast, the ADHD-I group exhibited atypical patterns within the dlPFC regions and cerebellum. Systematic motion-related artifact was noted, and highlighted the need for stringent motion correction. Findings reported were robust to the specific motion correction strategy employed. These data suggest that resting-state functional connectivity MRI (rs-fcMRI) data can be

  17. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data

    PubMed Central

    Fair, Damien A.; Nigg, Joel T.; Iyer, Swathi; Bathula, Deepti; Mills, Kathryn L.; Dosenbach, Nico U. F.; Schlaggar, Bradley L.; Mennes, Maarten; Gutman, David; Bangaru, Saroja; Buitelaar, Jan K.; Dickstein, Daniel P.; Di Martino, Adriana; Kennedy, David N.; Kelly, Clare; Luna, Beatriz; Schweitzer, Julie B.; Velanova, Katerina; Wang, Yu-Feng; Mostofsky, Stewart; Castellanos, F. Xavier; Milham, Michael P.

    2012-01-01

    In recent years, there has been growing enthusiasm that functional magnetic resonance imaging (MRI) could achieve clinical utility for a broad range of neuropsychiatric disorders. However, several barriers remain. For example, the acquisition of large-scale datasets capable of clarifying the marked heterogeneity that exists in psychiatric illnesses will need to be realized. In addition, there continues to be a need for the development of image processing and analysis methods capable of separating signal from artifact. As a prototypical hyperkinetic disorder, and movement-related artifact being a significant confound in functional imaging studies, ADHD offers a unique challenge. As part of the ADHD-200 Global Competition and this special edition of Frontiers, the ADHD-200 Consortium demonstrates the utility of an aggregate dataset pooled across five institutions in addressing these challenges. The work aimed to (1) examine the impact of emerging techniques for controlling for “micro-movements,” and (2) provide novel insights into the neural correlates of ADHD subtypes. Using support vector machine (SVM)-based multivariate pattern analysis (MVPA) we show that functional connectivity patterns in individuals are capable of differentiating the two most prominent ADHD subtypes. The application of graph-theory revealed that the Combined (ADHD-C) and Inattentive (ADHD-I) subtypes demonstrated some overlapping (particularly sensorimotor systems), but unique patterns of atypical connectivity. For ADHD-C, atypical connectivity was prominent in midline default network components, as well as insular cortex; in contrast, the ADHD-I group exhibited atypical patterns within the dlPFC regions and cerebellum. Systematic motion-related artifact was noted, and highlighted the need for stringent motion correction. Findings reported were robust to the specific motion correction strategy employed. These data suggest that resting-state functional connectivity MRI (rs-fcMRI) data can

  18. Cognitive Deficits in Adults with ADHD Go beyond Comorbidity Effects

    ERIC Educational Resources Information Center

    Silva, Katiane L.; Guimaraes-da-Silva, Paula O.; Grevet, Eugenio H.; Victor, Marcelo M.; Salgado, Carlos A. I.; Vitola, Eduardo S.; Mota, Nina R.; Fischer, Aline G.; Contini, Veronica; Picon, Felipe A.; Karam, Rafael G.; Belmonte-de-Abreu, Paulo; Rohde, Luis A.; Bau, Claiton H. D.

    2013-01-01

    Objective: This study addresses if deficits in cognitive, attention, and inhibitory control performance in adults with ADHD are better explained by the disorder itself or by comorbid conditions. Method Adult patients with ADHD ("n" = 352) and controls ("n" = 94) were evaluated in the ADHD program of a tertiary hospital. The…

  19. Atomoxetine Treatment of ADHD in Children with Comorbid Tourette Syndrome

    ERIC Educational Resources Information Center

    Spencer, Thomas J.; Sallee, F. Randy; Gilbert, Donald L.; Dunn, David W.; McCracken, James T.; Coffey, Barbara J.; Budman, Cathy L.; Ricardi, Randall K.; Leonard, Henrietta L.; Allen, Albert J.; Milton, Denai R.; Feldman, Peter D.; Kelsey, Douglas K.; Geller, Daniel A.; Linder, Steven L.; Lewis, Donald W.; Winner, Paul K.; Kurlan, Roger M.; Mintz, Mark

    2008-01-01

    Objective: This study examines changes in severity of tics and ADHD during atomoxetine treatment in ADHD patients with Tourette syndrome (TS). Method: Subjects (7-17 years old) with ADHD ("Diagnostic and Statistical Manual of Mental Disorders, DSM-IV") and TS were randomly assigned to double-blind treatment with placebo (n = 56) or atomoxetine…

  20. Inverse Effect of Fluoxetine on Medial Prefrontal Cortex Activation During Reward Reversal in ADHD and Autism.

    PubMed

    Chantiluke, Kaylita; Barrett, Nadia; Giampietro, Vincent; Brammer, Michael; Simmons, Andrew; Murphy, Declan G; Rubia, Katya

    2015-07-01

    Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) share brain function abnormalities during cognitive flexibility. Serotonin is involved in both disorders, and selective serotonin reuptake inhibitors (SSRIs) can modulate cognitive flexibility and improve behavior in both disorders. Thus, this study investigates shared and disorder-specific brain dysfunctions in these 2 disorders during reward reversal, and the acute effects of an SSRI on these. Age-matched boys with ADHD (15), ASD (18), and controls (21) were compared with functional magnetic resonance imaging (fMRI) during a reversal task. Patients were scanned twice, under either an acute dose of Fluoxetine or placebo in a double-blind, placebo-controlled randomized design. Repeated-measures analyses within patients assessed drug effects. Patients under each drug condition were compared with controls to assess normalization effects. fMRI data showed that, under placebo, ASD boys underactivated medial prefrontal cortex (mPFC), compared with control and ADHD boys. Both patient groups shared decreased precuneus activation. Under Fluoxetine, mPFC activation was up-regulated and normalized in ASD boys relative to controls, but down-regulated in ADHD boys relative to placebo, which was concomitant with worse task performance in ADHD. Fluoxetine therefore has inverse effects on mPFC activation in ASD and ADHD during reversal learning, suggesting dissociated underlying serotonin abnormalities. PMID:24451919

  1. Oppositional Defiant Disorder in Adults with ADHD

    ERIC Educational Resources Information Center

    Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

    2013-01-01

    Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…

  2. ADHD Perspectives: Medicalization and ADHD Connectivity

    ERIC Educational Resources Information Center

    Wright, Gloria Sunnie

    2012-01-01

    Today's "ADHDscape" is no longer confined to images of fidgety children falling off classroom chairs. Trans-generational images flood popular culture, from "ADHD creator" with entrepreneurial style, to "ADHD troublemaker". Indeed, ADHD's enigmatic characteristics seem to apply as much to crying babies as to forgetful grannies. With the recent…

  3. ADHD and growth: questions still unanswered.

    PubMed

    Ptacek, Radek; Kuzelova, Hana; Stefano, George B; Raboch, Jirí; Kream, Richard M; Goetz, Michal

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders. It is manifested in every part of an affected child's behavior, with multiple symptomatology and heterogenous etiology. Published studies report that ADHD children may show changes in growth and development. Most of the studies on ADHD have been focused on connections between medication and growth changes and describe growth delays associated with medication. However, recent research results point to the low significance of the changes accompanying pharmacological treatment. Changes in growth may not only be a secondary effect of the treatment, but may also be specific characteristics of ADHD. PMID:24625909

  4. Difference between healthy children and ADHD based on wavelet spectral analysis of nuclear magnetic resonance images

    NASA Astrophysics Data System (ADS)

    González Gómez, Dulce I.; Moreno Barbosa, E.; Martínez Hernández, Mario Iván; Ramos Méndez, José; Hidalgo Tobón, Silvia; Dies Suarez, Pilar; Barragán Pérez, Eduardo; De Celis Alonso, Benito

    2014-11-01

    The main goal of this project was to create a computer algorithm based on wavelet analysis of region of homogeneity images obtained during resting state studies. Ideally it would automatically diagnose ADHD. Because the cerebellum is an area known to be affected by ADHD, this study specifically analysed this region. Male right handed volunteers (infants with ages between 7 and 11 years old) were studied and compared with age matched controls. Statistical differences between the values of the absolute integrated wavelet spectrum were found and showed significant differences (p<0.0015) between groups. This difference might help in the future to distinguish healthy from ADHD patients and therefore diagnose ADHD. Even if results were statistically significant, the small size of the sample limits the applicability of this methods as it is presented here, and further work with larger samples and using freely available datasets must be done.

  5. Difference between healthy children and ADHD based on wavelet spectral analysis of nuclear magnetic resonance images

    SciTech Connect

    González Gómez Dulce, I. E-mail: emoreno@fcfm.buap.mx E-mail: joserm84@gmail.com; Moreno Barbosa, E. E-mail: emoreno@fcfm.buap.mx E-mail: joserm84@gmail.com; Hernández, Mario Iván Martínez E-mail: emoreno@fcfm.buap.mx E-mail: joserm84@gmail.com; Méndez, José Ramos E-mail: emoreno@fcfm.buap.mx E-mail: joserm84@gmail.com; Silvia, Hidalgo Tobón; Pilar, Dies Suarez E-mail: neurodoc@prodigy.net.mx; Eduardo, Barragán Pérez E-mail: neurodoc@prodigy.net.mx; Benito, De Celis Alonso

    2014-11-07

    The main goal of this project was to create a computer algorithm based on wavelet analysis of region of homogeneity images obtained during resting state studies. Ideally it would automatically diagnose ADHD. Because the cerebellum is an area known to be affected by ADHD, this study specifically analysed this region. Male right handed volunteers (infants with ages between 7 and 11 years old) were studied and compared with age matched controls. Statistical differences between the values of the absolute integrated wavelet spectrum were found and showed significant differences (p<0.0015) between groups. This difference might help in the future to distinguish healthy from ADHD patients and therefore diagnose ADHD. Even if results were statistically significant, the small size of the sample limits the applicability of this methods as it is presented here, and further work with larger samples and using freely available datasets must be done.

  6. Obsessive-compulsive adults with and without childhood ADHD symptoms.

    PubMed

    Tan, Oguz; Metin, Baris; Metin, Sinem

    2016-09-01

    Obsessive-compulsive disorder (OCD) and attention-deficit and hyperactivity disorder (ADHD) frequently coexist. To understand whether childhood ADHD can increase the risk of OCD in adulthood and whether it influences the phenomenology of OCD, we investigated the symptoms of ADHD during childhood in obsessive-compulsive adults who had never been diagnosed as ADHD. Adults with OCD (n = 83) were given the Wender Utah Rating Scale (WURS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Barratt Impulsiveness Scale-11 (BIS-11), Hamilton Depression Rating Scale-17 (HDRS-17) and Beck Anxiety Inventory (BAI). The prevalence of childhood ADHD symptoms was 40.9 % (n = 34) and that of adult ADHD was 16.9 % (n = 14). Patients with childhood ADHD symptoms had an earlier onset of OCD, higher scores of the BAI and BIS-11. The scores of the Y-BOCS and HDRS-17 did not differ between those having and not having childhood ADHD symptoms. Childhood history of ADHD symptoms is common in adult OCD patients who have never been diagnosed as ADHD. Childhood ADHD symptoms are associated with an earlier age of OCD, more severe anxiety and higher impulsiveness. Even remitted ADHD may be a risk factor for OCD in later life. PMID:27056070

  7. Comorbidity of ADHD and incontinence in children.

    PubMed

    von Gontard, Alexander; Equit, Monika

    2015-02-01

    ADHD and incontinence are common childhood disorders which co-occur at much higher rates than expected by chance. The aim of this review was to provide an overview both of the comorbidity of nocturnal enuresis (NE), daytime urinary incontinence (DUI) and faecal incontinence (FI) in children with ADHD; and, vice versa, of the co-occurrence of ADHD in children with NE, DUI and FI. Most clinical studies have focussed on the association of ADHD and NE. Population-based studies have shown that children with DUI have an even greater risk for ADHD than those with NE. While children with FI have the highest overall comorbidity rates of psychological disorders, these are heterogeneous with a wide range of internalising and externalising disorders--not necessarily of ADHD. Genetic studies indicate that ADHD and NE, DUI and FI do not share the same genetic basis. The comorbidity is conferred by non-genetic factors. Possible aetiological and pathogenetic links between ADHD and incontinence are provided by neurophysiological, imaging and pharmacological studies. The co-occurrence has clinical implications: children with ADHD and NE, DUI and FI are more difficult to treat, show lower compliance and have less favourable treatment outcomes for incontinence. Therefore, both groups of disorders have to be assessed and treated specifically. PMID:24980793

  8. [Immunological and endocrinological pattern in ADHD etiopathogenesis].

    PubMed

    Budziszewska, Bogusława; Basta-Kaim, Agnieszka; Kubera, Marta; Lasoń, Władysław

    2010-01-01

    Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder among children. There are 3 subtypes of ADHD: (1) with prevalent inattentive symptoms (2) with prevalent hyperactive-impulsive symptoms and (3) the combined subtype. It typically manifests itself before age 7 years and occurs more frequently in boys than in girls. It is diagnosed when the hyperactivity, impulsiveness and inattention last long, appear at least in two environments and their intensity impairs the functioning of the child. The etiology of ADHD is not well-known but recent studies have shown that genetic factors are of big importance. Also several environmental influences that raise the risk for ADHD development have been identified. Recently, it has been postulated that the reduced activity of the dopaminergic and noradrenergic systems play a crucial role in ADHD pathogenesis. It is evidenced by the fact that drugs intensifying the noradrenergic and dopaminergic transmission are the most successful for ADHD treatment. At present, it has been also postulated that the disturbances in endocrine and immune systems are involved in the ADHD pathogenesis. Interconnections between functions of these systems and function of neurotransmitters are better recognized now and show that disturbances in their cooperation can be involved in some psychiatric disorders. In the case of ADHD, most data are related to disturbances in the activity of the hypothalamus-pituitary-adrenal (HPA) axis activity. In particular, the lower level of cortisol in children with ADHD, especially in the hyperactive-impulsive type ADHD, the disturbance in the circadian rhythm of this steroid and the lack of its inhibition by the dexamethasone have been documented. Many clinical data indicate that in children with ADHD, the psychological stress evokes a weaker activation of the HPA axis than in the control group. Epidemiological and preclinical investigations have shown that the disturbance in

  9. Hypoactivation in right inferior frontal cortex is specifically associated with motor response inhibition in adult ADHD

    PubMed Central

    Morein-Zamir, Sharon; Dodds, Chris; van Hartevelt, Tim J; Schwarzkopf, Wolfgang; Sahakian, Barbara; Müller, Ulrich; Robbins, Trevor

    2014-01-01

    Adult ADHD has been linked to impaired motor response inhibition and reduced associated activation in the right inferior frontal cortex (IFC). However, it is unclear whether abnormal inferior frontal activation in adult ADHD is specifically related to a response inhibition deficit or reflects a more general deficit in attentional processing. Using functional magnetic resonance imaging, we tested a group of 19 ADHD patients with no comorbidities and a group of 19 healthy control volunteers on a modified go/no-go task that has been shown previously to distinguish between cortical responses related to response inhibition and attentional shifting. Relative to the healthy controls, ADHD patients showed increased commission errors and reduced activation in inferior frontal cortex during response inhibition. Crucially, this reduced activation was observed when controlling for attentional processing, suggesting that hypoactivation in right IFC in ADHD is specifically related to impaired response inhibition. The results are consistent with the notion of a selective neurocognitive deficit in response inhibition in adult ADHD associated with abnormal functional activation in the prefrontal cortex, whilst ruling out likely group differences in attentional orienting, arousal and motivation. Hum Brain Mapp 35:5141–5152, 2014. PMID:24819224

  10. A new rating scale for adult ADHD based on the Symptom Checklist 90 (SCL-90-R).

    PubMed

    Eich, Dominique; Angst, Jules; Frei, Anja; Ajdacic-Gross, Vladeta; Rössler, Wulf; Gamma, Alex

    2012-09-01

    Attention deficit hyperactivity disorder (ADHD) in adults is increasingly recognized as a clinically important syndrome. The aim of this study was to evaluate the psychometric performance of a new scale for adult ADHD based on the widely used Symptom Checklist 90 Revised (SCL-90-R). Scale performance was assessed in a clinical study including 100 ADHD patients and 65 opiate-dependent patient controls, and in the Zurich study, an epidemiological age cohort followed over 30 years of adult life. Assessments included a ROC analysis of sensitivity and specificity, internal consistency, test-retest reliability, external validity and measurement invariance over nine testing occasions. The new scale showed a sensitivity and specificity of 75 and 54%, respectively, internal consistency over 0.8 (McDonald's omega, Cronbach's alpha), one-year test-retest reliabilities over 0.7, statistically significant and substantial correlations with two other validated self-rating scales of adult ADHD (R = 0.5 and 0.66, respectively), and an acceptable degree of longitudinal stability (i.e., measurement invariance). The proposed scale must be further evaluated, but these preliminary results indicate it could be a useful rating instrument for adult ADHD in situations where SCL-90-R data, but no specific ADHD assessment, are available, such as in retrospective data analysis or in prospective studies with limited methodical resources. PMID:22212725

  11. Serious transport accidents in adults with ADHD, and the effect of medication: A population based study

    PubMed Central

    Chang, Zheng; Lichtenstein, Paul; D’Onofrio, Brian M.; Sjölander, Arvid; Larsson, Henrik

    2013-01-01

    Importance Studies have shown that Attention-deficit/hyperactivity disorder (ADHD) is associated with transport accidents, but the magnitude of the association remains unclear. Importantly, it is also unclear whether ADHD medication reduces this risk. Objective First, to estimate the association between ADHD and the risk of serious transport accidents. Second, to explore the extent to which ADHD medication influences this risk among ADHD patients. Design, Setting, and Participants 17,408 patients with a diagnosis of ADHD were followed from 2006 to 2009 for serious transport accidents in Swedish national registers. The association between ADHD and accidents was estimated with Cox regression. To study the effect of ADHD medication, we used stratified Cox regression to compare the risk of accidents during medication period with the risk during non-medication period within the same patients. Main Outcome and Measure Serious transport accident, identified as admission to an emergency hospital care or death due to transport accident. Results Compared with individuals without ADHD, male ADHD patients (adjusted hazard ratio [HR] =1.47, 95% confidence interval [CI] 1.32–1.63) and female ADHD patients (HR=1.45, 95% CI 1.24–1.71) had increased risk of serious transport accidents. In male ADHD patients, ADHD medication was associated with a 58% risk reduction (HR=0.42, 95% CI 0.23–0.75), but there was no significant association in female patients. Estimates of the population attributable fractions suggested that 41% – 49% of the accidents in male patients with ADHD could have been avoided if they had been on treatment the entire follow-up. Conclusions and Relevance ADHD is associated with an increased risk of serious transport accidents, and this risk seems to be possibly reduced by ADHD medication, at least among male ADHD patients. This should lead to increased awareness of the association between serious transport accidents and ADHD medication among clinicians and

  12. Knowledge of Attention Deficit Hyperactivity Disorder (ADHD) and Attitudes toward Teaching Children with ADHD: The Role of Teaching Experience

    ERIC Educational Resources Information Center

    Anderson, Donnah L.; Watt, Susan E.; Noble, William; Shanley, Dianne C.

    2012-01-01

    Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD are compared across stages of Australian teachers' careers. Relative to pre-service teachers with (n = 218) and without (n = 109) teaching experience, in-service teachers (n = 127) show more overall knowledge of ADHD, more knowledge of…

  13. [Differential Diagnosis of ADHD from Personality Disorders].

    PubMed

    Ushijima, Sadanobu

    2015-01-01

    The author discussed some points regarding the process of differentially diagnosing ADHD from antisocial personality disorder with antisocial behaviors, such as the use of amphetamines, theft, and violence, and borderline personality disorder with eating disorder, self-harming, overdose, and domestic violence. Firstly, the characteristics of ADHD are a lack of interest in criminal activity, cunning, cruelty, or coming from a broken home, which are frequently observed in cases of conduct disorder. The second point concerns the main anxieties and conflicts of those with ADHD and borderline personality disorder. ADHD patients usually do not have anxieties regarding sensitiveness in interpersonal relationships, which borderline patients are likely to have. The characteristic anxieties of ADHD patients usually involve self-reproach, self-deprecation, and self-hatred derived from various kinds of mistake associated with ADHD symptoms, such as a short attention span, restlessness, and impulsiveness. Finally, the author points out that we also have to be aware of the various kinds of identity problem, even in the case of patients with typical symptoms of ADHD. PMID:26721071

  14. Body Movements of Boys with Attention Deficit Hyperactivity Disorder (ADHD) during Computer Video Game Play.

    ERIC Educational Resources Information Center

    Farrace-DiZinno, Anna Marie; Douglas, Graham; Houghton, Stephen; Lawrence, Vivienne; West, John; Whiting, Ken

    2001-01-01

    Describes a study that recorded the type and severity of body movements of 79 boys with ADHD (attention deficit hyperactivity disorder) and 67 non-ADHD boys while playing a computer video game. Results of multivariate analysis of variance showed no statistically significant differences in body movements between ADHD and non-ADHD boys. (Author/LRW)

  15. The ADHD Concomitant Difficulties Scale (ADHD-CDS), a Brief Scale to Measure Comorbidity Associated to ADHD

    PubMed Central

    Fenollar-Cortés, Javier; Fuentes, Luis J.

    2016-01-01

    Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and

  16. ADHD matures: time for practitioners to do the same?

    PubMed

    Bolea, B; Adamou, M; Arif, M; Asherson, P; Gudjonsson, G; Müller, U; Nutt, D J; Pitts, M; Thome, J; Young, S

    2012-06-01

    Attention deficit and hyperactivity disorder (ADHD) is not restricted to children. Abundant evidence from follow-up studies accumulated since the 1970s supports the concept of ADHD in adulthood. Genetic research points to a heritability of 76%, and neuroimaging studies have reported structural and functional brain abnormalities in patients with ADHD. Contrary to popular belief, ADHD is not a culturally bound disorder and has been described worldwide. ADHD has a cost for society, as adults with this disorder suffer from increased rates of unemployment and psychiatric comorbidity, including substance use disorders. Studies undertaken in forensic populations describe high rates of ADHD in these groups, particularly amongst young offenders. One of the main issues in the diagnosis of ADHD in the adult is the fact that most clinicians have not been educated to diagnose and treat ADHD. Effective pharmacological treatments for ADHD are available and should be prescribed for these patients. The National Institute for Health and Clinical Excellence (NICE) and the British Association for Psychopharmacology (BAP) guidelines established a benchmark for service development required to treat ADHD adequately in the adult population. However, the implementation of new services has been slow. More resources are needed to effectively assess and treat ADHD in the adult. PMID:21890596

  17. Comorbidity of Migraine with ADHD

    ERIC Educational Resources Information Center

    Fasmer, Ole Bernt; Riise, Trond; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.

    2012-01-01

    Objective: The purpose of this study was to investigate how often drugs used to treat migraine and ADHD are prescribed to the same patients to assess, indirectly, the comorbidity of these disorders. Method: We used data from the Norwegian prescription database for 2006, including the total Norwegian population (N = 4,640,219). Results:…

  18. Comorbidity of Asthma with ADHD

    ERIC Educational Resources Information Center

    Fasmer, Ole Bernt; Riise, Trond; Eagan, Tomas Mikal; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.

    2011-01-01

    Objective: To assess how frequently drugs used to treat asthma and ADHD are prescribed to the same patients. Method: The authors used data from the Norwegian Prescription Database for 2006, including the total Norwegian population (n = 4,640,219). Results: Anti-asthma drugs were prescribed to 350,894 persons (7.56 % of the population), anti-ADHD…

  19. Relapse Prevention in Pediatric Patients with ADHD Treated with Atomoxetine: A Randomized, Double-Blind, Placebo-Controlled Study

    ERIC Educational Resources Information Center

    Michelson, David; Buitelaar, Jan K.; Danckaerts, Marina; Gillberg, Christopher; Spencer, Thomas J.; Zuddas, Alessandro; Faries, Douglas E.; Zhang, Shuyu; Biederman, Joseph

    2004-01-01

    Objective: Attention-deficit/hyperactivity disorder (ADHD) is typically treated over extended periods; however, few placebo-controlled, long-term studies of efficacy have been reported. Method: In a global multicenter study, children and adolescents who responded to an initial 12-week, open-label period of treatment with atomoxetine, a…

  20. Factor Invariance Assessment of the Dean-Woodcock Sensory-Motor Battery for Patients with ADHD versus Nonclinical Subjects

    ERIC Educational Resources Information Center

    Finch, Holmes; Davis, Andrew; Dean, Raymond S.

    2010-01-01

    The current study examined the measurement invariance of the Dean-Woodcock Sensory-Motor Battery (DWSMB) for children diagnosed with attention deficit hyperactivity disorder (ADHD) and an age- and gender-matched nonclinical sample. The DWSMB is a promising new instrument for assessing a wide range of cortical and subcortical sensory and motor…

  1. Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD

    PubMed Central

    Arcos-Burgos, Mauricio

    2012-01-01

    During the past 15 years, an impressive amount of genetic information has become available in the research field of psychiatry, particularly as it relates to attention-deficit/hyperactivity disorder (ADHD). However, the classical clinical approach to ADHD has minimally affected and not significantly been improved by this genetic revolution. It is difficult to predict how long it will take for genetic findings to alter the way clinicians treat patients with ADHD. New medications or treatment protocols may take years to become routine clinical practice. However, when taken together, recent successes in genomics, pharmacogenomics, and genetic epidemiology have the potential (1) to prevent comorbid consequences of ADHD, (2) to individualize therapies for patients with ADHD, and (3) to define new epidemiological policies to aid with the impact of ADHD on society. Here, we present an overview of how genetic research may affect and improve the quality of life of patients with ADHD: as an example, we use the discovery of LPHN3, a new gene in which variants have recently been shown to be associated with ADHD. PMID:21432600

  2. The impact of ADHD symptoms and global impairment in childhood on working disability in mid-adulthood: a 28-year follow-up study using official disability pension records in a high-risk in-patient population

    PubMed Central

    2012-01-01

    Background Individuals with ADHD have been associated with more employment difficulties in early adulthood than healthy community controls. To examine whether this association is attributable specifically to disturbance of activity and attention (ADHD) or to psychopathology in general, we wanted to extend existing research by comparing the rate of mid-adulthood working disabilities for individuals diagnosed with ADHD as children with the rate for clinical controls diagnosed with either conduct disorder, emotional disorder or mixed disorder of conduct and emotions. Methods Former Norwegian child-psychiatric in-patients (n = 257) were followed up 17–39 years after hospitalization by record linkage to the Norwegian national registry of disability pension (DP) awards. Based on the hospital records, the patients were re-diagnosed according to ICD-10. Associations between the diagnoses, other baseline factors and subsequent DP were investigated using Kaplan–Meier survival analyses and logrank testing. Results At follow-up, 19% of the participants had received a DP award. In the logrank testing, ADHD was the only disorder associated with a subsequent DP, with 30% being disabled at follow-up (p = 0.01). Low psychosocial functioning (assessed by the Children’s Global Assessment Scale) at admission uniquely predicted future DP (p = 0.04). Conclusions ADHD in childhood was highly associated with later receiving a DP. Our finding of worse prognosis in ADHD compared with other internalizing and externalizing disorders in mid-adulthood supports the assumption of ADHD being specifically linked to working disability. Assessment of psychosocial functioning in addition to diagnostic features could enhance prediction of children who are most at risk of future disability. PMID:23083209

  3. What Is ADHD?

    MedlinePlus

    ... school failures and social problems, and have low self-esteem . About 15% to 20% of kids with ADHD ... art, or music — can boost social skills and self-esteem. previous continue Alternative Treatments The only ADHD therapies ...

  4. Toward Personalized Smoking-Cessation Treatment: Using a Predictive Modeling Approach to Guide Decisions Regarding Stimulant Medication Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in Smokers

    PubMed Central

    Luo, Sean X.; Covey, Lirio S.; Hu, Mei-Chen; Levin, Frances R.; Nunes, Edward V.; Winhusen, Theresa M.

    2015-01-01

    Background and Objectives Osmotic-release oral system methylphenidate (OROS-MPH) did not show overall benefit as an adjunct smoking cessation treatment for adult smokers with ADHD in a randomized, placebo-controlled, multicenter clinical trial. A secondary analysis revealed a significant interaction between ADHD symptom severity and treatment-response to OROS-MPH, but did not account for other baseline covariates or estimate the magnitude of improvement in outcome if treatment were optimized. This present study addressed the gaps in how this relationship should inform clinical practice. Methods Using data from the Adult Smokers with ADHD Trial (N = 255, six sites in five US States), we build predictive models to calculate the probability of achieving prolonged abstinence, verified by self-report, and expired carbon monoxide measurement. We evaluate the potential improvement in achieving prolonged abstinence with and without stratification on baseline ADHD severity. Results Predictive modeling demonstrates that the interaction between baseline ADHD severity and treatment group is not affected by adjusting for other baseline covariates. A clinical trial simulation shows that giving OROS-MPH to patients with baseline Adult ADHD Symptom Rating Scale (ADHD-RS) >35 and placebo to those with ADHD-RS ≤35 would significantly improve the prolonged abstinence rate (52 ± 8% vs. 42 ± 5%, p < .001). Conclusions and Scientific Significance In smokers with ADHD, utilization of a simple decision rule that stratifies patients based on baseline ADHD severity can enhance overall achievement of prolonged smoking abstinence. Similar analysis methods should be considered for future clinical trials for other substance use disorders. PMID:25659348

  5. ADHD: Tips to Try

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD: Tips to Try KidsHealth > For Teens > ADHD: Tips to Try Print A A A Text Size en español TDAH: Consejos que puedes probar ADHD , or attention deficit hyperactivity disorder, is a medical ...

  6. ADHD in College Students

    ERIC Educational Resources Information Center

    Weyandt, Lisa L.; DuPaul, George

    2006-01-01

    Objective: According to the American Psychiatric Association, 3% to 7% of the school-age population has ADHD and many children continue to display significant symptoms throughout adolescences and adulthood. Relative to the childhood literature, less is known about ADHD in adults, especially college students with ADHD. The principle purpose of this…

  7. Motor regulation problems and pain in adults diagnosed with ADHD

    PubMed Central

    2013-01-01

    Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often complain about back, shoulder, hip, and leg pain. We also investigate reported pain in adults with ADHD. Methods Twenty-five adult outpatients diagnosed with ADHD/HKD who were responders to methylphenidate (MPH) were compared to 23 non-ADHD controls on 16 MFNU subtests and using a ‘total score’ (‘TS’) parameter. The MFNU test leader was blinded to group identity. The two groups were also compared using the Pain Drawing and Numerical Pain Rating Scale. Results The adult ADHD group had significantly (p < .001) more motor problems (higher TS) than controls. On the muscle regulation subtests, 36–96% of the ADHD group showed ‘moderate’ to ‘severe’ problems compared to 13–52% of the control group, and 80% of the ADHD group reported widespread pain. Highly significant differences were found between the ADHD and control groups for the variables ‘pain level’ (p < .001) and ‘pain location’ (p < .001). Significant correlations were found between TS and ‘pain location’ and between TS and ‘pain level’. Conclusions These findings suggest that similar to children with ADHD, adults diagnosed with ADHD also have motor inhibition problems and heightened muscle tone. The presence of significantly higher pain levels and more widespread pain in the ADHD group compared to non-ADHD controls might indicate that pain is a long-term secondary effect of heightened muscle tone and restricted movement that can be demonstrated in children and adults by the MFNU

  8. Occurrence of ADHD in parents of ADHD children in a clinical sample

    PubMed Central

    Starck, Martina; Grünwald, Julia; Schlarb, Angelika A

    2016-01-01

    Background Despite the fact that there is a large amount of research on childhood attention deficit hyperactivity disorder (ADHD) treatment and an increasing amount of research on adult ADHD, little is known about the prevalence and influence of parental ADHD. Therefore, this study examined the frequency of parental ADHD in a clinical sample of German children suffering from ADHD. We also tried to find different levels of symptom severity for prognostic relevance. Furthermore, the association between subtypes of ADHD in children and their parents was investigated. Method In this study, parents of 79 ADHD children were screened for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. The Wender Utah Rating Scale and the ADHS-Self-Report were given to 75 mothers and 49 fathers for retrospective and current symptoms. Frequency of ADHD symptoms and severity groups was calculated and relationship between parental and children’s ADHD was tested. Results ADHD occurrence for mothers of children with ADHD was 41.3%, for fathers 51.0%. About 16.0% of the mothers had a mixed type, 9.3% had a hyperactive-impulsive subtype, and 16.0% had an inattentive subtype. Of the fathers, 18.4% had a mixed type, 10.2% had a hyperactive-impulsive subtype, and 22.4% had an inattentive subtype; 61% of the mothers and 46.9% of the fathers had low symptom severity. Medium symptom severity was reported by 37.7% mothers and 46.9% fathers, while 1.3% of the mothers and 6.2% of the fathers showed severe symptoms. No significant correlation between parental and child diagnoses was observed. Conclusion As nearly half of the parents suffered from ADHD, these results are a matter of concern in families with ADHD children. Besides parent–child interactions, parental ADHD symptoms might influence parental education style and also effects parent training as well as the child’s therapy outcome. In the

  9. Attenuated Readiness Potential in the Absence of Executive Dysfunction in Adults With ADHD.

    PubMed

    Seo, Bo-Kyung; Sartory, Gudrun; Kis, Bernhard; Scherbaum, Norbert; Müller, Bernhard W

    2013-10-25

    Objective: Patients with ADHD display a decreased contingent negative variation in Go/NoGo tasks. It is unclear whether the attenuation is due to deficits of executive function or to disorder of motor planning. The readiness potential (RP) recorded during self-initiated movements could cast light on this question. Method: RP was recorded in 25 stably medicated adult ADHD patients and 21 healthy controls matched for age, education, and verbal IQ. Participants also completed neuropsychological tests of executive function. Results: Compared with healthy controls, ADHD patients showed significantly diminished RP peaks and also decreased negativity in preparation of the movement at frontal locations. There were no significant group differences with regard to tests of executive function. Conclusion: In adults with ADHD, deficits of motor organization are also manifest in situations not involving external stimulus processing. The attenuated RP occurred in the absence of executive dysfunction. Results are consistent with partial independence between motor and executive dysfunction in ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24163327

  10. Inflammation: good or bad for ADHD?

    PubMed

    Donev, Rossen; Thome, Johannes

    2010-12-01

    Attention deficit hyperactivity disorder (ADHD) is characterised by the typical behavioural core symptoms of inattentiveness, hyperactivity and impulsiveness. ADHD is a usually chronic health conditions, mostly diagnosed in childhood, creating a significant challenge for youth, their families and professionals who treat it. This disorder requires long-term treatments, including psychotherapeutic and pharmacological interventions, which in some cases may lead to adverse effects. Understanding the mechanism by which ADHD risk factors affect the biochemical processes in the human brain and consequentially the behaviour will help to identify novel targets for the development of therapeutics with less adverse results and better efficacy including higher responder rates. Although inflammatory responses in the brain have been recognised for years as critical in neurodegeneration and behaviour in a number of neurological and psychiatric disorders, their role for the development, treatment and prevention of ADHD has been so far largely overlooked, although historically, ADHD symptoms were initially observed in patients who survived an ONJ infection, i.e. inflammation. In this review, we discuss the interrelationship between different ADHD risk factors and inflammation with respect to the triggered molecular mechanisms and the contribution they are likely to have to this disorder. This paper provides a rationale for future studies on ADHD with an intent to inspiring the development of new agents for a more efficient management of this disorder. PMID:21432611

  11. Effects of norepinephrine transporter gene variants on NET binding in ADHD and healthy controls investigated by PET

    PubMed Central

    Sigurdardottir, Helen L.; Kranz, Georg S.; Rami‐Mark, Christina; James, Gregory M.; Vanicek, Thomas; Gryglewski, Gregor; Kautzky, Alexander; Hienert, Marius; Traub‐Weidinger, Tatjana; Mitterhauser, Markus; Wadsak, Wolfgang; Hacker, Marcus; Rujescu, Dan; Kasper, Siegfried

    2016-01-01

    Abstract Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with a strong genetic component. The norepinephrine transporter (NET) is a key target for ADHD treatment and the NET gene has been of high interest as a possible modulator of ADHD pathophysiology. Therefore, we conducted an imaging genetics study to examine possible effects of single nucleotide polymorphisms (SNPs) within the NET gene on NET nondisplaceable binding potential (BPND) in patients with ADHD and healthy controls (HCs). Twenty adult patients with ADHD and 20 HCs underwent (S,S)‐[18F]FMeNER‐D2 positron emission tomography (PET) and were genotyped on a MassARRAY MALDI‐TOF platform using the Sequenom iPLEX assay. Linear mixed models analyses revealed a genotype‐dependent difference in NET BPND between groups in the thalamus and cerebellum. In the thalamus, a functional promoter SNP (−3081 A/T) and a 5′‐untranslated region (5′UTR) SNP (−182 T/C), showed higher binding in ADHD patients compared to HCs depending on the major allele. Furthermore, we detected an effect of genotype in HCs, with major allele carriers having lower binding. In contrast, for two 3′UTR SNPs (*269 T/C, *417 A/T), ADHD subjects had lower binding in the cerebellum compared to HCs depending on the major allele. Additionally, symptoms of hyperactivity and impulsivity correlated with NET BPND in the cerebellum depending on genotype. Symptoms correlated positively with cerebellar NET BPND for the major allele, while symptoms correlated negatively to NET BPND in minor allele carriers. Our findings support the role of genetic influence of the NE system on NET binding to be pertubated in ADHD. Hum Brain Mapp 37:884–895, 2016. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:26678348

  12. Effects of norepinephrine transporter gene variants on NET binding in ADHD and healthy controls investigated by PET.

    PubMed

    Sigurdardottir, Helen L; Kranz, Georg S; Rami-Mark, Christina; James, Gregory M; Vanicek, Thomas; Gryglewski, Gregor; Kautzky, Alexander; Hienert, Marius; Traub-Weidinger, Tatjana; Mitterhauser, Markus; Wadsak, Wolfgang; Hacker, Marcus; Rujescu, Dan; Kasper, Siegfried; Lanzenberger, Rupert

    2016-03-01

    Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with a strong genetic component. The norepinephrine transporter (NET) is a key target for ADHD treatment and the NET gene has been of high interest as a possible modulator of ADHD pathophysiology. Therefore, we conducted an imaging genetics study to examine possible effects of single nucleotide polymorphisms (SNPs) within the NET gene on NET nondisplaceable binding potential (BPND ) in patients with ADHD and healthy controls (HCs). Twenty adult patients with ADHD and 20 HCs underwent (S,S)-[18F]FMeNER-D2 positron emission tomography (PET) and were genotyped on a MassARRAY MALDI-TOF platform using the Sequenom iPLEX assay. Linear mixed models analyses revealed a genotype-dependent difference in NET BPND between groups in the thalamus and cerebellum. In the thalamus, a functional promoter SNP (-3081 A/T) and a 5'-untranslated region (5'UTR) SNP (-182 T/C), showed higher binding in ADHD patients compared to HCs depending on the major allele. Furthermore, we detected an effect of genotype in HCs, with major allele carriers having lower binding. In contrast, for two 3'UTR SNPs (*269 T/C, *417 A/T), ADHD subjects had lower binding in the cerebellum compared to HCs depending on the major allele. Additionally, symptoms of hyperactivity and impulsivity correlated with NET BPND in the cerebellum depending on genotype. Symptoms correlated positively with cerebellar NET BPND for the major allele, while symptoms correlated negatively to NET BPND in minor allele carriers. Our findings support the role of genetic influence of the NE system on NET binding to be pertubated in ADHD. PMID:26678348

  13. A randomized controlled trial of CBT therapy for adults with ADHD with and without medication

    PubMed Central

    2012-01-01

    Background Previous studies of psychological treatment in adults with ADHD have not controlled for medication status and include either medicated participants or mixed samples of medicated and unmedicated participants. The objective of this study is to examine whether use of medication improves outcome of therapy. Method This was a secondary analysis comparing 23 participants randomized to CBT and Dextroamphetamine vs. 25 participants randomized to CBT and placebo. Both patients and investigators were blind to treatment assignment. Two co-primary outcomes were used: ADHD symptoms on the ADHD-RS-Inv completed by the investigator and improvement in functioning as reported by the patient on the Sheehan Disability Scale. Results Both groups showed robust improvement in both symptoms and functioning, but the use of medication did not significantly improve outcome over and above use of CBT and placebo. Conclusion This study replicates previous work demonstrating that CBT is an effective treatment for ADHD in adults. Within the limits of this pilot, secondary analysis we were not able to demonstrate that medication significantly augments the outcome of CBT therapy for adults with ADHD. The study was funded by GlaxoSmithKline, Clinical Trials Registry #GSK707. PMID:22480189

  14. Neuropsychological correlates of emotional lability in children with ADHD

    PubMed Central

    Banaschewski, Tobias; Jennen-Steinmetz, Christine; Brandeis, Daniel; Buitelaar, Jan K.; Kuntsi, Jonna; Poustka, Luise; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Frazier-Wood, Alexis C.; Albrecht, Björn; Chen, Wai; Uebel, Henrik; Schlotz, Wolff; van der Meere, Jaap J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V.; Asherson, Philip

    2012-01-01

    Background Emotional lability (EL) is commonly seen in patients with Attention Deficit/Hyperactivity Disorder (ADHD). The reasons for this association are currently unknown. To address this question we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. Methods A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6 to 18 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned 4-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion, and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. Results Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate to low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. Conclusions The neuropsychological parameters examined here predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD

  15. Pharmacotherapy for adult ADHD.

    PubMed

    Adler, Lenard A

    2009-05-01

    The U.S. Food and Drug Administration has approved 3 medications, atomoxetine and the extended-release formulations of amphetamine salts and dexmethylphenidate, for the treatment of adult attention-deficit hyperactivity disorder (ADHD). Different formulations of the same drugs, as well as other agents and cognitive-behavioral therapy, have been tested to determine efficacy in ADHD alone and in ADHD with comorbid substance use disorders, mood disorders, and anxiety disorders. A deficit in research exists in regard to these comorbidities in adults with ADHD. PMID:19552859

  16. ADHD and Adolescent Athletes

    PubMed Central

    Nazeer, Ahsan; Mansour, Miriam; Gross, Kathleen A.

    2014-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects the child and adolescent population. It is characterized by impairment in attention/concentration, hyperactivity, and impulsivity, all of which can impact performance of athletes. ADHD treatment within the athletic population is a unique challenge. The research in this field has been relatively limited. The National Collegiate Athletic Association and International Olympic Committee both regulate the use of psychostimulants for treatment of ADHD due to their performance-enhancing effects. In this article, authors have discussed the screening methods, pharmacological treatment, side effects, and behavioral approaches for the treatment of ADHD in adolescent athletes. PMID:24987666

  17. Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders

    PubMed Central

    Mariani, John J.; Levin, Frances R.

    2009-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common co-occurring mental disorder among patients with substance use disorders (SUD). Clinicians must be cognizant of the complicated nature of diagnosis and treatment of ADHD when comorbid with SUD. Pharmacotherapy remains the mainstay of treatment for ADHD, although complementary psychotherapeutic approaches have been developed. Psychostimulant medications are the most commonly used medications to treat ADHD, but many clinicians are reluctant to prescribe stimulants to patients with SUD. Recommendations for treatment planning and clinical management for patients with co-occurring ADHD and SUD are discussed. PMID:17453606

  18. Event-Related Potentials in Adolescents with Combined ADHD and CD Disorder: A Single Stimulus Paradigm

    ERIC Educational Resources Information Center

    Du, Jing; Li, Jianming; Wang, Ying; Jiang, Qianjin; Livesley, W. John; Jang, Kerry L.; Wang, Kai; Wang, Wei

    2006-01-01

    Some studies of the event-related potentials demonstrated a reduction of the voluntary component P3 (P300 or P3b) in youngsters with the attention deficit/hyperactivity disorder (ADHD) or in conduct disorders (CD), and a reduction of the automatic processing component, mismatch negativity, in patients with both ADHD and CD (ADHD+CD). Recently, a…

  19. The Identification and Assessment of Late-Life ADHD in Memory Clinics

    ERIC Educational Resources Information Center

    Fischer, Barbara L.; Gunter-Hunt, Gail; Steinhafel, Courtney Holm; Howell, Timothy

    2012-01-01

    Objective: Little data exist about ADHD in late life. While evaluating patients' memory problems, the memory clinic staff has periodically identified ADHD in previously undiagnosed older adults. The authors conducted a survey to assess the extent to which other memory clinics view ADHD as a relevant clinical issue. Method: The authors developed…

  20. Holistic Treatment Approaches to ADHD: Nutrition, Sleep,and Exercise, Part 7

    ERIC Educational Resources Information Center

    Lavoie, Theresa

    2009-01-01

    This article is part of a series exploring Attention Deficit Hyperactivity Disorder (ADHD). In this seventh installment, the author discusses three holistic treatments for children and adults with ADHD: diet and nutrition, sleep, and exercise. These approaches focus and improve the overall health of ADHD patients. (For Part 6 of this series, see…

  1. ER Docs Only Ask Half of Suicidal Patients about Guns, Study Shows

    MedlinePlus

    ... Docs Only Ask Half of Suicidal Patients About Guns, Study Shows Finding points to missed chances to ... EDs) are asked if they have access to guns, a new study finds. National guidelines say doctors ...

  2. Pathophysiology of ADHD and associated problems—starting points for NF interventions?

    PubMed Central

    Albrecht, Björn; Uebel-von Sandersleben, Henrik; Gevensleben, Holger; Rothenberger, Aribert

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is characterized by severe and age-inappropriate levels of hyperactivity, impulsivity and inattention. ADHD is a heterogeneous disorder, and the majority of patients show comorbid or associated problems from other psychiatric disorders. Also, ADHD is associated with cognitive and motivational problems as well as resting-state abnormalities, associated with impaired brain activity in distinct neuronal networks. This needs to be considered in a multimodal treatment, of which neurofeedback (NF) may be a promising component. During NF, specific brain activity is fed-back using visual or auditory signals, allowing the participants to gain control over these otherwise unaware neuronal processes. NF may be used to directly improve underlying neuronal deficits, and/or to establish more general self-regulatory skills that may be used to compensate behavioral difficulties. The current manuscript describes pathophysiological characteristics of ADHD, heterogeneity of ADHD subtypes and gender differences, as well as frequently associated behavioral problems such as oppositional defiant/conduct or tic disorder. It is discussed how NF may be helpful as a treatment approach within these contexts. PMID:26157377

  3. Incidence of ADHD in adults with severe mental health problems.

    PubMed

    Kennemer, Kordell; Goldstein, Sam

    2005-01-01

    The purpose of this study was to determine the prevalence rates of attention deficit hyperactivity disorder (ADHD) and comorbid disorders in an adult inpatient psychiatric setting. Patient charts were reviewed from a state hospital in the western United States. Of the 292 persons served in 2002, only 6 received a diagnosis of ADHD. Of these patients, 2 received additional diagnoses for Major Depression, 1 for General Anxiety and 1 for Bipolar Disorder. Five of the 6 ADHD participants had a history of substance abuse and 4 were diagnosed with Personality Disorders. None of the 6 diagnosed with ADHD received a diagnosis of Learning Disability. A variety of nonstimulant medications were utilized to treat these patients. Characteristics of adult psychiatric populations are reviewed. Prevalence, comorbidity and implications for future research regarding adult ADHD are discussed. PMID:16083396

  4. Neuropsychological Correlates of Emotional Lability in Children with ADHD

    ERIC Educational Resources Information Center

    Banaschewski, Tobias; Jennen-Steinmetz, Christine; Brandeis, Daniel; Buitelaar, Jan K.; Kuntsi, Jonna; Poustka, Luise; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Frazier-Wood, Alexis C.; Albrecht, Bjorn; Chen, Wai; Uebel, Henrik; Schlotz, Wolff; van der Meere, Jaap J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V.; Asherson, Philip

    2012-01-01

    Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms…

  5. Research Forum on Psychological Treatment of Adults with ADHD

    ERIC Educational Resources Information Center

    Weiss, Margaret; Safren, Steven A.; Solanto, Mary V.; Hechtman, Lily; Rostain, Anthony L.; Ramsay, J. Russell; Murray, Candice

    2008-01-01

    Background: A literature search found five empirical studies of psychological treatment for adults with ADHD, out of 1,419 articles on ADHD in adults. Practice guidelines to date all recommend multimodal intervention, given that a significant number of patients cannot tolerate, do not respond to, or fail to reach optimal outcomes with medication…

  6. Functional Outcomes in the Treatment of Adults with ADHD

    ERIC Educational Resources Information Center

    Adler, Lenard A.; Spencer, Thomas J.; Levine, Louise R.; Ramsey, Janet L.; Tamura, Roy; Kelsey, Douglas; Ball, Susan G.; Allen, Albert J.; Biederman, Joseph

    2008-01-01

    Objective: ADHD is associated with significant functional impairment in adults. The present study examined functional outcomes following 6-month double-blind treatment with either atomoxetine or placebo. Method: Patients were 410 adults (58.5% male) with "DSM-IV"--defined ADHD. They were randomly assigned to receive either atomoxetine 40 mg/day to…

  7. Restless Leg Syndrome in ADHD children: levetiracetam as a reasonable therapeutic option.

    PubMed

    Gagliano, Antonella; Aricò, Irene; Calarese, Tiziana; Condurso, Rosaria; Germanò, Eva; Cedro, Clemente; Spina, Edoardo; Silvestri, Rosalia

    2011-06-01

    The comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) with sleep disorders has been extensively studied. In particular, Restless Legs Syndrome (RLS) appears to be consistently more frequent in children with ADHD. Several papers also draw attention to the frequent occurrence of epileptic seizures and EEG abnormalities in ADHD children. We performed a preliminary open label study to evaluate the efficacy of Levetiracetam (LEV) to ameliorate the sleep pattern and reduce RLS symptoms in children with a complex comorbidity between Attention Deficit Hyperactivity Disorder (ADHD), RLS and focal interictal epileptic discharges (IEDs) on EEG. We recruited seven children (all males, aged between 5 and 12years) who fulfilled the following criteria: ADHD diagnosis combined subtype; presence of idiopathic RLS; and presence of focal IEDs on EEG. All children were given LEV at a starting dose of approximately 10-20mg/kg/day followed by 10mg/kg/day incrementing at 1-week intervals up to 50-60mg/kg/day given in two separate doses. At a 3 and 6month follow-up, all children showed significant improvement (p<0.05) in global International RLS Rating Scale (IRLS-RS). Parents' reports revealed improved sleep quality with fewer awakenings and restorative sleep in their children. LEV was well tolerated and no major side effects were reported. With an accessory report we observed the reduction of epileptiform EEG activity during sleep. In most patients (6 on 7) the discharges completely disappeared; in the last patient epileptiform EEG activity was significantly reduced. These children may represent a subgroup of ADHD patients in which the hyperactivity and attention difficulties might be aggravated by sleep disturbances and by IEDs. LEV could represent a therapeutic option for these comorbid conditions. PMID:20950971

  8. Gastric cancers of Western European and African patients show different patterns of genomic instability

    PubMed Central

    2011-01-01

    Background Infection with H. pylori is important in the etiology of gastric cancer. Gastric cancer is infrequent in Africa, despite high frequencies of H. pylori infection, referred to as the African enigma. Variation in environmental and host factors influencing gastric cancer risk between different populations have been reported but little is known about the biological differences between gastric cancers from different geographic locations. We aim to study genomic instability patterns of gastric cancers obtained from patients from United Kingdom (UK) and South Africa (SA), in an attempt to support the African enigma hypothesis at the biological level. Methods DNA was isolated from 67 gastric adenocarcinomas, 33 UK patients, 9 Caucasian SA patients and 25 native SA patients. Microsatellite instability and chromosomal instability were analyzed by PCR and microarray comparative genomic hybridization, respectively. Data was analyzed by supervised univariate and multivariate analyses as well as unsupervised hierarchical cluster analysis. Results Tumors from Caucasian and native SA patients showed significantly more microsatellite instable tumors (p < 0.05). For the microsatellite stable tumors, geographical origin of the patients correlated with cluster membership, derived from unsupervised hierarchical cluster analysis (p = 0.001). Several chromosomal alterations showed significantly different frequencies in tumors from UK patients and native SA patients, but not between UK and Caucasian SA patients and between native and Caucasian SA patients. Conclusions Gastric cancers from SA and UK patients show differences in genetic instability patterns, indicating possible different biological mechanisms in patients from different geographical origin. This is of future clinical relevance for stratification of gastric cancer therapy. PMID:21226972

  9. Molecular epidemiology of Candida isolates from AIDS patients showing different fluconazole resistance profiles.

    PubMed Central

    Lischewski, A; Ruhnke, M; Tennagen, I; Schönian, G; Morschhäuser, J; Hacker, J

    1995-01-01

    Thirty Candida isolates obtained from the oropharynxes of three AIDS patients were genotypically characterized. In vitro fluconazole MIC determination revealed increasing fluconazole resistances during treatment, thereby confirming the in vivo situation. Pulsed-field gel electrophoresis karyotyping, randomly amplified polymorphic DNA analysis, and hybridizations with Candida albicans repetitive element 2 were used to determine possible genotypic changes. The isolates from two patients showed genetic homogeneity, suggesting the selection for resistant variants. One patient experienced a strain switch to Candida krusei. Horizontal spread of identical strains between the patients could be excluded. However, the molecular methods used might not be sufficient to detect the underlying genetic basis of resistance to fluconazole. PMID:7751395

  10. The Experience of Receiving a Diagnosis and Treatment of ADHD in Adulthood: A Qualitative Study of Clinically Referred Patients Using Interpretative Phenomenological Analysis

    ERIC Educational Resources Information Center

    Young, Susan; Bramham, Jessica; Gray, Katie; Rose, Esther

    2008-01-01

    Objective: To evaluate the psychological impact of receiving a diagnosis of ADHD in adulthood and treatment with medication and to examine how diagnosis and treatment with medication changes an individual's self-perception and view of the future. Method: Participants were eight individuals diagnosed with ADHD at a tertiary service. Semistructured…

  11. Using the Autism-Spectrum Quotient to Discriminate Autism Spectrum Disorder from ADHD in Adult Patients with and without Comorbid Substance Use Disorder

    ERIC Educational Resources Information Center

    Sizoo, Bram B.; van den Brink, Wim; Gorissen-van Eenige, Marielle; Koeter, Maarten W.; van Wijngaarden-Cremers, Patricia J. M.; van der Gaag, Rutger Jan

    2009-01-01

    It is unknown whether the Autism-spectrum quotient (AQ) can discriminate between Autism Spectrum Disorder (ASD) and Attention Deficit and Hyperactivity Disorder (ADHD) with or without comorbid Substance Use Disorder (SUD). ANOVA's were used to analyse the mean AQ (sub)scores of 129 adults with ASD or ADHD. We applied receiver operating…

  12. Associations of sleep disturbance with ADHD: implications for treatment.

    PubMed

    Hvolby, Allan

    2015-03-01

    Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies; increased sleep onset latency and shorter sleep time in actigraphic studies; and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also 'paradoxically' calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder; sleep problems may cause or mimic ADHD; ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity; and ADHD and sleep problems may share a common underlying neurological etiology. PMID:25127644

  13. ADHD: A Teachers' Guide.

    ERIC Educational Resources Information Center

    Templeton, Rosalyn A.

    This paper provides a brief historical outline of attention deficit hyperactivity disorder (ADHD), its definition, its behavioral characteristics, and a guide to creating successful learning environments for these students. Diagnostic criteria for ADHD are listed and discussed, and incidence figures of 3 to 5 percent of all school-age children are…

  14. Diagnosing ADHD in Adolescence

    ERIC Educational Resources Information Center

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  15. Stimulant ADHD medication and risk for substance abuse

    PubMed Central

    Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D’Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

    2013-01-01

    Background There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Methods Using Swedish national registers, we studied all individuals born 1960–1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. Results ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also the longer duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. Conclusions We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. PMID:25158998

  16. Zolpidem and Sleep in Pediatric Burn Patients with Attention Deficit/Hyperactivity Disorder.

    PubMed

    Cronin, Stephanie D; Gottschlich, Michele M; Gose, Lacy M; Kagan, Richard J

    2015-01-01

    Existing research shows that hospitalized patients, especially pediatric burn patients, are often sleep deprived. A pre-existing diagnosis of attention deficit/hyperactivity disorder (ADHD) further compounds a burn patient's inability to sleep. This retrospective study compared the effectiveness of zolpidem on patients with acute burns with ADHD (n = 23) and patients with acute burns without ADHD (n = 23). Effectiveness was defined based on the need for a change in the sleep medication or an increase in the zolpidem dose during the first 12 days of treatment. This study found that sleep dysfunction was similar in pediatric burn patients with and without a concurrent diagnosis of ADHD. Sixteen (69.6%) patients with and 13 (56.5%) patients without ADHD required a sleep medication change (p = 0.541). Further, while patients with ADHD required a sleep medication change (median = 5 days) sooner than those without ADHD (median = 9 days), it appears that zolpidem is not an effective drug for managing sleep in pediatric burn patients with or without ADHD. PMID:26201171

  17. Patient No-Show Predictive Model Development using Multiple Data Sources for an Effective Overbooking Approach

    PubMed Central

    Hanauer, D.A.

    2014-01-01

    Summary Background Patient no-shows in outpatient delivery systems remain problematic. The negative impacts include underutilized medical resources, increased healthcare costs, decreased access to care, and reduced clinic efficiency and provider productivity. Objective To develop an evidence-based predictive model for patient no-shows, and thus improve overbooking approaches in outpatient settings to reduce the negative impact of no-shows. Methods Ten years of retrospective data were extracted from a scheduling system and an electronic health record system from a single general pediatrics clinic, consisting of 7,988 distinct patients and 104,799 visits along with variables regarding appointment characteristics, patient demographics, and insurance information. Descriptive statistics were used to explore the impact of variables on show or no-show status. Logistic regression was used to develop a no-show predictive model, which was then used to construct an algorithm to determine the no-show threshold that calculates a predicted show/no-show status. This approach aims to overbook an appointment where a scheduled patient is predicted to be a no-show. The approach was compared with two commonly-used overbooking approaches to demonstrate the effectiveness in terms of patient wait time, physician idle time, overtime and total cost. Results From the training dataset, the optimal error rate is 10.6% with a no-show threshold being 0.74. This threshold successfully predicts the validation dataset with an error rate of 13.9%. The proposed overbooking approach demonstrated a significant reduction of at least 6% on patient waiting, 27% on overtime, and 3% on total costs compared to other common flat-overbooking methods. Conclusions This paper demonstrates an alternative way to accommodate overbooking, accounting for the prediction of an individual patient’s show/no-show status. The predictive no-show model leads to a dynamic overbooking policy that could improve patient

  18. Two forms of implicit learning in childhood ADHD

    PubMed Central

    Barnes, Kelly Anne; Howard, James H.; Howard, Darlene V.; Kenealy, Laura; Vaidya, Chandan J.

    2010-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, impulsivity and hyperactivity mediated by frontal-striatal-cerebellar dysfunction. These circuits support implicit learning of perceptual-motor sequences but not visual-spatial context. ADHD and control children performed the Alternating Serial Reaction Time (ASRT) task, a measure of sequence learning, and the Contextual Cueing (CC) task, a measure of spatial contextual learning. Relative to controls, children with ADHD showed inconsistent ASRT learning but did not differ on CC learning. Thus, implicit sequence learning, a cognitive process mediated by frontal-striatal-cerebellar circuitry that is not under executive control, was atypical in ADHD. PMID:20721771

  19. Lisdexamfetamine: A Review in ADHD in Adults.

    PubMed

    Frampton, James E

    2016-04-01

    Lisdexamfetamine dimesylate (lisdexamfetamine) is a long-acting amfetamine prodrug with a convenient once-daily oral regimen that offers the potential for improved adherence and reduced abuse compared with short-acting preparations of amfetamines. Lisdexamfetamine (as Elvanse Adult(®); Tyvense Adult™) has been approved for use in adults with attention-deficit hyperactivity disorder (ADHD) under the EU decentralization procedure, with the first approvals in the UK, Sweden and Denmark. This approval reflects the results of three short-term trials in adults with ADHD in which fixed- or flexible-dose lisdexamfetamine produced significantly greater improvements than placebo in ADHD symptoms, overall functioning, executive functioning (including in patients with significant pre-existing impairment) and quality of life. Of note, a post hoc analysis of one of these studies suggested that the response to lisdexamfetamine was generally similar in treatment-naïve patients and those who had already received-and not responded satisfactorily to-previous ADHD therapies, including methylphenidate (MPH). Two further studies demonstrated the longer-term effectiveness of flexible-dose lisdexamfetamine in reducing ADHD symptoms, albeit maintenance of efficacy required ongoing treatment with the drug. Lisdexamfetamine was generally well tolerated in clinical trials, with an adverse event profile typical of that reported for other long-acting stimulants. Head-to-head comparisons with other long-acting agents, notably MPH and atomoxetine, are lacking. Nonetheless, on the basis of the available data, lisdexamfetamine provides a useful alternative option for the treatment of adults with ADHD, including those who have not responded adequately to previous ADHD therapies, including MPH. PMID:27048350

  20. Spectrum of attention deficit hyperactivity disorders (ADHD) among Sudanese children with epilepsy

    PubMed Central

    Ahmed, Elwaleed E; Mohamed, Inaam N

    2015-01-01

    Epilepsy is commonly encountered in children with attention deficit hyperactivity disorder (ADHD). This study aims to determine the spectrum of ADHD among Sudanese children with epilepsy. The study was conducted at the Epilepsy and Neurodisabilities Outpatient Clinic for Children at Saad Abu Elila University Hospital, Khartoum, Sudan during the period January – July 2013. All patients with epilepsy who presented to the clinic during the study period were assessed for ADHD using psychometric questionnaire. According to the interpretation guide, the degree of probability of ADHD was identified. Out of 720 patients with epilepsy 77(10.6%) were identified as having ADHD. Of these 50 (19.50%) patients had a high probability of having ADHD, 29 (37.70%) above average, 29 (37.70%) average and 4 (5.20%) had low ADHD spectrum. PMID:27493420

  1. Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings.

    PubMed

    Matthies, Swantje; Philipsen, Alexandra

    2016-04-01

    Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures. PMID:26893231

  2. A Patient with Idiopathic Pleuroparenchymal Fibroelastosis Showing a Sustained Pulmonary Function due to Treatment with Pirfenidone.

    PubMed

    Sato, Seidai; Hanibuchi, Masaki; Takahashi, Mikiko; Fukuda, Yuh; Morizumi, Shun; Toyoda, Yuko; Goto, Hisatsugu; Nishioka, Yasuhiko

    2016-01-01

    The patient was a 68-year-old man presenting with body weight loss and exertional dyspnea. High-resolution computed tomography of the chest showed dense subpleural consolidation with traction bronchiectasis and volume loss predominantly in bilateral apical lesions and upper lobes. A histopathological analysis of a specimen of the right upper lobe showed histological patterns which were consistent with idiopathic pleuroparenchymal fibroelastotis (IPPFE). Treatment with pirfenidone was introduced with the expectation of its potential benefit. The effect of pirfenidone was satisfactory, and a decline in forced vital capacity was inhibited during treatment. This is the first case report suggesting the efficacy of pirfenidone for patients with IPPFE. PMID:26935370

  3. [Cognitive Behavioral Therapy and the Treatment of ADHD in Adults].

    PubMed

    Auclair, Vickie; Harvey, Philippe-Olivier; Lepage, Martin

    2016-01-01

    Background The international prevalence of adult attention deficit hyperactivity disorder (ADHD) is estimated at 2.5%. ADHD is associated with serious impairment in academic, occupational, social and emotional functioning. Despite the debilitating nature of this disorder, few individuals with ADHD receive appropriate help. Further, although psychopharmacology is considered the first-line treatment of adults with ADHD, it is now recognized that medication alone may be insufficient. Thus, cognitive behavioral therapy (CBT) is a promising approach.Objectives This study aimed to review literature and investigate the efficacy of CBT, in reducing ADHD symptoms and comorbid conditions such anxiety and depression for adults with ADHD, by several studies through a meta-analysis.Methods We searched the literature from 1946 through 2015 using especially MEDLINE, EMBASE and PsycINFO. We used a random-effects model, Odds Ratios (OR) and Hedge's g.Results Data from 12 randomized controlled studies were included, totaling 575 subjects. The results showed a significant reduction in ADHD symptoms (Hedge's g = 0.95) and comorbid anxiety (Hedge's g = 0.39) and depression (Hedge's g = 0.30) for the CBT group in comparison with controls. Following the end of treatment, ADHD symptoms continue to improve, but not the comorbid conditions.Conclusion In summary, in adults with ADHD, CBT appears to be a promising treatment. PMID:27570962

  4. Animal models of ADHD.

    PubMed

    Bari, A; Robbins, T W

    2011-01-01

    Studies employing animal models of attention-deficit/hyperactivity disorder (ADHD) present clear inherent advantages over human studies. Animal models are invaluable tools for the study of underlying neurochemical, neuropathological and genetic alterations that cause ADHD, because they allow relatively fast, rigorous hypothesis testing and invasive manipulations as well as selective breeding. Moreover, especially for ADHD, animal models with good predictive validity would allow the assessment of potential new therapeutics. In this chapter, we describe and comment on the most frequently used animal models of ADHD that have been created by genetic, neurochemical and physical alterations in rodents. We then discuss that an emerging and promising direction of the field is the analysis of individual behavioural differences among a normal population of animals. Subjects presenting extreme characteristics related to ADHD can be studied, thereby avoiding some of the problems that are found in other models, such as functional recovery and unnecessary assumptions about aetiology. This approach is justified by the theoretical need to consider human ADHD as the extreme part of a spectrum of characteristics that are distributed normally in the general population, as opposed to the predominant view of ADHD as a separate pathological category. PMID:21287324

  5. Questioning the Specificity of ASRS-v1.1 to Accurately Detect ADHD in Substance Abusing Populations

    ERIC Educational Resources Information Center

    Chiasson, Jean-Pierre; Stavro, Katherine; Rizkallah, Elie; Lapierre, Luc; Dussault, Maxime; Legault, Louis; Potvin, Stephane

    2012-01-01

    Objective: To assess the specificity of the Adult ADHD Self-Report Scale (ASRS-v1.1) in detecting ADHD among individuals with substance use disorders (SUDs). Method: A chart review of 183 SUD patients was conducted. Patients were screened for ADHD with the ASRS-v1.1 and were later assessed by a psychiatrist specialized in ADHD. Results: Among SUD…

  6. Increase in Teachers' Knowledge about ADHD after a Week-Long Training Program: A Pilot Study

    ERIC Educational Resources Information Center

    Syed, Ehsan Ullah; Hussein, Sajida Abdul

    2010-01-01

    Objectives: ADHD affects 3% to 5% of school-age children. Clinical and community based epidemiological studies in Pakistan have shown a high prevalence of ADHD among school going children. A thorough review of literature shows that no studies of teachers' training programs regarding ADHD have been published in Pakistani research literature. The…

  7. How to handle patients who miss appointments or show up late.

    PubMed

    Hills, Laura Sachs

    2009-01-01

    Patients who don't show for their appointments or who come late can take a toll on your practice's bottom line and become a huge stressor. This article offers practical suggestions for preventing unnecessary broken, missed, and late appointments and for dealing effectively both with first- and repeat offenders. It provides a 10-question quiz you can take to assess and improve your current patient attendance policies. This article then divides missed appointments into three categories-cancelled, broken, and no-show appointments-and describes effective strategies for dealing with each of them. It suggests policies to use with repeat attendance offenders, including sample language medical practices can use, and offers guidelines ultimately for dismissing those who miss appointments chronically. Finally, this article explores the reasons patients often miss appointments and strategies medical practices can use to prevent and minimize them. PMID:20073172

  8. ADHD and Writing Learning Disabilities: Overlapping Disorders and Educational Implications

    ERIC Educational Resources Information Center

    Rodríguez, Celestino; Areces, Débora; García, Trinidad; Cueli, Marisol; Loew, Stephen J.; González-Castro, Paloma

    2015-01-01

    In this review, we discuss the historic evolution of ADHD research up until the present, and explain the actual theoretical models of writing in relation to ADHD and attention. Given the characterization of writing as a recursive process, and in order to show its relationship with attention disorders, examples of applicable writing models are also…

  9. MRI volumetry shows increased anterior thalamic volumes in patients with absence seizures.

    PubMed

    Betting, Luiz Eduardo; Mory, Susana Barreto; Lopes-Cendes, Iscia; Li, Li Min; Guerreiro, Marilisa M; Guerreiro, Carlos A M; Cendes, Fernando

    2006-05-01

    The interaction between thalamus and cortex appears to be critical to the pathophysiology of idiopathic generalized epilepsies (IGEs). The objective of this study was to investigate thalamic volumes of a group of patients with IGEs using high-resolution MRI. Thalamic segmentation was performed by the same rater, who was unaware of the diagnosis. Thalamic volumes were divided into anterior half and posterior half. One hundred forty-seven patients were scanned (71 with juvenile myoclonic epilepsy, 49 with generalized tonic-clonic seizures only, and 27 with absence epilepsy). Subgroup analyses with corrections for multiple comparisons showed that, when compared with those of controls, anterior thalamic volumes were increased in patients with absence epilepsy and juvenile myoclonic epilepsy with absence seizures, but not in patients with generalized tonic-clonic seizures only and juvenile myoclonic epilepsy without absence seizures. Our results demonstrated that the anterior thalamus is structurally different in patients with IGEs and absence seizures as compared with patients with IGEs without absence seizures. PMID:16530016

  10. Challenges and Limitations to Treating ADHD in Incarcerated Populations.

    PubMed

    Hall, Ryan C W; Myers, Wade C

    2016-06-01

    An often underappreciated and hard-to-treat condition in correctional institutions is attention-deficit/hyperactivity disorder (ADHD). Although there are many effective psychopharmacologic treatments for ADHD, such as various formulations of amphetamines, many physicians are hesitant to prescribe controlled stimulants in correctional settings because of concerns about abuse and safety. Although nonstimulant alternatives are available, they are generally seen as less effective than stimulants. However, there are many unique factors regarding corrections populations and their responses to treatment, which makes it difficult to know what the ideal treatment regimen would be for this population. We review the standard treatments for ADHD, for prescribing in correctional institutions, barriers to using medications for off-label treatment of ADHD, and suggest future research that could better guide correctional treatment staff on how to approach patients with ADHD. PMID:27236170

  11. LINE-1 methylation shows little intra-patient heterogeneity in primary and synchronous metastatic colorectal cancer

    PubMed Central

    2012-01-01

    Background Long interspersed nucleotide element 1 (LINE-1) hypomethylation is suggested to play a role in the progression of colorectal cancer (CRC). To assess intra-patient heterogeneity of LINE-1 methylation in CRC and to understand its biological relevance in invasion and metastasis, we evaluated the LINE-1 methylation at multiple tumor sites. In addition, the influence of stromal cell content on the measurement of LINE-1 methylation in tumor tissue was analyzed. Methods Formalin-fixed paraffin-embedded primary tumor tissue was obtained from 48 CRC patients. Matched adjacent normal colon tissue, lymph node metastases and distant metastases were obtained from 12, 18 and 7 of these patients, respectively. Three different areas were microdissected from each primary tumor and included the tumor center and invasive front. Normal mucosal and stromal cells were also microdissected for comparison with the tumor cells. The microdissected samples were compared in LINE-1 methylation level measured by multicolor MethyLight assay. The assay results were also compared between microdissected and macrodissected tissue samples. Results LINE-1 methylation within primary tumors showed no significant intra-tumoral heterogeneity, with the tumor center and invasive front showing identical methylation levels. Moreover, no difference in LINE-1 methylation was observed between the primary tumor and lymph node and distant metastases from the same patient. Tumor cells showed significantly less LINE-1 methylation compared to adjacent stromal and normal mucosal epithelial cells. Consequently, LINE-1 methylation was significantly lower in microdissected samples compared to macrodissected samples. A trend for less LINE-1 methylation was also observed in more advanced stages of CRC. Conclusions LINE-1 methylation shows little intra-patient tumor heterogeneity, indicating the suitability of its use for molecular diagnosis in CRC. The methylation is relatively stable during CRC progression

  12. Medicines for ADHD

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007592.htm Medicines for ADHD To use the sharing features on ... that the treatment plan is successful. TYPES OF MEDICINES Stimulants are the most commonly used type of ...

  13. ADHD & Down Syndrome

    MedlinePlus

    ... at an accredited sleep center. What Types of Communication Difficulties Can Look Like ADHD? People with Down ... Down syndrome have a wide range of learning styles. A child's educational team may need to try ...

  14. Learning Disabilities and ADHD

    MedlinePlus

    ... several areas, including speaking, reading, writing, and doing math. Attention deficit hyperactivity disorder (ADHD) is not a ... Dyscalculia makes it hard for people to understand math. They may also have problems telling time and ...

  15. Latest trends in ADHD drug prescribing patterns in children in the UK: prevalence, incidence and persistence

    PubMed Central

    Beau-Lejdstrom, Raphaelle; Douglas, Ian; Evans, Stephen J W; Smeeth, Liam

    2016-01-01

    Objectives To investigate attention deficit and hyperactivity disorder (ADHD) drug prescribing in children under 16 years old in the UK between 1992 and 2013. Methods All patients under 16 registered in the Clinical Practice Research Datalink (CPRD) with a minimum of 1 year of observation time and who received at least one prescription of any ADHD drug between 1 January 1992 and 31 December 2013.Trends in prevalence and incidence of use of ADHD drugs in children were calculated between 1995 and 2013 and persistence in new users was estimated. Results The prevalence of ADHD drug use in children under 16 increased 34-fold overall, rising from 1.5 95% CI (1.1 to 2.0) per 10 000 children in 1995 to 50.7 95% CI (49.2 to 52.1) per 10 000 children in 2008 then stabilising to 51.1 95% CI (49.7 to 52.6) per 10 000 children in 2013. The rate of new users increased eightfold reaching 10.2 95% CI (9.5 to 10.9) per 10 000 children in 2007 then decreasing to 9.1 95% CI (8.5 to 9.7) per 10 000 children in 2013. Although prevalence and incidence increased rather steeply after 1995, this trend seems to halt from 2008 onwards. We identified that 77%, 95% CI (76% to 78%) of children were still under treatment after 1 year and 60% 95% CI (59% to 61%) after 2 years. Conclusions There was a marked increase in ADHD drug use among children in the UK from 1992 until around 2008, with stable levels of use since then. UK children show relatively long persistence of treatment with ADHD medications compared to other countries. PMID:27297009

  16. Integration of an EEG biomarker with a clinician's ADHD evaluation

    PubMed Central

    Snyder, Steven M; Rugino, Thomas A; Hornig, Mady; Stein, Mark A

    2015-01-01

    Background This study is the first to evaluate an assessment aid for attention-deficit/hyperactivity disorder (ADHD) according to both Class-I evidence standards of American Academy of Neurology and De Novo requirements of US Food and Drug Administration. The assessment aid involves a method to integrate an electroencephalographic (EEG) biomarker, theta/beta ratio (TBR), with a clinician's ADHD evaluation. The integration method is intended as a step to help improve certainty with criterion E (i.e., whether symptoms are better explained by another condition). Methods To evaluate the assessment aid, investigators conducted a prospective, triple-blinded, 13-site, clinical cohort study. Comprehensive clinical evaluation data were obtained from 275 children and adolescents presenting with attentional and behavioral concerns. A qualified clinician at each site performed differential diagnosis. EEG was collected by separate teams. The reference standard was consensus diagnosis by an independent, multidisciplinary team (psychiatrist, psychologist, and neurodevelopmental pediatrician), which is well-suited to evaluate criterion E in a complex clinical population. Results Of 209 patients meeting ADHD criteria per a site clinician's judgment, 93 were separately found by the multidisciplinary team to be less likely to meet criterion E, implying possible overdiagnosis by clinicians in 34% of the total clinical sample (93/275). Of those 93, 91% were also identified by EEG, showing a relatively lower TBR (85/93). Further, the integration method was in 97% agreement with the multidisciplinary team in the resolution of a clinician's uncertain cases (35/36). TBR showed statistical power specific to supporting certainty of criterion E per the multidisciplinary team (Cohen's d, 1.53). Patients with relatively lower TBR were more likely to have other conditions that could affect criterion E certainty (10 significant results; P ≤ 0.05). Integration of this information with a

  17. Chronic Rhinosinusitis Patients Show Accumulation of Genetic Variants in PARS2

    PubMed Central

    Henmyr, Viktor; Lind-Halldén, Christina; Halldén, Christer; Säll, Torbjörn; Carlberg, Daniel; Bachert, Claus; Cardell, Lars-Olaf

    2016-01-01

    Genetic studies of chronic rhinosinusitis (CRS) have identified a total of 53 CRS-associated SNPs that were subsequently evaluated for their reproducibility in a recent study. The rs2873551 SNP in linkage disequilibrium with PARS2 showed the strongest association signal. The present study aims to comprehensively screen for rare variants in PARS2 and evaluate for accumulation of such variants in CRS-patients. Sanger sequencing and long-range PCR were used to screen for rare variants in the putative promoter region and coding sequence of 310 CRS-patients and a total of 21 variants were detected. The mutation spectrum was then compared with data from European populations of the 1000Genomes project (EUR) and the Exome Aggregation Consortium (ExAC). The CRS population showed a significant surplus of low-frequency variants compared with ExAC data. Haplotype analysis of the region showed a significant excess of rare haplotypes in the CRS population compared to the EUR population. Two missense mutations were also genotyped in the 310 CRS patients and 372 CRS-negative controls, but no associations with the disease were found. This is the first re-sequencing study in CRS research and also the first study to show an association of rare variants with the disease. PMID:27348859

  18. Patients with Parkinson's Disease Show Impaired Use of Priors in Conditions of Sensory Uncertainty.

    PubMed

    Perugini, Alessandra; Ditterich, Jochen; Basso, Michele A

    2016-07-25

    Perceptual decisions arise after considering the available sensory evidence [1]. When sensory information is unreliable, a good strategy is to rely on previous experience in similar situations to guide decisions [2-6]. It is well known that patients with Parkinson's disease (PD) are impaired at value-based decision-making [7-11]. How patients combine past experience and sensory information to make perceptual decisions is unknown. We developed a novel, perceptual decision-making task and manipulated the statistics of the sensory stimuli presented to patients with PD and healthy participants to determine the influence of past experience on decision-making. We show that patients with PD are impaired at combining previously learned information with current sensory information to guide decisions. We modeled the results using the drift-diffusion model (DDM) and found that the impairment corresponds to a failure in adjusting the amount of sensory evidence needed to make a decision. Our modeling results also show that two complementary mechanisms operate to implement a bias when two sets of priors are learned concurrently. Asymmetric decision threshold adjustments, as reflected by changes in the starting point of evidence accumulation, are responsible for a general choice bias, whereas the adjustment of a dynamic bias that develops over the course of a trial, as reflected by a drift-rate offset, provides the stimulus-specific component of the prior. A proper interplay between these two processes is required to implement a bias based on concurrent, stimulus-specific priors in decision-making. We show here that patients with PD are impaired in these across-trial decision threshold adjustments. PMID:27322000

  19. Deciphering interference control in adults with ADHD by using distribution analyses and electromyographic activity.

    PubMed

    Suarez, Isabel; Burle, B; Tobon, C; Pineda, D; Lopera, F; Hasbroucq, T; Casini, L

    2015-07-01

    A deficit in "interference control" is commonly found in adults with Attention Deficit Hyperactivity Disorder (ADHD). This has mainly been interpreted as difficulties in inhibiting inappropriate responses. However, interference control involves processes other than simply the ability to inhibit. Consequently, we used sophisticated analysis to decipher the additional processes of interference control in these patients. We compared interference control between 16 adults with ADHD and 15 control adults performing a Simon task. In most studies, performance is generally reported in terms of mean error rates and reaction times (RTs). However, here we used distribution analyses of behavioral data, complemented by analyses of electromyographic (EMG) activity. This allowed us to better quantify the control of interference, specifically the part that remains hidden when pure correct trials are not distinguished from partial errors. Partial errors correspond to sub-threshold EMG bursts induced by incorrect responses that immediately precede a correct response. Moreover, besides "online" control, we also investigated cognitive control effects manifesting across consecutive trials. The main findings were that adults with ADHD were slower and showed a larger interference effect in comparison to controls. However, the data revealed that the larger interference effect was due neither to higher impulse expression, nor to a deficit in inhibition but that these patients presented a larger interference effect than the controls after congruent trials. We propose and discuss the hypothesis that the interference control deficit found in adults with ADHD is secondary to impairments in sustained attention. PMID:26057599

  20. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    PubMed

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed. PMID:23581602

  1. Cytokine profiles show heterogeneity of interferon-β response in multiple sclerosis patients

    PubMed Central

    Hegen, Harald; Adrianto, Indra; Lessard, Christopher J.; Millonig, Alban; Bertolotto, Antonio; Comabella, Manuel; Giovannoni, Gavin; Guger, Michael; Hoelzl, Martina; Khalil, Michael; Fazekas, Franz; Killestein, Joep; Lindberg, Raija L.P.; Malucchi, Simona; Mehling, Matthias; Montalban, Xavier; Rudzki, Dagmar; Schautzer, Franz; Sellebjerg, Finn; Sorensen, Per Soelberg; Deisenhammer, Florian; Steinman, Lawrence

    2016-01-01

    Objective: To evaluate serum cytokine profiles for their utility to determine the heterogeneous responses to interferon (IFN)–β treatment in patients with multiple sclerosis (MS). Methods: Patients with relapsing-remitting MS (RRMS) or clinically isolated syndrome receiving de novo IFN-β treatment were included in this prospective, observational study. Number of relapses and changes in disability were assessed 2 years prior to and 2 years after initiation of treatment. Sera were collected at baseline and after 3 months on therapy. Cytokine levels in sera were assessed by Luminex multiplex assays. Baseline cytokine profiles were grouped by hierarchical clustering analysis. Demographic features, changes in cytokines, and clinical outcome were then assessed in the clustered patient groups. Results: A total of 157 patients were included in the study and clustered into 6 distinct subsets by baseline cytokine profiles. These subsets differed significantly in their clinical and biological response to IFN-β therapy. Two subsets were associated with patients who responded poorly to therapy. Two other subsets, associated with a good response to therapy, showed a significant reduction in relapse rates and no worsening of disability. Each subset also had differential changes in cytokine levels after 3 months of IFN-β treatment. Conclusions: There is heterogeneity in the immunologic pathways of the RRMS population, which correlates with IFN-β response. PMID:26894205

  2. Multimodal neuroimaging in patients with disorders of consciousness showing "functional hemispherectomy".

    PubMed

    Bruno, M A; Fernández-Espejo, D; Lehembre, R; Tshibanda, L; Vanhaudenhuyse, A; Gosseries, O; Lommers, E; Napolitani, M; Noirhomme, Q; Boly, M; Papa, M; Owen, A; Maquet, P; Laureys, S; Soddu, A

    2011-01-01

    Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information on the structural location and extent of brain lesions (e.g., morphometric MRI and diffusion tensor imaging (DTI-MRI) assessing structural connectivity) but also their functional impact (e.g., metabolic FDG-PET, hemodynamic fMRI, and EEG measurements obtained in "resting state" conditions). We here illustrate the role of multimodal imaging in severe brain injury, presenting a patient in unresponsive wakefulness syndrome (UWS; i.e., vegetative state, VS) and in a "fluctuating" minimally conscious state (MCS). In both cases, resting state FDG-PET, fMRI, and EEG showed a functionally preserved right hemisphere, while DTI showed underlying differences in structural connectivity highlighting the complementarities of these neuroimaging methods in the study of disorders of consciousness. PMID:21854972

  3. Atypical EEG Beta Asymmetry in Adults with ADHD1

    PubMed Central

    Hale, T. Sigi; Smalley, Susan L.; Walshaw, Patricia D.; Hanada, Grant; Macion, James; McCracken, James T.; McGough, James J.; Loo, Sandra K.

    2010-01-01

    Background Abnormal brain laterality (ABL) is well established in ADHD. However, its clinical specificity and association to cognitive and clinical symptoms is not yet understood. Previous studies indicate increased right hemisphere (RH) contribution in both ADHD and reading impaired samples. The current study investigates whether this ABL characteristic occurs in adults with ADHD absent comorbid language impairment. Methods EEG beta asymmetry was compared in 35 adult ADHD subjects and 104 controls during rest and active cognition. Group differences in beta asymmetry were then further evaluated for association to linguistic and attentional abilities, as well as association to beta asymmetry measures across different brain regions. Results Adults with ADHD showed pronounced rightward beta asymmetry (p = .00001) in inferior parietal regions (P8-P7) during a continuous performance task (CPT) that could not be attributed to linguistic ability. Among ADHD subjects only, greater rightward beta asymmetry at this measure was correlated with better CPT performance. Furthermore, this measure showed a lack of normal association (i.e., observed in controls) to left-biased processing in temporal-parietal (TP8-TP7) brain regions important for higher order language functions. Conclusion Adult ADHD involves abnormally increased right-biased contribution to CPT processing that could not be attributed to poor language ability. This appears to also involve abnormal recruitment of LH linguistic processing regions and represents an alternative, albeit less effective, CPT processing strategy. These findings suggest different pathophysiologic mechanisms likely underlie RH biased processing in ADHD and reading impaired samples. PMID:20705076

  4. Familiality of Co-existing ADHD and Tic Disorders: Evidence from a Large Sibling Study

    PubMed Central

    Roessner, Veit; Banaschewski, Tobias; Becker, Andreas; Buse, Judith; Wanderer, Sina; Buitelaar, Jan K.; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Steinhausen, Hans-Christoph; Faraone, Steven V.; Asherson, Philip; Rothenberger, Aribert

    2016-01-01

    Background: The association of attention-deficit/hyperactivity disorder (ADHD) and tic disorder (TD) is frequent and clinically important. Very few and inconclusive attempts have been made to clarify if and how the combination of ADHD+TD runs in families. Aim: To determine the first time in a large-scale ADHD sample whether ADHD+TD increases the risk of ADHD+TD in siblings and, also the first time, if this is independent of their psychopathological vulnerability in general. Methods: The study is based on the International Multicenter ADHD Genetics (IMAGE) study. The present sub-sample of 2815 individuals included ADHD-index patients with co-existing TD (ADHD+TD, n = 262) and without TD (ADHD–TD, n = 947) as well as their 1606 full siblings (n = 358 of the ADHD+TD index patients and n = 1248 of the ADHD-TD index patients). We assessed psychopathological symptoms in index patients and siblings by using the Strength and Difficulties Questionnaire (SDQ) and the parent and teacher Conners' long version Rating Scales (CRS). For disorder classification the Parental Account of Childhood Symptoms (PACS-Interview) was applied in n = 271 children. Odds ratio with the GENMOD procedure (PROCGENMOD) was used to test if the risk for ADHD, TD, and ADHD+TD in siblings was associated with the related index patients' diagnoses. In order to get an estimate for specificity we compared the four groups for general psychopathological symptoms. Results: Co-existing ADHD+TD in index patients increased the risk of both comorbid ADHD+TD and TD in the siblings of these index patients. These effects did not extend to general psychopathology. Interpretation: Co-existence of ADHD+TD may segregate in families. The same holds true for TD (without ADHD). Hence, the segregation of TD (included in both groups) seems to be the determining factor, independent of further behavioral problems. This close relationship between ADHD and TD supports the clinical approach to carefully assess ADHD in any case

  5. Narcoleptic Patients Show Fragmented EEG-Microstructure During Early NREM Sleep.

    PubMed

    Kuhn, Alena; Brodbeck, Verena; Tagliazucchi, Enzo; Morzelewski, Astrid; von Wegner, Frederic; Laufs, Helmut

    2015-07-01

    Narcolepsy is a chronic disorder of the sleep-wake cycle with pathological shifts between sleep stages. These abrupt shifts are induced by a sleep-regulating flip-flop mechanism which is destabilized in narcolepsy without obvious alterations in EEG oscillations. Here, we focus on the question whether the pathology of narcolepsy is reflected in EEG microstate patterns. 30 channel awake and NREM sleep EEGs of 12 narcoleptic patients and 32 healthy subjects were analyzed. Fitting back the dominant amplitude topography maps into the EEG led to a temporal sequence of maps. Mean microstate duration, ratio total time (RTT), global explained variance (GEV) and transition probability of each map were compared between both groups. Nine patients reached N1, 5 N2 and only 4 N3. All healthy subjects reached at least N2, 19 also N3. Four dominant maps could be found during wakefulness and all NREM- sleep stages in healthy subjects. During N3, narcolepsy patients showed an additional fifth map. The mean microstate duration was significantly shorter in narcoleptic patients than controls, most prominent in deep sleep. Single maps' GEV and RTT were also altered in narcolepsy. Being aware of the limitation of our low sample size, narcolepsy patients showed wake-like features during sleep as reflected in shorter microstate durations. These microstructural EEG alterations might reflect the intrusion of brain states characteristic of wakefulness into sleep and an instability of the sleep-regulating flip-flop mechanism resulting not only in pathological switches between REM- and NREM-sleep but also within NREM sleep itself, which may lead to a microstructural fragmentation of the EEG. PMID:25168255

  6. Understanding ADHD: Symptoms in Children

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Symptoms In Children Past Issues / Spring 2014 Table ... hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be ...

  7. Women and Girls (With ADHD)

    MedlinePlus

    ... Medication and Pregnancy ADHD and Driving Organization and Time Management Managing Money Relationships & Social Skills Marriage and Partnerships ... For more information on organization, see Organizing and Time Management . 5. Career guidance . Just as women with ADHD ...

  8. The Dopamine Receptor D5 May Influence Age of Onset: An Exploratory Study on Indo-Caucasoid ADHD Subjects.

    PubMed

    Maitra, Subhamita; Sarkar, Kanyakumarika; Sinha, Swagata; Mukhopadhyay, Kanchan

    2016-09-01

    The objective was to investigate contribution of the dopamine receptor 5 (DRD5) gene variants in the symptoms of attention-deficit/hyperactivity disorder (ADHD) probands since brain regions identified to be affected in these group of patients have higher expression of the DRD5 receptor. Out of 22 exonic variants, 19 were monomorphic in the Indo-Caucasoid individuals. rs6283 "C" and rs113828117 "A" exhibited significant higher occurrence in families with ADHD probands. Several haplotypes showed biased occurrence in the probands. Early and late onset groups exhibited significantly different genotypic frequencies. A new G>A substitution was observed in the control samples only. The late onset group exhibited higher scores for hyperactivity as compared to the early onset group. The authors infer that the age of onset of ADHD may at least partially be affected by DRD5 variants warranting further investigation on the role of DRD5 in the disease etiology. PMID:27250208

  9. Influence of a Latrophilin 3 (LPHN3) risk haplotype on event-related potential measures of cognitive response control in attention-deficit hyperactivity disorder (ADHD)

    PubMed Central

    Fallgatter, Andreas J.; Ehlis, Ann-Christine; Dresler, Thomas; Reif, Andreas; Jacob, Christian P.; Arcos-Burgos, Mauricio; Muenke, Maximilian; Lesch, Klaus-Peter

    2014-01-01

    Current research strategies have made great efforts to further elucidate the complex genetic architecture of attention-deficit hyperactivity disorder (ADHD). The present study examined the impact of an LPHN3 haplotype that has recently been associated with ADHD (Arcos-Burgos et al., 2010) on neural activity in a visual Go-NoGo task. Two hundred sixteen adult ADHD patients completed a Continuous Performance Test (CPT) while the ongoing EEG was simultaneously recorded. Results showed that patients carrying two copies of the LPHN3 risk haplotype (n=114) made more omission errors and had a more anterior Go-centroid of the P300 than patients carrying at least one LPHN3 non-risk haplotype (n=102). Accordingly, the NoGo-Anteriorization (NGA; topographical ERP difference of the Go- and NoGo-condition), a neurophysiological marker of prefrontal functioning, was reduced in the LPHN3 high risk group. However, in the NoGo-condition itself no marked differences attributable to the LPHN3 haplotype could be found. Our findings indicate that, within a sample of ADHD patients, the LPHN3 gene impacts behavioral and neurophysiological measures of cognitive response control. The results of our study further strengthen the concept of an LPHN3 risk haplotype for ADHD and support the usefulness of the endophenotype approach in psychiatric and psychological research. PMID:23245769

  10. Sleep disturbance and neuropsychological function in young children with ADHD.

    PubMed

    Schneider, Heather E; Lam, Janet C; Mahone, E Mark

    2016-01-01

    Sleep disturbance, common among children with ADHD, can contribute to cognitive and behavioral dysfunction. It is therefore challenging to determine whether neurobehavioral dysfunction should be attributed to ADHD symptoms, sleep disturbance, or both. The present study examined parent-reported sleep problems (Children's Sleep Habits Questionnaire) and their relationship to neuropsychological function in 64 children, aged 4-7 years, with and without ADHD. Compared to typically developing controls, children with ADHD were reported by parents to have significantly greater sleep disturbance--including sleep onset delay, sleep anxiety, night awakenings, and daytime sleepiness--(all p ≤ .01), and significantly poorer performance on tasks of attention, executive control, processing speed, and working memory (all p < .01). Within the ADHD group, total parent-reported sleep disturbance was significantly associated with deficits in attention and executive control skills (all p ≤ .01); however, significant group differences (relative to controls) on these measures remained (p < .01) even after controlling for total sleep disturbance. While sleep problems are common among young children with ADHD, these findings suggest that inattention and executive dysfunction appear to be attributable to symptoms of ADHD rather than to sleep disturbance. The relationships among sleep, ADHD symptoms, and neurobehavioral function in older children may show different patterns as a function of the chronicity of disordered sleep. PMID:25765292

  11. Sleep Disturbance and Neuropsychological Function in Young Children with ADHD

    PubMed Central

    Schneider, Heather E.; Lam, Janet C.; Mahone, E. Mark

    2015-01-01

    Sleep disturbance, common among children with ADHD, can contribute to cognitive and behavioral dysfunction. It is therefore challenging to determine whether neurobehavioral dysfunction should be attributed to ADHD symptoms, sleep disturbance, or both. The present study examined parent-reported sleep problems (Children’s Sleep Habits Questionnaire) and their relationship to neuropsychological function in 64 children, ages 4-7 years, with and without ADHD. Compared to typically developing controls, children with ADHD were reported by parents to have significantly greater sleep disturbance—including sleep onset delay, sleep anxiety, night awakenings, and daytime sleepiness—(all p≤0.01), and significantly poorer performance on tasks of attention, executive control, processing speed, and working memory (all p<0.01). Within the ADHD group, total parent-reported sleep disturbance was significantly associated with deficits in attention and executive control skills (all p≤0.01); however, significant group differences (relative to controls) on these measures remained (p<0.01) even after controlling for total sleep disturbance. While sleep problems are common among young children with ADHD, these findings suggest that inattention and executive dysfunction appear to be attributable to symptoms of ADHD, rather than to sleep disturbance. The relationships among sleep, ADHD symptoms, and neurobehavioral function in older children may show different patterns as a function of the chronicity of disordered sleep. PMID:25765292

  12. OROS-methylphenidate efficacy on specific executive functioning deficits in adults with ADHD: a randomized, placebo-controlled cross-over study.

    PubMed

    Bron, Tannetje I; Bijlenga, Denise; Boonstra, A Marije; Breuk, Minda; Pardoen, Willem F H; Beekman, Aartjan T F; Kooij, J J Sandra

    2014-04-01

    Attention-deficit/hyperactivity disorder (ADHD) is linked to impaired executive functioning (EF). This is the first study to objectively investigate the effects of a long-acting methylphenidate on neurocognitive test performance of adults with ADHD. Twenty-two adults with ADHD participated in a 6-weeks study examining the effect of osmotic-release oral system methylphenidate (OROS-mph) on continuous performance tests (CPTs; objective measures), and on the self-reported ADHD rating scale (subjective measure) using a randomized, double-blind, placebo-controlled cross-over design. OROS-mph significantly improved reaction time variability (RTV), commission errors (CE) and d-prime (DP) as compared to baseline (Cohen's d>.50), but did not affect hit reaction time (HRT) or omission errors (OE). Compared to placebo, OROS-mph only significantly influenced RTV on one of two CPTs (p<.050). Linear regression analyses showed predictive ability of more beneficial OROS-mph effects in ADHD patients with higher EF severity (RTV: β=.670, t=2.097, p=.042; omission errors (OE): β=-.098, t=-4.759, p<.001), and with more severe ADHD symptoms (RTV: F=6.363, p=.019; HRT: F=3.914, p=.061). Side effects rates were substantially but non-significantly greater for OROS-mph compared to placebo (77% vs. 46%, p=.063). OROS-mph effects indicated RTV as the most sensitive parameter for measuring both neuropsychological and behavioral deficits in adults with ADHD. These findings suggest RTV as an endophenotypic parameter for ADHD symptomatology, and propose CPTs as an objective method for monitoring methylphenidate titration. PMID:24508533

  13. Exploring DRD4 and its interaction with SLC6A3 as possible risk factors for adult ADHD: a meta-analysis in four European populations.

    PubMed

    Sánchez-Mora, Cristina; Ribasés, Marta; Casas, Miquel; Bayés, Mònica; Bosch, Rosa; Fernàndez-Castillo, Noelia; Brunso, Lucas; Jacobsen, Kaya K; Landaas, Elisabeth T; Lundervold, Astri J; Gross-Lesch, Silke; Kreiker, Susanne; Jacob, Christian P; Lesch, Klaus-Peter; Buitelaar, Jan K; Hoogman, Martine; Kiemeney, Lambertus A L M; Kooij, J J Sandra; Mick, Eric; Asherson, Phil; Faraone, Stephen V; Franke, Barbara; Reif, Andreas; Johansson, Stefan; Haavik, Jan; Ramos-Quiroga, Josep Antoni; Cormand, Bru

    2011-07-01

    Attention-deficit hyperactivity disorder (ADHD) is a common behavioral disorder affecting about 4-8% of children. ADHD persists into adulthood in around 65% of cases, either as the full condition or in partial remission with persistence of symptoms. Pharmacological, animal and molecular genetic studies support a role for genes of the dopaminergic system in ADHD due to its essential role in motor control, cognition, emotion, and reward. Based on these data, we analyzed two functional polymorphisms within the DRD4 gene (120 bp duplication in the promoter and 48 bp VNTR in exon 3) in a clinical sample of 1,608 adult ADHD patients and 2,352 controls of Caucasian origin from four European countries that had been recruited in the context of the International Multicentre persistent ADHD CollaboraTion (IMpACT). Single-marker analysis of the two polymorphisms did not reveal association with ADHD. In contrast, multiple-marker meta-analysis showed a nominal association (P = 0.02) of the L-4R haplotype (dup120bp-48bpVNTR) with adulthood ADHD, especially with the combined clinical subtype. Since we previously described association between adulthood ADHD and the dopamine transporter SLC6A3 9R-6R haplotype (3'UTR VNTR-intron 8 VNTR) in the same dataset, we further tested for gene × gene interaction between DRD4 and SLC6A3. However, we detected no epistatic effects but our results rather suggest additive effects of the DRD4 risk haplotype and the SLC6A3 gene. PMID:21595008

  14. Unique white matter microstructural patterns in ADHD presentations-a diffusion tensor imaging study.

    PubMed

    Svatkova, Alena; Nestrasil, Igor; Rudser, Kyle; Goldenring Fine, Jodene; Bledsoe, Jesse; Semrud-Clikeman, Margaret

    2016-09-01

    Attention-deficit/hyperactivity disorder predominantly inattentive (ADHD-PI) and combined (ADHD-C) presentations are likely distinct disorders that differ neuroanatomically, neurochemically, and neuropsychologically. However, to date, little is known about specific white matter (WM) regions differentiating ADHD presentations. This study examined differences in WM microstructure using diffusion tensor imaging (DTI) data from 20 ADHD-PI, 18 ADHD-C, and 27 typically developed children. Voxel-wise analysis of DTI measurements in major fiber bundles was carried out using tract-based spatial statistics (TBSS). Clusters showing diffusivity abnormalities were used as regions of interest for regression analysis between fractional anisotropy (FA) and neuropsychological outcomes. Compared to neurotypicals, ADHD-PI children showed higher FA in the anterior thalamic radiations (ATR), bilateral inferior longitudinal fasciculus (ILF), and in the left corticospinal tract (CST). In contrast, the ADHD-C group exhibited higher FA in the bilateral cingulum bundle (CB). In the ADHD-PI group, differences in FA in the left ILF and ATR were accompanied by axial diffusivity (AD) abnormalities. In addition, the ADHD-PI group exhibited atypical mean diffusivity in the forceps minor (FMi) and left ATR and AD differences in right CB compared to healthy subjects. Direct comparison between ADHD presentations demonstrated radial diffusivity differences in FMi. WM clusters with FA irregularities in ADHD were associated with neurobehavioral performance across groups. In conclusion, differences in WM microstructure in ADHD presentations strengthen the theory that ADHD-PI and ADHD-C are two distinct disorders. Regions with WM irregularity seen in both ADHD presentations might serve as predictors of executive and behavioral functioning across groups. Hum Brain Mapp 37:3323-3336, 2016. © 2016 Wiley Periodicals, Inc. PMID:27159198

  15. Hamartomas from patients with tuberous sclerosis show loss of heterozygosity for chromosome 9q34

    SciTech Connect

    Green, A.J.; Sepp, T.; Yates, J.R.W. |

    1994-09-01

    We have previously shown allele loss in hamartomas from cases of tuberous sclerosis (TSC) for markers in the region of the recently characterized TSC2 gene on chromosome 16p13.3. Germline deletions in the TSC2 gene have been shown in 5% of patients with TSC. These data strongly suggest that the TSC2 gene acts as a tumor suppressor gene. We hypothesised that hamartomas from patients with TSC can also show allele loss for markers on chromosome 9q34 in the region of the TSC1 gene. We studied 7 hamartomas (3 renal angiomyolipomas, 3 giant cell astrocytomas, and a cardiac rhabdomyoma) from 7 cases of TSC, none of which showed allele loss for markers on chromosome 16p13.3. Eight microsatellite markers were analyzed, comprising from centromeric to telomeric, ASS - D9S64 - D9S149 -D9S150 - DBH - D9S66 - D9S114 - D9S67. Two hamartomas (one renal angiomyolipoma and one giant cell astrocytoma) showed allele loss for at least two markers. The region of allele loss involved the TSC1 locus, but did not include D9S149 or D9S67. We have shown allele loss in two of seven TSC hamartomas in the region of the TSC1 gene on 9q34. Based on this deletion mapping, we suggest that the TSC1 gene on 9a34, like the TSC2 gene, acts as a tumor suppressor gene.

  16. Glyphosate Use Predicts ADHD Hospital Discharges in the Healthcare Cost and Utilization Project Net (HCUPnet): A Two-Way Fixed-Effects Analysis

    PubMed Central

    Fluegge, Keith R.; Fluegge, Kyle R.

    2015-01-01

    There has been considerable international study on the etiology of rising mental disorders, such as attention-deficit hyperactivity disorder (ADHD), in human populations. As glyphosate is the most commonly used herbicide in the world, we sought to test the hypothesis that glyphosate use in agriculture may be a contributing environmental factor to the rise of ADHD in human populations. State estimates for glyphosate use and nitrogen fertilizer use were obtained from the U.S. Geological Survey (USGS). We queried the Healthcare Cost and Utilization Project net (HCUPNET) for state-level hospitalization discharge data in all patients for all-listed ADHD from 2007 to 2010. We used rural-urban continuum codes from the USDA-Economic Research Service when exploring the effect of urbanization on the relationship between herbicide use and ADHD. Least squares dummy variable (LSDV) method and within method using two-way fixed effects was used to elucidate the relationship between glyphosate use and all-listed ADHD hospital discharges. We show that a one kilogram increase in glyphosate use, in particular, in one year significantly positively predicts state-level all-listed ADHD discharges, expressed as a percent of total mental disorders, the following year (coefficient = 5.54E-08, p<.01). A study on the effect of urbanization on the relationship between glyphosate and ADHD indicates that the relationship is marginally significantly positive after multiple comparison correction only in urban U.S. counties (p<.025). Furthermore, total glyphosate use is strongly positively associated with total farm use of nitrogen fertilizers from 1992 to 2006 (p<.001). We present evidence from the biomedical research literature of a plausible link among glyphosate, nitrogen dysbiosis and ADHD. Glyphosate use is a significant predictor of state hospitalizations for all-listed ADHD hospital discharges, with the effect concentrated in urban U.S. counties. This effect is seen even after controlling

  17. Glyphosate Use Predicts ADHD Hospital Discharges in the Healthcare Cost and Utilization Project Net (HCUPnet): A Two-Way Fixed-Effects Analysis.

    PubMed

    Fluegge, Keith R; Fluegge, Kyle R

    2015-01-01

    There has been considerable international study on the etiology of rising mental disorders, such as attention-deficit hyperactivity disorder (ADHD), in human populations. As glyphosate is the most commonly used herbicide in the world, we sought to test the hypothesis that glyphosate use in agriculture may be a contributing environmental factor to the rise of ADHD in human populations. State estimates for glyphosate use and nitrogen fertilizer use were obtained from the U.S. Geological Survey (USGS). We queried the Healthcare Cost and Utilization Project net (HCUPNET) for state-level hospitalization discharge data in all patients for all-listed ADHD from 2007 to 2010. We used rural-urban continuum codes from the USDA-Economic Research Service when exploring the effect of urbanization on the relationship between herbicide use and ADHD. Least squares dummy variable (LSDV) method and within method using two-way fixed effects was used to elucidate the relationship between glyphosate use and all-listed ADHD hospital discharges. We show that a one kilogram increase in glyphosate use, in particular, in one year significantly positively predicts state-level all-listed ADHD discharges, expressed as a percent of total mental disorders, the following year (coefficient = 5.54E-08, p<.01). A study on the effect of urbanization on the relationship between glyphosate and ADHD indicates that the relationship is marginally significantly positive after multiple comparison correction only in urban U.S. counties (p<.025). Furthermore, total glyphosate use is strongly positively associated with total farm use of nitrogen fertilizers from 1992 to 2006 (p<.001). We present evidence from the biomedical research literature of a plausible link among glyphosate, nitrogen dysbiosis and ADHD. Glyphosate use is a significant predictor of state hospitalizations for all-listed ADHD hospital discharges, with the effect concentrated in urban U.S. counties. This effect is seen even after controlling

  18. High loading of polygenic risk for ADHD in children with comorbid aggression.

    PubMed

    Hamshere, Marian L; Langley, Kate; Martin, Joanna; Agha, Sharifah Shameem; Stergiakouli, Evangelia; Anney, Richard J L; Buitelaar, Jan; Faraone, Stephen V; Lesch, Klaus-Peter; Neale, Benjamin M; Franke, Barbara; Sonuga-Barke, Edmund; Asherson, Philip; Merwood, Andrew; Kuntsi, Jonna; Medland, Sarah E; Ripke, Stephan; Steinhausen, Hans-Christoph; Freitag, Christine; Reif, Andreas; Renner, Tobias J; Romanos, Marcel; Romanos, Jasmin; Warnke, Andreas; Meyer, Jobst; Palmason, Haukur; Vasquez, Alejandro Arias; Lambregts-Rommelse, Nanda; Roeyers, Herbert; Biederman, Joseph; Doyle, Alysa E; Hakonarson, Hakon; Rothenberger, Aribert; Banaschewski, Tobias; Oades, Robert D; McGough, James J; Kent, Lindsey; Williams, Nigel; Owen, Michael J; Holmans, Peter; O'Donovan, Michael C; Thapar, Anita

    2013-08-01

    OBJECTIVE Although attention deficit hyperactivity disorder (ADHD) is highly heritable, genome-wide association studies (GWAS) have not yet identified any common genetic variants that contribute to risk. There is evidence that aggression or conduct disorder in children with ADHD indexes higher genetic loading and clinical severity. The authors examine whether common genetic variants considered en masse as polygenic scores for ADHD are especially enriched in children with comorbid conduct disorder. METHOD Polygenic scores derived from an ADHD GWAS meta-analysis were calculated in an independent ADHD sample (452 case subjects, 5,081 comparison subjects). Multivariate logistic regression analyses were employed to compare polygenic scores in the ADHD and comparison groups and test for higher scores in ADHD case subjects with comorbid conduct disorder relative to comparison subjects and relative to those without comorbid conduct disorder. Association with symptom scores was tested using linear regression. RESULTS Polygenic risk for ADHD, derived from the meta-analysis, was higher in the independent ADHD group than in the comparison group. Polygenic score was significantly higher in ADHD case subjects with conduct disorder relative to ADHD case subjects without conduct disorder. ADHD polygenic score showed significant association with comorbid conduct disorder symptoms. This relationship was explained by the aggression items. CONCLUSIONS Common genetic variation is relevant to ADHD, especially in individuals with comorbid aggression. The findings suggest that the previously published ADHD GWAS meta-analysis contains weak but true associations with common variants, support for which falls below genome-wide significance levels. The findings also highlight the fact that aggression in ADHD indexes genetic as well as clinical severity. PMID:23599091

  19. High Loading of Polygenic Risk for ADHD in Children With Comorbid Aggression

    PubMed Central

    Hamshere, Marian L.; Langley, Kate; Martin, Joanna; Agha, Sharifah Shameem; Stergiakouli, Evangelia; Anney, Richard J.L.; Buitelaar, Jan; Faraone, Stephen V.; Lesch, Klaus-Peter; Neale, Benjamin M.; Franke, Barbara; Sonuga-Barke, Edmund; Asherson, Philip; Merwood, Andrew; Kuntsi, Jonna; Medland, Sarah E.; Ripke, Stephan; Steinhausen, Hans-Christoph; Freitag, Christine; Reif, Andreas; Renner, Tobias J.; Romanos, Marcel; Romanos, Jasmin; Warnke, Andreas; Meyer, Jobst; Palmason, Haukur; Vasquez, Alejandro Arias; Lambregts-Rommelse, Nanda; Roeyers, Herbert; Biederman, Joseph; Doyle, Alysa E.; Hakonarson, Hakon; Rothenberger, Aribert; Banaschewski, Tobias; Oades, Robert D.; McGough, James J.; Kent, Lindsey; Williams, Nigel; Owen, Michael J.; Holmans, Peter

    2013-01-01

    Objective Although attention deficit hyperactivity disorder (ADHD) is highly heritable, genome-wide association studies (GWAS) have not yet identified any common genetic variants that contribute to risk. There is evidence that aggression or conduct disorder in children with ADHD indexes higher genetic loading and clinical severity. The authors examine whether common genetic variants considered en masse as polygenic scores for ADHD are especially enriched in children with comorbid conduct disorder. Method Polygenic scores derived from an ADHD GWAS meta-analysis were calculated in an independent ADHD sample (452 case subjects, 5,081 comparison subjects). Multivariate logistic regression analyses were employed to compare polygenic scores in the ADHD and comparison groups and test for higher scores in ADHD case subjects with comorbid conduct disorder relative to comparison subjects and relative to those without comorbid conduct disorder. Association with symptom scores was tested using linear regression. Results Polygenic risk for ADHD, derived from the meta-analysis, was higher in the independent ADHD group than in the comparison group. Polygenic score was significantly higher in ADHD case subjects with conduct disorder relative to ADHD case subjects without conduct disorder. ADHD polygenic score showed significant association with comorbid conduct disorder symptoms. This relationship was explained by the aggression items. Conclusions Common genetic variation is relevant to ADHD, especially in individuals with comorbid aggression. The findings suggest that the previously published ADHD GWAS meta-analysis contains weak but true associations with common variants, support for which falls below genome-wide significance levels. The findings also highlight the fact that aggression in ADHD indexes genetic as well as clinical severity. PMID:23599091

  20. Validation of the adult attention-deficit/hyperactivity disorder quality-of-life scale in European patients: comparison with patients from the USA.

    PubMed

    Brod, Meryl; Adler, Lenard A; Lipsius, Sarah; Tanaka, Yoko; Heinloth, Alexandra N; Upadhyaya, Himanshu

    2015-06-01

    The adult attention-deficit/hyperactivity disorder (ADHD) quality-of-life (AAQoL) scale was previously validated in adult patients in the USA; here, the AAQoL is validated in adult European patients. Data from a 12-week open-label acute treatment period with atomoxetine (80-100 mg/day) in adults with ADHD were used. Patients (≥ 18 to ≤ 50 years old) had a score ≥ 2 on ≥ 6 items on the inattentive or hyperactive core subscales of Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV); a CAARS-Inv:SV 18-item total ADHD symptom score ≥ 20; and Conners' Adult ADHD Rating Scale-Observer: Screening Version 6-item inattentive or hyperactive core subscale scores ≥ 2. Data were stratified based on patients' geographic region (Europe vs USA). Scale validation psychometric properties results were very similar between European (n = 1,217; 57.7 % male; mean age 33.0 years) and US (n = 602; 62.1 % male; mean age 33.5 years) patients, including factor loading, internal consistency, convergent and discriminant validity, and responsiveness. Exploratory factor analysis confirmed four AAQoL subscales. Internal consistency was acceptable (Cronbach's alpha > 0.70 for all subscales). The AAQoL total score showed moderate convergent validity with CAARS-Inv:SV 18-item total ADHD symptom and clinical global impression-ADHD-severity (CGI-ADHD-S) scores; and strong convergent validity with Behavior Rating Inventory of Executive Function-Adult Version: Self-Report Global-Executive-Composite Index scores. Mean AAQoL total scores were significantly different among patients grouped by CGI-ADHD-S scores, suggesting good discriminant validity. The AAQoL total and subscale scores presented good responsiveness from baseline to 12 weeks. The AAQoL scale shows comparable validity in European and US adults with ADHD. PMID:25563210

  1. 1H MRSI of middle frontal gyrus in pediatric ADHD.

    PubMed

    Tafazoli, Sharwin; O'Neill, Joseph; Bejjani, Anthony; Ly, Ronald; Salamon, Noriko; McCracken, James T; Alger, Jeffry R; Levitt, Jennifer G

    2013-04-01

    Neuroimaging studies in multiple modalities have implicated the left or right dorsolateral prefrontal cortex (here, middle frontal gyrus) in attentional functions, in ADHD, and in dopamine agonist treatment of ADHD. The far lateral location of this cortex in the brain, however, has made it difficult to study with magnetic resonance spectroscopy (MRS). We used the smaller voxel sizes of the magnetic resonance spectroscopic imaging (MRSI) variant of MRS, acquired at a steep coronal-oblique angle to sample bilateral middle frontal gyrus in 13 children and adolescents with ADHD and 13 age- and sex-matched healthy controls. Within a subsample of the ADHD patients, aspects of attention were also assessed with the Trail Making Task. In right middle frontal gyrus only, mean levels of N-acetyl-aspartate + N-acetyl-aspartyl-glutamate (tNAA), creatine + phosphocreatine (Cr), choline-compounds (Cho), and myo-inositol (mI) were significantly lower in the ADHD than in the control sample. In the ADHD patients, lower right middle frontal Cr was associated with worse performance on Trails A and B (focused attention, concentration, set-shifting), while the opposite relationship held true for the control group on Trails B. These findings add to evidence implicating right middle frontal cortex in ADHD. Lower levels of these multiple species may reflect osmotic adjustment to elevated prefrontal cortical perfusion in ADHD and/or a previously hypothesized defect in astrocytic production of lactate in ADHD resulting in decelerated energetic metabolism (Cr), membrane synthesis (Cho, mI), and acetyl-CoA substrate for NAA synthesis. Lower Cr levels may indicate attentional or executive impairments. PMID:23273650

  2. [Symptom variations in ADHD: importance of context, development and comorbidity].

    PubMed

    Purper-Ouakil, D; Wohl, M; Michel, G; Mouren, M C; Gorwood, P

    2004-01-01

    Attention-deficit hyperactivity (ADHD) is a common disorder in school-aged children and is associated with significant impairment in social and academic functioning. Its recognition is based on congruent information from different sources, because most ADHD children and adolescents are not completely aware of impairments caused by inattention and/or hyperactivity/impulsivity. Fluctuations in symptom expression may complicate the diagnosis: during clinical examination or tests sessions, ADHD symptoms may be less severe than usual or completely absent. This review examines variations in ADHD symptoms due to environmental context, internal state, circadian factors, development, psychiatric comorbidity and discusses their clinical relevance. Generally, ADHD symptoms are pervasive and identified in different areas of functioning. Despite their chronicity, they show a relative context-dependency. An unfamiliar environment or situation may lessen symptoms. The same happens in dual relations or in calm settings, when the child receives attention and positive reinforcement from the adult. On the contrary, the classroom situation with its high stimulation level (noise, visual distractors, large class size) is likely to reveal or accentuate instability, impulsivity and inattention. Independently from objective symptom fluctuations, the impact of ADHD symptoms, and their consequences on self-esteem may also vary with the degree of environmental mismatch. Recent research in experimental psychology also draws attention to the motivational state of ADHD children: preference for immediate gratification and delay aversion may explain why most of them show satisfactory attentional capacities in certain activities (for instance video games or TV), while showing impairment in school work or in other effortful tasks. The diagnosis of the full ADHD syndrome requires significant impact on functioning in at least two areas. Some children with "situational" ADHD are impaired either in

  3. ADHD stigma among college students.

    PubMed

    Thompson, Amanda Chi; Lefler, Elizabeth K

    2016-03-01

    The current study examined ADHD stigma within a college-enrolled young adult population, including the debate regarding the cause of stigma: label or behavior. In Phase 1, 135 college students rated stigma toward one of the four fictitious partners described as having either: the label of ADHD alone, the behaviors associated with ADHD alone, the label of ADHD and a set of behaviors associated with ADHD, or neither the label nor behaviors. In Phase 2, 48 college students rated stigma toward one of the two assigned fictitious partners described as having either: the label of ADHD and a set of behaviors associated with ADHD, or the label of Depression and a set of behaviors associated with Depression. It was hypothesized that the interaction between the label and the behaviors would cause the highest levels of ADHD stigma and that ADHD would elicit more stigma than Depression. In Phase 1, stigma was associated with the behaviors of ADHD, but not the label. In Phase 2, ADHD and Depression were found to be equally stigmatized. Implications, limitations, and future directions are discussed. PMID:26135022

  4. Reading Performance of Young Adults With ADHD Diagnosed in Childhood: Relations With Executive Functioning.

    PubMed

    Miranda, Ana; Mercader, Jessica; Fernández, M Inmaculada; Colomer, Carla

    2013-10-22

    Objective: To study reading performance of young adults with ADHD and its relation with executive functioning. Method: Thirty young adults with a childhood diagnosis of ADHD and 30 with normal development (ND) were compared on reading accuracy, fluency, and comprehension. Furthermore, ADHD with reading disabilities (ADHD+RD) and ADHD without reading disabilities (ADHD-RD) subgroups were compared using self-report and informant-report versions of the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A). Results: Adults with ADHD obtained significantly worse results than the ND adults on reading speed, responses to literal questions, and a cloze test. Although the comparison of the ADHD+RD and ADHD-RD groups did not show significant differences on the BRIEF-A subscales, the ADHD+RD group surpassed the critical percentile (85) on more subscales, with working memory and metacognition especially affected. Conclusion: The findings point out that reading should be assessed in individuals with ADHD as part of their evaluation to design effective early interventions. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24149941

  5. College Students' Attitudes toward Their ADHD Peers

    ERIC Educational Resources Information Center

    Chew, Brandi L.; Jensen, Scott A.; Rosen, Lee A.

    2009-01-01

    Objective: The attitudes of college students with and without ADHD toward peers with ADHD were examined. Method: A total of 196 college students (30 diagnosed with ADHD) anonymously completed four attitude measures. General analyses of attitudes toward peers with ADHD as well as comparisons between those with and without ADHD are made. Results:…

  6. Disorder-specific functional abnormalities during temporal discounting in youth with Attention Deficit Hyperactivity Disorder (ADHD), Autism and comorbid ADHD and Autism.

    PubMed

    Chantiluke, Kaylita; Christakou, Anastasia; Murphy, Clodagh M; Giampietro, Vincent; Daly, Eileen M; Ecker, Christina; Brammer, Michael; Murphy, Declan G; Rubia, Katya

    2014-08-30

    Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are often comorbid and share cognitive abnormalities in temporal foresight. A key question is whether shared cognitive phenotypes are based on common or different underlying pathophysiologies and whether comorbid patients have additive neurofunctional deficits, resemble one of the disorders or have a different pathophysiology. We compared age- and IQ-matched boys with non-comorbid ADHD (18), non-comorbid ASD (15), comorbid ADHD and ASD (13) and healthy controls (18) using functional magnetic resonance imaging (fMRI) during a temporal discounting task. Only the ASD and the comorbid groups discounted delayed rewards more steeply. The fMRI data showed both shared and disorder-specific abnormalities in the three groups relative to controls in their brain-behaviour associations. The comorbid group showed both unique and more severe brain-discounting associations than controls and the non-comorbid patient groups in temporal discounting areas of ventromedial and lateral prefrontal cortex, ventral striatum and anterior cingulate, suggesting that comorbidity is neither an endophenocopy of the two pure disorders nor an additive pathology. PMID:24929553

  7. Clinical recommendations in current practice guidelines for diagnosis and treatment of ADHD in adults.

    PubMed

    Gibbins, Christopher; Weiss, Margaret

    2007-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder in which approximately two thirds of patients experience impairment in adulthood. Although some adults with ADHD were diagnosed as children, many are first diagnosed as adults. This poses particular challenges given the limited familiarity with ADHD of many adult mental health services. As a result, several organizations, including the Canadian ADHD Resource Alliance, the American Academy of Child and Adolescent Psychiatry, the National Institutes of Health, and the British Association for Psychopharmacology, have developed practice guidelines for the assessment and treatment of adults with ADHD. This article reviews those guidelines in order to examine current best practices in adult ADHD. There is considerable agreement among these guidelines, which should be a critical part of moving from emerging knowledge to patient care, although both empirical evaluation and ongoing updates as new knowledge emerges will be important for their future development. PMID:17915083

  8. DAT1 and DRD4 genes involved in key dimensions of adult ADHD.

    PubMed

    Hasler, R; Salzmann, A; Bolzan, T; Zimmermann, J; Baud, P; Giannakopoulos, P; Perroud, N

    2015-06-01

    Attention-deficit hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder often persisting in adulthood. Genetic studies of ADHD mainly focused on the Dopamine Transporter (DAT1) and the Dopamine Receptor 4 (DRD4) genes. Nevertheless, polymorphisms of these genes explain only a small fraction of the assigned risk, suggesting that intermediate dimensions and environmental factors should also be considered. We investigated in 77 adult ADHD subjects compared to 474 controls, how polymorphisms within the genes coding for DAT1 (40-bp VNTR in 3'UTR), the Dopamine Receptor 2 (DRD2) (rs1799732) and DRD4 (48-bp VNTR in exon 3), may modulate the expression of the disorder. By genotyping DAT1, we detected a new 9.5R allele showing a deletion of 40 bp and also an insertion of 19 bp compared to the 10R allele. This novel allele was found to be significantly protective for ADHD (p < 0.0001). Another significant difference was found in the distribution of DRD4 48-bp VNTR 6R allele when comparing patients and controls (p = 0.0007). In addition significant results were also found for DAT1 9.5R allele, which was associated with impulsiveness (p = 1.98 × 10(-4)) and trait anger scores (p = 7.66 × 10(-4)). Moreover, impulsiveness scores were partly modulated by an interaction between the DRD4 48-bp VNTR 6R allele and childhood maltreatment (p = 0.01), however, this result did not resist correction for multiple comparisons. Altogether, our results show the putative involvement of DAT1 and DRD4 genes in the aetiology of ADHD with a main role in modulation of key dimensions of the disorder. PMID:25555995

  9. Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder

    PubMed Central

    Aymamí, N.; Jiménez-Murcia, S.; Granero, R.; Ramos-Quiroga, J. A.; Fernández-Aranda, F.; Claes, L.; Sauvaget, A.; Grall-Bronnec, M.; Gómez-Peña, M.; Savvidou, L. G.; Fagundo, A. B.; del Pino-Gutierrez, A.; Moragas, L.; Casas, M.; Penelo, E.; Menchón, J. M.

    2015-01-01

    Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits. PMID:26229967

  10. Perceptual abnormalities related to sensory gating deficit are core symptoms in adults with ADHD.

    PubMed

    Micoulaud-Franchi, Jean-Arthur; Lopez, Régis; Vaillant, Florence; Richieri, Raphaëlle; El-Kaim, Alexandre; Bioulac, Stéphanie; Philip, Pierre; Boyer, Laurent; Lancon, Christophe

    2015-12-15

    This study investigated and compared perceptual abnormalities related to sensory gating deficit in adult patients with Attention Deficit Disorder with Hyperactivity (A-ADHD) and adult patients with schizophrenia. Subjects were evaluated with the Sensory Gating Inventory (SGI). We compared SGI scores between patients with A-ADHD, patients with schizophrenia and healthy subjects. We also assessed the relationship between SGI scores and clinical symptoms, and evaluated the ability of the SGI to detect perceptual abnormalities in A-ADHD. Seventy adult patients with ADHD reported higher SGI scores than the 70 healthy subjects and the 70 patients with schizophrenia. The inattention factor of the ASRS correlated significantly with the overall SGI score. The ROC AUC for the overall SGI score in the A-ADHD group (versus the healthy group) illustrated good performance. The findings suggest that i) perceptual abnormalities are core symptoms of adult patients with ADHD and ii) the attention of patients with A-ADHD may be involuntarily drowned by many irrelevant environmental stimuli leading to their impaired attention on relevant stimuli. They also confirm that the SGI could be a useful self-report instrument to diagnose the clinical features of A-ADHD. PMID:26416589

  11. Diagnosis and management of ADHD in children.

    PubMed

    Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van

    2014-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing. Physicians should evaluate for ADHD in children with behavioral concerns (e.g., inattention, hyperactivity, impulsivity, oppositionality) or poor academic progress using validated assessment tools with observers from several settings (home, school, community) and self-observation, if possible. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) should be identified and treated. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages. Effective behavioral therapies include parent training, classroom management, and peer interventions. Medications are recommended as first-line therapy for older children. Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles. There are fewer supporting studies for atomoxetine, guanfacine, and clonidine, and they are less effective than the psychostimulants. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits. PMID:25369623

  12. An Analysis of Patient Adherence to Treatment during a 1-Year, Open-Label Study of OROS[R] Methylphenidate in Children with ADHD

    ERIC Educational Resources Information Center

    Faraone, Stephen V.; Biederman, Joseph; Zimmerman, Brenda

    2007-01-01

    Objective: Treatment adherence is an important aspect of ADHD symptom management, but there are many factors that may influence adherence. Method: This analysis assessed adherence to OROS methylphenidate during a 1-year, open-label study in children. Adherence was defined as the number of days medication was taken divided by the number of days in…

  13. Sensitivity of Scales to Evaluate Change in Symptomatology with Psychostimulants in Different ADHD Subtypes

    PubMed Central

    Grizenko, Natalie; Rodrigues Pereira, Ricardo M.; Joober, Ridha

    2013-01-01

    Objective: To assess the sensitivity of scales (Conners’ Global Index Parent and Teacher form [CGI-P, CGI-T], Clinical Global Impression Scale [CGI], Continuous Performance Test [CPT], and Restricted Academic Situation Scale [RASS]) in evaluating improvement in symptomatology with methylphenidate in different Attention Deficit Hyperactivity Disorder (ADHD) subtypes. Method: Four hundred and ninety children (309 with ADHD Combined/Hyperactive [ADHD-CH] and 181 with ADHD Inattentive subtype [ADHD-I]) participated in a two week double-blind placebo-controlled crossover methylphenidate trial. Results: CGI-P showed small effect size for ADHD-I and medium effect size for the ADHD-CH subtype. CGI-T showed medium effect size for ADHD-I and large effect size for ADHD-CH subtype. CGI and RASS showed large effect size while CPT showed medium effect size for both subtypes. Conclusion: Acute behavioural assessments by clinicians (CGI, RASS) are better at detecting improvement with medication in all subtypes than parent or teacher reports (CGI-P, CGI-T). CGI-T is better than CGI-P for ADHD-I in detecting change in symptomatology as there is a greater demand for attention at school. PMID:23667362

  14. Treating ADHD with Agomelatine

    ERIC Educational Resources Information Center

    Niederhofer, Helmut

    2012-01-01

    Objective: Agomelatine is a relatively new antidepressant, with affinities to MT1 and MT2 (responsible for the circadian rhythm) as well as to 5-HT2C receptors. Since antidepressants have demonstrated some benefit in the treatment of ADH and because of the fact, that ADHD is often associated with sleep disorders, we assumed, that it might be a…

  15. Colour Perception in ADHD

    ERIC Educational Resources Information Center

    Banaschewski, Tobias; Ruppert, Sinje; Tannock, Rosemary; Albrecht, Bjorn; Becker, Andreas; Uebel, Henrik; Sergeant, Joseph A.; Rothenberger, Aribert

    2006-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is associated with unexplained impairments on speeded naming of coloured stimuli. These deficits may reflect hypofunctioning retinal dopaminergic mechanisms impairing particularly blue-yellow colour discrimination. Colour perception and rapid colour naming ability were investigated in 14 children…

  16. ADHD, Culture and Education

    ERIC Educational Resources Information Center

    Singh, Ilina

    2008-01-01

    This article is a socio-historical account of the development of the Attention Deficit/Hyperactivity Disorder (ADHD) diagnosis and methylphenidate treatment in America, attending particularly to the political and institutional contexts that have supported this development. Historical developments in early-mid-twentieth-century America frame a…

  17. A Preliminary Neuroimaging Study of Preschool Children with ADHD

    PubMed Central

    E.M., Mahone; D., Crocetti; M.E., Ranta; A., Gaddis; M., Cataldo; K.J., Slifer; M.B., Denckla; S.H., Mostofsky

    2012-01-01

    Attention-deficit/Hyperactivity Disorder (ADHD) is a developmental disorder which, by current definition, has onset prior to age 7 years. MRI studies have provided some insight into brain differences associated with ADHD, but thus far have almost exclusively focused on children ages 7 years and older. To better understand the neurobiological development of ADHD, cortical and subcortical brain development should be systematically examined in younger children presenting with symptoms of the disorder. High resolution anatomical (MPRAGE) images, acquired on a 3.0T scanner, were analyzed in a total of 26 preschoolers, ages 4–5 years (13 with ADHD, 13 controls, matched on age and sex). The ADHD sample was diagnosed using DSM-IV criteria, and screened for language disorders. Cortical regions were delineated and measured using automated methods in Freesurfer; basal ganglia structures were manually delineated. Children with ADHD showed significantly reduced caudate volumes bilaterally; in contrast, there were no significant group differences in cortical volume or thickness in this age range. After controlling for age and total cerebral volume, left caudate volume was a significant predictor of hyperactive/impulsive, but not inattentive symptom severity. Anomalous basal ganglia, particularly caudate, development appears to play an important role among children presenting with early onset symptoms of ADHD. PMID:21660881

  18. Attention-Deficit Hyperactivity Disorder (ADHD): Treatment

    MedlinePlus

    MENU Return to Web version Attention-Deficit Hyperactivity Disorder (ADHD) | Treatment What medicines are used to treat ADHD? Some of the medicines for ADHD are called psychostimulants. Some of these ...

  19. Structured dyadic behavior therapy processes for ADHD intervention.

    PubMed

    Curtis, David F

    2014-03-01

    Children with Attention-Deficit/Hyperactivity Disorder (ADHD) present significant problems with behavioral disinhibition that often negatively affect their peer relationships. Although behavior therapies for ADHD have traditionally aimed to help parents and teachers better manage children's ADHD-related behaviors, therapy processes seldom use peer relationships to implement evidence-based behavioral principles. This article introduces Structured Dyadic Behavior Therapy as a milieu for introducing effective behavioral techniques within a socially meaningful context. Establishing collaborative behavioral goals, benchmarking, and redirection strategies are discussed to highlight how in-session dyadic processes can be used to promote more meaningful reinforcement and change for children with ADHD. Implications for improving patient care, access to care, and therapist training are also discussed. PMID:24377401

  20. Abuse of Medications Employed for the Treatment of ADHD: Results From a Large-Scale Community Survey

    PubMed Central

    Bright, George M.

    2008-01-01

    Objective The objective is to assess abuse of prescription and illicit stimulants among individuals being treated for attention-deficit/hyperactivity disorder (ADHD). Methods A survey was distributed to patients enrolled in an ADHD treatment center. It included questions designed to gain information about demographics; ADHD treatment history; illicit drug use; and misuse of prescribed stimulant medications, including type of stimulant medication most frequently misused or abused, and how the stimulant was prepared and administered. Results A total of 545 subjects (89.2% with ADHD) were included in the survey. Results indicated that 14.3% of respondents abused prescription stimulants. Of these, 79.8% abused short-acting agents; 17.2% abused long-acting stimulants; 2.0% abused both short- and long-acting agents; and 1.0% abused other agents. The specific medications abused most often were mixed amphetamine salts (Adderall; 40.0%), mixed amphetamine salts extended release (Adderall XR; 14.2%), and methylphenidate (Ritalin; 15.0%), and the most common manner of stimulant abuse was crushing pills and snorting (75.0%). Survey results also showed that 39.1% of respondents used nonprescription stimulants, most often cocaine (62.2%), methamphetamine (4.8%), and both cocaine and amphetamine (31.1%). Choice of illicit drug was based on rapidity of high onset (43.5%), ease of acquisition (40.7%), ease of use (10.2%), and cost (5.5%). Conclusions The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic. Prescription agents used most often are those with pharmacologic and pharmacokinetic characteristics that provide a rapid high. This suggests that long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations. PMID:18596945

  1. Editorial Perspective: How to optimise frequency band neurofeedback for ADHD.

    PubMed

    Bluschke, Annet; Roessner, Veit; Beste, Christian

    2016-04-01

    Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent paediatric neuropsychiatric disorders and is characterised by hyperactivity, inattention and increased impulsivity. Children with ADHD are often also characterised by deficits in a variety of cognitive domains, including problems in working memory, a generally slower and more variable style of information processing and deficits in temporal processing, inhibitory functions and delay processing. Overarching executive functions like information updating, response inhibition and mental set shifting are also impaired in many, but not all, children with ADHD, demonstrating the neuropsychological heterogeneity characterising this disorder. Deficits in executive functions can persist into adulthood and have a substantial negative impact on everyday life. A variety of approaches are commonly considered for the treatment of ADHD (including pharmacological interventions, patient-centred cognitive-behavioural therapy approaches and specific teacher/parent training programmes). More recently, adding to this multimodal treatment approach, neurofeedback has grown in popularity as an intervention option for patients with ADHD. This article considers this intervention approach and the opportunities for optimising treatment for executive control dysfunctions in ADHD using theta/beta neurofeedback. PMID:26968314

  2. Organizational-skills interventions in the treatment of ADHD.

    PubMed

    Langberg, Joshua M; Epstein, Jeffery N; Graham, Amanda J

    2008-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with temporal and materials organization. These difficulties remain prominent throughout development. For children, organizational problems are most apparent in the school setting and result in impairments such as lost and forgotten homework assignments and inadequate planning for tests. Temporal aspects of organization tend to be most salient for adults with ADHD and manifest as procrastination and missed appointments and deadlines. Skills and strategy training interventions have been developed to address the organizational problems of children and adults with ADHD. Patients are taught systems for managing their time and materials more effectively. Contingency management is often used in conjunction with organizational skills training to promote the use of organizational skills and their generalization. Organizational skills interventions have been evaluated as standalone interventions and part of multicomponent interventions for children, adolescents and adults with ADHD. These interventions are associated with significant improvements in the organization of materials, homework management, time management and planning. There is also some evidence to suggest that organizational improvements lead to reductions in ADHD symptoms and gains in academic functioning. Additional research using randomized controlled research designs and long-term follow-up evaluation is necessary before organizational interventions may be considered established evidence-based interventions for patients with ADHD. PMID:18928347

  3. Executive Functions in Girls with ADHD Followed Prospectively into Young Adulthood

    PubMed Central

    Miller, Meghan; Ho, Jennifer; Hinshaw, Stephen P.

    2013-01-01

    Overview We prospectively followed an ethnically and socioeconomically diverse sample of girls with ADHD (n = 140) and a matched comparison group (n = 88) into young adulthood (Mage = 19.6), 10 years after childhood initial assessments, to evaluate neuropsychological functioning. We hypothesized that neuropsychological deficits would persist through young adulthood for those with ADHD, and that those with continuing ADHD symptomatology in young adulthood would show the largest impairments. Method Neuropsychological measures at follow-up emphasized executive functions (EF) including planning, organization, inhibitory control, sustained attention, working memory, and set shifting. Results Parallel to findings from childhood and adolescence, the girls with childhood-diagnosed ADHD displayed medium to large deficits in EF relative to comparisons at follow-up, even with statistical control of baseline demographic and comorbidity variables. The addition of IQ as a covariate attenuated differences but several remained significant. Comparisons between the inattentive and combined subtypes of ADHD yielded nonsignificant results with small effect sizes. EF impairments were evident in both participants whose ADHD diagnoses persisted and in those whose ADHD symptoms had remitted to a non-diagnosable level; both subgroups had more EF deficits than those who did not meet criteria for ADHD in either childhood or young adulthood. Conclusions Those in both the persistent and remitted ADHD groups showed impairments in EF relative to comparisons and generally did not differ from each other. Overall, childhood ADHD in girls portends neuropsychological/EF deficits that persist for at least 10 years. PMID:22468822

  4. ADHD: does parenting style matter?

    PubMed

    Modesto-Lowe, Vania; Danforth, Jeffrey S; Brooks, Donna

    2008-11-01

    Attention deficit hyperactivity disorder (ADHD) is a condition typically arising in childhood, which untreated, can have consequences reaching into adolescence and beyond. Effective pharmacological treatment is available and has become widespread in the West. Outcomes for both the child with ADHD and the parent may be influenced by the nature of interaction between them. The authors of this article aim to review published research examining the interaction between parents and their children with ADHD. A PubMed search was conducted of studies written in English between 2000 and 2007 with the keywords ADHD and parenting. Child ADHD elicits high levels of parental stress and maladaptive parenting. The presence of parental psychopathology is common and influences the parent's response to the child's ADHD symptoms. Optimizing parent-child interaction and parental psychiatric status may improve outcomes for both parent and child. PMID:18559885

  5. Using a Brief Parent-Report Measure to Track Outcomes for Children and Teens with ADHD.

    PubMed

    McCarthy, Alyssa; Asghar, Sunna; Wilens, Timothy; Romo, Stephanie; Kamin, Hayley; Jellinek, Michael; Murphy, Michael

    2016-06-01

    The Pediatric Symptom Checklist (PSC) is a widely used, parent-completed measure of children's emotional and behavioral functioning. Previous research has shown that the PSC and its subscales are responsive to patient progress over the course of psychiatric treatment. In this naturalistic study, parents and clinicians of 1736 patients aged 17 or younger completed standardized measures at intake and 3-month follow-up appointments. We assessed the 5-item PSC Attention Subscale (PSC-AS) as a longitudinal measure of attention-related symptoms in routine outpatient psychiatry treatment. Secondarily, we compared PSC-AS scores with clinician-reported diagnoses, psychomotor excitation symptoms, and overall functioning. Change scores on the PSC-AS were larger among patients with ADHD diagnoses than those with non-ADHD diagnoses. Comparisons between PSC-AS scores and clinician reports also showed acceptable levels of agreement. Given its effectiveness in tracking attention-related symptoms, the PSC may be particularly useful as a quality assurance or treatment outcome measure for clinicians treating ADHD. PMID:26271346

  6. Innovations at Miami practice show promise for treating high-risk Medicare patients.

    PubMed

    Tanio, Craig; Chen, Christopher

    2013-06-01

    Patients with five or more chronic conditions drive most Medicare costs. Our organization, ChenMed, developed a scalable primary care-led delivery model that focuses on this population while getting reimbursed through full-risk capitation by Medicare Advantage plans. ChenMed is a primary care-led group practice based in Florida that serves low-to-moderate-income elderly patients, largely through the Medicare Advantage program. Our model includes a number of innovations: a one-stop-shop approach for delivering multispecialty services in the community, smaller physician panel sizes of 350-450 patients that allow for intensive health coaching and preventive care, on-site physician pharmacy dispensing, a collaborative physician culture with peer review, and customized information technology. These innovations have improved patient medication adherence, increased the time doctors and patients spend together, and led to high rates of patient satisfaction. Additionally, our Medicare patients have substantially lower rates of hospital use than their peers in the Miami Medicare market. Creating chronic disease centers focused on seniors with multiple chronic conditions is a promising delivery system innovation with major potential to improve the cost and quality of care. PMID:23733982

  7. Alzheimer's disease treated patients showed different patterns for oxidative stress and inflammation markers.

    PubMed

    Gubandru, Miriana; Margina, Denisa; Tsitsimpikou, Christina; Goutzourelas, Nikos; Tsarouhas, Konstantinos; Ilie, Mihaela; Tsatsakis, Aristidis Michael; Kouretas, Demetrios

    2013-11-01

    Alzheimer's disease (AD) is the most common type of dementia accounting for 60-80% of the reported cases. The aim of this study was to evaluate levels of certain parameters of oxidative stress and markers of endothelial dysfunction in the blood of 21 AD patients under standard treatment compared with 10 controls, in an attempt to elucidate the contribution of AD to the total oxidative stress status of the patients. Results indicate that IL-6, TNF-α, ADMA and homocysteine levels were significantly elevated in AD patients. Protein carbonyls levels were higher in AD group, while glutathione reductase and total antioxidant capacity were lower, depicting decreased defense ability against reactive oxygen species. Besides, a higher level of advanced glycation end-products was observed in AD patients. Depending on the treatment received, a distinct inflammatory and oxidative stress profile was observed: in Rivastigmine-treated group, IL6 levels were 47% lower than the average value of the remaining AD patients; homocysteine and glutathione reductase were statistically unchanged in the Rivastigmine and Donepezil-Memantine, respectively Donepezil group. Although the study is based on a limited population, the results could constitute the basis for further studies regarding the effect of medication and diet on AD patients. PMID:23871825

  8. Rhinitis Patients With Sputum Eosinophilia Show Decreased Lung Function in the Absence of Airway Hyperresponsiveness

    PubMed Central

    Yang, Min-Suk; Lee, Hyun-Seung; Kim, Min-Hye; Song, Woo-Jung; Kim, Tae-Wan; Kwon, Jae-Woo; Kim, Sae-Hoon; Park, Heung-Woo; Chang, Yoon-Seok; Min, Kyung-Up

    2013-01-01

    Purpose Sputum eosinophilia is observed frequently in patients with rhinitis. Sputum eosinophilia in patients with non-asthmatic allergic rhinitis has been suggested to be related to nonspecific airway hyperresponsiveness (AHR). However, the clinical significance of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR has not been determined. We conducted a retrospective study examining the influence of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR on pulmonary function and expression of fibrosis-related mediators. Methods Eighty-nine patients with moderate-to-severe perennial rhinitis without AHR were included. All underwent lung function tests (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]), skin tests to inhalant allergens, methacholine bronchial challenge tests, and hypertonic saline-induced sputum to determine eosinophil counts. Sputum mRNA levels for transforming growth factor-β (TGF-β), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also examined. Patients were divided into two groups according to the presence of sputum eosinophilia (≥3%, eosinophilia-positive [EP] and <3%, eosinophilia-negative [EN] groups). Results FEV1 was significantly lower (P=0.04) and FEV1/FVC tended to be lower (P=0.1) in the EP group than in the EN group. In sputum analyses, the MMP-9 mRNA level (P=0.005) and the ratio of MMP-9 to TIMP-1 expression (P=0.01) were significantly higher in the EP group than in the EN group. There was no significant difference in TGF-β mRNA expression between the two groups. Conclusions Sputum eosinophilia in patients with moderate-to-severe perennial rhinitis without AHR influenced FEV1 and the expression pattern of fibrosis-related mediators. PMID:23814677

  9. Jejuna of patients with insulin-dependent diabetes mellitus (IDDM) show signs of immune activation

    PubMed Central

    SAVILAHTI, E; ÖRMÄLÄ, T; SAUKKONEN, T; SANDINI-POHJAVUORI, U; KANTELE, J M; ARATO, A; ILONEN, J; ÅKERBLOM, H K

    1999-01-01

    The roles of enteric viruses and food antigens as possible triggers in human insulin-dependent diabetes mellitus and the evidence that mucosal-associated homing receptors are important in both human and experimental diabetes prompted us to undertake an immunohistochemical study of intestinal specimens from patients with IDDM. We studied jejunal morphology and immunohistochemistry in 26 patients with IDDM, 13 of whom had the HLA-DQB1*0201 gene and therefore a higher risk of coeliac disease. The findings were compared with those in specimens from age-matched controls. Villous structure and the density of the intraepithelial lymphocytes were normal in every biopsy specimen. The extent of positivity with anti-DR and -DP antibodies in the villous epithelium was significantly greater in the specimens from patients than in those from controls (P = 0.0002 in both comparisons). The crypts were also more positive: for DR P = 0.0001, and for DP P = 0.002. The densities of T cells, CD4+, CD8+, and T cell receptor α/β+ and γ/δ+ cells in the epithelium and lamina propria were similar in patients and controls, but the patients had significantly more α4/β7 integrin+ cells in the lamina propria (P = 0.006). No difference was seen between HLA-DQB1*0201-positive and -negative patients. These findings reflect a stage of inflammation in the structurally normal intestines of patients with IDDM and suggest secretion of inflammatory Th1-type cytokines in the intestine. PMID:10209507

  10. Enhanced Physical Activity Improves Selected Outcomes in Children With ADHD: Systematic Review.

    PubMed

    Song, MinKyoung; Lauseng, Deborah; Lee, Soohee; Nordstrom, Megan; Katch, Victor

    2016-09-01

    This review examines associations between physical activity (PA) and cognitive, behavioral, and physiological outcomes in children with attention-deficit/hyperactivity disorder (ADHD). We reviewed studies on participants ≤18 years old, published in English between January 1998 and December 2014, in PubMed, CINAHL, PsycINFO, and Cochrane Reviews. Twenty-six studies were grouped into two categories: those that did and did not account for effects of ADHD medications. The first category showed lower levels of PA and improved cognitive and behavioral outcomes in youth whose ADHD was treated with medications. The second category showed a positive association between PA levels and cognitive and behavioral outcomes in youth whose ADHD was not treated with medications. For both categories of studies, results were inconclusive regarding physiological outcomes. Randomized controlled trials are needed to better clarify the relationship between PA and outcomes in youth with ADHD, and particularly to understand the impact of ADHD medications on that relationship. PMID:27226208

  11. Macrophages from Patients with Cirrhotic Ascites Showed Function Alteration of Host Defense Receptor

    PubMed Central

    Ahmed, Abdel Motaal M.; Kadaru, Abdel Gadir Y.; Omer, Ibtihal; Musa, Ahmed M.; Enan, Khalid; El Khidir, Isam M.; Williams, Roger

    2014-01-01

    Background Patients with cirrhotic ascites (PCA) are susceptible to spontaneous bacterial peritonitis (SBP) which has increased morbidity and mortality. Since some host defense aspects of peritoneal macrophages (PMф) from PCA are altered this study examined factors related to receptor-mediated phagocytosis. Methods Twelve PCA were studied. PMɸ were isolated from ascitic fluid (AF) samples removed from these patients. Uptake of mannose receptor (MR)-specific ligand, fluorescein isothiocyanate-mannosylated-bovine serum albumin (FITC-man-BSA), by patients' PMɸ and controls, a human monocytic cell line, was measured pre- and post-IL-4 treatment. Phagocytosis of FITC-labeled yeast particles by patients' PMɸ was measured pre- and post-IL-4 treatment. Fluorescence values were obtained using a spectrofuorometer. MRC1 gene was analyzed in blood samples from PCA and controls, healthy donors, using standard polymerase chain reaction (PCR) technique. Results Past SBP episode(s) were reported in 58.3% of patients. Mean AF volume analyzed per patient was 1.3L. PMɸ ratio in cell yield was 53.73% (SD 18.1). Mean uptake absorbance of patients' PMф was 0.0841 (SD 0.077) compared to 0.338 (SD 0.34) of controls, P = 0.023. Following IL-4 treatment absorbance increased to 0.297 (SD 0.28) in patients' PMф (P = 0.018 on paired sample t-test), and to 0.532 (SD 0.398 in controls (P = 0.053 on independent sample t-test). Mean phagocytosis absorbance of patients' PMф was 0.1250 (SD 0.032) before IL-4 treatment compared to 0.2300 (SD 0.104) after (P = 0.026). PCR analysis for MRC1 gene was negative in all PCA samples compared to positive results in all controls. Conclusion Since decreased phagocytosis and MR uptake were enhanced post-IL-4 treatment MR downregulation pre-treatment is plausible. Negative PCR results for MRC1 might suggest an anomaly, but this awaits further ellucidation. These altered host defense findings are relevant to infection pathophysiology, and their

  12. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

    PubMed Central

    de Araujo, Ana Carla Pereira; Santos, Bruno F. de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M. Francisco; de Oliveira, Daniel Pio; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-01-01

    Background Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all‑cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 – 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 – 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia. PMID:25352460

  13. Classification of ADHD children through multimodal magnetic resonance imaging.

    PubMed

    Dai, Dai; Wang, Jieqiong; Hua, Jing; He, Huiguang

    2012-01-01

    Attention deficit/hyperactivity disorder (ADHD) is one of the most common diseases in school-age children. To date, the diagnosis of ADHD is mainly subjective and studies of objective diagnostic method are of great importance. Although many efforts have been made recently to investigate the use of structural and functional brain images for the diagnosis purpose, few of them are related to ADHD. In this paper, we introduce an automatic classification framework based on brain imaging features of ADHD patients and present in detail the feature extraction, feature selection, and classifier training methods. The effects of using different features are compared against each other. In addition, we integrate multimodal image features using multi-kernel learning (MKL). The performance of our framework has been validated in the ADHD-200 Global Competition, which is a world-wide classification contest on the ADHD-200 datasets. In this competition, our classification framework using features of resting-state functional connectivity (FC) was ranked the 6th out of 21 participants under the competition scoring policy and performed the best in terms of sensitivity and J-statistic. PMID:22969710

  14. Premarket Safety and Efficacy Studies for ADHD Medications in Children

    PubMed Central

    Bourgeois, Florence T.; Kim, Jeong Min; Mandl, Kenneth D.

    2014-01-01

    Background Attention-deficit hyperactivity disorder (ADHD) is a chronic condition and pharmacotherapy is the mainstay of treatment, with a variety of ADHD medications available to patients. However, it is unclear to what extent the long-term safety and efficacy of ADHD drugs have been evaluated prior to their market authorization. We aimed to quantify the number of participants studied and their length of exposure in ADHD drug trials prior to marketing. Methods We identified all ADHD medications approved by the Food and Drug Administration (FDA) and extracted data on clinical trials performed by the sponsor and used by the FDA to evaluate the drug’s clinical efficacy and safety. For each ADHD medication, we measured the total number of participants studied and the length of participant exposure and identified any FDA requests for post-marketing trials. Results A total of 32 clinical trials were conducted for the approval of 20 ADHD drugs. The median number of participants studied per drug was 75 (IQR 0, 419). Eleven drugs (55%) were approved after <100 participants were studied and 14 (70%) after <300 participants. The median trial length prior to approval was 4 weeks (IQR 2, 9), with 5 (38%) drugs approved after participants were studied <4 weeks and 10 (77%) after <6 months. Six drugs were approved with requests for specific additional post-marketing trials, of which 2 were performed. Conclusions Clinical trials conducted for the approval of many ADHD drugs have not been designed to assess rare adverse events or long-term safety and efficacy. While post-marketing studies can fill in some of the gaps, better assurance is needed that the proper trials are conducted either before or after a new medication is approved. PMID:25007171

  15. [Mindfulness-based intervention in attention-deficit-/hyperactivity disorder (ADHD)].

    PubMed

    Schmiedeler, Sandra

    2015-03-01

    This paper reviews the current literature on mindfulness-based interventions in the treatment of attention-deficit/hyperactivity disorder (ADHD). Mindfulness means paying attention and being aware of the experiences occurring in the present moment, and it is usually developed by the practice of meditation. Research shows that mindfulness training is associated with improved attention systems and self-regulation, and that it therefore fosters those skills that are underdeveloped in individuals with ADHD. Although only few studies have investigated the effectiveness of mindfulness training in ADHD (many of which showing methodological limitations), the findings do suggest that mindfulness may be useful in ADHD interventions. PMID:25769764

  16. [Which patients with ovarian cancer shows the combination of trabectedin with pegylated liposomal doxorubicin].

    PubMed

    Khokhlova, S V; Cherkasova, M V; Orel, N F; Limareva, S V; Bazaeva, I Ia; Gorbunova, V A

    2013-01-01

    Given the high rate of recurrence of ovarian cancer, the search for new therapeutic strategies are topical issue. According to various studies the effectiveness of drug treatment relapse depends on the platinum-free interval, increasing in proportion to its duration. If therapy is platinum-resistant recurrent ovarian cancer is a standard approach, the treatment of platinum-sensitive recurrent algorithm is not fully defined. Comparison of platinum and non-platinum combinations revealed the advantage of combined platinum- treatment for patients with platinum-free interval of more than 6 months without an increase in life expectancy. Non-platinum combination of trabected in with pegylated liposomal doxorubicin has shown comparable efficacy with an advantage in overall survival in patients with platinum-free interval of 6-12 months. A platinum-free interval prolongation by the use of non-platinum mode increases the efficiency of subsequent platinum-based therapy, increasing the life expectancy of patients. Currently under study molecular markers and prognostic factors allowing to define a group of patients who have the greatest benefit from the use trabectedin with pegylated liposomal doxorubicin as second-line chemotherapy. PMID:24640740

  17. Characteristics of Adolescents and Young Adults with ADHD Who Divert or Misuse Their Prescribed Medications

    ERIC Educational Resources Information Center

    Wilens, Timothy E.; Gignac, Martin; Swezey, Allison; Monuteaux, Michael C.; Biederman, Joseph

    2006-01-01

    Objective: Little is known about the risks and characteristics of attention-deficit/hyperactivity disorder (ADHD) patients who misuse or divert their stimulant medications. As part of a 10-year longitudinal study of youths with ADHD, the authors evaluated medication diversion or misuse at the last follow-up period. Method: Structured psychiatric…

  18. Associations between Sleep Characteristics, Seasonal Depressive Symptoms, Lifestyle, and ADHD Symptoms in Adults

    ERIC Educational Resources Information Center

    Bijlenga, Denise; van der Heijden, Kristiaan B.; Breuk, Minda; van Someren, Eus J. W.; Lie, Maria E. H.; Boonstra, A. Marije; Swaab, Hanna J. T.; Kooij, J. J. Sandra

    2013-01-01

    Objective: The authors explored associations between ADHD symptoms, seasonal depressive symptoms, lifestyle, and health. Method: Adult ADHD patients ("n" = 202) and controls ("n" = 189) completed the ASESA questionnaire involving lifestyle, eating pattern, and physical and psychological health, and validated measures on ADHD…

  19. ADHD, Substance Use Disorders, and Psychostimulant Treatment: Current Literature and Treatment Guidelines

    ERIC Educational Resources Information Center

    Kollins, Scott H.

    2008-01-01

    Objective: This review explores the relationship between ADHD and substance use disorder (SUD), factors that determine the abuse potential of psychostimulants, and strategies for identifying and treating at-risk ADHD patients. Method: This study uses a Medline review of literature. Results: Psychostimulants, such as methylphenidate and…

  20. Pregabalin and placebo responders show different effects on central pain processing in chronic pancreatitis patients

    PubMed Central

    Bouwense, Stefan AW; Olesen, Søren S; Drewes, Asbjørn M; van Goor, Harry; Wilder-Smith, Oliver HG

    2015-01-01

    Background Pain control in chronic pancreatitis is a major challenge; the mechanisms behind analgesic treatment are poorly understood. This study aims to investigate the differences in pain sensitivity and modulation in chronic pancreatitis patients, based on their clinical response (responders vs nonresponders) to placebo or pregabalin treatment. Methods This study was part of a randomized, double-blind, placebo-controlled trial evaluating the analgesic effects of pregabalin and placebo in chronic pancreatitis. Post hoc, patients were assigned to one of four groups, ie, responders and nonresponders to pregabalin (n=16; n=15) or placebo (n=12; n=17) treatment. Responders were defined as patients with >30% pain reduction after 3 weeks of treatment. We measured change in pain sensitivity before and after the treatment using electric pain detection thresholds (ePDT) in dermatomes C5 (generalized effects) and Ventral T10 (segmental effects). Descending endogenous pain modulation was quantified via conditioned pain modulation (CPM) paradigm. Results Sixty patients were analyzed in a per-protocol analysis. ePDT change in C5 was significant vs baseline and greater in pregabalin (1.3 mA) vs placebo responders (−0.1 mA; P=0.015). This was not so for ePDT in Ventral T10. CPM increased more in pregabalin (9%) vs placebo responders (−17%; P<0.001). CPM changed significantly vs baseline only for pregabalin responders (P=0.006). Conclusion This hypothesis-generating study provides the first evidence that pain relief with pregabalin is associated with anti-hyperalgesic effects and increased endogenous inhibitory modulation. No such effects were observed in patients experiencing pain relief with the placebo treatment. The mechanisms underlying analgesic response to placebo vs drug treatments are different and, together with their interactions, deserve further study. PMID:26203273

  1. The Tryptophan Hydroxylase Inhibitor LX1031 Shows Clinical Benefit in Patients With Nonconstipating Irritable Bowel Syndrome

    PubMed Central

    Brown, Philip M.; Drossman, Douglas A.; Wood, Alastair J. J.; Cline, Gary A.; Frazier, Kenny S.; Jackson, Jessica I.; Bronner, Johanna; Freiman, Joel; Zambrowicz, Brian; Sands, Arthur; Gershon, Michael D.

    2016-01-01

    BACKGROUND & AIMS Serotonin (5-hydroxytryptamine [5-HT]) has an important role in gastrointestinal function. LX1031 is an oral, locally acting, small molecule inhibitor of tryptophan hydroxylase (TPH). Local inhibition of TPH in the gastrointestinal tract might reduce mucosal production of serotonin (5-HT) and be used to treat patients with nonconstipating irritable bowel syndrome (IBS). METHODS We evaluated 2 dose levels of LX1031 (250 mg or 1000 mg, given 4 times/day) in a 28-day, multicenter, randomized, double-blind, placebo-controlled study of 155 patients with nonconstipating IBS. 5-hydroxyindoleacetic acid (5-HIAA), a biomarker of pharmacodynamic activity, was measured in urine samples at baseline (24 hours after LX1031 administration), and at weeks 4 and 6 (n = 76). RESULTS Each dose of LX1031 was safe and well-tolerated. The primary efficacy end point, relief of IBS pain and discomfort, improved significantly in patients given 1000 mg LX1031 (25.5%), compared with those given placebo, at week 1 (P = .018); with nonsignificant improvements at weeks 2, 3, and 4 (17.9%, 16.3%, and 11.6%, respectively). Symptom improvement correlated with a dose-dependent reduction in 5-HIAA, a marker for TPH inhibition, from baseline until week 4. This suggests the efficacy of LX1031 is related to the extent of inhibition of 5-HT biosynthesis. Stool consistency significantly improved, compared with the group given placebo, at weeks 1 and 4 (P < .01) and at week 2 (P < .001). CONCLUSIONS In a phase 2 study, LX1031 was well tolerated, relieving symptoms and increasing stool consistency in patients with nonconstipating IBS. Symptom relief was associated with reduced levels of 5-HIAA in urine samples. This marker might be used to identify patients with nonconstipating IBS who respond to inhibitors of 5-HT synthesis. PMID:21684281

  2. ADHD Expressive Writing Difficulties of ADHD Children: When Good Declarative Knowledge Is Not Sufficient

    ERIC Educational Resources Information Center

    Re, Anna Maria; Cornoldi, Cesare

    2010-01-01

    A large body of evidence shows that many of the academic difficulties Attention Deficit Hyperactivity Disorder (ADHD) children have may be related to their problems in executive control. However, the particular case of expressive writing has not been deeply explored. The present study examines the typical school exercise of writing a letter.…

  3. ADHD-200 Global Competition: diagnosing ADHD using personal characteristic data can outperform resting state fMRI measurements.

    PubMed

    Brown, Matthew R G; Sidhu, Gagan S; Greiner, Russell; Asgarian, Nasimeh; Bastani, Meysam; Silverstone, Peter H; Greenshaw, Andrew J; Dursun, Serdar M

    2012-01-01

    Neuroimaging-based diagnostics could potentially assist clinicians to make more accurate diagnoses resulting in faster, more effective treatment. We participated in the 2011 ADHD-200 Global Competition which involved analyzing a large dataset of 973 participants including Attention deficit hyperactivity disorder (ADHD) patients and healthy controls. Each participant's data included a resting state functional magnetic resonance imaging (fMRI) scan as well as personal characteristic and diagnostic data. The goal was to learn a machine learning classifier that used a participant's resting state fMRI scan to diagnose (classify) that individual into one of three categories: healthy control, ADHD combined (ADHD-C) type, or ADHD inattentive (ADHD-I) type. We used participants' personal characteristic data (site of data collection, age, gender, handedness, performance IQ, verbal IQ, and full scale IQ), without any fMRI data, as input to a logistic classifier to generate diagnostic predictions. Surprisingly, this approach achieved the highest diagnostic accuracy (62.52%) as well as the highest score (124 of 195) of any of the 21 teams participating in the competition. These results demonstrate the importance of accounting for differences in age, gender, and other personal characteristics in imaging diagnostics research. We discuss further implications of these results for fMRI-based diagnosis as well as fMRI-based clinical research. We also document our tests with a variety of imaging-based diagnostic methods, none of which performed as well as the logistic classifier using only personal characteristic data. PMID:23060754

  4. Parent-adolescent conflict in teenagers with ADHD and ODD.

    PubMed

    Edwards, G; Barkley, R A; Laneri, M; Fletcher, K; Metevia, L

    2001-12-01

    Eighty-seven male teens (ages 12-18 years) with ADHD/ODD and their parents were compared to 32 male teens and their parents in a community control (CC) group on mother, father, and teen ratings of parent-teen conflict and communication quality, parental self-reports of psychological adjustment, and direct observations of parent-teen problem-solving interactions during a neutral and conflict discussion. Parents and teens in the ADHD/ODD group rated themselves as having significantly more issues involving parent-teen conflict, more anger during these conflict discussions, and more negative communication generally, and used more aggressive conflict tactics with each other than did parents and teens in the CC group. During a neutral discussion, only the ADHD/ODD teens demonstrated more negative behavior. During the conflict discussion, however, the mothers, fathers, and teens in the ADHD/ODD group displayed more negative behavior, and the mothers and teens showed less positive behavior than did participants in the CC group. Differences in conflicts related to sex of parent were evident on only a few measures. Both mother and father self-rated hostility contributed to the level of mother-teen conflict whereas father self-rated hostility and anxiety contributed to father-teen conflict beyond the contribution made by level of teen ODD and ADHD symptoms. Results replicated past studies of mother-child interactions in ADHD/ODD children, extended these results to teens with these disorders, showed that greater conflict also occurs in father-teen interactions, and found that degree of parental hostility, but not ADHD symptoms, further contributed to levels of parent-teen conflict beyond the contribution made by severity of teen ADHD and ODD symptoms. PMID:11761288

  5. EEG Power Spectrum Analysis in Children with ADHD

    PubMed Central

    Kamida, Akira; Shimabayashi, Kenta; Oguri, Masayoshi; Takamori, Toshihiro; Ueda, Naoyuki; Koyanagi, Yuki; Sannomiya, Naoko; Nagira, Haruki; Ikunishi, Saeko; Hattori, Yuiko; Sato, Kengo; Fukuda, Chisako; Hirooka, Yasuaki; Maegaki, Yoshihiro

    2016-01-01

    Background Attention deficit disorder/hyperactivity disorder (ADHD) is a pathological condition that is not fully understood. In this study, we investigated electroencephalographic (EEG) power differences between children with ADHD and healthy control children. Methods EEGs were recorded as part of routine medical care received by 80 children with ADHD aged 4–15 years at the Department of Pediatric Neurology in Tottori University Hospital. Additionally, we recorded in 59 control children aged 4–15 years after obtaining informed consent. Specifically, awake EEG signals were recorded from each child using the international 10–20 system, and we used ten 3-s epochs on the EEG power spectrum to calculate the powers of individual EEG frequency bands. Results The powers of different EEG bands were significantly higher in the frontal brain region of those in the ADHD group compared with the control group. In addition, the power of the beta band in the ADHD group was significantly higher in all brain regions, except for the occipital region, compared with control children. With regard to developmental changes, the power of the alpha band in the occipital region showed an age-dependent decrease in both groups, with slightly lower power in the ADHD group. Additionally, the intergroup difference decreased in children aged 11 years or older. As with the alpha band in the occipital region, the beta band in the frontal region showed an age-dependent decrease in both groups. Unlike the alpha band, the power of the beta band was higher in the ADHD group than in the control group for children of all ages. Conclusion The observed intergroup differences in EEG power may provide insight into the brain function of children with ADHD. PMID:27493489

  6. Adaptations for Students with ADHD

    ERIC Educational Resources Information Center

    McGrady, Mart

    2005-01-01

    ADHD is a neurobiological-based brain disorder, most often hereditary, affecting nearly one in twenty students. The ADHD brain functions differently because the area between the frontal lobe and rear lobe is having short-circuit problems and is not transmitting necessary information. The technical part of the disorder does not engage us as…

  7. ADHD: Implications for School Counselors

    ERIC Educational Resources Information Center

    Branscome, Jennifer; Cunningham, Teddi; Kelley, Heather; Brown, Caitlyn

    2014-01-01

    The focus of this article is to provide an overview of the current state of knowledge of ADHD and to provide evidence-based training interventions for school counselors. An overview of basic information about ADHD will be provided, including diagnosis, presentation, causes, prevalence, and common misconceptions. Evidence-based training…

  8. Understanding ADHD: Our Personal Journey

    ERIC Educational Resources Information Center

    Blahy, Tammy Lynn

    2004-01-01

    No good time exists to face the realities of attention deficit and hyperactivity disorder (ADHD). Children across the United States and Canada are accompanied to clinics and schools by frightened, worried parents. In the book, In Understanding ADHD (2001), Ken and Andrea McCluskey bring to life the realities of the everyday journey of coping with…

  9. Attention, Task Difficulty, and ADHD

    ERIC Educational Resources Information Center

    Nigg, Joel T.

    2005-01-01

    Comments on analysis of attention tasks in Attention Deficit Hyperactivity Disorder (ADHD) provided by Wilding (2005)points out that whereas many regulatory functions, including alertness or arousal, appear to be impaired in ADHD, demonstrating basic attention deficits in selection or orienting functions in the disorder has proven difficult. Yet…

  10. ADHD: From Intervention to Implementation

    ERIC Educational Resources Information Center

    Chaban, Peter

    2010-01-01

    Attention deficit/hyperactivity disorder (ADHD), a chronic neurological disorder, is not formally recognized in the educational systems across Canada. As a result, there is little opportunity for collaboration or sharing of information between the medical/research community and the educational system. Because ADHD is not formally identified,…

  11. Contemporary Trends in ADHD Research

    ERIC Educational Resources Information Center

    Norvilitis, Jill M., Ed.

    2012-01-01

    With many children and adults affected by Attention Deficit Hyperactivity Disorder, researchers strive to understand the underpinnings of ADHD and associated factors on both a basic and applied level. The goal of this volume is to explore some of the broad array of research in the field of ADHD. The 12 chapters cover a variety of topics as varied…

  12. Doppler Sonography Confirmation in Patients Showing Calcified Carotid Artery Atheroma in Panoramic Radiography and Evaluation of Related Risk Factors

    PubMed Central

    Imanimoghaddam, Mahrokh; Rah Rooh, Mohammad; Mahmoudi Hashemi, Elahe; Javadzade Blouri, Abbas

    2012-01-01

    Background and aims The purpose of this study was to identify patients at the risk of cerebrovascular attack (CVA) by detecting calcified carotid artery atheroma (CCAA) in panoramic radiography and evaluating their risk factors. Materials and methods A total of 960 panoramic radiographs of patients above 40 years old were evaluated. Doppler Sonography (DS) was performed for patients who showed calcified carotid artery atheroma (CCAA) in panoramic radiogra-phy in order to determine the presence of CCAA and the degree of stenosis. Cardiovascular risk factors in both groups of patients with CCAA (12 subjects) and without CCAA (3 subjects) were compared using a questionnaire filled out by the patients. Statistical analysis including Fisher and independent t-test applied for data analysis. Results Fifteen patients (30 sides) showed calcification in their panoramic radiographs, and underwent DS which revealed CCAA in 16 sides (12 patients). Two patients (13.33%) showed stenosis greater than 70%. Among the risk factors, only age showed a significant association with the occurrence of carotid calcified atheroma (P=0.026). Conclusion Considering the results, dentists should refer especially elderly patients with radiographically identified atheromas for further examinations, as asymptomatic CCAA might be associated with high degrees of stenosis. PMID:22991627

  13. Alternative pharmacological strategies for adult ADHD treatment: a systematic review.

    PubMed

    Buoli, Massimiliano; Serati, Marta; Cahn, Wiepke

    2016-01-01

    Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder. PMID:26693882

  14. Non-Pharmacological Treatments for ADHD in Youth

    PubMed Central

    Sharma, Anup; Gerbarg, Patricia L.; Brown, Richard P.

    2016-01-01

    Background Complementary and alternative medicine (CAM) in psychiatry or integrative psychiatry covers a wide range of biological, psychological and mind-body treatments that enhance standard medical practices and patient outcomes. While CAM approaches are popular amongst patients in their practice as well as in self-report because of their ease of use, health professionals have received limited education in these interventions and often are unaware of their patients’ use of CAM treatments. Method This overview highlights evidence-based CAM treatments for attention deficit hyperactivity disorder (ADHD) including dietary interventions, phytomedicines, mind-body practices and neurofeedback. Results While conventional treatments are the mainstays for ADHD, there are a large number of available treatments that can be used to enhance treatment response. Conclusion With improved education and further scientific and clinical research, validated integrative treatments will provide more effective, lower risk and lower cost care for patients with ADHD. PMID:27489754

  15. A Review of Co-Morbid Depression in Pediatric ADHD: Etiologies, Phenomenology, and Treatment

    PubMed Central

    2008-01-01

    Abstract This paper reviews the literature and highlights the need for further research regarding the phenomenology, etiology, assessment, and treatment of co-morbid depression in patients with attention-deficit/hyperactivity disorders (ADHD). Depression occurs in youths with ADHD at a significantly higher rate than in youths without ADHD. Youths with ADHD and depression together have a more severe course of psychopathology and a higher risk of long-term impairment and suicide than youths with either disorder alone. Assessment of such co-morbid depression is complicated by overlapping symptoms with ADHD and with other disorders that commonly occur with ADHD. Depressive disorders typically emerge several years after the onset of ADHD and may arise from environmental difficulties associated with chronic ADHD that interact with genetic risks as the child gets older. Despite a scarcity of well-designed treatment studies for youths with ADHD and co-morbid depression, there is increasing preliminary evidence for the role of stimulants, selective serotonergic reuptake inhibitors, bupropion, and atomoxetine to target either or both disorders. There is also some indirect evidence for the benefit of combining pharmacological treatments with psychosocial interventions that specifically target relevant environmental factors and functional impairments. PMID:19108661

  16. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective

    PubMed Central

    Bachmann, Katharina; Lam, Alexandra P.; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  17. Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective.

    PubMed

    Bachmann, Katharina; Lam, Alexandra P; Philipsen, Alexandra

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD. PMID:27445873

  18. Cognitive Load Differentially Impacts Response Control in Girls and Boys with ADHD.

    PubMed

    Seymour, Karen E; Mostofsky, Stewart H; Rosch, Keri S

    2016-01-01

    Children with attention-deficit hyperactivity disorder (ADHD) consistently show impaired response control, including deficits in response inhibition and increased intrasubject variability (ISV) compared to typically-developing (TD) children. However, significantly less research has examined factors that may influence response control in individuals with ADHD, such as task or participant characteristics. The current study extends the literature by examining the impact of increasing cognitive demands on response control in a large sample of 81children with ADHD (40 girls) and 100 TD children (47 girls), ages 8-12 years. Participants completed a simple Go/No-Go (GNG) task with minimal cognitive demands, and a complex GNG task with increased cognitive load. Results showed that increasing cognitive load differentially impacted response control (commission error rate and tau, an ex-Gaussian measure of ISV) for girls, but not boys, with ADHD compared to same-sex TD children. Specifically, a sexually dimorphic pattern emerged such that boys with ADHD demonstrated higher commission error rate and tau on both the simple and complex GNG tasks as compared to TD boys, whereas girls with ADHD did not differ from TD girls on the simple GNG task, but showed higher commission error rate and tau on the complex GNG task. These findings suggest that task complexity influences response control in children with ADHD in a sexually dimorphic manner. The findings have substantive implications for the pathophysiology of ADHD in boys versus girls with ADHD. PMID:25624066

  19. Confronting ADHD in the Music Classroom

    ERIC Educational Resources Information Center

    Moore, Patience

    2009-01-01

    Tell-tale signs of Attention Deficit Hyperactive Disorder (ADHD) ADHD and its relative ADD (Attention Deficit Disorder) include an inability to maintain attention, impulsive behaviors, and/or motor restlessness. There are three subcategories of ADHD; for the purpose of this article, the blanket term ADHD applies to all three. A crucial first step…

  20. [Alternative agents used in ADHD].

    PubMed

    Hässler, Frank; Dück, Alexander; Reis, Olaf; Buchmann, Johannes

    2009-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is, with a prevalence of 2% to 6%, one of the most common neurobehavioral disorder affecting children and adolescents, persisting into adulthood. Comorbidity and psychosocial circumstances enter into the choice of intervention strategies. Several agents have been demonstrated effective in treating individuals with ADHD. Direct or indirect attenuation of dopamine and norepinephrine neurotransmission appears closely related to both the stimulant and nonstimulant medications efficacious in ADHD. However, important differences concerning efficacy and side effects exist both between and with the specific classes of agents like neuroleptics, antidepressants, antiepileptics, alpha-agonists, beta-blockers, buspiron, l-dopa, melatonin, pycnogenol, zinc, magnesium, polyunsaturated fatty acids, and homeopathy. Elucidating the various mechanisms of action of ADHD medications may lead to better choices in matching potential responses to the characteristics of individuals. We review the purported mechanism of action and available evidence for selected complementary and alternative medicine therapies for ADHD in childhood and adolescence. PMID:19105161

  1. A Patient with Refractory Psoriasis Who Developed Sebaceous Carcinoma on the Neck during Cyclosporine Therapy and Showed Rapid Progression

    PubMed Central

    Shima, Tomoko; Yamamoto, Yuki; Okuhira, Hisako; Mikita, Naoya; Furukawa, Fukumi

    2016-01-01

    We report a patient who developed sebaceous carcinoma on the neck during therapy with immunosuppressive agents (cyclosporine, corticosteroid, methotrexate) for refractory psoriasis vulgaris, which showed rapid enlargement, leading to a fatal outcome. Multiple-organ metastases were detected. Weekly carboplatin + paclitaxel therapy resulted in the disappearance of tumor cells, but the patient died of febrile neutropenia. The development of sebaceous carcinoma is rare among psoriasis patients receiving immunosuppressive agents including cyclosporine. PMID:27462222

  2. A Patient with Refractory Psoriasis Who Developed Sebaceous Carcinoma on the Neck during Cyclosporine Therapy and Showed Rapid Progression.

    PubMed

    Shima, Tomoko; Yamamoto, Yuki; Okuhira, Hisako; Mikita, Naoya; Furukawa, Fukumi

    2016-01-01

    We report a patient who developed sebaceous carcinoma on the neck during therapy with immunosuppressive agents (cyclosporine, corticosteroid, methotrexate) for refractory psoriasis vulgaris, which showed rapid enlargement, leading to a fatal outcome. Multiple-organ metastases were detected. Weekly carboplatin + paclitaxel therapy resulted in the disappearance of tumor cells, but the patient died of febrile neutropenia. The development of sebaceous carcinoma is rare among psoriasis patients receiving immunosuppressive agents including cyclosporine. PMID:27462222

  3. Fibroblasts from patients with major depressive disorder show distinct transcriptional response to metabolic stressors

    PubMed Central

    Garbett, K A; Vereczkei, A; Kálmán, S; Wang, L; Korade, Ž; Shelton, R C; Mirnics, K

    2015-01-01

    Major depressive disorder (MDD) is increasingly viewed as interplay of environmental stressors and genetic predisposition, and recent data suggest that the disease affects not only the brain, but the entire body. As a result, we aimed at determining whether patients with major depression have aberrant molecular responses to stress in peripheral tissues. We examined the effects of two metabolic stressors, galactose (GAL) or reduced lipids (RL), on the transcriptome and miRNome of human fibroblasts from 16 pairs of patients with MDD and matched healthy controls (CNTR). Our results demonstrate that both MDD and CNTR fibroblasts had a robust molecular response to GAL and RL challenges. Most importantly, a significant part (messenger RNAs (mRNAs): 26–33% microRNAs (miRNAs): 81–90%) of the molecular response was only observed in MDD, but not in CNTR fibroblasts. The applied metabolic challenges uncovered mRNA and miRNA signatures, identifying responses to each stressor characteristic for the MDD fibroblasts. The distinct responses of MDD fibroblasts to GAL and RL revealed an aberrant engagement of molecular pathways, such as apoptosis, regulation of cell cycle, cell migration, metabolic control and energy production. In conclusion, the metabolic challenges evoked by GAL or RL in dermal fibroblasts exposed adaptive dysfunctions on mRNA and miRNA levels that are characteristic for MDD. This finding underscores the need to challenge biological systems to bring out disease-specific deficits, which otherwise might remain hidden under resting conditions. PMID:25756806

  4. Patients with bipolar disorder show differential executive dysfunctions: A case-control study.

    PubMed

    Leung, Meranda M W; Lui, Simon S Y; Wang, Ya; Tsui, Chi F; Au, Angie C W; Yeung, Hera K H; Yang, Tian-Xiao; Li, Zhi; Cheng, Chi-Wai; Cheung, Eric F C; Chan, Raymond C K

    2016-04-30

    Executive deficits in euthymic bipolar I disorder were examined in a fractionated manner based on the "Supervisory Attentional System" (SAS) model, and the relationship between the degree of executive impairment and the demographic and clinical characteristics of bipolar I participants was explored. A battery of neurocognitive tests capturing specific components of executive function was administered on 30 patients with bipolar I disorder in euthymic state, and compared with 30 healthy controls who were matched by age, gender and IQ. A differential impairment in executive function was demonstrated in euthymic bipolar I participants by using a fractionated approach of the SAS. Euthymic bipolar I patients were found to have significantly poorer performance in immediate and delayed visual memory; and in the executive domains of "initiation", "sustained attention", and "attention allocation and planning". Those with a greater number of executive impairments had lower IQ and higher negative sub-scores on PANSS. These findings might provide a the basis for further studies on identifying the executive components that are associated with particular disease characteristics of bipolar disorder, and those with poorer functional outcome, so that rehabilitation can be focused on the selective domains concerned. PMID:27086222

  5. Exogenous orienting of visual-spatial attention in ADHD children.

    PubMed

    Ortega, Rodrigo; López, Vladimir; Carrasco, Ximena; Anllo-Vento, Lourdes; Aboitiz, Francisco

    2013-02-01

    Visual spatial orienting of attention towards exogenous cues has been one of the attentional functions considered to be spared in ADHD. Here we present a design in which 60 (30 ADHD) children, age: 10.9±1.4, were asked to covertly orient their attention to one or two (out of four) cued locations, and search for a target stimulus in one of these locations, while recording behavioral responses and EEG/ERP. In all conditions, ADHD children showed delayed reaction times and poorer behavioral performance. They also exhibited larger cue-elicited P2 but reduced CNV in the preparation stage. Larger amplitude of CNV predicted better performance in the task. Target-elicited N1 and selection negativity were also reduced in the ADHD group compared to non-ADHD. Groups also differed in the early and late P3 time-windows. The present results suggest that exogenous orienting of attention could be dysfunctional in ADHD under certain conditions. This limitation is not necessarily caused by an impairment of the orienting process itself, but instead by a difficulty in maintaining the relevant information acquired during the early preparation stage through the target processing stage, when it is really needed. PMID:23200900

  6. Computer Simulation Shows the Effect of Communication on Day of Surgery Patient Flow.

    PubMed

    Taaffe, Kevin; Fredendall, Lawrence; Huynh, Nathan; Franklin, Jennifer

    2015-07-01

    To improve patient flow in a surgical environment, practitioners and academicians often use process mapping and simulation as tools to evaluate and recommend changes. We used simulations to help staff visualize the effect of communication and coordination delays that occur on the day of surgery. Perioperative services staff participated in tabletop exercises in which they chose the delays that were most important to eliminate. Using a day-of-surgery computer simulation model, the elimination of delays was tested and the results were shared with the group. This exercise, repeated for multiple groups of staff, provided an understanding of not only the dynamic events taking place, but also how small communication delays can contribute to a significant loss in efficiency and the ability to provide timely care. Survey results confirmed these understandings. PMID:26119616

  7. Patients treated with high-dose intravenous immunoglobulin show selective activation of regulatory T cells

    PubMed Central

    Tjon, A S W; Tha-In, T; Metselaar, H J; van Gent, R; van der Laan, L J W; Groothuismink, Z M A; te Boekhorst, P A W; van Hagen, P M; Kwekkeboom, J

    2013-01-01

    Intravenous immunoglobulin (IVIg) is used to treat autoimmune and systemic inflammatory diseases caused by derailment of humoral and cellular immunity. In this study we investigated whether IVIg treatment can modulate regulatory T cells (Tregs) in humans in vivo. Blood was collected from IVIg-treated patients with immunodeficiency or autoimmune disease who were treated with low-dose (n = 12) or high-dose (n = 15) IVIg before, immediately after and at 7 days after treatment. Percentages and activation status of circulating CD4+CD25+forkhead box protein 3 (FoxP3+) Tregs and of conventional CD4+FoxP3− T-helper cells (Tconv) were measured. The suppressive capacity of Tregs purified from blood collected at the time-points indicated was determined in an ex-vivo assay. High-dose, but not low-dose, IVIg treatment enhanced the activation status of circulating Tregs, as shown by increased FoxP3 and human leucocyte antigen D-related (HLA-DR) expression, while numbers of circulating Tregs remained unchanged. The enhanced activation was sustained for at least 7 days after infusion, and the suppressive capacity of purified Tregs was increased from 41 to 70% at day 7 after IVIg treatment. The activation status of Tconv was not affected by IVIg. We conclude that high-dose IVIg treatment activates Tregs selectively and enhances their suppressive function in humans in vivo. This effect may be one of the mechanisms by which IVIg restores imbalanced immune homeostasis in patients with autoimmune and systemic inflammatory disorders. PMID:23607448

  8. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

    PubMed

    Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-11-01

    Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.Fundamento: Estudos têm demonstrado a acurácia diagnóstica e o valor prognóstico da ecocardiografia com estresse f

  9. De novo WDR45 mutation in a patient showing clinically Rett syndrome with childhood iron deposition in brain.

    PubMed

    Ohba, Chihiro; Nabatame, Shin; Iijima, Yoshitaka; Nishiyama, Kiyomi; Tsurusaki, Yoshinori; Nakashima, Mitsuko; Miyake, Noriko; Tanaka, Fumiaki; Ozono, Keiichi; Saitsu, Hirotomo; Matsumoto, Naomichi

    2014-05-01

    Rett syndrome (RTT) is a neurodevelopmental disorder mostly caused by MECP2 mutations. We identified a de novo WDR45 mutation, which caused a subtype of neurodegeneration with brain iron accumulation, in a patient showing clinically typical RTT. The mutation (c.830+1G>A) led to aberrant splicing in lymphoblastoid cells. Sequential brain magnetic resonance imaging demonstrated that iron deposition in the globus pallidus and the substantia nigra was observed as early as at 11 years of age. Because the patient showed four of the main RTT diagnostic criteria, WDR45 should be investigated in patients with RTT without MECP2 mutations. PMID:24621584

  10. Peritoneal macrophages from patients with cirrhotic ascites show impaired phagocytosis and vigorous respiratory burst

    PubMed Central

    Ahmed, Abdel Motaal M.; Bomford, Adrian; Nouri-Aria, Kayhan T.; Davies, Ted; Smith, Roger; Williams, Roger

    2011-01-01

    Cirrhotic patients (CPs) are susceptible to spontaneous bacterial peritonitis (SBP). Aim of this study was to examine if this susceptibility was related to peritoneal macrophages' (PMs) altered host defence. Absorbance of phagocytosed particles by PMs from CPs was lower than that of control (31.88% vs. 77.2%). Particle opsonisation increased the absorbance to 41% in CPs' PMs, and this value remains lower than the control; 77.2%. Respiratory burst (RB) was expressed as fluorescence index values, and these were higher in PMs from CPs than in controls (82 vs. 41, 73 vs. 26 and 71 vs. 26). IFN-γ made no further increase of RB values in PMs from CPs. CD14 expression was also higher in CPs' PMs. IFN-γ significantly downregulated CD14 expression in both CPs' PMs and control. Reduced phagocytosis by predominantly CD14-positive PMs from CPs could be related to intense RB. Findings suggest altered host defence that could contribute to susceptibility to SBP. PMID:24371553

  11. The role of ASTN2 variants in childhood and adult ADHD, comorbid disorders and associated personality traits.

    PubMed

    Freitag, Christine M; Lempp, Thomas; Nguyen, T Trang; Jacob, Christian P; Weissflog, Lena; Romanos, Marcel; Renner, Tobias J; Walitza, Susanne; Warnke, Andreas; Rujescu, Dan; Lesch, Klaus-Peter; Reif, Andreas

    2016-08-01

    Previous linkage and genome wide association (GWA) studies in ADHD indicated astrotactin 2 (ASTN2) as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). ASTN2 plays a key role in glial-guided neuronal migration. To investigate whether common variants in ASTN2 contribute to ADHD disorder risk, we tested 63 SNPs spanning ASTN2 for association with ADHD and specific comorbid disorders in two samples: 171 families of children with ADHD and their parents (N = 592), and an adult sample comprising 604 adult ADHD cases and 974 controls. The C-allele of rs12376789 in ASTN2 nominally increased the risk for ADHD in the trio sample (p = 0.025). This was not observed in the adult case-control sample alone, but retained in the combined sample (nominal p = 0.030). Several other SNPs showed nominally significant association with comorbid disorders, especially anxiety disorder, in the childhood and adult ADHD samples. Some ASTN2 variants were nominally associated with personality traits in the adult ADHD sample and overlapped with risk alleles for comorbid disorders in childhood. None of the findings survived correction for multiple testing, thus, results do not support a major role of common variants in ASTN2 in the pathogenesis of ADHD, its comorbid disorders or ADHD associated personality traits. PMID:27138430

  12. Brain lateralization and self-reported symptoms of ADHD in a population sample of adults: a dimensional approach

    PubMed Central

    Mohamed, Saleh M. H.; Börger, Norbert A.; Geuze, Reint H.; van der Meere, Jaap J.

    2015-01-01

    Many clinical studies reported a compromised brain lateralization in patients with Attention-Deficit/Hyperactivity Disorder (ADHD) without being conclusive about whether the deficit existed in the left or right hemisphere. It is well-recognized that studying ADHD dimensionally is more controlled for comorbid problems and medication effects, and provides more accurate assessment of the symptoms. Therefore, the present study applied the dimensional approach to test the relationship between brain lateralization and self-reported ADHD symptoms in a population sample. Eighty-five right-handed university students filled in the Conners’ Adult ADHD Rating Scales and performed a lateralization reaction time task. The task consists of two matching conditions: one condition requires nominal identification for letters tapping left hemisphere specialization (Letter Name-Identity condition) and the other one requires physical and visuospatial identification for shapes tapping right hemisphere specialization (Shape Physical-Identity condition). The letters or shapes to be matched are presented in left or right visual field of a fixation cross. For both task conditions, brain lateralization was indexed as the difference in mean reaction time between left and right visual field. Linear regression analyses, controlled for mood symptoms reported by a depression, anxiety, and stress scale, showed no relationship between the variables. These findings from a population sample of adults do not support the dimensionality of lateralized information processing deficit in ADHD symptomatology. However, group comparison analyses showed that subjects with high level of inattention symptoms close to or above the clinical cut-off had a reduced right hemisphere processing in the Shape Physical-Identity condition. PMID:26441789

  13. Daytime Sleepiness in Adults With ADHD: A Pilot Trial With a Multiple Sleep Latency Test.

    PubMed

    Sobanski, Esther; Alm, Barbara; Hennig, Oliver; Riemann, Dieter; Feige, Bernd; Schredl, Michael

    2014-04-17

    Objective: To evaluate sleep latency (SL) during the multiple sleep latency test (MSLT) and subjective daytime sleepiness in adult ADHD and controls. Method: Subjective daytime sleepiness was assessed by Epworth Sleepiness Scale (ESS) in 27 unmedicated adults with ADHD and in 182 controls. Thirteen ADHD patients and 26 controls underwent MSLT after one night of polysomnography (PSG). Results: Mean MSLT-SL was 10.6 ± 4.8 min in ADHD and 12.2 ± 4.2 min in controls (n.s.). Mean ESS score was 9.3 ± 4.9 points in ADHD and 6.9 ± 3.4 points in controls (p < .005). MSLT-SL and ESS scores correlated inversely by trend (r = -.45, p < .1) but not with ADHD symptoms or ADHD subtype. Conclusion: Adults with ADHD do not differ from controls in mean MSLT-SL but experience increased subjective daytime sleepiness. Patients with subjective higher daytime tiredness fell asleep faster during MSLT. PMID:24743976

  14. Longitudinal changes in individual symptoms across the preschool years in children with ADHD.

    PubMed

    Harvey, Elizabeth A; Lugo-Candelas, Claudia I; Breaux, Rosanna P

    2015-01-01

    The present study examined trajectories of individual Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) across the preschool years in children with ADHD. It also evaluated whether preschool symptoms vary in their ability to discriminate children who later meet criteria for ADHD from typically developing children. ADHD and ODD symptoms were assessed annually in 75 ethnically diverse children (46 boys) who presented with behavior problems at age 3 and met criteria for ADHD 3 years later, and in 51 typically developing children (26 boys). Children with ADHD generally exhibited stable levels of hyperactivity/impulsivity but increases in several symptoms of inattention. Most ADHD symptoms showed at least fair utility in discriminating children with and without ADHD; however, 3 symptoms of inattention (carelessness, losing things, and forgetfulness) and 1 symptom of hyperactivity/impulsivity (blurting out answers) had relatively poor utility. These symptoms demonstrated only somewhat greater utility at age 4, but by the age of 5 were better able to classify children. Children with ADHD exhibited increases in several ODD symptoms, including symptoms related to negative affect. Although most symptoms of hyperactivity/impulsivity appear to extend well down to age 3, more developmentally appropriate symptoms of inattention may be required to develop more sensitive assessments for 3- and 4-year-old children. PMID:24697647

  15. Associations of Age, Gender, and Subtypes With ADHD Symptoms and Related Comorbidity in a Danish Sample of Clinically Referred Adults.

    PubMed

    Soendergaard, Helle Moeller; Thomsen, Per Hove; Pedersen, Erik; Pedersen, Pernille; Poulsen, Agnethe Elkjaer; Winther, Lars; Nielsen, Jette Moeskjaer; Henriksen, Anne; Rungoe, Berit; Soegaard, Hans Joergen

    2014-01-10

    Objective: The aim was to examine associations of age and gender with ADHD subtypes and subsequently to examine associations of age, gender, and subtypes with comorbid psychiatric disorders. Method: Odds ratios were calculated and logistic regression performed using information from a clinical sample of 155 ADHD adults referred to a Danish specialized ADHD unit from 2010 to 2011. Results: A majority of men (65%) was found in the sample. Most patients were subtyped ADHD combined (78%), followed by ADHD inattentive (18%), and ADHD hyperactive-impulsive (4%). No significant differences were found in gender and age across subtypes. Current comorbid disorders were found in 57% of the ADHD patients. Significantly more comorbidity was found in the ADHD combined type and in patients ≥25 years. Significantly more men had substance use disorders and significantly more women had personality disorders. Conclusion: When assessing adult ADHD patients' age, gender, subtype, and related comorbid symptom profiles should be taken into account. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24412968

  16. Top-Down Dysregulation—From ADHD to Emotional Instability

    PubMed Central

    Petrovic, Predrag; Castellanos, F. Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., “cool” executive functions) to mainly emotional regulatory processes (including “hot” executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in “cool” processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while “hot” processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with “cool” regulatory circuits) or emotional information related to the interoceptive environment (associated with “hot” regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental

  17. Top-Down Dysregulation-From ADHD to Emotional Instability.

    PubMed

    Petrovic, Predrag; Castellanos, F Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., "cool" executive functions) to mainly emotional regulatory processes (including "hot" executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in "cool" processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while "hot" processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with "cool" regulatory circuits) or emotional information related to the interoceptive environment (associated with "hot" regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental conditions. PMID:27242456

  18. The impact of instructional context on classroom on-task behavior: a matched comparison of children with ADHD and non-ADHD classmates.

    PubMed

    Imeraj, Lindita; Antrop, Inge; Sonuga-Barke, Edmund; Deboutte, Dirk; Deschepper, Ellen; Bal, Sarah; Roeyers, Herbert

    2013-08-01

    Classroom inattentiveness is an important reason for clinical referral of children with ADHD and a strong predictor of their educational achievement. This study investigates classroom on-task behavior of Flemish children with ADHD withdrawn from medication as a function of instructional context. Thirty-one pairs of children (one with ADHD and one age- and sex-matched control; 25 boys and 6 girls 6 to 12years of age) were observed in their classroom environment during two consecutive school days. On-task behavior (time on-task and on-task span) of ADHD and non-ADHD individuals was compared in different class contexts (i.e., different class structures and academic content types). Individualized teacher supervision was simultaneously assessed. Generalized estimation equation analyses showed that children with ADHD were significantly less on-task than controls during individual work and whole class group teaching, but not during small group work, and had significantly shorter on-task span during academic tasks (mathematics, language, and sciences) and instructional transitions between tasks, but not during music and arts. These effects persisted even after controlling for the higher levels of teacher supervision observed for ADHD pupils (7%) across all contexts (vs. 4% in controls). Findings suggest that despite receiving more overall teacher supervision, children with ADHD displayed lower levels of on-task behavior in settings that place high self-regulatory, information processing, and motivational demands on them. This finding may have initial implications for classroom interventions in this population. PMID:23870443

  19. Treatment Response in CP/ADHD Children with Callous/Unemotional Traits

    ERIC Educational Resources Information Center

    Haas, Sarah M.; Waschbusch, Daniel A.; Pelham, William E.; King, Sara; Andrade, Brendan F.; Carrey, Normand J.

    2011-01-01

    The current study examines the role of callous/unemotional (CU) traits in response to treatment among children with conduct problems (CP) and attention-deficit/hyperactivity disorder (ADHD). Fifty-four children with CP/ADHD and 16 controls (age = 9.48, SD = 1.58) took part in a summer treatment and research program. Simple correlations showed that…

  20. Road-Crossing Safety in Virtual Reality: A Comparison of Adolescents With and Without ADHD

    ERIC Educational Resources Information Center

    Clancy, Tamera A.; Rucklidge, Julia J.; Owen, Dean

    2006-01-01

    This study investigated the potential accident-proneness of adolescents with attention deficit hyperactivity disorder (ADHD) in a hazardous road-crossing environment. An immersive virtual reality traffic gap-choice task was used to determine whether ADHD adolescents show more unsafe road-crossing behavior than controls. Participants (ages 13 to…

  1. Temporal Discounting of Monetary Rewards in Children and Adolescents with ADHD and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Demurie, Ellen; Roeyers, Herbert; Baeyens, Dieter; Sonuga-Barke, Edmund

    2012-01-01

    It has been difficult to differentiate attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in terms of some aspects of their cognitive profile. While both show deficits in executive functions, it has been suggested that they may differ in their response to monetary reward. For instance, children with ADHD prefer…

  2. School-Based Administration of ADHD Drugs Decline, along with Diversion, Theft, and Misuse

    ERIC Educational Resources Information Center

    DuPont, Robert L.; Bucher, Richard H.; Wilford, Bonnie B.; Coleman, John J.

    2007-01-01

    Since 2000 researchers have reported a decline in the administration of attention-deficit/hyperactivity disorder (ADHD) medications given by school nurses, although no decline has been noted in the incidence of ADHD in school-age populations. Government data for the same period show reduced levels of methylphenidate abuse as measured by its…

  3. Performance Variability, Impulsivity Errors and the Impact of Incentives as Gender-Independent Endophenotypes for ADHD

    ERIC Educational Resources Information Center

    Uebel, Henrik; Albrecht, Bjorn; Asherson, Philip; Borger, Norbert A.; Butler, Louise; Chen, Wai; Christiansen, Hanna; Heise, Alexander; Kuntsi, Jonna; Schafer, Ulrike; Andreou, Penny; Manor, Iris; Marco, Rafaela; Miranda, Ana; Mulligan, Aisling; Oades, Robert D.; van der Meere, Jaap; Faraone, Stephen V.; Rothenberger, Aribert; Banaschewski, Tobias

    2010-01-01

    Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common and highly heritable child psychiatric disorders. There is strong evidence that children with ADHD show slower and more variable responses in tasks such as Go/Nogo tapping aspects of executive functions like sustained attention and response control which may be…

  4. Approaching ADHD as a chronic condition: implications for long-term adherence.

    PubMed

    Van Cleave, Jeanne; Leslie, Laurel K

    2008-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic conditions of childhood. Although evidence-based treatments for ADHD, including stimulant medication and behavior modification, have long been established, and guidelines for care of ADHD in primary care settings have been developed, adherence to long-term therapy is poor among youth with ADHD. This article proposes use of the Chronic Care Model for Child Health, the purpose of which is to develop informed, activated patients who will interact with a prepared, proactive health care team. Six "pillars" make up the model: decision support, delivery system design, clinical information systems, family and self-management support, community resources and policies, and health care organizations. Each of these is discussed, and an individual example is described. Adopting the Chronic Care Model for Child Health has the potential to improve the quality of care for ADHD. PMID:18777966

  5. Family conflict tendency and ADHD.

    PubMed

    Niederhofer, H; Hackenberg, B; Lanzendörfer, K

    2004-04-01

    A lack of perseverance, poor attention, and poorly modulated behaviour are important criteria of Attention Deficit Hyperactive Disorder (ADHD). Instructions often have to be repeated, sometimes even by different family members before a child with ADHD attends and complies. We hypothesised that a child with ADHD might cause less disagreement in families with almost no conflicts. Responses to the Mannheim Parents Interview and teacher's form of the Conners scale completed by families of 15 boys (ages 6 to 12 years), diagnosed with ADHD were compared with those of a matched, healthy control group of 15 boys. Parents completed a form assessing the family's cooperation and child-rearing practices. Having few family conflicts, i.e., almost no Verbal Disagreement may reduce Physical Punishment and Anger and Disregard and augment the Openness to another's needs and, for that reason, have protective effects on children's behaviour modulation. PMID:15154188

  6. ADHD, Methylphenidate, and Childhood Epilepsy.

    PubMed

    Sharma, Rahul; Plioplys, Sigita

    2016-06-01

    Investigators from the Department of Functional Neurology, Epileptology and Epilepsy Institute (IDEE), and the Lyon's University Hospital examined the clinical determinants of ADHD severity in children with epilepsy (CWE) along with the response to treatment with methylphenidate (MPH). PMID:27617408

  7. No behavioral or ERP evidence for a developmental lag in visual working memory capacity or filtering in adolescents and adults with ADHD.

    PubMed

    Spronk, Marjolein; Vogel, Edward K; Jonkman, Lisa M

    2013-01-01

    Attention-deficit/hyperactivity disorder (ADHD) patients have both working memory (WM) and attention problems. Good attention skills are important for WM performance; individuals have higher WM capacity when being able to prevent storage of irrelevant information through efficient filtering. Since it is unknown how filtering ability is associated with WM performance in ADHD, this was investigated in the present study. A visuospatial working memory (VSWM) change detection task with distracting stimuli was administered to adolescents (12-16 years old) and adults (20-46 years old) with and without ADHD matched on education/IQ. Besides performance, contralateral delay activity (CDA) was measured; a neural correlate of the number of targets and distracters encoded and maintained in WM during the retention interval. Performance data showed similar WM-load, WM-distracter interference and developmental effects in ADHD and control groups. Adolescents' performance on the WM task deteriorated more than that of adults in the presence of distracters and with higher WM-load, irrespective of Diagnosis. The CDA data suggested that initially all groups encoded/maintained distracting information, but only adults were able to bounce this information from memory later in the retention interval, leading to better WM performance. The only effect of Diagnosis was a smaller CDA in adolescents and adults with ADHD than in age/IQ-matched controls when maintaining a low 1-item load, which was possibly related to an inability to keep attention focused at cued stimuli with low task demands. Overall, the development of filtering efficiency and VSWM storage capacity in adolescents with ADHD was not different from that in typically developing peers. PMID:23650525

  8. No Behavioral or ERP Evidence for a Developmental Lag in Visual Working Memory Capacity or Filtering in Adolescents and Adults with ADHD

    PubMed Central

    Spronk, Marjolein; Vogel, Edward K.; Jonkman, Lisa M.

    2013-01-01

    Attention-deficit/hyperactivity disorder (ADHD) patients have both working memory (WM) and attention problems. Good attention skills are important for WM performance; individuals have higher WM capacity when being able to prevent storage of irrelevant information through efficient filtering. Since it is unknown how filtering ability is associated with WM performance in ADHD, this was investigated in the present study. A visuospatial working memory (VSWM) change detection task with distracting stimuli was administered to adolescents (12–16 years old) and adults (20–46 years old) with and without ADHD matched on education/IQ. Besides performance, contralateral delay activity (CDA) was measured; a neural correlate of the number of targets and distracters encoded and maintained in WM during the retention interval. Performance data showed similar WM-load, WM-distracter interference and developmental effects in ADHD and control groups. Adolescents’ performance on the WM task deteriorated more than that of adults in the presence of distracters and with higher WM-load, irrespective of Diagnosis. The CDA data suggested that initially all groups encoded/maintained distracting information, but only adults were able to bounce this information from memory later in the retention interval, leading to better WM performance. The only effect of Diagnosis was a smaller CDA in adolescents and adults with ADHD than in age/IQ-matched controls when maintaining a low 1-item load, which was possibly related to an inability to keep attention focused at cued stimuli with low task demands. Overall, the development of filtering efficiency and VSWM storage capacity in adolescents with ADHD was not different from that in typically developing peers. PMID:23650525

  9. The estimated prevalence and correlates of adult ADHD in a German community sample.

    PubMed

    de Zwaan, Martina; Gruss, Barbara; Müller, Astrid; Graap, Holmer; Martin, Alexandra; Glaesmer, Heide; Hilbert, Anja; Philipsen, Alexandra

    2012-02-01

    Little research on the prevalence and correlates of adult ADHD has been conducted outside the United States. The aim of the present study was to estimate the prevalence and correlates of adult ADHD in a large representative sample of the German population aged 18-64 years (n = 1,655). Two self-rating screening instruments to assess childhood and adult ADHD symptomatology were used to estimate the prevalence of ADHD. A 4-item screening tool was used to assess probable cases of current depression and anxiety (Patient Health Questionnaire). The estimated crude prevalence rate of current ADHD was 4.7%. Adult ADHD was significantly associated with lower age, low educational level, unemployment, marital status (never married and divorced), and rural residency. No association was found with gender. Adult ADHD was strongly associated with positive screening results for depression and anxiety. ADHD is a common disorder of adulthood, is associated with significant social impairment and psychiatric co-morbidity, and should receive further research attention. PMID:21499942

  10. Nonstimulant therapies for attention-deficit hyperactivity disorder (ADHD) in children and adults.

    PubMed

    Waxmonsky, James G

    2005-01-01

    While stimulant medications are the primary pharmacological treatment for ADHD across the lifespan, a subset of patients with ADHD do not experience significant symptom relief from stimulants or can not tolerate effective stimulant doses. Psychosocial therapies, particularly behavioral modification techniques, should be considered for children with ADHD and oppositional behaviors, while Cognitive Behavioral Therapy (CBT) may be a helpful adjunct for adolescents and adults with ADHD. Among the nonstimulant medications, atomoxetine (Strattera) is the only the FDA approved option. It has been found to be efficacious for the entire spectrum of ADHD symptoms in both children and adults. However, daily compliance is essential, and it may take several weeks to achieve full therapeutic effect. Other nonstimulants that have been used to treat ADHD include bupropion (Wellbutrin), the alpha-2 agonists guanfacine (Tenex) and clonidine (Catapres) as well as the tricylic antidepressants. Modafinil (Provigil) is actively being studied for the treatment of pediatric ADHD, and there has been some preliminary studies assessing the efficacy of cholinergic agents for ADHD. Recently, there has been increasing interest in combining nonstimulant therapies with stimulants to further enhance treatment effects. However, more controlled data on the safety and efficacy of combining pharmacological therapies are needed. PMID:16222911

  11. Differences in hypothalamic-pituitary-adrenal axis functioning among children with ADHD predominantly inattentive and combined types.

    PubMed

    van West, Dirk; Claes, Stephan; Deboutte, Dirk

    2009-09-01

    Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress. The results indicate that a low-cortisol responsivity to stress may be a neurobiological marker for children with ADHD-C, but not for those with ADHD-I. Directions for future research and clinical implications are discussed. PMID:19294447

  12. [Language and executive functioning skills of students with attention deficit/hyperactivity disorder (ADHD), and in reading comprehension difficulties (RCD)].

    PubMed

    Miranda Casas, Ana; Fernández Andrés, María Inmaculada; García Castellar, Rosa; Roselló Miranda, Belén; Colomer Diago, Carla

    2011-11-01

    The aim of this work was to study the specificity of deficits in linguistic and executive functioning of students with ADHD and with RCD and to determine the profile of deficits in the comorbid group (ADHD+RCD). Participants in the study were 84 students, ages 12-16 years divided into four groups with an equal number of subjects (N= 21): ADHD, RCD, ADHD+RCD and comparison group (without ADHD and without RCD). We measured vocabulary, oral comprehension, lexical access, verbal and visual working memory, inhibition and attention. The results show that the ADHD+RCD group presents the most important linguistic deficits, followed by the RCD group. On the other hand, the three clinical groups (ADHD, RCD and ADHD+RCD) display greater performance problems in working memory than the comparison group, whereas the two groups with ADHD had more problems in attention and inhibition. These results suggest the dissociation of linguistic and executive deficits that affect the RCD group and ADHD group to a greater extent, respectively. Lastly, the comorbid group showed deficits both in language and in executive skills. We discuss the implications of these findings for designing interventions. PMID:22047859

  13. Second Opinions Improve ADHD Prescribing in a Medicaid-Insured Community Population

    ERIC Educational Resources Information Center

    Thompson, Jeffrey N.; Varley, Christopher K.; McClellan, Jon; Hilt, Robert; Lee, Terry; Kwan, Alan C.; Lee, Taik; Trupin, Eric

    2009-01-01

    Washington State Medicaid mandates a second opinion when threshold safety parameters for attention deficit hyperactivity disorder (ADHD) medications are exceeded. This is found to save $1.2 million and saves 538 fewer patients from exceeding safety thresholds.

  14. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    ERIC Educational Resources Information Center

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  15. Does IQ influence Associations between ADHD Symptoms and other Cognitive Functions in young Preschoolers?

    PubMed Central

    2014-01-01

    Background Working memory, inhibition, and expressive language are often impaired in ADHD and many children with ADHD have lower IQ-scores than typically developing children. The aim of this study was to test whether IQ-score influences associations between ADHD symptoms and verbal and nonverbal working memory, inhibition, and expressive language, respectively, in a nonclinical sample of preschool children. Methods In all, 1181 children recruited from the Norwegian Mother and Child Cohort Study were clinically assessed at the age of 36 to 46 months. IQ-score and working memory were assessed with subtasks from the Stanford Binet test battery, expressive language was reported by preschool teachers (Child Development Inventory), response inhibition was assessed with a subtask from the NEPSY test, and ADHD symptoms were assessed by parent interview (Preschool Age Psychiatric Assessment). Results The results showed an interaction between ADHD symptoms and IQ-score on teacher-reported expressive language. In children with below median IQ-score, a larger number of ADHD symptoms were more likely to be accompanied by reports of lower expressive language skills, while the level of ADHD symptoms exerted a smaller effect on reported language skills in children with above median IQ-score. The associations between ADHD symptoms and working memory and response inhibition, respectively, were not influenced by IQ-score. Conclusions Level of IQ-score affected the relation between ADHD symptoms and teacher-reported expressive language, whereas associations between ADHD symptoms and working memory and response inhibition, respectively, were significant and of similar sizes regardless of IQ-score. Thus, in preschoolers, working memory and response inhibition should be considered during an ADHD assessment regardless of IQ-score, while language skills of young children are especially important to consider when IQ-scores are average or low. PMID:24884579

  16. ADHD and behavioral disorders: Assessment, management, and an update from DSM-5.

    PubMed

    Austerman, Joseph

    2015-11-01

    Behavioral disorders in pediatric patients--primarily attention deficit hyperactivity disorder (ADHD)--pose a clinical challenge for health care providers to accurately assess, diagnose, and treat. In 2013, updated diagnostic criteria for behavioral disorders were published, including ADHD and a new diagnostic entity: disruptive mood dysregulation disorder. Revised criteria for ADHD includes oldest age for occurrence of symptoms, need for symptoms to be present in more than one setting, and requirement for number of symptoms in those aged 17 and older. Assessment of ADHD relies primarily on the clinical interview, including the medical and social history, along with the aid of objective measures. The clinical course of ADHD is chronic with symptom onset occurring well before adolescence. Most patients have symptoms that continue into adolescence, and some into adulthood. Many patients with ADHD have comorbid disorders such as depression, disruptive behavior disorders, or substance abuse, which need to be addressed first in the treatment plan. Treatment of ADHD relies on a combination of psychopharmacologic, academic, and behavioral interventions, which produce response rates up to 80%. PMID:26555810

  17. Symptoms of autism and ADHD: a Swedish twin study examining their overlap.

    PubMed

    Ronald, Angelica; Larsson, Henrik; Anckarsäter, Henrik; Lichtenstein, Paul

    2014-05-01

    Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) show high comorbidity. The following questions were addressed regarding their specific symptoms: What is the factor structure of ASD and ADHD symptoms, to what degree do different symptom domains cluster together, to what extent are these domains caused by the same genetic and environmental influences, and what is the best model of their co-occurrence? A population-based twin cohort of over 17,000 9- and 12-year-olds were assessed using the Autism-Tics, AD/HD, and other Comorbidities parental interview inventory. Principal component analyses were conducted, and symptom domain clustering was assessed. Four multivariate twin models were compared. Factors split into three ASD (social impairments, communication impairments, and restricted repetitive behaviors and interests), and three ADHD (inattention, hyperactivity, and impulsivity) symptom domains. Some ASD-ADHD symptom domain combinations clustered together often, although others not at all. A two-factor common pathway model fit the data, suggesting that ASD and ADHD symptom domains tap into separate "ASD" and "ADHD" latent factors that showed high genetic overlap. All subdomains also showed significant specific genetic and environmental influences, reflecting the etiological heterogeneity both within and between ASD and ADHD. These findings support the conceptual distinction of ASD and ADHD, and demonstrate the considerable natural co-occurrence of particular ASD/ADHD symptom domains. The results imply that more children with 1 condition show features of the other condition than show complete comorbidity. Emphasis on symptom co-occurrence, rather than complete comorbidity between disorders, may help focus clinical approaches and advance molecular genetic research. PMID:24731073

  18. Attention-deficit hyperactivity disorder (ADHD) as a pyridoxine-dependent condition: urinary diagnostic biomarkers.

    PubMed

    Dolina, S; Margalit, D; Malitsky, S; Rabinkov, A

    2014-01-01

    The data obtained in children with different forms of epilepsy allowed us to consider epilepsy as an inborn error of pyridoxine (vitamin B6) metabolism (Dolina et al., 2012). Mutual interconnections between ADHD and epilepsy indicate that such an approach is reasonable for ADHD. To check such an assumption we analyzed in ADHD patients the same parameters of pyridoxal phosphate (PLP)-dependent tryptophan (TRP) degradation, which were analyzed in epileptic children. The level of TRP and concentrations of compounds formed or metabolized by TRP degradation, the ratios between some of them, and the level of 4-pyridoxic acid were HPLC detected in ADHD children and healthy controls. The data obtained, including low values of 4PA/TRP, IND/TRP and IND/KYN ratios, have evidenced dramatically impaired activity of pyridoxine-dependent enzymes in ADHD patients. Ritalin treatment did not change the general pattern of TRP degradation, but still created a kind of balance between some of detected metabolites. However, the 4PA/TRP, IND/TRP and IND/KYN ratios remained as low as in untreated patients, keeping the importance of diagnostic markers. Almost identical parameters of TRP degradation in untreated ADHD and epileptic patients allow to assume that inborn disorders of vitamin B6 metabolism are the common biochemical background of both diseases. The disturbed activity of PLP dependent enzymes apparently forms those profound disturbances of neurotransmitter systems, which are inherent in ADHD: low concentrations of monoamines and disordered amino acid metabolism. If vitamin B6 disorders are the core biochemical disturbances inherent in ADHD, then the long-term pyridoxine treatment is pathogenetically based replacement therapy of the disease. According to our data, multi-year pyridoxine treatment normalizes completely the pattern of ADHD behavior, without causing any serious side effects. PMID:24321736

  19. Randomized Controlled Trial Shows Biofeedback to be Superior to Alternative Treatments for Patients with Pelvic Floor Dyssynergia-type Constipation

    PubMed Central

    Heymen, Steve; Scarlett, Yolanda; Jones, Kenneth; Ringel, Yehuda; Drossman, Douglas; Whitehead, William E.

    2013-01-01

    Purpose To determine whether biofeedback is more effective than diazepam or placebo in a randomized controlled trial for patients with pelvic floor dyssynergia-type constipation, and whether instrumented biofeedback is necessary for successful training. Methods One hundred seventeen patients participated in a 4-week run-in (education and medical management). The 84 who remained constipated were randomized to Biofeedback (n=30); Diazepam (n=30); or Placebo (n=24). All patients were trained to do pelvic floor muscle exercises to correct pelvic floor dyssynergia during 6 biweekly 1-hour sessions, but only Biofeedback patients received electromyography feedback. All other patients received pills 1-2 hours before attempting defecation. Diary data on cathartic use, straining, incomplete bowel movements, Bristol stool scores, and compliance with homework were reviewed biweekly. Results Before treatment, the groups did not differ on demographic (average age 50, 85 percent females), physiologic or psychologic characteristics, severity of constipation, or expectation of benefit. Biofeedback was superior to diazepam by intention to treat analysis (70 percent vs. 23 percent reported adequate relief of constipation 3 months after treatment, χ2 = 13.1, p < 0.001), and also superior to placebo (38 percent successful, χ2 = 5.7, p = 0.017). Biofeedback patients had significantly more unassisted bowel movements at follow-up compared to Placebo (p = .005), with a trend favoring biofeedback over diazepam (p = .067). Biofeedback patients reduced pelvic floor electromyography during straining significantly more than diazepam patients (p < 0.001). Conclusions This investigation provides definitive support for the efficacy of biofeedback for pelvic floor dyssynergia and shows that instrumented biofeedback is essential to successful treatment. PMID:19966605

  20. Comparative Study of Children with ADHD Only, Autism Spectrum Disorder + ADHD, and Chronic Multiple Tic Disorder + ADHD

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; DeVincent, Carla J.; Schneider, Jayne

    2009-01-01

    Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in…

  1. Processing Patterns of ADHD, ADHD-I, and ADHD/LD Children on the LET-II.

    ERIC Educational Resources Information Center

    Webster, Raymond E.

    This paper discusses the findings from a study that investigated the information processing characteristics of 93 children (ages 8-16) who have been diagnosed as having either attention deficit hyperactivity disorder (ADHD) only, ADHD-Predominately Inattentive Type, and combined ADHD and learning disabilities (LD). Thirty-nine average students,…

  2. Do ADHD Medicines Boost Substance Abuse Risk?

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_159904.html Do ADHD Medicines Boost Substance Abuse Risk? Chances were actually ... that their children who take stimulants to treat attention deficit hyperactivity disorder (ADHD) may be at higher risk for substance ...

  3. Faststats: Attention Deficit Hyperactivity Disorder (ADHD)

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Attention Deficit Hyperactivity Disorder (ADHD)* Recommend on Facebook Tweet Share Compartir Data ... attention deficit disorder (ADD)" is used rather than "attention deficit hyperactivity disorder (ADHD)" in some data sources. More data Association ...

  4. Comprehension of televised stories by preschool children with ADHD.

    PubMed

    Sanchez, R P; Lorch, E P; Milich, R; Welsh, R

    1999-09-01

    Investigated visual attention to and story comprehension of televised stories in 4- to 6-year-old children with attention deficit hyperactivity disorder (ADHD) and comparison children. Half of the children in each group watched the program with toys in the room, and the other half watched without toys. Visual attention to the television was recorded, and story comprehension was assessed by performance on cued recall questions. All children attended significantly less when toys were present, but the difference when toys were present was greater for children with ADHD. The groups did not differ on recall of factual information when toys were absent. When toys were present, the comparison children showed no decrement in performance on factual questions, whereas the performance of children with ADHD was significantly worse. On questions testing causal connections, the children with ADHD performed more poorly than comparison children regardless of whether toys were present. Implications of these results for understanding and treating the academic and social difficulties of children with ADHD are discussed. PMID:10446687

  5. Functional Genomics of Attention-Deficit/ Hyperactivity Disorder (ADHD) Risk Alleles on Dopamine Transporter Binding in ADHD and Healthy Control Subjects

    PubMed Central

    Spencer, Thomas J.; Biederman, Joseph; Faraone, Stephen V.; Madras, Bertha K.; Bonab, Ali A.; Dougherty, Darin D.; Batchelder, Holly; Clarke, Allison; Fischman, Alan J.

    2013-01-01

    Background The main aim of this study was to examine the relationship between dopamine transporter (DAT) binding in the striatum in individuals with and without attention-deficit/hyperactivity disorder (ADHD), attending to the 3′-untranslated region of the gene (3′-UTR) and intron8 variable number of tandem repeats (VNTR) polymorphisms of the DAT (SLC6A3) gene. Methods Subjects consisted of 68 psychotropic (including stimulant)-naïve and smoking-naïve volunteers between 18 and 55 years of age (ADHD n = 34; control subjects n = 34). Striatal DAT binding was measured with positron emission tomography with 11C altropane. Genotyping of the two DAT (SLC6A3) 3′-UTR and intron8 VNTRs used standard protocols. Results The gene frequencies of each of the gene polymorphisms assessed did not differ between the ADHD and control groups. The ADHD status (t = 2.99; p < .004) and 3′-UTR of SLC6A3 9 repeat carrier status (t = 2.74; p < .008) were independently and additively associated with increased DAT binding in the caudate. The ADHD status was associated with increased striatal (caudate) DAT binding regardless of 3′-UTR genotype, and 3′-UTR genotype was associated with increased striatal (caudate) DAT binding regardless of ADHD status. In contrast, there were no significant associations between polymorphisms of DAT intron8 or the 3′-UTR-intron8 haplotype with DAT binding. Conclusions The 3′-UTR but not intron8 VNTR genotypes were associated with increased DAT binding in both ADHD patients and healthy control subjects. Both ADHD status and the 3′-UTR polymorphism status had an additive effect on DAT binding. Our findings suggest that an ADHD risk polymorphism (3′-UTR) of SLC6A3 has functional consequences on central nervous system DAT binding in humans. PMID:23273726

  6. Reduced Acute Recovery from Alcohol Impairment in Adults with ADHD

    PubMed Central

    Roberts, Walter; Milich, Richard; Fillmore, Mark T.

    2013-01-01

    Rationale Prior research has found that adults with attention-deficit/hyperactivity disorder (ADHD) show increased sensitivity to the impairing effects of alcohol (Weafer et al. 2009). However, these studies have focused exclusively on the ascending limb of the blood alcohol concentration (BAC) curve, and it is unclear whether these adults continue to show increased sensitivity during the later phase of the dose as BAC is declining. Objective This study tested the hypothesis that those with ADHD would display increased response to alcohol during the ascending limb of the BAC curve and less recovery from the impairing effects during the descending limb. Methods Adult social drinkers with ADHD and control adults completed measures of motor coordination, reaction time, and subjective intoxication twice following 0.64 g/kg alcohol and placebo. The measures were administered during the ascending limb of the BAC curve and again during the descending limb. Results During the ascending limb, alcohol reduced motor coordination, slowed reaction time (RT), and increased self-reports of subjective intoxication. Those with ADHD displayed greater impairment of motor coordination compared with controls. During the descending limb, controls reported diminished subjective intoxication and showed recovery from the impairing effects of alcohol on both their motor coordination and their RT. Those with ADHD showed reduced subjective intoxication and faster RT during this time, but they did not recover motor control. Conclusions The protracted time course of motor impairment in adults with ADHD despite reductions in subjective intoxication may contribute to poor decision making and diminished behavioral control in this group. PMID:23430161

  7. Distinct frontal lobe morphology in girls and boys with ADHD

    PubMed Central

    Dirlikov, Benjamin; Shiels Rosch, Keri; Crocetti, Deana; Denckla, Martha B.; Mahone, E. Mark; Mostofsky, Stewart H.

    2014-01-01

    Objective This study investigated whether frontal lobe cortical morphology differs for boys and girls with ADHD (ages 8–12 years) in comparison to typically developing (TD) peers. Method Participants included 226 children between the ages of 8–12 including 93 children with ADHD (29 girls) and 133 TD children (42 girls) for which 3T MPRAGE MRI scans were obtained. A fully automated frontal lobe atlas was used to generate functionally distinct frontal subdivisions, with surface area (SA) and cortical thickness (CT) assessed in each region. Analyses focused on overall diagnostic differences as well as examinations of the effect of diagnosis within boys and girls. Results Girls, but not boys, with ADHD showed overall reductions in total prefrontal cortex (PFC) SA. Localization revealed that girls showed widely distributed reductions in the bilateral dorsolateral PFC, left inferior lateral PFC, right medial PFC, right orbitofrontal cortex, and left anterior cingulate; and boys showed reduced SA only in the right anterior cingulate and left medial PFC. In contrast, boys, but not girls, with ADHD showed overall reductions in total premotor cortex (PMC) SA. Further localization revealed that in boys, premotor reductions were observed in bilateral lateral PMC regions; and in girls reductions were observed in bilateral supplementary motor complex. In line with diagnostic group differences, PMC and PFC SAs were inversely correlated with symptom severity in both girls and boys with ADHD. Conclusions These results elucidate sex-based differences in cortical morphology of functional subdivisions of the frontal lobe and provide additional evidence of associations among SA and symptom severity in children with ADHD. PMID:25610784

  8. Kernel Principal Component Analysis for dimensionality reduction in fMRI-based diagnosis of ADHD.

    PubMed

    Sidhu, Gagan S; Asgarian, Nasimeh; Greiner, Russell; Brown, Matthew R G

    2012-01-01

    This study explored various feature extraction methods for use in automated diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) from functional Magnetic Resonance Image (fMRI) data. Each participant's data consisted of a resting state fMRI scan as well as phenotypic data (age, gender, handedness, IQ, and site of scanning) from the ADHD-200 dataset. We used machine learning techniques to produce support vector machine (SVM) classifiers that attempted to differentiate between (1) all ADHD patients vs. healthy controls and (2) ADHD combined (ADHD-c) type vs. ADHD inattentive (ADHD-i) type vs. controls. In different tests, we used only the phenotypic data, only the imaging data, or else both the phenotypic and imaging data. For feature extraction on fMRI data, we tested the Fast Fourier Transform (FFT), different variants of Principal Component Analysis (PCA), and combinations of FFT and PCA. PCA variants included PCA over time (PCA-t), PCA over space and time (PCA-st), and kernelized PCA (kPCA-st). Baseline chance accuracy was 64.2% produced by guessing healthy control (the majority class) for all participants. Using only phenotypic data produced 72.9% accuracy on two class diagnosis and 66.8% on three class diagnosis. Diagnosis using only imaging data did not perform as well as phenotypic-only approaches. Using both phenotypic and imaging data with combined FFT and kPCA-st feature extraction yielded accuracies of 76.0% on two class diagnosis and 68.6% on three class diagnosis-better than phenotypic-only approaches. Our results demonstrate the potential of using FFT and kPCA-st with resting-state fMRI data as well as phenotypic data for automated diagnosis of ADHD. These results are encouraging given known challenges of learning ADHD diagnostic classifiers using the ADHD-200 dataset (see Brown et al., 2012). PMID:23162439

  9. ADHD symptoms, academic achievement, self-perception of academic competence and future orientation: a longitudinal study.

    PubMed

    Scholtens, Sara; Rydell, Ann-Margret; Yang-Wallentin, Fan

    2013-06-01

    In the investigation of the effect of attention deficit hyperactivity disorder (ADHD) symptoms on school careers there is a need to study the role of adolescent and childhood ADHD symptoms and academic achievement, and to incorporate measures that include the individual's perspective. Our aim was to gain an overview of the long-term development of school careers in relation to ADHD symptoms. We studied associations between ADHD symptoms and academic achievement at different time-points and future orientation at the end of high school, and assessed the role of self-perceptions of academic competence in these associations. Participants were 192 children (47% girls) with a range of ADHD symptoms taken from a community sample. Collecting data at three time points, in 6th, 11th and 12th grade we tested a structural equation model. Results showed that ADHD symptoms in 6th grade negatively affected academic achievement concurrently and longitudinally. ADHD symptoms in 11th grade negatively affected concurrent academic achievement and academic self-perception and future orientation in 12th grade. Academic achievement had a positive influence on academic self-perception and future orientation. Given the other factors, self-perception of academic competence did not contribute to outcomes. We concluded that early ADHD symptoms may cast long shadows on young people's academic progress. This happens mainly by way of stability in symptoms and relations to early low academic achievement. PMID:23510262

  10. Semantic conflicts are resolved differently by adults with and without ADHD.

    PubMed

    Segal, Dorit; Mashal, Nira; Shalev, Lilach

    2015-12-01

    Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder characterized by various behavioral and cognitive difficulties. Previous studies indicated that children with ADHD have language difficulties, including difficulties in metaphor understanding but the relation between metaphor processing and specific cognitive functions needs further investigation. In the current study we examined how adults with and without ADHD resolve semantic conflicts between a metaphorical prime and a metaphorical or literal target sentence. Twenty-six adults with ADHD and 24 age-matched control participants underwent a thorough evaluation of neuropsychological skills, as well as assessment of various aspects of attention. Results suggested that people with ADHD were less efficient than controls in resolving conflicts between metaphorical and literal meanings of sentence pairs. In addition they showed deficient sustained attention and executive attention. Moreover, the ability to resolve semantic conflicts was related to semantic fluency in the ADHD group, but to executive attention in the control group. These findings emphasize the various specific difficulties of adults with ADHD and shed light on the different role of attention in the resolution of semantic conflicts among ADHD individuals as compared to controls. PMID:26513742

  11. Characterizing heterogeneity in children with and without ADHD based on reward system connectivity

    PubMed Central

    Costa Dias, Taciana G.; Iyer, Swathi P.; Carpenter, Samuel D.; Cary, Robert P.; Wilson, Vanessa B.; Mitchell, Suzanne H.; Nigg, Joel T.; Fair, Damien A.

    2015-01-01

    One potential obstacle limiting our ability to clarify ADHD etiology is the heterogeneity within the disorder, as well as in typical samples. In this study, we utilized a community detection approach on 106 children with and without ADHD (aged 7–12 years), in order to identify potential subgroups of participants based on the connectivity of the reward system. Children with ADHD were compared to typically developing children within each identified community, aiming to find the community-specific ADHD characteristics. Furthermore, to assess how the organization in subgroups relates to behavior, we evaluated delay-discounting gradient and impulsivity-related temperament traits within each community. We found that discrete subgroups were identified that characterized distinct connectivity profiles in the reward system. Importantly, which connections were atypical in ADHD relative to the control children were specific to the community membership. Our findings showed that children with ADHD and typically developing children could be classified into distinct subgroups according to brain functional connectivity. Results also suggested that the differentiation in “functional” subgroups is related to specific behavioral characteristics, in this case impulsivity. Thus, combining neuroimaging data and community detection might be a valuable approach to elucidate heterogeneity in ADHD etiology and examine ADHD neurobiology. PMID:25660033

  12. Impairment in flexible regulation of speed and accuracy in children with ADHD.

    PubMed

    Vallesi, Antonino; D'Agati, Elisa; Pasini, Augusto; Pitzianti, Mariabernarda; Curatolo, Paolo

    2013-10-01

    Attention deficit hyperactivity disorder (ADHD) is characterized by poor adaptation of behavior to environmental demands, including difficulties in flexibly regulating behavior. To understand whether ADHD is associated with a reduction of strategic flexibility in modulating speed and accuracy, we used a perceptual decision-making task that required participants to randomly stress either fast or accurate responding. Thirty-one drug-free boys with ADHD combined-type (mean age: 10.2 years) and 33 healthy control boys (mean age: 10.7 years), matched for age and IQ, participated. Both reaction time and accuracy data were analyzed. Our findings demonstrated significantly lower accuracy in ADHD children than in controls when switching from speed to accuracy instructions. This deficit was directly associated with hyperactivity symptoms but not with inattention. Our results showed that ADHD is associated with a deficit in dynamically switching response strategy according to task demands on a trial-to-trial basis. PMID:24007981

  13. Parental monitoring in late adolescence: relations to ADHD symptoms and longitudinal predictors.

    PubMed

    Salari, Raziye; Thorell, Lisa B

    2015-04-01

    In this study, we aimed to replicate Stattin and Kerr's (2000) study on parental monitoring and adolescents' deviant behavior, to extend their findings to ADHD symptoms, and to examine the longitudinal predictors (8-18 years) of parental knowledge and child disclosure. Results showed that conduct problems were primarily associated with parental knowledge and child disclosure, but not with parental solicitation and control. A similar pattern was observed for ADHD symptoms. However, while the relations for conduct problems were generally independent of ADHD symptoms, the relations for ADHD symptoms were primarily non-significant after controlling for conduct problems. Moreover, early behavior problems, but not insecure/disorganized attachment, were associated with parental knowledge and child disclosure in adolescence. In conclusion, child disclosure is primarily associated with deviant behavior rather than ADHD, and early child problem behavior is a more important predictor of child disclosure (implicating reciprocal relations between these two constructs) than is insecure/disorganized attachment. PMID:25602918

  14. A diffusion modelling approach to understanding contextual cueing effects in children with ADHD

    PubMed Central

    Weigard, Alexander; Huang-Pollock, Cynthia

    2014-01-01

    Background Strong theoretical models suggest implicit learning deficits may exist among children with Attention Deficit Hyperactivity Disorder (ADHD). Method We examine implicit contextual cueing (CC) effects among children with ADHD (n=72) and non-ADHD Controls (n=36). Results Using Ratcliff’s drift diffusion model, we found that among Controls, the CC effect is due to improvements in attentional guidance and to reductions in response threshold. Children with ADHD did not show a CC effect; although they were able to use implicitly acquired information to deploy attentional focus, they had more difficulty adjusting their response thresholds. Conclusions Improvements in attentional guidance and reductions in response threshold together underlie the CC effect. Results are consistent with neurocognitive models of ADHD that posit sub-cortical dysfunction but intact spatial attention, and encourage the use of alternative data analytic methods when dealing with reaction time data. PMID:24798140

  15. Working Memory and Response Inhibition as One Integral Phenotype of Adult ADHD? A Behavioral and Imaging Correlational Investigation

    ERIC Educational Resources Information Center

    Schecklmann, Martin; Ehlis, Ann-Christine; Plichta, Michael M.; Dresler, Thomas; Heine, Monika; Boreatti-Hummer, Andrea; Romanos, Marcel; Jacob, Christian; Pauli, Paul; Fallgatter, Andreas J.

    2013-01-01

    Objective: It is an open question whether working memory (WM) and response inhibition (RI) constitute one integral phenotype in attention deficit hyperactivity disorder (ADHD). Method: The authors investigated 45 adult ADHD patients and 41 controls comparable for age, gender, intelligence, and education during a letter n-back and a stop-signal…

  16. Effective Methylphenidate Treatment of an Adult Aspergers Syndrome and a Comorbid ADHD: A Clinical Investigation with fMRI

    ERIC Educational Resources Information Center

    Roy, Mandy; Dillo, Wolfgang; Bessling, Svenja; Emrich, Hinderk M.; Ohlmeier, Martin D.

    2009-01-01

    Objective: Aspergers Syndrome can present as comorbid with attention-deficit/hyperactivity disorder (ADHD). Very few cases of the assessment and treatment of this comorbidity in adulthood are described in the research literature. Method: A 26-year-old patient as suffering from ADHD in combination with Aspergers Syndrome is diagnosed. Treatment is…

  17. EEG anomalies in adult ADHD subjects performing a working memory task.

    PubMed

    Missonnier, P; Hasler, R; Perroud, N; Herrmann, F R; Millet, P; Richiardi, J; Malafosse, A; Giannakopoulos, P; Baud, P

    2013-06-25

    Functional imaging studies have revealed differential brain activation patterns in attention deficit hyperactivity disorder (ADHD) adult patients performing working memory (WM) tasks. The existence of alterations in WM-related cortical circuits during childhood may precede executive dysfunctions in this disorder in adults. To date, there is no study exploring the electrophysiological activation of WM-related neural networks in ADHD. To address this issue, we carried out an electroencephalographic (EEG) activation study associated with time-frequency (TF) analysis in 15 adults with ADHD and 15 controls performing two visual N-back WM tasks, as well as oddball detection and passive fixation tasks. Frontal transient (phasic) theta event-related synchronization (ERS, 0-500 msec) was significantly reduced in ADHD as compared to control subjects. Such reduction was equally present in a task-independent manner. In contrast, the power of the later sustained (∼500-1200 msec) theta ERS for all tasks was comparable in ADHD and control groups. In active WM tasks, ADHD patients displayed lower alpha event-related desynchronization (ERD, ∼200-900 msec) and higher subsequent alpha ERS (∼900-2400 msec) compared to controls. The time course of alpha ERD/ERS cycle was modified in ADHD patients compared to controls, suggesting that they are able to use late compensatory mechanisms in order to perform this WM task. These findings support the idea of an ADHD-related dysfunction of neural generators sub-serving attention directed to the incoming visual information. ADHD cases may successfully face WM needs depending on the preservation of sustained theta ERS and prolonged increase of alpha ERS at later post-stimulus time points. PMID:23518223

  18. Combination of letrozole, metronomic cyclophosphamide and sorafenib is well-tolerated and shows activity in patients with primary breast cancer

    PubMed Central

    Bazzola, L; Foroni, C; Andreis, D; Zanoni, V; R Cappelletti, M; Allevi, G; Aguggini, S; Strina, C; Milani, M; Venturini, S; Ferrozzi, F; Giardini, R; Bertoni, R; Turley, H; Gatter, K; Petronini, P G; Fox, S B; Harris, A L; Martinotti, M; Berruti, A; Bottini, A; Reynolds, A R; Generali, D

    2015-01-01

    Purpose: To assess whether the combination of letrozole, metronomic cyclophosphamide and sorafenib (LCS) is well tolerated and shows activity in primary breast cancer (BC). Methods: Thirteen oestrogen receptor-positive, postmenopausal, T2-4, N0-1 BC patients received the LCS combination for 6 months. In these patients we examined the pharmacokinetics of sorafenib and cyclophosphamide, toxicity of the regimen, the clinical response to therapy and changes in the levels of biologically relevant biomarkers. Results: Adequate plasma concentrations of sorafenib were achieved in patients when it was dosed in combination with L+C. The mean plasma concentrations of C were consistently lower following administration of LCS, compared with administration of L+C only. The most common drug-related grade 3/4 adverse events were skin rash (69.3%), hand-foot skin reaction (69.3%) and diarrhoea (46.1%). According to RECIST Criteria, a clinical complete response was observed in 6 of 13 patients. A significant reduction in tumour size, evaluated with MRI, was also observed between baseline and 14 days of treatment in all 13 patients (P=0.005). A significant reduction in SUV uptake, measured by 18FDG-PET/CT, was observed in all patients between baseline and 30 days of treatment (P=0.015) and between baseline and definitive surgery (P=0.0002). Using modified CT Criteria, a response was demonstrated in 8 out of 10 evaluable patients at 30 days and in 11 out of 13 evaluable patients at the definitive surgery. A significant reduction in Ki67 expression was observed in all patients at day 14 compared with baseline (P<0.00001) and in 9 out of 13 patients at the definitive surgery compared with baseline (P<0.03). There was also a significant suppression of CD31 and VEGF-A expression in response to treatment (P=0.01 and P=0.007, respectively). Conclusions: The LCS combination is feasible and tolerable. The tumour response and target biomarker modulation indicate that the combination is

  19. Autism and ADHD: Overlapping and Discriminating Symptoms

    ERIC Educational Resources Information Center

    Mayes, Susan Dickerson; Calhoun, Susan L.; Mayes, Rebecca D.; Molitoris, Sarah

    2012-01-01

    Children with ADHD and autism have some similar features, complicating a differential diagnosis. The purpose of our study was to determine the degree to which core ADHD and autistic symptoms overlap in and discriminate between children 2-16 years of age with autism and ADHD. Our study demonstrated that 847 children with autism were easily…

  20. The Neurobiological Profile of Girls with ADHD

    ERIC Educational Resources Information Center

    Mahone, E. Mark; Wodka, Ericka L.

    2008-01-01

    Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and…

  1. Interpersonal Coping among Boys with ADHD

    ERIC Educational Resources Information Center

    Hampel, Petra; Manhal, Simone; Roos, Thomas; Desman, Christiane

    2008-01-01

    Objective: The authors investigate self-reported coping with interpersonal stressors among boys with and without ADHD in two studies and provide initial evidence for effects of different subgroups of ADHD on coping in Study 2. Method: In Study 1, 20 Austrian adolescents with ADHD were compared to 20 healthy controls. In Study 2, 44 German children…

  2. Children with ADHD in Residential Care

    ERIC Educational Resources Information Center

    Casey, Kathryn J.; Hagaman, Jessica L.; Trout, Alexandra L.; Reid, Robert; Chmelka, Beth; Thompson, Ronald W.; Daly, Daniel L.

    2008-01-01

    Little is known about the characteristics or functioning of children with ADHD in residential care as compared to their non-ADHD peers. This study evaluated data on 538 children with (n = 125) and without (n = 413) ADHD in residential care to determine demographic, mental health, behavioral, and treatment (i.e., medication use) characteristics.…

  3. Gifted Children with AD/HD.

    ERIC Educational Resources Information Center

    Lovecky, Deirdre V.

    This brief paper on gifted children with attention deficit hyperactivity disorder (AD/HD) focuses on the special educational needs of this population. Emphasis is on four major conclusions: (1) gifted children with AD/HD differ from average children with AD/HD in cognitive, social, and emotional variables (e.g., the gifted child is likely to show…

  4. Evaluation and treatment of ADHD.

    PubMed

    Smucker, W D; Hedayat, M

    2001-09-01

    Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychologic conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. The stimulants methylphenidate and dextroamphetamine remain the pharmacologic agents of first choice for the management of ADHD. These agents are equally effective in improving the core symptoms of the disorder, but individual children may respond better to one stimulant medication than to another. Achievement of maximal benefit may require titration of the initial dosage and dosing before breakfast, before lunch and in the afternoon. The family physician should tailor the treatment plan to meet the unique needs of the child and family. Psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in the child with ADHD. PMID:11563573

  5. A Comparison between Children with ADHD and Children with Epilepsy in Self-Esteem and Parental Stress Level

    PubMed Central

    Gagliano, Antonella; Lamberti, Marco; Siracusano, Rosamaria; Ciuffo, Massimo; Boncoddo, Maria; Maggio, Roberta; Rosina, Simona; Cedro, Clemente; Germanò, Eva

    2014-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is frequently associated with negative psychological outcomes. This study explores the relationship between self-esteem, ADHD symptoms and parental stress. It compares children with ADHD, children with epilepsy (E) and typical developmental controls (TD). Participants included 65 children (aged 9-12 yrs) and their parents. The assessment was conducted by Multidimensional Self-Concept Scale (MSCS), Parent Stress Index (PSI) and Conners' Parent Rating Scales–Revised. Significant differences were found in Social, Competence and Academic areas of self-esteem between children with ADHD, with E and TD. Moreover, parents of children with ADHD showed a higher overall stress than both other groups. In conclusion, it seems important to evaluate the psychological aspects of ADHD con-dition, both in children and in parents, in order to suggest an individual multimodal treatment. PMID:25614755

  6. Behavior Management for School Aged Children with ADHD

    PubMed Central

    Pfiffner, Linda J.; Haack, Lauren M.

    2014-01-01

    Synopsis Behavior management treatments are the most commonly used nonpharmacological approaches for treating ADHD and associated impairments. This review focuses on behavioral parent training interventions for school age children in the home setting and adjunctive treatments developed to extend effects across settings. The underlying theoretical basis and content of these interventions are described. Empirical support includes numerous randomized clinical trials, systematic reviews, and meta-analyses showing positive effects of these interventions on child compliance, ADHD symptoms and impairments, parent-child interactions, parenting and parenting stress. These studies support categorization of behavior management treatment as a well-established, evidence-based treatment for ADHD. Factors for consideration in clinical decision-making and future directions for research are provided. PMID:25220083

  7. ADHD subtypes and neuropsychological performance in an adult sample.

    PubMed

    Dobson-Patterson, Roberta; O'Gorman, John G; Chan, Raymond C K; Shum, David H K

    2016-08-01

    The study investigated, with an adult sample, the hypothesis that differences between subtypes of ADHD on neuropsychological tests contribute to the poor separation of ADHD and healthy groups on tests of this kind. Groups of ADHD inattentive (n=16) and combined (n=16) subtypes were carefully identified using DSM-IV criteria, and their performance on 14 measures of attention, memory, and executive function (EF) was compared between subtypes and between the two subtypes combined and a group of healthy controls (n=30). Multivariate analyses showed statistically significant differences between the two subtypes, and between the two subtypes combined and the healthy controls. Importantly for the hypothesis, where differences for neuropsychological tests in terms of effect sizes between subtypes were largest, the differences in effect sizes between the two groups combined and controls were smallest (r=-0.64, 95% CI [-0.15, -0.87]). PMID:27043366

  8. Chemotherapy Agents Alter Plasma Lipids in Breast Cancer Patients and Show Differential Effects on Lipid Metabolism Genes in Liver Cells.

    PubMed

    Sharma, Monika; Tuaine, Jo; McLaren, Blair; Waters, Debra L; Black, Katherine; Jones, Lynnette M; McCormick, Sally P A

    2016-01-01

    Cardiovascular complications have emerged as a major concern for cancer patients. Many chemotherapy agents are cardiotoxic and some appear to also alter lipid profiles, although the mechanism for this is unknown. We studied plasma lipid levels in 12 breast cancer patients throughout their chemotherapy. Patients received either four cycles of doxorubicin and cyclophosphamide followed by weekly paclitaxel or three cycles of epirubicin, cyclophosphamide and 5'-fluorouracil followed by three cycles of docetaxel. Patients demonstrated a significant reduction (0.32 mmol/L) in high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1) levels (0.18 g/L) and an elevation in apolipoprotein B (apoB) levels (0.15 g/L) after treatment. Investigation of the individual chemotherapy agents for their effect on genes involved in lipoprotein metabolism in liver cells showed that doxorubicin decreased ATP binding cassette transporter A1 (ABCA1) via a downregulation of the peroxisomal proliferator activated receptor γ (PPARγ) and liver X receptor α (LXRα) transcription factors. In contrast, ABCA1 levels were not affected by cyclophosphamide or paclitaxel. Likewise, apoA1 levels were reduced by doxorubicin and remained unaffected by cyclophosphamide and paclitaxel. Doxorubicin and paclitaxel both increased apoB protein levels and paclitaxel also decreased low density lipoprotein receptor (LDLR) protein levels. These findings correlate with the observed reduction in HDL-C and apoA1 and increase in apoB levels seen in these patients. The unfavourable lipid profiles produced by some chemotherapy agents may be detrimental in the longer term to cancer patients, especially those already at risk of cardiovascular disease (CVD). This knowledge may be useful in tailoring effective follow-up care plans for cancer survivors. PMID:26807857

  9. Chemotherapy Agents Alter Plasma Lipids in Breast Cancer Patients and Show Differential Effects on Lipid Metabolism Genes in Liver Cells

    PubMed Central

    Sharma, Monika; Tuaine, Jo; McLaren, Blair; Waters, Debra L.; Black, Katherine

    2016-01-01

    Cardiovascular complications have emerged as a major concern for cancer patients. Many chemotherapy agents are cardiotoxic and some appear to also alter lipid profiles, although the mechanism for this is unknown. We studied plasma lipid levels in 12 breast cancer patients throughout their chemotherapy. Patients received either four cycles of doxorubicin and cyclophosphamide followed by weekly paclitaxel or three cycles of epirubicin, cyclophosphamide and 5’-fluorouracil followed by three cycles of docetaxel. Patients demonstrated a significant reduction (0.32 mmol/L) in high density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 (apoA1) levels (0.18 g/L) and an elevation in apolipoprotein B (apoB) levels (0.15 g/L) after treatment. Investigation of the individual chemotherapy agents for their effect on genes involved in lipoprotein metabolism in liver cells showed that doxorubicin decreased ATP binding cassette transporter A1 (ABCA1) via a downregulation of the peroxisomal proliferator activated receptor γ (PPARγ) and liver X receptor α (LXRα) transcription factors. In contrast, ABCA1 levels were not affected by cyclophosphamide or paclitaxel. Likewise, apoA1 levels were reduced by doxorubicin and remained unaffected by cyclophosphamide and paclitaxel. Doxorubicin and paclitaxel both increased apoB protein levels and paclitaxel also decreased low density lipoprotein receptor (LDLR) protein levels. These findings correlate with the observed reduction in HDL-C and apoA1 and increase in apoB levels seen in these patients. The unfavourable lipid profiles produced by some chemotherapy agents may be detrimental in the longer term to cancer patients, especially those already at risk of cardiovascular disease (CVD). This knowledge may be useful in tailoring effective follow-up care plans for cancer survivors. PMID:26807857

  10. Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility.

    PubMed

    Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

    2015-10-01

    The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance-manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was < 1 and IEM-B when MRS contraction DCI was <450 mm Hg-s-cm. One IEM subject inadequately performed MRS. Among the remaining 52 IEM subjects, 18 (34.6%) were classified into IEM-A and 23 (44.2%) into IEM-B. IEM subjects showed less complete bolus transit (median 0.0%, interquartile range 0.0-20.0% vs 60.0%, 30.0-80.0; P < 0.001) resulting in higher impaired bolus transit than NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is < 450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

  11. Multiple Rapid Swallow Maneuver Enhances the Clinical Utility of High-Resolution Manometry in Patients Showing Ineffective Esophageal Motility

    PubMed Central

    Min, Yang Won; Shin, Inseub; Son, Hee Jung; Rhee, Poong-Lyul

    2015-01-01

    Abstract The clinical significance of ineffective esophageal motility (IEM) together with multiple rapid swallow (MRS) has not been yet evaluated in the Chicago Classification v3.0. This study evaluated the adjunctive role of MRS in IEM and determined the criteria of abnormal MRS to maximize the utility of IEM. We analyzed 186 patients showing IEM or normal esophageal motility (NEM), who underwent esophageal high-resolution impedance–manometry for esophageal symptoms. Two different criteria for abnormal MRS were applied to IEM subjects, resulting in 2 corresponding subgroups: IEM-A when distal contractile integral (DCI) ratio between an average wet swallows and MRS contraction was <1 and IEM-B when MRS contraction DCI was <450 mm Hg-s-cm. One IEM subject inadequately performed MRS. Among the remaining 52 IEM subjects, 18 (34.6%) were classified into IEM-A and 23 (44.2%) into IEM-B. IEM subjects showed less complete bolus transit (median 0.0%, interquartile range 0.0–20.0% vs 60.0%, 30.0–80.0; P < 0.001) resulting in higher impaired bolus transit than NEM subjects (98.1% vs 66.9%, P = 0.001). IEM-B subjects showed additionally higher pathologic bolus exposure than NEM subjects (55.6% vs 29.3%, P = 0.001), whereas IEM-A subjects could not. Although IEM-B subjects had the highest prevalence of gastroesophageal reflux disease among the subjects groups, it did not reach statistical significance. In conclusion, IEM patients with abnormal MRS contraction have an increased risk of prolonged bolus clearance, poor bolus transit, and pathologic bolus exposure. IEM patients need to be assessed concerning whether MRS contraction DCI is <450 mm Hg-s-cm to segregate clinically relevant patients. PMID:26448010

  12. Discriminating among ADHD alone, ADHD with a comorbid psychological disorder, and feigned ADHD in a college sample.

    PubMed

    Williamson, Kimberly D; Combs, Hannah L; Berry, David T R; Harp, Jordan P; Mason, Lisa H; Edmundson, Maryanne

    2014-01-01

    Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III). PMID:25225947

  13. Methylphenidate Ameliorates Depressive Comorbidity in ADHD Children without any Modification on Differences in Serum Melatonin Concentration between ADHD Subtypes

    PubMed Central

    Cubero-Millán, Isabel; Molina-Carballo, Antonio; Machado-Casas, Irene; Fernández-López, Luisa; Martínez-Serrano, Sylvia; Tortosa-Pinto, Pilar; Ruiz-López, Aida; Luna-del-Castillo, Juan-de-Dios; Uberos, José; Muñoz-Hoyos, Antonio

    2014-01-01

    The vast majority of Attention-deficit/hyperactivity disorder (ADHD) patients have other associated pathologies, with depressive symptoms as one of the most prevalent. Among the mediators that may participate in ADHD, melatonin is thought to regulate circadian rhythms, neurological function and stress response. To determine (1) the serum baseline daily variations and nocturnal excretion of melatonin in ADHD subtypes and (2) the effect of chronic administration of methylphenidate, as well as the effects on symptomatology, 136 children with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR criteria) were divided into subgroups using the “Children’s Depression Inventory” (CDI). Blood samples were drawn at 20:00 and 09:00 h, and urine was collected between 21:00 and 09:00 h, at inclusion and after 4.61 ± 2.29 months of treatment. Melatonin and its urine metabolite were measured by radioimmunoassay RIA. Factorial analysis was performed using STATA 12.0. Melatonin was higher predominantly in hyperactive-impulsive/conduct disordered children (PHI/CD) of the ADHD subtype, without the influence of comorbid depressive symptoms. Methylphenidate ameliorated this comorbidity without induction of any changes in the serum melatonin profile, but treatment with it was associated with a decrease in 6-s-melatonin excretion in both ADHD subtypes. Conclusions: In untreated children, partial homeostatic restoration of disrupted neuroendocrine equilibrium most likely led to an increased serum melatonin in PHI/CD children. A differential cerebral melatonin metabolization after methylphenidate may underlie some of the clinical benefit. PMID:25257531

  14. Saccadic movement deficiencies in adults with ADHD tendencies.

    PubMed

    Lee, Yun-Jeong; Lee, Sangil; Chang, Munseon; Kwak, Ho-Wan

    2015-12-01

    The goal of the present study was to explore deficits in gaze detection and emotional value judgment during a saccadic eye movement task in adults with attention deficit/hyperactivity disorder (ADHD) tendencies. Thirty-two participants, consisting of 16 ADHD tendencies and 16 controls, were recruited from a pool of 243 university students. Among the many problems in adults with ADHDs, our research focused on the deficits in the processing of nonverbal cues, such as gaze direction and the emotional value of others' faces. In Experiment 1, a cue display containing a face with emotional value and gaze direction was followed by a target display containing two faces located on the left and right side of the display. The participant's task was to make an anti-saccade opposite to the gaze direction if the cue face was not emotionally neutral. ADHD tendencies showed more overall errors than controls in making anti-saccades. Based on the hypothesis that the exposure duration of the cue display in Experiment 1 may have been too long, we presented the cue and target display simultaneously to prevent participants from preparing saccades in advance. Participants in Experiment 2 were asked to make either a pro-saccade or an anti-saccade depending on the emotional value of the central cue face. Interestingly, significant group differences were observed for errors of omission and commission. In addition, a significant three-way interaction among groups, cue emotion, and target gaze direction suggests that the emotional recognition and gaze control systems might somehow be interconnected. The result also shows that ADHDs are more easily distracted by a task-irrelevant gaze direction. Taken together, these results suggest that tasks requiring both response inhibition (anti-saccade) and gaze-emotion recognition might be useful in developing a diagnostic test for discriminating adults with ADHDs from healthy adults. PMID:25993912

  15. Rare copy number variation discovery and cross-disorder comparisons identify risk genes for ADHD.

    PubMed

    Lionel, Anath C; Crosbie, Jennifer; Barbosa, Nicole; Goodale, Tara; Thiruvahindrapuram, Bhooma; Rickaby, Jessica; Gazzellone, Matthew; Carson, Andrew R; Howe, Jennifer L; Wang, Zhuozhi; Wei, John; Stewart, Alexandre F R; Roberts, Robert; McPherson, Ruth; Fiebig, Andreas; Franke, Andre; Schreiber, Stefan; Zwaigenbaum, Lonnie; Fernandez, Bridget A; Roberts, Wendy; Arnold, Paul D; Szatmari, Peter; Marshall, Christian R; Schachar, Russell; Scherer, Stephen W

    2011-08-10

    Attention deficit hyperactivity disorder (ADHD) is a common and persistent condition characterized by developmentally atypical and impairing inattention, hyperactivity, and impulsiveness. We identified de novo and rare copy number variations (CNVs) in 248 unrelated ADHD patients using million-feature genotyping arrays. We found de novo CNVs in 3 of 173 (1.7%) ADHD patients for whom we had DNA from both parents. These CNVs affected brain-expressed genes: DCLK2, SORCS1, SORCS3, and MACROD2. We also detected rare inherited CNVs in 19 of 248 (7.7%) ADHD probands, which were absent in 2357 controls and which either overlapped previously implicated ADHD loci (for example, DRD5 and 15q13 microduplication) or identified new candidate susceptibility genes (ASTN2, CPLX2, ZBBX, and PTPRN2). Among these de novo and rare inherited CNVs, there were also examples of genes (ASTN2, GABRG1, and CNTN5) previously implicated by rare CNVs in other neurodevelopmental conditions including autism spectrum disorder (ASD). To further explore the overlap of risks in ADHD and ASD, we used the same microarrays to test for rare CNVs in an independent, newly collected cohort of 349 unrelated individuals with a primary diagnosis of ASD. Deletions of the neuronal ASTN2 and the ASTN2-intronic TRIM32 genes yielded the strongest association with ADHD and ASD, but numerous other shared candidate genes (such as CHCHD3, MACROD2, and the 16p11.2 region) were also revealed. Our results provide support for a role for rare CNVs in ADHD risk and reinforce evidence for the existence of common underlying susceptibility genes for ADHD, ASD, and other neuropsychiatric disorders. PMID:21832240

  16. Nutritional supplements for the treatment of ADHD.

    PubMed

    Bloch, Michael H; Mulqueen, Jilian

    2014-10-01

    Polyunsaturated fatty acid supplementation appears to have modest benefit for improving ADHD symptoms. Melatonin appears to be effective in treating chronic insomnia in children with ADHD but appears to have minimal effects in reducing core ADHD symptoms. Many other natural supplements are widely used in the United States despite minimal evidence of efficacy and possible side effects. This review synthesizes and evaluates the scientific evidence regarding the potential efficacy and side effects of natural supplements and herbal remedies for ADHD. We provide clinicians with recommendations regarding their potential use and role in overall ADHD treatment. PMID:25220092

  17. Induced Pluripotent Stem Cells from Patients with Huntington’s Disease Show CAG Repeat Expansion Associated Phenotypes

    PubMed Central

    Mattis, Virginia B; Svendsen, Soshana P; Ebert, Allison; Svendsen, Clive N; King, Alvin R; Casale, Malcolm; Winokur, Sara T; Batugedara, Gayani; Vawter, Marquis; Donovan, Peter J; Lock, Leslie F; Thompson, Leslie M; Zhu, Yu; Fossale, Elisa; Singh Atwal, Ranjit; Gillis, Tammy; Mysore, Jayalakshmi; Li, Jian-hong; Seong, IhnSik; Shen, Yiping; Chen, Xiaoli; Wheeler, Vanessa C; MacDonald, Marcy E; Gusella, James F; Akimov, Sergey; Arbez, Nicolas; Juopperi, Tarja; Ratovitski, Tamara; Chiang, Jason H; Kim, Woon Roung; Chighladze, Eka; Watkin, Erin; Zhong, Chun; Makri, Georgia; Cole, Robert N; Margolis, Russell L; Song, Hongjun; Ming, Guoli; Ross, Christopher A; Kaye, Julia A; Daub, Aaron; Sharma, Punita; Mason, Amanda R; Finkbeiner, Steven; Yu, Junying; Thomson, James A; Rushton, David; Brazier, Stephen P; Battersby, Alysia A; Redfern, Amanda; Tseng, Hsui-Er; Harrison, Alexander W; Kemp, Paul J; Allen, Nicholas D; Onorati, Marco; Castiglioni, Valentina; Cattaneo, Elena; Arjomand, Jamshid

    2013-01-01

    Huntington's disease (HD) is an inherited neurodegenerative disorder caused by an expanded stretch of CAG trinucleotide repeats that results in neuronal dysfunction and death. Here, the HD consortium reports the generation and characterization of 14 induced pluripotent stem cell (iPSC) lines from HD patients and controls. Microarray profiling revealed CAG expansion-associated gene expression patterns that distinguish patient lines from controls, and early onset versus late onset HD. Differentiated HD neural cells showed disease associated changes in electrophysiology, metabolism, cell adhesion, and ultimately cell death for lines with both medium and longer CAG repeat expansions. The longer repeat lines were however the most vulnerable to cellular stressors and BDNF withdrawal using a range of assays across consortium laboratories. The HD iPSC collection represents a unique and well-characterized resource to elucidate disease mechanisms in HD and provides a novel human stem cell platform for screening new candidate therapeutics. PMID:22748968

  18. Examining autistic traits in children with ADHD: Does the Autism Spectrum Extend to ADHD?

    PubMed Central

    Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier

    2010-01-01

    We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated ratings of core ASD traits (ADHD+) not accounted for by ADHD or behavioral symptoms. Further, analyses revealed greater oppositional behaviors, but not ADHD severity or anxiety, in the ADHD+ subgroup compared to those with ADHD only. These results highlight the importance of specifically examining autistic traits in children with ADHD for better characterization in studies of the underlying physiopathology and treatment. PMID:21108041

  19. A Proposed Multisite Double-Blind Randomized Clinical Trial of Neurofeedback for ADHD: Need, Rationale, and Strategy

    ERIC Educational Resources Information Center

    Kerson, Cynthia

    2013-01-01

    Objective: Additional treatments with persisting benefit are needed for ADHD. Because ADHD often shows excessive theta electroencephalogram (EEG) power, low beta, and excessive theta-beta ratio (TBR), a promising treatment is neurofeedback (NF) downtraining TBR. Although several nonblind randomized clinical trials (RCTs) show a medium-large…

  20. A Multi-Methodological MR Resting State Network Analysis to Assess the Changes in Brain Physiology of Children with ADHD

    PubMed Central

    de Celis Alonso, Benito; Hidalgo Tobón, Silvia; Dies Suarez, Pilar; García Flores, Julio; de Celis Carrillo, Benito; Barragán Pérez, Eduardo

    2014-01-01

    The purpose of this work was to highlight the neurological differences between the MR resting state networks of a group of children with ADHD (pre-treatment) and an age-matched healthy group. Results were obtained using different image analysis techniques. A sample of n = 46 children with ages between 6 and 12 years were included in this study (23 per cohort). Resting state image analysis was performed using ReHo, ALFF and ICA techniques. ReHo and ICA represent connectivity analyses calculated with different mathematical approaches. ALFF represents an indirect measurement of brain activity. The ReHo and ICA analyses suggested differences between the two groups, while the ALFF analysis did not. The ReHo and ALFF analyses presented differences with respect to the results previously reported in the literature. ICA analysis showed that the same resting state networks that appear in healthy volunteers of adult age were obtained for both groups. In contrast, these networks were not identical when comparing the healthy and ADHD groups. These differences affected areas for all the networks except the Right Memory Function network. All techniques employed in this study were used to monitor different cerebral regions which participate in the phenomenological characterization of ADHD patients when compared to healthy controls. Results from our three analyses indicated that the cerebellum and mid-frontal lobe bilaterally for ReHo, the executive function regions in ICA, and the precuneus, cuneus and the clacarine fissure for ALFF, were the “hubs” in which the main inter-group differences were found. These results do not just help to explain the physiology underlying the disorder but open the door to future uses of these methodologies to monitor and evaluate patients with ADHD. PMID:24945408

  1. Impaired visuomotor adaptation in adults with ADHD.

    PubMed

    Kurdziel, Laura B F; Dempsey, Katherine; Zahara, Mackenzie; Valera, Eve; Spencer, Rebecca M C

    2015-04-01

    Attention-deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task known to be impaired following cerebellar lesions. Participants adapted reaching movements to a visual representation that was rotated by 30°. Individuals with ADHD and those with ADHD-like symptoms took longer to correct the angle of movement once the rotation was applied relative to controls. However, post-adaptation residual effect did not differ for individuals with ADHD and ADHD-like symptoms compared to the control group. These results are consistent with the hypothesis that mild cerebellar deficits are evident in the motor performance of adults with ADHD. PMID:25567090

  2. Impaired visuomotor adaptation in adults with ADHD

    PubMed Central

    Kurdziel, Laura B. F.; Dempsey, Katherine; Zahara, Mackenzie; Valera, Eve; Spencer, Rebecca M. C.

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task known to be impaired following cerebellar lesions. Participants adapted reaching movements to a visual representation that was rotated by 30°. Individuals with ADHD and those with ADHD-like symptoms took longer to correct the angle of movement once the rotation was applied relative to controls. However, post-adaptation residual effect did not differ for individuals with ADHD and ADHD-like symptoms compared to the control group. These results are consistent with the hypothesis that mild cerebellar deficits are evident in the motor performance of adults with ADHD. PMID:25567090

  3. Pharmacology and pharmacogenetics of pediatric ADHD with associated aggression: a review.

    PubMed

    Patel, Bianca D; Barzman, Drew H

    2013-12-01

    Attention deficit hyperactivity disorder (ADHD) is often associated with symptoms of aggression in children and adolescents. Clinically, this is complex because aggression can be from hyperactivity and impulsivity, or could be a distinct symptom from a comorbid diagnosis. Past research has recommended first treating the primary disorder of ADHD. Stimulants are the most common treatment for pediatric ADHD, which can be helpful in decreasing aggressive behaviors. Alpha-adrenergic agonists and atomoxetine (ATX) are non-stimulant medications for ADHD and aggression, but more research is necessary to compare these drugs to stimulants. If aggressive symptoms do not improve from treating the primary disorder, aggression can be treated separately. Risperidone, lithium, valproic acid, clonidine, and guanfacine have shown positive results in reducing aggression, but studies including children with aggression and ADHD are limited. The variability in treatment tolerability in patients has stimulated research in pharmacogenetics for ADHD. Although this field is still emerging, research has found evidence supporting a link between the response rate of methylphenidate and the dopamine transporter (DAT1) and a link between the metabolism rate of atomoxetine and hepatic cytochrome 450 isozymes. Pharmacogenetics may be relevant to ADHD and associated aggression. Further research in pharmacogenetics will strive to identify patterns of genetic variations that can tailor individual treatments. PMID:23443759

  4. Hemodynamic response of children with attention-deficit and hyperactive disorder (ADHD) to emotional facial expressions.

    PubMed

    Ichikawa, Hiroko; Nakato, Emi; Kanazawa, So; Shimamura, Keiichi; Sakuta, Yuiko; Sakuta, Ryoichi; Yamaguchi, Masami K; Kakigi, Ryusuke

    2014-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) have difficulty recognizing facial expressions. They identify angry expressions less accurately than typically developing (TD) children, yet little is known about their atypical neural basis for the recognition of facial expressions. Here, we used near-infrared spectroscopy (NIRS) to examine the distinctive cerebral hemodynamics of ADHD and TD children while they viewed happy and angry expressions. We measured the hemodynamic responses of 13 ADHD boys and 13 TD boys to happy and angry expressions at their bilateral temporal areas, which are sensitive to face processing. The ADHD children showed an increased concentration of oxy-Hb for happy faces but not for angry faces, while TD children showed increased oxy-Hb for both faces. Moreover, the individual peak latency of hemodynamic response in the right temporal area showed significantly greater variance in the ADHD group than in the TD group. Such atypical brain activity observed in ADHD boys may relate to their preserved ability to recognize a happy expression and their difficulty recognizing an angry expression. We firstly demonstrated that NIRS can be used to detect atypical hemodynamic response to facial expressions in ADHD children. PMID:25152531

  5. ADHD in college: A qualitative analysis.

    PubMed

    Lefler, Elizabeth K; Sacchetti, Gina M; Del Carlo, Dawn I

    2016-06-01

    Attention-deficit/hyperactivity disorder (ADHD) affects many adults and is particularly impairing for emerging adults enrolled in college. Research has shown substantial academic impairment for these individuals. However, research on ADHD impairment has largely been quantitative and focused on children. Therefore, the current study employed Interpretative Phenomenological Analysis to explore the lived experience of college students with ADHD with the following two research questions: (1) What is it like to be a college student with ADHD? and (2) What resources are utilized by college students with ADHD? Thirty-six college students with ADHD were interviewed in focus group settings. Our participants reported a complex and mixed experience living with ADHD in college and varied use of treatments and other accommodations. Specifically, three Constructs emerged in the current study: Consequences of Diagnosis, Impairment, and Treatment Management. Implications for professionals working with these students and future directions for researchers are discussed. PMID:26825556

  6. Recalled Initiation and Duration of Maternal Breastfeeding Among Children with and Without ADHD in a Well Characterized Case-Control Sample.

    PubMed

    Stadler, Diane D; Musser, Erica D; Holton, Kathleen F; Shannon, Jackilen; Nigg, Joel T

    2016-02-01

    Early environmental influences are increasingly of interest in understanding ADHD as a neurodevelopmental condition, particularly in light of recognition that gene by environment interplay are likely involved in this condition. Breastfeeding duration predicts cognitive development, as well as development of brain white matter connectivity, in areas similar to those seen in ADHD. Prior studies show an association between breastfeeding and ADHD but without adequate evaluation of ADHD. A case control cohort of 474 children aged 7-13 years was examined, 291 with well characterized ADHD (71.5 % male) and the rest typically developing controls (51.9 % male). Mothers retrospectively reported on breast feeding initiation and duration. Initiation of breastfeeding was not associated with child ADHD, but shorter duration of breastfeeding was associated with child ADHD with a medium effect size (d = 0.40, p < 0.05); this effect held after covarying a broad set of potential confounders, including child oppositional defiant and conduct problems and including maternal and paternal ADHD symptoms. Effects were replicated across both parent and teacher ratings of child ADHD symptoms. Shorter duration of breastfeeding is among several risk factors in early life associated with future ADHD, or else longer duration is protective. The direction of this effect is unknown, however. It may be that some children are more difficult to breastfeed or that breastfeeding provides nutrients or other benefits that reduce future chance of ADHD. PMID:25749651

  7. Numerical and Calculation Abilities in Children with ADHD

    ERIC Educational Resources Information Center

    Colomer, Carla; Re, Anna M.; Miranda, Ana; Lucangeli, Daniela

    2013-01-01

    The aim of this study was to investigate the specific numerical and calculation abilities of 28 children with ADHD without comorbid mathematical learning disabilities (LD), ranging from the 1st to the 5th grade of primary school, and to examine the stability or the development of the arithmetic profile. Our results showed that a high percentage of…

  8. Integrative Analyses of Colorectal Cancer Show Immunoscore Is a Stronger Predictor of Patient Survival Than Microsatellite Instability.

    PubMed

    Mlecnik, Bernhard; Bindea, Gabriela; Angell, Helen K; Maby, Pauline; Angelova, Mihaela; Tougeron, David; Church, Sarah E; Lafontaine, Lucie; Fischer, Maria; Fredriksen, Tessa; Sasso, Maristella; Bilocq, Amélie M; Kirilovsky, Amos; Obenauf, Anna C; Hamieh, Mohamad; Berger, Anne; Bruneval, Patrick; Tuech, Jean-Jacques; Sabourin, Jean-Christophe; Le Pessot, Florence; Mauillon, Jacques; Rafii, Arash; Laurent-Puig, Pierre; Speicher, Michael R; Trajanoski, Zlatko; Michel, Pierre; Sesboüe, Richard; Frebourg, Thierry; Pagès, Franck; Valge-Archer, Viia; Latouche, Jean-Baptiste; Galon, Jérôme

    2016-03-15

    Microsatellite instability in colorectal cancer predicts favorable outcomes. However, the mechanistic relationship between microsatellite instability, tumor-infiltrating immune cells, Immunoscore, and their impact on patient survival remains to be elucidated. We found significant differences in mutational patterns, chromosomal instability, and gene expression that correlated with patient microsatellite instability status. A prominent immune gene expression was observed in microsatellite-instable (MSI) tumors, as well as in a subgroup of microsatellite-stable (MSS) tumors. MSI tumors had increased frameshift mutations, showed genetic evidence of immunoediting, had higher densities of Th1, effector-memory T cells, in situ proliferating T cells, and inhibitory PD1-PDL1 cells, had high Immunoscores, and were infiltrated with mutation-specific cytotoxic T cells. Multivariate analysis revealed that Immunoscore was superior to microsatellite instability in predicting patients' disease-specific recurrence and survival. These findings indicate that assessment of the immune status via Immunoscore provides a potent indicator of tumor recurrence beyond microsatellite-instability staging that could be an important guide for immunotherapy strategies. PMID:26982367

  9. Relationship of DAT1 and adult ADHD to task-positive and task-negative working memory networks.

    PubMed

    Brown, Ariel Beth; Biederman, Joseph; Valera, Eve; Makris, Nikos; Doyle, Alysa; Whitfield-Gabrieli, Susan; Mick, Eric; Spencer, Thomas; Faraone, Stephen; Seidman, Larry

    2011-07-30

    Alterations in working memory, default-mode network (DMN), and dopamine transporter have all been proposed as endophenotypes for attention-deficit/hyperactivity disorder (ADHD). Despite evidence that these systems are interrelated, their relationship to each other has never been studied in the context of ADHD. In order to understand the potential mediating effects of task-positive and task-negative networks between DAT1 and diagnosis, we tested effects of genotype and diagnosis on regions of positive and negative BOLD signal change (as measured with fMRI) in 53 adults with ADHD and 38 control subjects during a working memory task. We also examined the relationship of these responses to ADHD symptoms. Our results yielded four principal findings: 1) association of the DAT1 9R allele with adult ADHD, 2) marginal DAT1 association with task-related suppression in left medial PFC, 3) marginal genotype×diagnosis interaction in the dorsal anterior cingulate cortex, and 4) correlation of DMN suppression to ADHD symptoms. These findings replicate the association of the 9R allele with adult ADHD. Further, we show that DMN suppression is likely linked to DAT1 and to severity of inattention in ADHD. DMN may therefore be a target of DAT1 effects, and lie on the path between the gene and inattention in ADHD. PMID:21596533

  10. Central Processing Energetic Factors Mediate Impaired Motor Control in ADHD Combined Subtype but Not in ADHD Inattentive Subtype

    ERIC Educational Resources Information Center

    Egeland, Jens; Ueland, Torill; Johansen, Susanne

    2012-01-01

    Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I)…

  11. Less discontinuation of ADHD drug use since the availability of long-acting ADHD medication in children, adolescents and adults under the age of 45 years in the Netherlands

    PubMed Central

    Souverein, Patrick C.; Swaab, Hanna; van Engeland, Herman; Egberts, Toine C. G.; Heerdink, Eibert R.

    2010-01-01

    Treatment options for ADHD in the Netherlands have increased with the introduction of the extended-release formulations of methylphenidate (MPH ER, Concerta®) in 2003 and atomoxetine (ATX, Strattera®) in 2005, but data on the effect on drug usage patterns are scarce. The objective of the present study was to describe changes in the patterns of ADHD medication use and determinants thereof among children, adolescents and adults (<45 years) starting ADHD medication since the introduction of MPH ER and ATX. Data were obtained from Dutch community pharmacies as collected by the Foundation for Pharmaceutical Statistics, covering 97% of all dispenses for prescription medicines to outpatients in the Netherlands. Usage patterns (continuation, discontinuation, switching and addition) of ADHD drugs were evaluated at 3, 6 and 12 months after initiation for three separate time cohorts (patients starting ADHD medication in Jan-Dec 2002, Jan 2003–June 2004, respectively July 2004–Dec 2005). It was found that between 2002 and 2006, most ADHD drug users were initiated on methylphenidate IR. Discontinuation of any ADHD drug treatment decreased over time partly in favour of switching and addition. Discontinuation at 3 months decreased from around 33% to around 25%, at 6 months from less than 50% to almost 35%, and at 12 months from just fewer than 60% to less than 45%. Discontinuation was higher among females and in adults >18 years. After the introduction of MPH ER and ATX (time cohort III), 16.5% of the incident ADHD drug users switched their medication and almost 9% added an ADHD drug to the prior ADHD drug. In conclusion, discontinuation of incident ADHD drug use is high after 3, 6 and 12 months. During the study period, the incidence of discontinuation decreased because of the availability of extended-release methylphenidate and atomoxetine. PMID:21258431

  12. Measurement of the effect of physical exercise on the concentration of individuals with ADHD.

    PubMed

    Silva, Alessandro P; Prado, Sueli O S; Scardovelli, Terigi A; Boschi, Silvia R M S; Campos, Luiz C; Frère, Annie F

    2015-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) mainly affects the academic performance of children and adolescents. In addition to bringing physical and mental health benefits, physical activity has been used to prevent and improve ADHD comorbidities; however, its effectiveness has not been quantified. In this study, the effect of physical activity on children's attention was measured using a computer game. Intense physical activity was promoted by a relay race, which requires a 5-min run without a rest interval. The proposed physical stimulus was performed with 28 volunteers: 14 with ADHD (GE-EF) and 14 without ADHD symptoms (GC-EF). After 5 min of rest, these volunteers accessed the computer game to accomplish the tasks in the shortest time possible. The computer game was also accessed by another 28 volunteers: 14 with ADHD (GE) and 14 without these symptoms (GC). The response time to solve the tasks that require attention was recorded. The results of the four groups were analyzed using D'Agostino statistical tests of normality, Kruskal-Wallis analyses of variance and post-hoc Dunn tests. The groups of volunteers with ADHD who performed exercise (GE-EF) showed improved performance for the tasks that require attention with a difference of 30.52% compared with the volunteers with ADHD who did not perform the exercise (GE). The (GE-EF) group showed similar performance (2.5% difference) with the volunteers in the (GC) group who have no ADHD symptoms and did not exercise. This study shows that intense exercise can improve the attention of children with ADHD and may help their school performance. PMID:25803290

  13. The Diversity of Attention Deficits in ADHD: The Prevalence of Four Cognitive Factors in ADHD Versus Controls

    ERIC Educational Resources Information Center

    Tsal, Yehoshua; Shalev, Lilach; Mevorach, Carmel

    2005-01-01

    The performance of participants with attention-deficit/hyperactivity disorder (ADHD) relative to control participants was measured on four tasks uniquely assessing the functions of selective attention, executive attention, sustained attention, and orienting of attention. The results showed that deficits in sustained attention were the most…

  14. Executive Functioning in Children with Asperger Syndrome, ADHD-Combined Type, ADHD-Predominately Inattentive Type, and Controls

    ERIC Educational Resources Information Center

    Semrud-Clikeman, Margaret; Walkowiak, Jenifer; Wilkinson, Alison; Butcher, Brianne

    2010-01-01

    The purpose of the study was to evaluate neuropsychological and behavioral rating measures of executive functions (EF) in children with two subtypes of ADHD, Asperger syndrome (AS), and controls. Relative to the control group, the clinical groups experienced more difficulty in EF. The AS group showed the most difficulty in emotional control,…

  15. [Pediatric ADHD: what does the otolaryngologist need to know?].

    PubMed

    Gehrmann, J; Brandl, A

    2013-07-01

    According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, attention deficit hyperactivity disorder (ADHD) affects around 5% of all children and adolescents worldwide. The causes of ADHD are multifactorial, with a large genetic influence but also involvement of exogenic and psychosocial factors. Its core symptoms consist of attention deficits, hyperactivity and disruption of impulse control. It is important that symptoms appear before the age of six and are evident in multiple different situations, such as in familial and school environments. ADHD is a dimensional disorder, which means that the diagnostic process is time consuming, comprising a physical and neurological examination, behavioral observations and differentiated psychological assessments. In the field of otolaryngology, ADHD represents one of the important differential diagnoses to an auditory processing disorder (APD), alongside reading- and writing impairments and delayed speech development. In the instance of additional behavioral problems or more severe symptoms, it is advisable to transfer the patient to a specialized pediatrician or child and adolescent psychiatrist for appropriate counseling and treatment where required. PMID:23842699

  16. Exercise: Applications to Childhood ADHD

    ERIC Educational Resources Information Center

    Wigal, Sharon B.; Emmerson, Natasha; Gehricke, Jean-G.; Galassetti, Pietro

    2013-01-01

    ADHD is the most common neurobehavioral disorder of childhood, presenting with pervasive and impairing symptoms of inattention, hyperactivity, impulsivity, or a combination. The leading hypothesis of the underlying physiology of this disorder of inattention and/or hyperactivity-impulsivity is based on catecholamine dysfunction. Pharmacotherapy…

  17. Is ADHD a "Real" Disorder?

    ERIC Educational Resources Information Center

    Quinn, Michael; Lynch, Andrea

    2016-01-01

    In many western countries, attention deficit hyperactivity disorder (ADHD) has achieved celebrity status, such that it probably no longer requires introduction. The disorder is a global phenomenon, spreading rapidly as result of the increasing dominance internationally of US psychiatric models, the need for new markets for major pharmaceutical…

  18. Are ADHD Kids More Creative?

    ERIC Educational Resources Information Center

    Fugate, C. Matthew

    2016-01-01

    Unfortunately, there are many students that feel "stupid" in classrooms all around the country. They know they are gifted, but their ADHD and co-occurring conditions can make them feel isolated and alone. This is hard not only for the children, but for the parents who may feel powerless in helping their child know how special he or she…

  19. ADHD Psychosocial Treatments: Generalization Reconsidered

    ERIC Educational Resources Information Center

    Abikoff, Howard

    2009-01-01

    Behavioral interventions have demonstrated clinical utility in improving the behavior of children with ADHD, especially in specialized therapeutic milieus (Pelham et al., 2000). Improvements in children's target behaviors often occur in the treatment settings where contingencies are in place and delivered consistently. However, generalization of…

  20. Auditory Conflict Processing in ADHD

    ERIC Educational Resources Information Center

    van Mourik, Rosa; Sergeant, Joseph A.; Heslenfeld, Dirk; Konig, Claudia; Oosterlaan, Jaap

    2011-01-01

    Background: Impaired cognitive control has been implicated as an important developmental pathway to attention deficit/hyperactivity disorder (ADHD). Cognitive control is crucial to suppress interference resulting from conflicting information and can be measured by Stroop-like tasks. This study was conducted to gain insight into conflict processing…

  1. [The course of attention deficit hyperactivity disorder (ADHD) over the life span].

    PubMed

    Koumoula, A

    2012-06-01

    Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder, associated with the maturation of the nervous system and appearing on a standard proceeding with special cognitive impairments. For many years ADHD was concerned as a typical childhood disorder. Long-term studies though, showed that an important percentage of children with ADHD grew as adults with ADHD. The clinical picture varies with the developmental stage. In pre-school years (3-5 years) the clinical picture is characterized by excessive physical activity, difficulty in cooperation with peers and non-compliance to the recommendations of adults. In school age (6-12 years), apart from the nuclear symptoms of the disorder, as described in the classification systems, i.e. inattention, hyperactivity and impulsivity, oppositional behavior often occurs, conflicts with peers and academic problems. In adolescence hyperactivity lessens, conflicts with parents continue and high risk behaviors often appear. In adults physical activity usually decreases significantly, while inattention and impulsivity still remain. With the passing of time the number of symptoms are usually reduced, however the impact and impairment caused by the disorder remain. The diagnosis of ADHD in adults requires a retrospective diagnosis of ADHD in childhood. Since childhood, comorbid disorders are common, most times continuing until adult life. The Oppositional Defiant Disorder during childhood is related to the presenting of Antisocial Personality Disorder in adults. On the other hand, emotional disorders, which are also rather common in children, adolescents and adults with ADHD, can be due to either common biological mechanisms or the long-standing effect of psychosocial and environmental factors which follow people with ADHD. The relationship between ADHD and substance abuse has been a subject of research, with the view of the existence of Conduct Disorder being necessary for a person to present a Substance Use Disorder

  2. The clinical presentation of attention deficit‐hyperactivity disorder (ADHD) in children with 22q11.2 deletion syndrome

    PubMed Central

    Martin, Joanna; Thapar, Anita; Owen, Michael J.

    2015-01-01

    Background: Although attention deficit‐hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children with 22q11.2DS, it remains unclear whether its clinical presentation is similar to that in children with idiopathic ADHD. The aim of this study is to compare the ADHD phenotype in children with and without 22q11.2DS by examining ADHD symptom scores, patterns of psychiatric comorbidity, IQ and gender distribution. Methods: Forty‐four children with 22q11.2DS and ADHD (mean age = 9.6), 600 clinic children (mean age = 10.8) and 77 children with ADHD from a population cohort (mean age = 10.8) participated in the study. Psychopathology was assessed using parent‐report research diagnostic instruments. Results: There was a higher proportion of females in the 22q11.2DS ADHD sample in relation to the clinical sample (χ2 = 18.2, P < 0.001). The 22q11.2DS group showed a higher rate of ADHD inattentive subtype (χ2 = 114.76, P < 0.001), and fewer hyperactive‐impulsive symptoms compared to the clinical group (z = 8.43, P < 0.001). The 22q11.2DS ADHD group parents reported fewer oppositional defiant disorder/conduct disorder symptoms (z = 6.33, P < 0.001) and a higher rate of generalized anxiety disorder (χ2 = 4.56, P = 0.03) in relation to the clinical group. Two percent of the 22q11.2 DS ADHD sample had received ADHD treatment. The results were similar when the 22q11.2 ADHD group was compared to the population cohort ADHD group. Conclusions: The clinical presentation of ADHD and patterns of co‐morbidity in 22q11.2DS is different from that in idiopathic ADHD. This could lead to clinical under‐recognition of ADHD in this group. Examining psychopathology in 22q11.2DS can provide insights into the genetic origins of psychiatric problems with implications beyond the 22q11.2DS population. © 2015 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley

  3. Sex- and Subtype-Related Differences of Personality Disorders (Axis II) and Personality Traits in Persistent ADHD.

    PubMed

    Jacob, Christian P; Gross-Lesch, Silke; Reichert, Susanne; Geissler, Julia; Jans, Thomas; Kittel-Schneider, Sarah; Nguyen, Trang T; Romanos, Marcel; Reif, Andreas; Dempfle, Astrid; Lesch, Klaus-Peter

    2014-02-01

    Objective: Despite growing awareness of adult ADHD and its comorbidity with personality disorders (PDs), little is known about sex- and subtype-related differences. Method: In all, 910 patients (452 females, 458 males) affected with persistent adult ADHD were assessed for comorbid PDs with the Structured Clinical Interview of DSM-IV and for personality traits with the revised NEO personality inventory, and the Tridimensional Personality Questionnaire. Results: The most prevalent PDs were narcissistic PD in males and histrionic PD in females. Affected females showed higher Neuroticism, Openness to Experience, and Agreeableness scores as well as Harm Avoidance and Reward Dependence scores. Narcissistic PD and antisocial PD have the highest prevalence in the H-type, while Borderline PD is more frequent in the C-type. Conclusion: Sex- and subtype-related differences in Axis II disorder comorbidity as well as impairment-modifying personality traits have to be taken into account in epidemiological studies of persistent ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24510476

  4. ADHD Knowledge, Perceptions and Information Sources: Perspectives from a Community Sample of Adolescents and their Parents”

    PubMed Central

    Bussing, Regina; Zima, Bonnie T.; Mason, Dana M.; Meyer, Johanna.M.; White, Kimberly; Garvan, Cynthia W.

    2012-01-01

    PURPOSE The chronic illness model advocates for psychoeducation within a collaborative care model to enhance outcomes. To inform psychoeducational approaches for attention-deficit/hyperactivity disorder (ADHD), this study describes parent and adolescent knowledge, perceptions and information sources and explores how these vary by sociodemographic characteristics, ADHD risk, and past child mental health service use. METHODS Parents and adolescents were assessed 7.7 years after initial school district screening for ADHD risk. The study sample included 374 adolescents (56% high and 44% low ADHD risk), on average 15.4 (SD 1.8) years old, and 36% were African American. Survey questions assessed ADHD knowledge, perceptions, and cues to action, and elicited utilized and preferred information sources. Multiple logistic regression was used to determine potential independent predictors of ADHD knowledge. McNemar's tests compared information source utilization against preference. RESULTS Despite relatively high self-rated ADHD familiarity, misperceptions among parents and adolescents were common, including a sugar etiology (25% and 27%, respectively) and medication overuse (85% and 67%). African American respondents expressed lower ADHD awareness and greater belief in sugar etiology than Caucasians. Parents used a wide range of ADHD information sources while adolescents relied on social network members and teachers/school. However, parents and adolescents expressed similar strong preferences for the Internet (49% and 51%) and doctor (40% and 27%) as ADHD information sources. CONCLUSION Culturally appropriate psychoeducational strategies are needed that combine doctor-provided ADHD information with reputable Internet sources. Despite time limitations during patient visits, both parents and teens place high priority on receiving information from their doctor. PMID:23174470

  5. Parents, ADHD and the internet.

    PubMed

    Terbeck, Sylvia; Chesterman, L Paul

    2012-09-01

    The objective of this study is to examine the potential impact of using the internet on medical consultations by analysing the attitudes, attributions, and emotional responses of parents who have been informed by specialists that their child does not have attention-deficit hyperactivity disorder (ADHD) and to examine the nature of the feedback they obtained from members of online internet support groups. Over 40,000 messages from the five most popular international internet forums discussing children with ADHD were analysed. Messages from parents who reported that they had seen at least one specialist (e.g. paediatrician, psychiatrist or psychologist) because of their concerns that their child had ADHD were identified. The children included boys and girls with an age range from 2 to 16 years. Of these, we analysed messages where the parents additionally reported that the specialist had excluded a diagnosis of ADHD. Using these criteria, 91 messages from parents who had consulted over 200 different specialists and 398 replies to these messages were identified for content analysis. The replies to concerned parents were analysed to determine whether they were offered impartial advice. A majority of the parents reported that they did not believe the specialist and were unhappy about their child not being diagnosed with ADHD. They expressed dissatisfaction with the professional's opinions and the implication that their child's conduct was caused by their poor parenting skills. Importantly, 87.6 % of the responses that these parents received, from other members of online forums, reinforced the parent's negative attitude towards the professional's judgement. It was generally suggested that the parents should not believe the expert and should seek a further opinion. The use of the internet may encourage "doctor shopping" and mistrust in health services. Medical professionals and others may need to be aware of this, and parents may need more support than is generally

  6. Child maltreatment and ADHD symptoms in a sample of young adults

    PubMed Central

    Sanderud, Karoline; Murphy, Siobhan; Elklit, Ask

    2016-01-01

    Objective The present study investigated the relationship between different types of childhood maltreatment (emotional, sexual, overall abuse, and no abuse) and the symptoms of attention deficit hyperactivity disorder (ADHD) in young adulthood. Method Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4,718 young adults (24 years of age) were randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with a response rate of 63%, equating to a total sample size of 2,980 participants. Results Chi-square analyses revealed significant relationships between child maltreatment groups and a probable diagnosis of ADHD using the Adult ADHD Self-Report Scale (ASRS). Binary logistic regression analysis showed that the overall abuse class was more strongly associated with probable ADHD (OR=5.08), followed by emotional abuse (OR=3.09) and sexual abuse (OR=2.07). Conclusions The results showed that childhood maltreatment was associated with increased risk of ADHD symptoms in young adulthood. The findings of this study are discussed within the existing literature and suggestions for future research are outlined in order to replicate these findings in other adult populations. Highlights of the article Child maltreatment is associated with higher levels of ADHD symptoms in a nationally representative sample of young Danish adults. Co-occurring (multiple) types of maltreatment display stronger associations with ADHD symptoms with attenuated effects for sexual abuse. Males confer stronger associations with ADHD symptoms than females. Findings underscore the importance of exploring the role of childhood trauma in young adults with ADHD symptoms. PMID:27306866

  7. Atypical Acquisition and Atypical Expression of Memory Consolidation Gains in a Motor Skill in Young Female Adults with ADHD

    ERIC Educational Resources Information Center

    Adi-Japha, Esther; Fox, Orly; Karni, Avi

    2011-01-01

    Individuals with ADHD often show performance deficits in motor tasks. It is not clear, however, whether this reflects less effective acquisition of skill (procedural knowledge), or deficient consolidation into long-term memory, in ADHD. The aim of the study was to compare the acquisition of skilled motor performance, the expression of…

  8. Effects of MPH-OROS on the Organizational, Time Management, and Planning Behaviors of Children with ADHD

    ERIC Educational Resources Information Center

    Abikoff, Howard; Nissley-Tsiopinis, Jenelle; Gallagher, Richard; Zambenedetti, Maurizio; Seyffert, Michael; Boorady, Roy; McCarthy, John

    2009-01-01

    A double-blind, placebo-controlled, crossover design study was done to evaluate the effects of methylphenidate-osmotic-release oral systems (MPH-OROS) on the organization, time management, and planning (OTMP) of children with attention deficit hyperactivity disorder (ADHD). Results show significant improvements on the OTMP of children with ADHD in…

  9. Examining Associations Among ADHD, Homework Behavior, and Reading Comprehension: A Twin Study.

    PubMed

    Little, Callie W; Hart, Sara A; Schatschneider, Christopher; Taylor, Jeanette

    2016-07-01

    Previous literature has indicated an important association between reading comprehension and both attention-deficit/hyperactivity disorder (ADHD) and homework habits. This investigation sought to extend previous knowledge by providing information about how ADHD and homework behavior (i.e., completing homework regularly) may jointly influence reading comprehension. Using a genetically sensitive design, this study examined the genetic and environmental influences on and between ADHD, homework behavior and reading comprehension. Participants for this study included 691 twin pairs (351 monozygotic, 340 same-sex dizygotic) from the Florida Twin Project on Behavior and Environment (FTP-BE) and 2647 twin pairs (865 monozygotic, 1782 dizygotic) from the larger Florida Twin Project on Reading (FTP-R) in Grades 3 through 7. Three separate models, each representing a different definition of ADHD (full ADHD, inattention only, and hyperactivity/impulsivity only), showed similar patterns of results; therefore, results of the full ADHD model are discussed. Overlapping genetic influences were found between ADHD, homework behavior, and reading comprehension, but no shared environmental influences among all three. However, shared environmental influences overlapped between homework behavior and reading comprehension. Although the sources of this environmental overlap are unknown, these results have implications for improving homework practices and their subsequent influence on literacy skills through homework environments. PMID:25349092

  10. An Examination of the Associations between ADHD, Homework Behavior and Reading Comprehension

    PubMed Central

    Little, Callie W.; Hart, Sara A.; Schatschneider, Christopher; Taylor, Jeanette

    2015-01-01

    Previous literature has indicated an important association between reading comprehension and both ADHD and homework habits. This investigation sought to extend previous knowledge by providing information about how ADHD and homework behavior (i.e., completing homework regularly) may jointly influence reading comprehension. Using a genetically sensitive design, this study examined the genetic and environmental influences on and between ADHD, homework behavior and reading comprehension. Participants for this study included 691 twin pairs (351 monozygotic, 340 same-sex dizygotic) from the Florida Twin Project on Behavior and Environment (FTP-BE) and 2647 twin pairs (865 monozygotic, 1782 dizygotic) from the larger Florida Twin Project on Reading (FTP-R) in grades 3 through 7. Three separate models, each representing a different definition of ADHD (full ADHD, Inattention only, and Hyperactivity/Impulsivity only), showed similar patterns of results, therefore, results of the full ADHD model are discussed. Overlapping genetic influences were found between ADHD, homework behavior and reading comprehension, but no shared environmental influences among all three. However, shared environmental influences overlapped between homework behavior and reading comprehension. Although the sources of this environmental overlap are unknown, these results have implications for improving homework practices and their subsequent influence on literacy skills through homework environments. PMID:25349092

  11. Causes of ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Causes of ADHD Past Issues / Spring 2014 Table of Contents Scientists ... research discounts this theory than supports it. Diagnosing ADHD Children mature at different rates and have different ...

  12. Adults with ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Adults with ADHD Past Issues / Spring 2014 Table of Contents Some ... as clear cut as symptoms seen in children. ADHD Research The expansion of knowledge in genetics, brain ...

  13. Treating ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Treating ADHD Past Issues / Spring 2014 Table of Contents Currently available treatments aim at reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types ...

  14. Causes of ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD ... percentage of children with ADHD have suffered a traumatic brain injury. Sugar. The idea that refined sugar ...

  15. ADHD Symptoms and Subtypes: Relationship between Childhood and Adolescent Symptoms

    ERIC Educational Resources Information Center

    Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.

    2007-01-01

    A study aims to examine attention-deficit/hyperactivity disorder(ADHD) symptoms and subtypes in childhood and adolescence. The results conclude the persistence of ADHD from childhood to adolescence with specific symptoms contributing to persistent ADHD.

  16. Evaluating Dopamine Reward Pathway in ADHD; clinical implications

    SciTech Connect

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Kollins, S.H., Wigal, t.L.; Newcorn, J.H.; Telang, F.; Fowler, J.S.; Zhu, W.; Logan, J.; Ma, Y.; Pradhan, K.; Wong, C.T.; Swanson, J.M.

    2009-09-09

    Attention-deficit/hyperactivity disorder (ADHD) - characterized by symptoms of inattention and hyperactivity-impulsivity - is the most prevalent childhood psychiatric disorder that frequently persists into adulthood, and there is increasing evidence of reward-motivation deficits in this disorder. To evaluate biological bases that might underlie a reward/motivation deficit by imaging key components of the brain dopamine reward pathway (mesoaccumbens). We used positron emission tomography to measure dopamine synaptic markers (transporters and D{sub 2}/D{sub 3} receptors) in 53 nonmedicated adults with ADHD and 44 healthy controls between 2001-2009 at Brookhaven National Laboratory. We measured specific binding of positron emission tomographic radioligands for dopamine transporters (DAT) using [{sup 11}C]cocaine and for D{sub 2}/D{sub 3} receptors using [{sup 11}C]raclopride, quantified as binding potential (distribution volume ratio -1). For both ligands, statistical parametric mapping showed that specific binding was lower in ADHD than in controls (threshold for significance set at P < .005) in regions of the dopamine reward pathway in the left side of the brain. Region-of-interest analyses corroborated these findings. The mean (95% confidence interval [CI] of mean difference) for DAT in the nucleus accumbens for controls was 0.71 vs 0.63 for those with ADHD (95% CI, 0.03-0.13, P = .004) and in the midbrain for controls was 0.16 vs 0.09 for those with ADHD (95% CI, 0.03-0.12; P {le} .001); for D{sub 2}/D{sub 3} receptors, the mean accumbens for controls was 2.85 vs 2.68 for those with ADHD (95% CI, 0.06-0.30, P = .004); and in the midbrain, it was for controls 0.28 vs 0.18 for those with ADHD (95% CI, 0.02-0.17, P = .01). The analysis also corroborated differences in the left caudate: the mean DAT for controls was 0.66 vs 0.53 for those with ADHD (95% CI, 0.04-0.22; P = .003) and the mean D{sub 2}/D{sub 3} for controls was 2.80 vs 2.47 for those with ADHD (95% CI, 0

  17. Psychiatric Comorbidity at the Time of Diagnosis in Adults With ADHD: The CAT Study.

    PubMed

    Piñeiro-Dieguez, Benjamin; Balanzá-Martínez, Vicent; García-García, Pilar; Soler-López, Begoña

    2014-01-24

    Objective: The CAT (Comorbilidad en Adultos con TDAH) study aimed to quantify and characterize the psychiatric comorbidity at the time of diagnosis of ADHD in adult outpatients. Method: Cross-sectional, multicenter, observational register of adults with ADHD diagnosed for the first time. Results: In this large sample of adult ADHD (n = 367), psychiatric comorbidities were present in 66.2% of the sample, and were more prevalent in males and in the hyperactive-impulsive and combined subtypes. The most common comorbidities were substance use disorders (39.2%), anxiety disorders (23%), and mood disorders (18.1%). In all, 88.8% patients were prescribed pharmacological treatment for ADHD (in 93.4% of cases, modified release methylphenidate capsules 50:50). Conclusion: A high proportion of psychiatric comorbidity was observed when adult outpatients received a first-time diagnosis of ADHD. The systematic registering of patients and comorbidities in clinical practice may help to better understand and manage the prognostic determinants in adult ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24464326

  18. Next-Generation Sequencing of Plasmodium vivax Patient Samples Shows Evidence of Direct Evolution in Drug-Resistance Genes

    PubMed Central

    Flannery, Erika L.; Wang, Tina; Akbari, Ali; Corey, Victoria C.; Gunawan, Felicia; Bright, A. Taylor; Abraham, Matthew; Sanchez, Juan F.; Santolalla, Meddly L.; Baldeviano, G. Christian; Edgel, Kimberly A.; Rosales, Luis A.; Lescano, Andrés G.; Bafna, Vineet; Vinetz, Joseph M.; Winzeler, Elizabeth A.

    2015-01-01

    Understanding the mechanisms of drug resistance in Plasmodium vivax, the parasite that causes the most widespread form of human malaria, is complicated by the lack of a suitable long-term cell culture system for this parasite. In contrast to P. falciparum, which can be more readily manipulated in the laboratory, insights about parasite biology need to be inferred from human studies. Here we analyze the genomes of parasites within 10 human P. vivax infections from the Peruvian Amazon. Using next-generation sequencing we show that some P. vivax infections analyzed from the region are likely polyclonal. Despite their polyclonality we observe limited parasite genetic diversity by showing that three or fewer haplotypes comprise 94% of the examined genomes, suggesting the recent introduction of parasites into this geographic region. In contrast we find more than three haplotypes in putative drug-resistance genes, including the gene encoding dihydrofolate reductase-thymidylate synthase and the P. vivax multidrug resistance associated transporter, suggesting that resistance mutations have arisen independently. Additionally, several drug-resistance genes are located in genomic regions with evidence of increased copy number. Our data suggest that whole genome sequencing of malaria parasites from patients may provide more insight about the evolution of drug resistance than genetic linkage or association studies, especially in geographical regions with limited parasite genetic diversity. PMID:26719854

  19. Psychological and cortisol reactivity to experimentally induced stress in adults with ADHD.

    PubMed

    Raz, Sivan; Leykin, Dmitry

    2015-10-01

    Individuals with ADHD suffer from increased vulnerability to environmental and mental stressors and may be at increased risk for chronic stress in everyday life. The Hypothalamic-Pituitary-Adrenal (HPA) axis is a critical physiological system that mediates responses to stress. The present study seeks to examine test performance, test anxiety, self-reported psychological stress and cortisol reactivity to mental-cognitive stress in adults with ADHD when compared with healthy controls. Stress was induced by an arithmetic ability test. Psychological stress was assessed repeatedly throughout the experimental session. Salivary cortisol, an indicator of the HPA axis function, was evaluated immediately upon arrival, as well as 1 min and 20 min post-test completion. Results revealed higher levels of test anxiety and poorer performance on the test in the ADHD group. The ADHD and control groups showed no difference in base-line levels of subjective stress and in subjective stress levels 20 min after the test. In contrast, individuals with ADHD reported significantly higher levels of stress at the test anticipation phase and 1 min post-test completion. Cortisol response to stress differed according to group: in the ADHD group, 20 min post-test cortisol levels were significantly higher than base-line cortisol levels. This was not evident in the control group. These results suggest greater activation of the HPA axis in response to stress in adults with ADHD when compared with healthy controls. Adults with ADHD do not differ from controls in basal levels of subjective stress and cortisol, but do have stronger psychophysiological reactions in response to stressful challenges. The present findings are among the first to demonstrate significant alterations in cortisol reactivity to stress in adults with ADHD. PMID:26107579

  20. The effects of a Self-Alert Training (SAT) program in adults with ADHD.

    PubMed

    Salomone, Simona; Fleming, Grainne R; Shanahan, Jacqueline M; Castorina, Marco; Bramham, Jessica; O'Connell, Redmond G; Robertson, Ian H

    2015-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD), a neuropsychiatric condition characterized by attention and impulsivity problems, is one of the most common behavioral disorders. The first line of treatment for ADHD is psychostimulant medication, but this has limited effectiveness, particularly in adults, and is often associated with adverse side-effects. Thus, it is imperative that new non-pharmaceutical approaches to treatment are developed. This study aims to evaluate the impact of a non-pharmacological Self-Alert Training (SAT) intervention on ADHD symptom prevalence, psychological and cognitive functioning, and on everyday functional impairment in adults with ADHD. Fifty-one adult participants with a current diagnosis of ADHD were randomized to either SAT or a Control Training (CT) program. They were assessed at baseline, immediately following the 5-week training period, and after 3-months using ADHD symptoms scales, as well as a series of neuropsychological tests and psychological questionnaires. Subjective ratings of everyday life attention and memory problems were also collected. The SAT group showed significant improvements in ADHD inattentive and impulsive symptoms, depressive symptoms and in self-efficacy ratings compared to the CT group at both post-training and at the 3-month assessment. Pre-post improvements in SAT participants on untrained cognitive tasks measuring selective attention and executive functions were also observed. Finally, the SAT group reported improved subjective ratings of everyday life attention at both assessment points. This pattern of results suggests that SAT may be beneficial in treating ADHD symptoms as well as psychological and cognitive impairments in adult ADHD. A large-scale randomized controlled trial (RCT) is needed. PMID:25713523

  1. The effects of a Self-Alert Training (SAT) program in adults with ADHD

    PubMed Central

    Salomone, Simona; Fleming, Grainne R.; Shanahan, Jacqueline M.; Castorina, Marco; Bramham, Jessica; O’Connell, Redmond G.; Robertson, Ian H.

    2015-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD), a neuropsychiatric condition characterized by attention and impulsivity problems, is one of the most common behavioral disorders. The first line of treatment for ADHD is psychostimulant medication, but this has limited effectiveness, particularly in adults, and is often associated with adverse side-effects. Thus, it is imperative that new non-pharmaceutical approaches to treatment are developed. This study aims to evaluate the impact of a non-pharmacological Self-Alert Training (SAT) intervention on ADHD symptom prevalence, psychological and cognitive functioning, and on everyday functional impairment in adults with ADHD. Fifty-one adult participants with a current diagnosis of ADHD were randomized to either SAT or a Control Training (CT) program. They were assessed at baseline, immediately following the 5-week training period, and after 3-months using ADHD symptoms scales, as well as a series of neuropsychological tests and psychological questionnaires. Subjective ratings of everyday life attention and memory problems were also collected. The SAT group showed significant improvements in ADHD inattentive and impulsive symptoms, depressive symptoms and in self-efficacy ratings compared to the CT group at both post-training and at the 3-month assessment. Pre-post improvements in SAT participants on untrained cognitive tasks measuring selective attention and executive functions were also observed. Finally, the SAT group reported improved subjective ratings of everyday life attention at both assessment points. This pattern of results suggests that SAT may be beneficial in treating ADHD symptoms as well as psychological and cognitive impairments in adult ADHD. A large-scale randomized controlled trial (RCT) is needed. PMID:25713523

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

    SciTech Connect

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Newcorn, J.H.; Kollins, S.H.; Wigal, T.L.; Telang, F.; Folwer, J.S.; Goldstein, R.Z.; Klein, N.; Logan, J.; Wong, C.; Swanson, J.M.

    2010-08-17

    Attention-deficit hyperactivity disorder (ADHD) is typically characterized as a disorder of inattention and hyperactivity/impulsivity but there is increasing evidence of deficits in motivation. Using positron emission tomography (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 [{sup 11}C]raclopride and [{sup 11}C]cocaine, respectively) in the dopamine reward pathway (midbrain and nucleus accumbens) and a surrogate measure 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.

  3. Incautiously Optimistic: Positively-Valenced Cognitive Avoidance in Adult ADHD

    PubMed Central

    Knouse, Laura E.; Mitchell, John T.

    2015-01-01

    Clinicians who conduct cognitive-behavioral therapy (CBT) targeting attention-deficit/hyperactivity disorder (ADHD) in adulthood have noted that their patients sometimes verbalize overly positive automatic thoughts and set overly optimistic goals. These cognitions are frequently related to failure to engage in compensatory behavioral strategies emphasized in CBT. In this paper, we offer a functional analysis of this problematic pattern, positively-valenced cognitive avoidance, and suggest methods for addressing it within CBT for adult ADHD. We propose that maladaptive positive cognitions function to relieve aversive emotions in the short-term and are therefore negatively reinforced but that, in the long-term, they are associated with decreased likelihood of active coping and increased patterns of behavioral avoidance. Drawing on techniques from Behavioral Activation (BA), we offer a case example to illustrate these concepts and describe step-by-step methods for clinicians to help patients recognize avoidant patterns and engage in more active coping. PMID:25908901

  4. Developmental psychopathology: Attention Deficit Hyperactivity Disorder (ADHD)

    PubMed Central

    Schmidt, Sören; Petermann, Franz

    2009-01-01

    Background Attention Deficit/Hyperactivity Disorder (ADHD), formerly regarded as a typical childhood disorder, is now known as a developmental disorder persisting over the lifespan. Starting in preschool-age, symptoms vary depending on the age group affected. Method According to the variability of ADHD-symptoms and the heterogeneity of comorbid psychiatric disorders, a broad review of recent studies was performed. These findings were summarized in a developmental psychopathological model, documenting relevant facts on a timeline. Results Based on a genetic disposition and a neuropsychological deregulation, there is evidence for factors which persist across the lifespan, change age-dependently, or show validity in a specific developmental phase. Qualitative changes can be found for children in preschool-age and adults. Conclusion These differences have implications for clinical practice as they can be used for prevention, diagnostic proceedings, and therapeutic intervention as well as for planning future studies. The present article is a translated and modified version of the German article "Entwicklungspsychopathologie der ADHS", published in Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 56, 2008, S. 265-274. PMID:19761584

  5. Learning disabilities and ADHD: overlapping spectrumn disorders.

    PubMed

    Mayes, S D; Calhoun, S L; Crowell, E W

    2000-01-01

    Clinical and psychoeducational data were analyzed for 119 children ages 8 to 16 years who were evaluated in a child diagnostic clinic. A learning disability (LD) was present in 70% of the children with attention-deficit/hyperactivity disorder (ADHD), with a learning disability in written expression two times more common (65%) than a learning disability in reading, math, or spelling. Children with LD and ADHD had more severe learning problems than children who had LD but no ADHD, and the former also had more severe attention problems than children who had ADHD but no LD. Further, children with ADHD but no LD had some degree of learning problem, and children with LD but no ADHD had some degree of attention problem. Results suggest that learning and attention problems are on a continuum, are interrelated, and usually coexist. PMID:15495544

  6. Brief Report: Adaptive Functioning in Children with ASD, ADHD and ASD + ADHD

    ERIC Educational Resources Information Center

    Ashwood, Karen L.; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick

    2015-01-01

    Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and…

  7. Examining Autistic Traits in Children with ADHD: Does the Autism Spectrum Extend to ADHD?

    ERIC Educational Resources Information Center

    Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier

    2011-01-01

    We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated…

  8. Social Adjustment among Taiwanese Children with Symptoms of ADHD, ODD, and ADHD Comorbid with ODD

    ERIC Educational Resources Information Center

    Tseng, Wan-Ling; Kawabata, Yoshito; Gau, Susan Shur-Fen

    2011-01-01

    This study examined social problems at school and relationships with peers, siblings, mothers, and fathers among children with ADHD only (n = 41), ODD only (n = 14), ADHD + ODD (n = 47), and normal controls (n = 204) from a school-based sample of 2,463 first to ninth graders in Taiwan. ADHD and ODD symptoms were determined by teacher and mother…

  9. Cardiac Reactivity and Stimulant Use in Adolescents with Autism Spectrum Disorders with Comorbid ADHD Versus ADHD

    ERIC Educational Resources Information Center

    Bink, M.; Popma, A.; Bongers, I. L.; van Boxtel, G. J. M.; Denissen, A.; van Nieuwenhuizen, Ch.

    2015-01-01

    A large number of youngsters with autism spectrum disorders (ASD) display comorbid attention deficit/hyperactivity disorder (ADHD) symptoms. However, previous studies are not conclusive whether psychophysiological correlates, like cardiac reactivity, are different for ASD with comorbid ADHD (ASD+) compared to ADHD. Therefore, the current study…

  10. Comparing ADHD in Velocardiofacial Syndrome to Idiopathic ADHD: A Preliminary Study

    ERIC Educational Resources Information Center

    Antshel, Kevin M.; Faraone, Stephen V.; Fremont, Wanda; Monuteaux, Michael C.; Kates, Wendy R.; Doyle, Alysa; Mick, Eric; Biederman, Joseph

    2007-01-01

    Objective: Background: Children with velocardiofacial syndrome (VCFS), a contiguous deletion syndrome, have an increased prevalence of attention deficit/hyperactivity disorder (ADHD). Method: The authors compared youth with VCFS+ADHD (from the SUNY Upstate VCFS Research Program) to those with ADHD but not VCFS (from the Massachusetts General…

  11. Global and local grey matter reductions in boys with ADHD combined type and ADHD inattentive type.

    PubMed

    Vilgis, Veronika; Sun, Li; Chen, Jian; Silk, Timothy J; Vance, Alasdair

    2016-08-30

    Attention-deficit/hyperactivity disorder (ADHD) has reliably been associated with global grey matter reductions but local alterations are largely inconsistent with perhaps the exception of the caudate nucleus. The aim of this study was to examine local and global brain volume differences between typically developing children (TD) and children with a diagnosis of ADHD. We also addressed whether these parameters would differ between children with the ADHD-combined type (ADHD-C) and those with the ADHD-inattentive type (ADHD-I). Using an ROI approach caudate volume differences were also examined. 79 boys between the ages of 8 and 17 participated in the study. Of those 33 met diagnostic criteria for the ADHD-C and 15 for the ADHD-I subtype. 31 boys were included in the TD group. Structural magnetic resonance imaging data were analysed using voxel-based morphometry. The ADHD group had significantly lower global and local grey matter volumes within clusters in the bilateral frontal, right parietal and right temporal regions compared to TD. A significant group by age interaction was found for right caudate nucleus volume. No differences between the ADHD-C and ADHD-I groups were found. Right caudate nucleus volume and age are more strongly related in ADHD than in TD consistent with previous research. PMID:27399309

  12. Teachers' Knowledge of ADHD, Treatments for ADHD, and Treatment Acceptability: An Initial Investigation. Research Brief

    ERIC Educational Resources Information Center

    Vereb, Rebecca L.; DiPerna, James C.

    2004-01-01

    The purpose of this study was to begin to explore the relationship among teachers' knowledge of Attention Deficit Hyperactivity Disorder (ADHD), knowledge of common treatments for ADHD, and acceptability of different approaches to treatment for ADHD (medication and behavior management). Relationships also were explored between these variables and…

  13. College students classified with ADHD and the foreign language requirement.

    PubMed

    Sparks, Richard L; Javorsky, James; Philips, Lois

    2004-01-01

    The conventional assumption of most disability service providers is that students classified as having attention-deficit/hyperactivity disorder (ADHD) will experience difficulties in foreign language (FL) courses. However, the evidence in support of this assumption is anecdotal. In this empirical investigation, the demographic profiles, overall academic performance, college entrance scores, and FL classroom performance of 68 college students classified as having ADHD were examined. All students had graduated from the same university over a 5-year period. The findings showed that all 68 students had completed the university's FL requirement by passing FL courses. The students' college entrance scores were similar to the middle 50% of freshmen at this university, and their graduating grade point average was similar to the typical graduating senior at the university. The students had participated in both lower (100) and upper (200, 300, 400) level FL courses and had achieved mostly average and above-average grades (A, B, C) in these courses. One student had majored and eight students had minored in an FL. Two thirds of the students passed all of their FL courses without the use of instructional accommodations. In this study, the classification of ADHD did not appear to interfere with participants' performance in FL courses. The findings suggest that students classified as having ADHD should enroll in and fulfill the FL requirement by passing FL courses. PMID:15493238

  14. Somatic and endocrinological changes in non medicated ADHD children.

    PubMed

    Ptácek, R; Kuzelová, H; Paclt, I; Zukov, I; Fischer, S

    2009-01-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders and it constitutes a group of developmental disorders, which are characterized by inadequate level of attention, excessive activity and impulsivity. In connection with neurological and endocrinological changes, children with ADHD can show also changes in the growth and development without consequence to the medication. Differences were found especially in higher weight and BMI. Very few studies were done on this topic and the results of the studies are very different, methods are heterogeneous and insufficient. The most serious absence is the much reduced number of anthropometrics and other characteristics and parameters. Studies usually analyse only BMI, height and weight and do not take into account socio-economic characteristics, feeding customs and other important factors. Many studies are done on changes in growth only associated with medical treatment of children ADHD. However changes in the development and growth can be a manifestation of the disorder itself. Authors of this paper review studies which monitor changes in the development of children with ADHD and compare their results. PMID:19591375

  15. Aspects of language in children with ADHD: applying functional analyses to explore language use.

    PubMed

    Mathers, Margaret E

    2006-02-01

    This article reports some outcomes from an exploratory study that compares children diagnosed with ADHD and without language impairment with typically developing children for aspects of language use. Discourse analysis based on a systemic functional linguistics approach is applied to spoken and written samples from three different text types that are supplied by 11 children diagnosed with ADHD and 11 typically developing children. Comparisons of multiple variables most often show differences in use between the groups. Closer examination of these differences shows that relative to the controls, the ADHD group uses fewer strategies of textual organization and more avoidance, tangential, and unrelated meanings and more abandoned utterances and spelling and punctuation errors. Clinical implications suggest that careful linguistic analysis of spoken and written language of children with ADHD cannot only identify the linguistic resources they use within everyday contexts but may also indicate areas where intervention may be beneficial. PMID:16481669

  16. Brain activation deficit in increased-load working memory tasks among adults with ADHD using fMRI.

    PubMed

    Ko, Chih-Hung; Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Lin, Wei-Chen; Wang, Peng-Wei; Liu, Gin-Chung

    2013-10-01

    Working memory (WM) is impaired among adults with attention-deficit hyperactivity disorder (ADHD). This study aimed to investigate the brain activation deficit for low-level or increased-load WM among adults with ADHD. A total of 20 adults with ADHD and controls were recruited according to diagnostic interviewing by a psychiatrist. Phonological and visual-spatial 2-back and 3-back tasks were performed under functional magnetic resonance scanning. The results demonstrated that both the adults with ADHD and the controls exhibited activation of the fronto-parietal network for WM, and the intensity was greater in the adult ADHD group. The ADHD group had higher brain activation over the bilateral anterior cingulate, left inferior frontal lobe, hippocampus, and supplementary motor area (SMA) for phonological WM than the control group. When the task loading increased from 2-back to 3-back tasks, the adults with ADHD perceived greater difficulty. The control group exhibited increased brain activation over the frontal-parietal network in response to increased phonological WM load. However, the ADHD group showed decreased brain activation over the left precuneus, insula, and SMA. Further analysis demonstrated that the ADHD group exhibited a greater decrease in brain activation over the left fronto-parietal network, including the precuneus, SMA, insula/inferior frontal lobe, and dorsolateral prefrontal cortex, than the control group. These results suggest that adults with ADHD pay more effort to low demanding phonological WM. On the other hand, brain activation of the left fronto-parietal network is impaired when the demands of WM exceed the capacity of adults with ADHD. PMID:23645101

  17. Parent training for preschool ADHD: A randomized controlled trial of specialized and generic programs

    PubMed Central

    Abikoff, Howard B.; Thompson, Margaret; Laver-Bradbury, Cathy; Long, Nicholas; Forehand, Rex L.; Brotman, Laurie Miller; Klein, Rachel G.; Reiss, Philip; Huo, Lan; Sonuga-Barke, Edmund

    2014-01-01

    Background The ‘New Forest Parenting Package’ (NFPP), an 8-week home-based intervention for parents of preschoolers with ADHD, fosters constructive parenting to target ADHD-related dysfunctions in attention and impulse control.Although NFPP has improved parent and laboratory measures of ADHD in community samples of children with ADHD-like problems, its efficacy in a clinical sample, and relative to an active treatment comparator, is unknown. The aims are to evaluate the short and long-term efficacy and generalization effects of NFPP compared to an established clinic-based parenting intervention for treating noncompliant behavior (‘Helping the Noncompliant Child’ [HNC]) in young children with ADHD. Methods A randomized controlled trial with three parallel arms was the design for this study. 164 3-4-year-olds, 73.8% male, meeting DSM-IV ADHD diagnostic criteria were randomized to NFPP (N = 67), HNC (N = 63), or wait-list control (WL, N = 34). All participants were assessed at post-treatment. NFPP and HNC participants were assessed at follow-up in the next school year. Primary outcomes were ADHD ratings by teachers blind to and uninvolved in treatment, and by parents. Secondary ADHD outcomes included clinician assessments, and laboratory measures of on-task behavior and delay of gratification. Other outcomes included parent and teacher ratings of oppositional behavior, and parenting measures. (Trial name: Home-Based Parent Training in ADHD Preschoolers; Registry: ClinicalTrials.gov Identifier: NCT01320098; URL: http://www/clinicaltrials.gov/ct2/show/NCT01320098). Results In both treatment groups, children's ADHD and ODD behaviors, as well as aspects of parenting, were rated improved by parents at the end of treatment compared to controls. Most of these gains in the children's behavior and in some parenting practices were sustained at follow-up. However, these parent-reported improvements were not corroborated by teacher ratings or objective observations. NFPP

  18. [Awareness of adult attention-deficit/hyperactivity disorder (ADHD) in Greece].

    PubMed

    Pehlivanidis, A

    2012-06-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopment disorder of childhood that persists into adulthood in the majority of cases. In adults, the clinical picture of ADHD is complex and comorbidity with other psychiatric disorders is the rule. The documentation that the disorder had a childhood onset and the various comorbid symptomatologies present both in childhood and adult life represent the most influential obstacles for the accurate clinical diagnosis of the disorder. In 75% of cases with adult ADHD there is at least one coexisting comorbid disorder, with anxiety and mood disorders as well as substance abuse and impulse control disorders being the most prevalent ones. Adult psychiatrists have limited experience in the diagnosis, treatment and overall management of the disorder. Greece is a member of the European Network Adult ADHD (ENAA), founded in 2003, aiming to increase awareness of the disorder and to improve knowledge and patient care for adults with ADHD across Europe. A clinic where diagnosis as well as treatment recommendations are given after a thorough assessment of adult ADHD patients, is hosted at the First Department of Psychiatry of the Athens National and Kapodistian University. The clinic is in close collaboration with ENAA. The diagnosis of ADHD is given after a detailed evaluation of the patient, based on history taken, self-administered questionnaires and a specific psychiatric interview. The reliable trace of the symptoms' onset back in early childhood, current symptomatology, as well as its impact on at least two major areas of functioning (school, home, work or personal relationships) are pivotal for the assessment procedure. Special attention should be paid in the distinction of symptoms often coexisting with the core symptoms of the ADHD, such as emotional liability, incessant mental activity, avoidance of situations like queuing, especially when there is also frustration, from those indicating a comorbid

  19. Combination pharmacotherapy for adult ADHD.

    PubMed

    Adler, Lenard A; Reingold, Lisa S; Morrill, Melinda S; Wilens, Timothy E

    2006-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of adulthood. Although clinical guidelines recommend monotherapy with stimulants or atomoxetine, combination pharmacotherapy is a common practice among clinicians. There are four main situations in which combination medications may be necessary: partial response, dose-limiting side effects, associated disorders, and comorbid diagnoses. We present data from two chart reviews that support existing research on combination pharmacotherapy. Adjunct treatment of d-methylphenidate to stimulant medications extended the duration of therapeutic effect. Adjunct treatment of mirtazapine to stimulant medications reduced associated insomnia. These data support previous research that validates the use of combination pharmacotherapy for adults with ADHD. PMID:16968624

  20. Cognitive endophenotypes of attention deficit/hyperactivity disorder and intra-subject variability in patients with autism spectrum disorder.

    PubMed

    Biscaldi, M; Bednorz, N; Weissbrodt, K; Saville, C W N; Feige, B; Bender, S; Klein, C

    2016-07-01

    Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have previously been studied mainly in isolation from each other. However the two conditions may be aetiologically related and thus show overlap in aetiologically relevant functions. In order to address this question of potential aetiological overlap between ADHD and ASD, the present study set out to investigate putative endophenotypes of ADHD in N=33 typically developing (TD) children and N=28 patients with ASD that were (ASD+) or were not (ASD-) co-morbid for ADHD. With regard to both the cognitive endophenotype candidates (working memory, inhibition, temporal processing) and intra-subject variability (ISV) the pattern of abnormalities was inconsistent. Furthermore, the overall profile of ASD-TD differences was extremely similar to the pattern of differences between the ASD+ and ASD- sub-groups, suggesting that any abnormalities found were due to the comorbid ASD subgroup. This held in particular for ISV, which did not show in patients with ASD the task-general increase that is common in ADHD samples. Altogether, the present results do not support the hypothesis of aetiological overlap between ASD and ADHD. PMID:27143193

  1. The efficacy of tenofovir-based therapy in patients showing suboptimal response to entecavir-adefovir combination therapy

    PubMed Central

    Kim, Jeong Han; Ahn, Sung Hyun; Ko, Soon Young; Choe, Won Hyeok; Kim, Kyun-Hwan; Kwon, So Young

    2016-01-01

    Background/Aims: Before tenofovir (TDF) become available in South Korea, combination therapy with entecavir (ETV) and adefovir (ADV) was the most potent regimen for chronic hepatitis B (CHB) patients who fail to respond to rescue therapy for drug resistance. We analyzed the efficacy of ETV-ADV combination therapy and investigated the clinical and clonal results of TDF-based rescue therapy in CHB patients refractory to this combination. Methods: We retrospectively reviewed the medical records of CHB patients treated for up to 3 years with ETV-ADV combination therapy as a rescue therapy for drug resistance. In cases refractory to this combination, clinical and clonal analyses were performed for TDF-based rescue therapy. Results: The analysis was performed on 48 patients. Twelve patients achieved a virological response (VR) within 3 years. A VR was subsequently achieved in nine of the ten patients without a VR who switched to TDF monotherapy. A VR was also achieved in six of the seven patients who switched to lamivudine-TDF combination therapy, and in two of the two patients who switched to ETV-TDF combination therapy. In an in vitro susceptibility test, viral replication was detected with TDF monotherapy but not with ETV-TDF combination therapy. Conclusions: The efficacy of ETV-ADV combination therapy was insufficient in CHB patients who were refractory to rescue therapy. A more potent regimen such as ETV-TDF combination therapy may be considered in such refractory cases. PMID:27304549

  2. Adolescents' ADHD symptoms and adjustment: The role of attachment and rejection sensitivity.

    PubMed

    Scharf, Miri; Oshri, Assaf; Eshkol, Varda; Pilowsky, Tammy

    2014-03-01

    The associations between attachment style, ADHD symptoms, and social adjustments were examined in a community sample of adolescents. Five hundred and eight junior high school students completed questionnaires pertaining to attachment style, ADHD symptoms (inattention and hyperactivity), and rejection sensitivity, and were rated by homeroom teachers on social adjustment. Analyses supported a 3-profile pattern of attachment styles: secure, dismissing, and preoccupied. The 3 attachment profiles showed differential risk on adolescents' social adjustment, as well as on ADHD symptoms. The secure profile showed the most adaptive outcomes on all of the examined adjustment outcomes, compared with the other 2 profiles. In contrast, the preoccupied attachment profile showed the highest levels of ADHD problems, angry and anxious expectations, while displaying a similar level of maladjustment to the dismissing profile. In addition, structural equation modeling was used and supported a model that tested an indirect link between attachment security and adolescent adjustment via an ADHD latent factor. Findings suggest that clinicians and educators should pay attention to relational patterns (attachment styles) in adolescence, as these may serve as a developmental precursor for ADHD and a range of adjustment problems in school. PMID:24826937

  3. Impairment of Concept Formation Ability in Children with ADHD: Comparisons between Lower Grades and Higher Grades

    PubMed Central

    Hong, Hye Jeong; Kim, Jin Sung; Seo, Wan Seok; Koo, Bon Hoon; Bai, Dai Seg; Jeong, Jin Young

    2010-01-01

    Objective We investigated executive functions (EFs), as evaluated by the Wisconsin Card Sorting Test (WCST), and other EF between lower grades (LG) and higher grades (HG) in elementary-school-age attention deficit hyperactivity disorder (ADHD) children. Methods We classified a sample of 112 ADHD children into 4 groups (composed of 28 each) based on age (LG vs. HG) and WCST performance [lower vs. higher performance on WCST, defined by the number of completed categories (CC)] Participants in each group were matched according to age, gender, ADHD subtype, and intelligence. We used the Wechsler intelligence Scale for Children 3rd edition to test intelligence and the Computerized Neurocognitive Function Test-IV, which included the WCST, to test EF. Results Comparisons of EFs scores in LG ADHD children showed statistically significant differences in performing digit spans backward, some verbal learning scores, including all memory scores, and Stroop test scores. However, comparisons of EF scores in HG ADHD children did not show any statistically significant differences. Correlation analyses of the CC and EF variables and stepwise multiple regression analysis in LG ADHD children showed a combination of the backward form of the Digit span test and Visual span test in lower-performance ADHD participants significantly predicted the number of CC (R2=0.273, p<0.001). Conclusion This study suggests that the design of any battery of neuropsychological tests for measuring EF in ADHD children should first consider age before interpreting developmental variations and neuropsychological test results. Researchers should consider the dynamics of relationships within EF, as measured by neuropsychological tests. PMID:20927306

  4. Attention-deficit/hyperactivity disorder (ADHD) symptoms, anxiety symptoms, and executive functioning in emerging adults.

    PubMed

    Jarrett, Matthew A

    2016-02-01

    The current study examined attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms in relation to self-reported executive functioning deficits in emerging adults. College students (N = 421; ages 17-25; 73.1% female) completed self-reports of ADHD, anxiety, and executive functioning in a laboratory setting. Structural equation modeling analyses revealed that self-reported executive functioning deficits were significantly related to all 3 symptom domains. Executive functioning deficits were most strongly related to inattention followed by hyperactivity/impulsivity and anxiety. Analyses based on clinical groups revealed that groups with ADHD and comorbid anxiety showed greater deficits on self-regulation of emotion and self-organization/problem solving than those with ADHD only or anxiety only. Groups with ADHD showed greater deficits with self-motivation and self-restraint than those with anxiety only. All clinical groups differed from a control group on executive functioning deficits. Overall, anxiety symptoms appear to be associated with college students' self-reported executive functioning deficits above and beyond relationships with ADHD symptomatology. Further, those with ADHD and anxiety appear to show increased difficulties with self-regulation of emotion and self-organization/problem solving, a domain which appears to overlap substantially with working memory. Future studies should seek to replicate our findings with a clinical population, utilize both report-based and laboratory task measures of executive functioning, and integrate both state and trait anxiety indices into study designs. Finally, future studies should seek to determine how executive functioning deficits can be best ameliorated in emerging adults with ADHD and anxiety. (PsycINFO Database Record PMID:26121381

  5. Effectiveness of a school-based multicomponent program for the treatment of children with ADHD.

    PubMed

    Miranda, Ana; Presentación, Maria Jesús; Soriano, Manuel

    2002-01-01

    The objective of this study was to evaluate the efficacy of a multicomponent program for treating attention-deficit/hyperactivity disorder (ADHD) carried out by teachers in a classroom context. Dependent measures included neuropsychological tasks, behavioral rating scales for parents and teachers, direct observation of behavior in the classroom, and academic records of children with ADHD. Fifty children with ADHD participated in the study. The teachers of 29 of the 50 students were trained in the use of behavior modification techniques, cognitive behavior strategies, and instructional management strategies. The other 21 students formed the control group. Parents' and teachers'ratings detected improvements in primary symptoms (inattention-disorganization, hyperactivity-impulsivity) and in behavioral difficulties usually associated with ADHD (e.g., antisocial behavior, psychopathological disorders, anxiety). Furthermore, the results showed increased academic scores, enhanced classroom behavioral observations, and improved teachers' knowledge about the strategies directed toward responding to the children's educational needs. PMID:15493252

  6. Getting Treatment for ADHD

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  7. Whole-body vibration improves cognitive functions of an adult with ADHD.

    PubMed

    Fuermaier, Anselm B M; Tucha, Lara; Koerts, Janneke; van den Bos, Meinris; Regterschot, G Ruben H; Zeinstra, Edzard B; van Heuvelen, Marieke J G; van der Zee, Eddy A; Lange, Klaus W; Tucha, Oliver

    2014-09-01

    Adult attention deficit hyperactivity disorder (ADHD) is associated with a variety of cognitive impairments, which were shown to affect academic achievement and quality of life. Current treatment strategies, such as stimulant drug treatment, were demonstrated to effectively improve cognitive functions of patients with ADHD. However, most treatment strategies are associated with a number of disadvantages in a considerable proportion of patients, such as unsatisfactory effects, adverse clinical side effects or high financial costs. In order to address limitations of current treatment strategies, whole-body vibration (WBV) might represent a novel approach to treat cognitive dysfunctions of patients with ADHD. WBV refers to the exposure of the whole body of an individual to vibration and was found to affect physiology and cognition. In the present study, WBV was applied on 10 consecutive days to an adult diagnosed with ADHD. Neuropsychological assessments were performed repeatedly at three different times, i.e., the day before the start of the treatment, on the day following completion of treatment and 14 days after the treatment have been completed (follow-up). An improved neuropsychological test performance following WBV treatment points to the high clinical value of WBV in treating patients with neuropsychological impairments such as ADHD. PMID:25031090

  8. Interference control in adult ADHD: no evidence for interference control deficits if response speed is controlled by delta plots.

    PubMed

    Soutschek, Alexander; Schwarzkopf, Wolfgang; Finke, Kathrin; Hennig-Fast, Kristina; Müller, Hermann J; Riedel, Michael; Möller, Hans-Jürgen; Sorg, Christian; Schubert, Torsten

    2013-05-01

    Several theoretical accounts assume that interference control deficits belong to the core symptoms of adult ADHD. However, findings of increased interference effects in adult ADHD patients compared with healthy adults may be confounded with the simultaneous finding of generally slower responses in the patient group. The current study compared the magnitude of the interference effect in the Stroop task between a group of adults with ADHD and a healthy adult control group in a procedure that accounted for differences in overall response speed by using delta plots. The amount of interference did not differ between patient and control group at comparable reaction time levels. These results challenge the conclusions of the previous studies, in that they indicate that interference control is not impaired in adult ADHD. PMID:23542807

  9. [Bone metastases or an insufficiency fracture? Oncology patients reporting pain or showing bone abnormalities on a scan].

    PubMed

    Meerveld-Eggink, Aafke; Bollen, Thomas L; Wijrdeman, Harm K; Los, Maartje

    2013-01-01

    A 71-year-old patient reported pain in the left hip 14 months after treatment with radiotherapy for a ypT3N1M0 rectal carcinoma, and a 61-year-old patient reported pain in the lower back with radiation to the buttocks 8 months after radiotherapy for a ypT3N2M0 rectal carcinoma. In both patients the initial diagnosis considered was bone metastasis. After MRI and nuclear bone scans, however, diagnoses of insufficiency fractures of the acetabulum and sacroiliac (SI) joints, respectively, were made. Insufficiency fractures of the SI joints or acetabula are a frequent complication of radiotherapy and should be considered in all oncology patients who present with sudden onset of back pain or lower back pain after radiotherapy. A MRI scan is the initial investigation of choice. Treatment is conservative, with analgesia and physiotherapy. Prognosis is good; symptoms disappear within 1 year in almost all patients. PMID:23841929

  10. Development of a multi-dimensional scale for PDD and ADHD.

    PubMed

    Funabiki, Yasuko; Kawagishi, Hisaya; Uwatoko, Teruhisa; Yoshimura, Sayaka; Murai, Toshiya

    2011-01-01

    A novel assessment scale, the multi-dimensional scale for pervasive developmental disorder (PDD) and attention-deficit/hyperactivity disorder (ADHD) (MSPA), is reported. Existing assessment scales are intended to establish each diagnosis. However, the diagnosis by itself does not always capture individual characteristics or indicate the level of support required, since inter-individual differences are substantial and co-morbidity is common. The MSPA consists of 14 domains and each domain is rated by a nine-point quantitative scale. The clinical and behavioral features are projected onto a radar-chart, which facilitates understanding of the disorders both by the patients themselves and by those in their surroundings. We assessed 179 patients and analyzed features by six diagnostic subgroups, which showed relationships between features and diagnoses. The inter-rater reliability was satisfactory. PMID:21353761

  11. Analysis of beta-globin mutations shows stable mixed chimerism in patients with thalassemia after bone marrow transplantation.

    PubMed

    Kapelushnik, J; Or, R; Filon, D; Nagler, A; Cividalli, G; Aker, M; Naparstek, E; Slavin, S; Oppenheim, A

    1995-10-15

    Beta-thalassemia major (TM) is caused by any of approximately 150 mutations within the beta-globin gene. To establish the degree of chimerism after bone marrow transplantation (BMT), we have performed molecular analysis of beta-globin mutations in 14 patients with TM over a period of 10 years. All patients underwent T cell-depleted allogeneic BMT from HLA-identical related donors, using either in vitro T-cell depletion with CAMPATH 1M and complement or in vivo depletion using CAMPATH 1G in the bone marrow collection bag. To date, at different time periods after BMT, seven patients have some degree of chimerism; six of these patients, all blood transfusion-independent, have donor cells in the range of 70% to 95%, with stable mixed chimerism (MC). The seventh patient has less than 10% donor cells with, surprisingly, only minimal transfusion requirements. The detection of beta-globin gene point mutation, as used here, is a highly specific and sensitive marker for engraftment and MC in patients with thalassemia. In light of its specificity, the method is applicable in all cases of TM, as it is independent of sex and other non-globin-related DNA markers. The high incidence of MC found in our patients may be a consequence of the pre-BMT T-cell depletion. Because MC was associated with transfusion independence, complete eradication of residual host cells for effective treatment of TM and possibly other genetic diseases may prove not to be essential. PMID:7579421

  12. Missense dopamine transporter mutations associate with adult parkinsonism and ADHD

    PubMed Central

    Hansen, Freja H.; Skjørringe, Tina; Yasmeen, Saiqa; Arends, Natascha V.; Sahai, Michelle A.; Erreger, Kevin; Andreassen, Thorvald F.; Holy, Marion; Hamilton, Peter J.; Neergheen, Viruna; Karlsborg, Merete; Newman, Amy H.; Pope, Simon; Heales, Simon J.R.; Friberg, Lars; Law, Ian; Pinborg, Lars H.; Sitte, Harald H.; Loland, Claus; Shi, Lei; Weinstein, Harel; Galli, Aurelio; Hjermind, Lena E.; Møller, Lisbeth B.; Gether, Ulrik

    2014-01-01

    Parkinsonism and attention deficit hyperactivity disorder (ADHD) are widespread brain disorders that involve disturbances of dopaminergic signaling. The sodium-coupled dopamine transporter (DAT) controls dopamine homeostasis, but its contribution to disease remains poorly understood. Here, we analyzed a cohort of patients with atypical movement disorder and identified 2 DAT coding variants, DAT-Ile312Phe and a presumed de novo mutant DAT-Asp421Asn, in an adult male with early-onset parkinsonism and ADHD. According to DAT single-photon emission computed tomography (DAT-SPECT) scans and a fluoro-deoxy-glucose-PET/MRI (FDG-PET/MRI) scan, the patient suffered from progressive dopaminergic neurodegeneration. In heterologous cells, both DAT variants exhibited markedly reduced dopamine uptake capacity but preserved membrane targeting, consistent with impaired catalytic activity. Computational simulations and uptake experiments suggested that the disrupted function of the DAT-Asp421Asn mutant is the result of compromised sodium binding, in agreement with Asp421 coordinating sodium at the second sodium site. For DAT-Asp421Asn, substrate efflux experiments revealed a constitutive, anomalous efflux of dopamine, and electrophysiological analyses identified a large cation leak that might further perturb dopaminergic neurotransmission. Our results link specific DAT missense mutations to neurodegenerative early-onset parkinsonism. Moreover, the neuropsychiatric comorbidity provides additional support for the idea that DAT missense mutations are an ADHD risk factor and suggests that complex DAT genotype and phenotype correlations contribute to different dopaminergic pathologies. PMID:24911152

  13. Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD)

    PubMed Central

    Esparham, Anna; Evans, Randall G.; Wagner, Leigh E.; Drisko, Jeanne A.

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback. PMID:27417475

  14. Methylphenidate improves diminished error and feedback sensitivity in ADHD: An evoked heart rate analysis.

    PubMed

    Groen, Yvonne; Mulder, Lambertus J M; Wijers, Albertus A; Minderaa, Ruud B; Althaus, Monika

    2009-09-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder that has previously been related to a decreased sensitivity to errors and feedback. Supplementary to the traditional performance measures, this study uses autonomic measures to study this decreased sensitivity in ADHD and the modulating effects of medication. Children with ADHD, on and off Methylphenidate (Mph), and typically developing (TD) children performed a selective attention task with three feedback conditions: reward, punishment and no feedback. Evoked Heart Rate (EHR) responses were computed for correct and error trials. All groups performed more efficiently with performance feedback than without. EHR analyses, however, showed that enhanced EHR decelerations on error trials seen in TD children, were absent in the medication-free ADHD group for all feedback conditions. The Mph-treated ADHD group showed 'normalised' EHR decelerations to errors and error feedback, depending on the feedback condition. This study provides further evidence for a decreased physiological responsiveness to errors and error feedback in children with ADHD and for a modulating effect of Mph. PMID:19464338

  15. Attention and response control in ADHD. Evaluation through integrated visual and auditory continuous performance test.

    PubMed

    Moreno-García, Inmaculada; Delgado-Pardo, Gracia; Roldán-Blasco, Carmen

    2015-01-01

    This study assesses attention and response control through visual and auditory stimuli in a primary care pediatric sample. The sample consisted of 191 participants aged between 7 and 13 years old. It was divided into 2 groups: (a) 90 children with ADHD, according to diagnostic (DSM-IV-TR) (APA, 2002) and clinical (ADHD Rating Scale-IV) (DuPaul, Power, Anastopoulos, & Reid, 1998) criteria, and (b) 101 children without a history of ADHD. The aims were: (a) to determine and compare the performance of both groups in attention and response control, (b) to identify attention and response control deficits in the ADHD group. Assessments were carried out using the Integrated Visual and Auditory Continuous Performance Test (IVA/CPT, Sandford & Turner, 2002). Results showed that the ADHD group had visual and auditory attention deficits, F(3, 170) = 14.38; p < .01, deficits in fine motor regulation (Welch´s t-test = 44.768; p < .001) and sensory/motor activity (Welch'st-test = 95.683, p < .001; Welch's t-test = 79.537, p < .001). Both groups exhibited a similar performance in response control, F(3, 170) = .93, p = .43.Children with ADHD showed inattention, mental processing speed deficits, and loss of concentration with visual stimuli. Both groups yielded a better performance in attention with auditory stimuli. PMID:25734571

  16. Preliminary Efficacy of a Behavioral Parent Training Program for Children With ADHD in Pakistan.

    PubMed

    Malik, Tamkeen Ashraf; Rooney, Mary; Chronis-Tuscano, Andrea; Tariq, Naeem

    2014-03-12

    Objective: In an effort to address the lack of evidence-based interventions for ADHD in developing South Asian countries, we examined the preliminary efficacy of a behavioral parent training program in Pakistan. Method: A quasi-experimental design was utilized. Eighty-five 4- to 12-year-old children with clinically significant ADHD symptoms participated: 55 were recruited from hospital clinics (active treatment group) and 30 were recruited from schools (waitlist control group). Parent and teacher ratings of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and impairment were collected. Results: Using intent-to-treat analyses, the treatment group showed significant pre-post improvement on parent-reported ODD symptoms and ADHD-related impairment. Teacher ratings showed no improvement. Conclusion: This study provides preliminary evidence for the feasibility and effectiveness of behavioral parenting training for children with ADHD in Pakistan and represents a critical first step in identifying evidence-based treatments for Pakistani children with ADHD. PMID:24621459

  17. The impact of distractions on young adult drivers with attention deficit hyperactivity disorder (ADHD).

    PubMed

    Reimer, Bryan; Mehler, Bruce; D'Ambrosio, Lisa A; Fried, Ronna

    2010-05-01

    Young adults with attention deficit hyperactivity disorder (ADHD) are at higher risk for being involved in automobile crashes. Although driving simulators have been used to identify and understand underlying behaviors, prior research has focused largely on single-task, non-distracted driving. However, in-vehicle infotainment and communications systems often vie for a driver's attention, potentially increasing the risk of collision. This paper explores the impact of secondary tasks on individuals with and without ADHD, a medical condition known to affect the regulation of attention. Data are drawn from a validated driving simulation representing periods before, during, and after participation in a secondary cognitive task. A hands-free phone task was employed in a high stimulus, urban setting and a working memory task during low stimulus, highway driving. Drivers with ADHD had more difficulty on the telephone task, yet did not show an increased decrement in driving performance greater than control participants. In contrast, participants with ADHD showed a larger decline in driving performance than controls during a secondary task in a low demand setting. The results suggest that the interaction of the nature of the driving context and the secondary task has a significant influence on how drivers with ADHD allocate attention and, in-turn, on the relative impact on driving performance. Drivers with ADHD appear particularly susceptible to distraction during periods of low stimulus driving. PMID:20380911

  18. The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents.

    PubMed

    van der Oord, Saskia; Bögels, Susan M; Peijnenburg, Dorreke

    2012-02-01

    This study evaluated the effectiveness of an 8-week mindfulness training for children aged 8-12 with ADHD and parallel mindful parenting training for their parents. Parents (N = 22) completed questionnaires on their child's ADHD and ODD symptoms, their own ADHD symptoms, parenting stress, parental overreactivity, permissiveness and mindful awareness before, immediately after the 8-week training and at 8-week follow-up. Teachers reported on ADHD and ODD behavior of the child. A within-group waitlist was used to control for the effects of time and repeated measurement. Training was delivered in group format. There were no significant changes between wait-list and pre-test, except on the increase of teacher-rated ODD behavior. There was a significant reduction of parent-rated ADHD behavior of themselves and their child from pre-to posttest and from pre- to follow-up test. Further, there was a significant increase of mindful awareness from pre-to posttest and a significant reduction of parental stress and overreactivity from pre-to follow-up test. Teacher-ratings showed non-significant effects. Our study shows preliminary evidence for the effectiveness of mindfulness for children with ADHD and their parents, as rated by parents. However, in the absence of substantial effects on teacher-ratings, we cannot ascertain effects are due to specific treatment procedures. PMID:22347788

  19. Mother-Child Communication: The Influence of ADHD Symptomatology and Executive Functioning on Paralinguistic Style.

    PubMed

    Nilsen, Elizabeth S; Rints, Ami; Ethier, Nicole; Moroz, Sarah

    2016-01-01

    Paralinguistic style, involving features of speech such as pitch and volume, is an important aspect of one's communicative competence. However, little is known about the behavioral traits and cognitive skills that relate to these aspects of speech. This study examined the extent to which ADHD traits and executive functioning (EF) related to the paralinguistic styles of 8- to 12-year-old children and their mothers. Data was collected via parent report (ADHD traits), independent laboratory tasks of EF (working memory, inhibitory control, and cognitive flexibility), and an interactive problem-solving task (completed by mothers and children jointly) which was coded for paralinguistic speech elements (i.e., pitch level/variability; volume level/variability). Dyadic data analyses revealed that elevated ADHD traits in children were associated with a more exaggerated paralinguistic style (i.e., elevated and more variable pitch/volume) for both mothers and children. Mothers' paralinguistic style was additionally predicted by an interaction of mothers' and children's ADHD traits, such that mothers with elevated ADHD traits showed exaggerated paralinguistic styles particularly when their children also had elevated ADHD traits. Highlighting a cognitive mechanism, children with weaker inhibitory control showed more exaggerated paralinguistic styles. PMID:27559327

  20. Mother-Child Communication: The Influence of ADHD Symptomatology and Executive Functioning on Paralinguistic Style

    PubMed Central

    Nilsen, Elizabeth S.; Rints, Ami; Ethier, Nicole; Moroz, Sarah

    2016-01-01

    Paralinguistic style, involving features of speech such as pitch and volume, is an important aspect of one’s communicative competence. However, little is known about the behavioral traits and cognitive skills that relate to these aspects of speech. This study examined the extent to which ADHD traits and executive functioning (EF) related to the paralinguistic styles of 8- to 12-year-old children and their mothers. Data was collected via parent report (ADHD traits), independent laboratory tasks of EF (working memory, inhibitory control, and cognitive flexibility), and an interactive problem-solving task (completed by mothers and children jointly) which was coded for paralinguistic speech elements (i.e., pitch level/variability; volume level/variability). Dyadic data analyses revealed that elevated ADHD traits in children were associated with a more exaggerated paralinguistic style (i.e., elevated and more variable pitch/volume) for both mothers and children. Mothers’ paralinguistic style was additionally predicted by an interaction of mothers’ and children’s ADHD traits, such that mothers with elevated ADHD traits showed exaggerated paralinguistic styles particularly when their children also had elevated ADHD traits. Highlighting a cognitive mechanism, children with weaker inhibitory control showed more exaggerated paralinguistic styles. PMID:27559327

  1. Hip Fractures: What Information Does the Evidence Show That Patients and Families Need to Decrease 30-Day Readmission?

    PubMed

    Gardner, Kristin OʼMara

    2015-01-01

    The current bundled payment reimbursement from the Centers for Medicare & Medicaid Services will not cover the additional cost of hospital readmission for the same diagnosis, and patients with hip fractures have one of the highest cost-saving opportunities when compared with other admission reasons. Common reasons for readmission to the hospital after hip fracture include pneumonia, dehydration, and mobility issues. The learning modalities including visual, aural, read/write, and kinesthetic were used to make recommendations on how the education can be incorporated into the instruction of patients with hip fractures and their families. These learning techniques can be used to develop education to decrease possibility of 30-day readmission after hip fracture. Nurses must focus their education to meet the needs of each individual patient, adapting to different types of adult learners to increase the health literacy of patients with hip fractures and their families. PMID:26575502

  2. Sepsis Patients with First and Second-Hit Infections Show Different Outcomes Depending on the Causative Organism

    PubMed Central

    Morgan, Matt P.; Szakmany, Tamas; Power, Sarah G.; Olaniyi, Patrick; Hall, Judith E.; Rowan, Kathy; Eberl, Matthias

    2016-01-01

    Objective: With improving rates of initial survival in severe sepsis, second-hit infections that occur following resolution of the primary insult carry an increasing burden of morbidity. However, despite the clinical relevance of these infections, no data are available on differential outcomes in patients with first and second-hit infections depending on the nature of the causative organism. This study aims to explore any differences in these subgroups. Design: In a retrospective, observational cohort study, the United Kingdom Intensive Care National Audit & Research Centre (ICNARC) database was used to explore the outcomes of patient with first-hit infections leading to sepsis, and sepsis patients with second-hit infections grouped according to the Gram status of the causative organism. Setting: General critical care units in England, Wales, and Northern Ireland participating in the ICNARC programme between 1 January, 2007 and 30 June, 2012. Patients: Patient groups analyzed included 2119 patients with and 1319 patients without sepsis who developed an intensive care unit acquired infection in blood. Subgroups included patients with trauma, emergency neurosurgery, elective surgery, and cardiogenic shock. Measurements and main results: Gram-negative organisms were associated with poorer outcomes in first-hit infections. The 90-day mortality of patients who developed a Gram-negative infection was 43.6% following elective surgery and 27.9% following trauma. This compared with a mortality of 25.6 and 20.6%, respectively, in Gram-positive infections. Unexpectedly, an inverse relationship between Gram status and mortality was observed in second-hit infections. Patients with an initial diagnosis of sepsis who developed secondary infections caused by Gram-negative organisms had a 90-day mortality of 40.4%, compared with 43.6% in Gram-positive infections. Conclusions: Our study identifies a fundamental difference in patient outcomes between first-hit and second

  3. Self-handicapping prior to academic-oriented tasks in children with attention deficit/hyperactivity disorder (ADHD): medication effects and comparisons with controls.

    PubMed

    Waschbusch, Daniel A; Craig, Rebecca; Pelham, William E; King, Sara

    2007-04-01

    Examined self-handicapping prior to academic-oriented tasks in children with and without ADHD and examined whether stimulant medication influenced self-handicapping. Participants were 61 children ages 6 to 13, including 22 children with ADHD tested after taking a placebo, 21 children with ADHD tested after taking stimulant medication, and 18 non-ADHD controls. Participants completed three measures of self handicapping and also completed self-evaluations of their performance. Results showed greater self handicapping and more positive self-evaluations in children with ADHD than in controls regardless of medication condition. Findings suggest children with ADHD may use self handicapping to ameliorate the effects of experiencing high rates of academic failure. PMID:17195950

  4. ADHD and Problem-Solving in Play

    ERIC Educational Resources Information Center

    Borg, Suzanne

    2009-01-01

    This paper reports a small-scale study to determine whether there is a difference in problem-solving abilities, from a play perspective, between individuals who are diagnosed as ADHD and are on medication and those not on medication. Ten children, five of whom where on medication and five not, diagnosed as ADHD predominantly inattentive type, were…

  5. What Parents Should Know about ADHD

    ERIC Educational Resources Information Center

    Mullet, Dianna R.; Rinn, Anne N.

    2016-01-01

    Some gifted children suffer from Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder that impairs a child's functioning. For a diagnosis of ADHD, children under the age of 17 must display at least six symptoms of inattention or hyperactivity/impulsivity in at least two different settings (school and home, for example),…

  6. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

    Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio

    2012-01-01

    Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…

  7. An ADHD Primer. 2nd Edition

    ERIC Educational Resources Information Center

    Weyandt, Lisa L.

    2007-01-01

    Filled with current, practical, and useful information for professionals and individuals, this second edition summarizes the literature concerning ADHD across the lifespan. It offers a better understanding of the disorder by addressing the potential causes of ADHD, the developmental course, and numerous treatment approaches. The author delivers…

  8. Classroom Management and the ADHD Student

    ERIC Educational Resources Information Center

    Colberg, Laura

    2010-01-01

    Meeting the academic needs of a student with Attention Deficit Hyperactivity Disorder (ADHD) can be taxing on teachers and students. This research highlights classroom management strategies that general education teachers might include in their teaching to support the academic growth students with ADHD, while continuing to support all students in…

  9. Rethinking a Right Hemisphere Deficit in ADHD

    ERIC Educational Resources Information Center

    Hale, T. Sigi; Loo, Sandra K.; Zaidel, Eran; Hanada, Grant; Macion, James; Smalley, Susan L.

    2009-01-01

    Introduction: Early observations from lesion studies suggested right hemisphere (RH) dysfunction in ADHD. However, a strictly right-lateralized deficit has not been well supported. An alternatively view suggests increased R greater than L asymmetry of brain function and abnormal interhemispheric interaction. If true, RH pathology in ADHD should…

  10. Agomelatine Treatment with Adolescents with ADHD

    ERIC Educational Resources Information Center

    Niederhofer, Helmut

    2012-01-01

    Objective: Antidepressants, in particular Atomextine, along with stimulants have demonstrated benefit in the treatment of ADHD. Agomelatine is a new antidepressant with additional affinities to the melatonergic system. As ADHD has been associated with sleep disorders, it is assumed that Agomelatiine might serve as a therapeutic alternative to…

  11. Intervention Strategies for Students with ADHD

    ERIC Educational Resources Information Center

    DuPaul, George J.; White, George P.

    2005-01-01

    The authors describe three types of ADHD behavior that affect from 3 percent to 7 percent of elementary school children, mostly boys. They recommend supplementing stimulant medication with behavior modification strategies, at home and school, to improve ADHD students' social skills and school performance.

  12. Language Characteristics of Children with ADHD.

    ERIC Educational Resources Information Center

    Kim, Okmi H.; Kaiser, Ann P.

    2000-01-01

    Language characteristics of 11 children (ages 6-8) with attention-deficit/hyperactivity disorder (ADHD) and 11 typically developing children were compared for semantic, syntactic, and pragmatic language skills. Findings indicated no differences on receptive vocabulary, but children with ADHD performed worse on tests of expressive speech and…

  13. The Neurobiological Profile of Girls with ADHD

    PubMed Central

    Mahone, E. Mark; Wodka, Ericka L.

    2012-01-01

    Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and neurobiological basis of these deficits is less consistently observed. There is growing evidence that boys’ and girls’ brains develop and mature at different rates, suggesting that the trajectory of early anomalous brain development in ADHD may also be sex-specific. It remains unclear, however, whether earlier brain maturation observed in girls with ADHD is protective. In this review, we outline the current theory and research findings that seek to establish a unique neurobiological profile of girls with ADHD, highlighting sex differences in typical brain development and among children with ADHD. The review highlights findings from neurological, neurocognitive, and behavioral studies. Future research directions are suggested, including the need for longitudinal neuroimaging and neurobehavioral investigation beginning as early as the preschool years, and continuing through adolescence and adulthood, with consideration of identified sex differences in the development of ADHD. PMID:19072756

  14. Characterizing the ADHD Phenotype for Genetic Studies

    ERIC Educational Resources Information Center

    Stevenson, Jim; Asherson, Phil; Hay, David; Levy, Florence; Swanson, Jim; Thapar, Anita; Willcutt, Erik

    2005-01-01

    The genetic study of ADHD has made considerable progress. Further developments in the field will be reliant in part on identifying the most appropriate phenotypes for genetic analysis. The use of both categorical and dimensional measures of symptoms related to ADHD has been productive. The use of multiple reporters is a valuable feature of the…

  15. Heart Rate and Reinforcement Sensitivity in ADHD

    ERIC Educational Resources Information Center

    Luman, Marjolein; Oosterlaan, Jaap; Hyde, Christopher; van Meel, Catharina S.; Sergeant, Joseph A.

    2007-01-01

    Background: Both theoretical and clinical accounts of attention-deficit/hyperactivity disorder (ADHD) implicate a dysfunctional reinforcement system. This study investigated heart rate parameters in response to feedback associated with reward and response cost in ADHD children and controls aged 8 to 12. Methods: Heart rate responses (HRRs)…

  16. The Relationship between ADHD and Giftedness

    ERIC Educational Resources Information Center

    Orendorff, Kimberly A.

    2009-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder that is often identified when a child first enters school. About 2% of boys and girls in our population are diagnosed with the disorder (Kaufmann, 2000). Although ADHD is the most frequent reason that children are referred to a mental health professional, the diagnosis of ADHD…

  17. Aberrant CYP2D6 metabolizer phenotypes do not show increased frequency in patients undergoing ECT after antidepressant therapy.

    PubMed

    Mirzakhani, Hooman; van Dormolen, Juliët; van der Weide, Karen; Guchelaar, Henk-Jan; van Noorden, Martijn S; Swen, Jesse

    2015-10-01

    We investigated the accumulation of aberrant CYP2D6 genotypes and predicted metabolizer phenotypes (ultrarapid metabolizer, intermediate metabolizer and poor metabolizer) potentially affecting the antidepressant treatment response in depressive patients indicated for electroconvulsive therapy (ECT) compared with patients with a single episode of depression. Seventy-six Dutch White patients with unipolar or bipolar treatment-resistant depression who underwent ECT were genotyped using the Amplichip CYP450 Test for CYP2D6. Two hundred and eight patients with a single episode of unipolar or bipolar depression were used as controls. No difference was observed in the prevalence of CYP2D6 phenotypes (poor metabolizer, intermediate metabolizer, extensive metabolizer and ultrarapid metabolizer) between the ECT and the control patients (5.3, 38.7, 56.0 and 0.0% vs. 6.4, 51.0, 42.6 and 0.0%, respectively). The types of depression (odds ratio = 0.33, P = 0.018) and age (odds ratio = 1.55 for a 10-year increase, P < 0.001), but not CYP2D6 phenotype or activity score were associated with the response to antidepressant treatment. In conclusion, preemptive genotyping for CYP2D6 currently appears to have no clinical implications in treatment-resistant depressive patients indicated for ECT. PMID:26230381

  18. Reexamining the Familial Association between Asthma and ADHD in Girls

    ERIC Educational Resources Information Center

    Hammerness, Paul; Monuteaux, Michael C.; Faraone, Stephen V.; Gallo, Lauren; Murphy, Heather; Biederman, Joseph

    2005-01-01

    The objective of this study is to further evaluate the association between asthma and ADHD, addressing issues of familiality in female probands. A case control study of referred ADHD proband girls, controls, and relatives are used. Participants include 140 ADHD proband girls and 122 non-ADHD comparisons, with 417 and 369 first-degree biological…

  19. Giftedness and ADHD: Identification, Misdiagnosis, and Dual Diagnosis

    ERIC Educational Resources Information Center

    Mullet, Dianna R.; Rinn, Anne N.

    2015-01-01

    Many gifted characteristics overlap the symptoms of attention deficity-hyperactivity disorder (ADHD). The potential for the misdiagnosis of giftedness as ADHD exists, but so does the potential for a dual diagnosis of giftedness and ADHD. A decade after the misdiagnosis of giftedness as ADHD was first investigated we examine lessons learned…

  20. ADHD Symptomology and Impairment: Relevance to Postsecondary Education

    ERIC Educational Resources Information Center

    Jansen, Joy

    2010-01-01

    ADHD is a pervasive and persistent condition which continues into adulthood with a prevalence rate of 5%. Research demonstrates that 2% to 4% of the college learner population is affected by ADHD and, interestingly enough, ADHD symptomology prevalence rates have been shown to be higher than expected within the general college population. ADHD is a…

  1. Alerting, Orienting, and Executive Attention in Children with ADHD

    ERIC Educational Resources Information Center

    Mullane, Jennifer C.; Corkum, Penny V.; Klein, Raymond M.; McLaughlin, Elizabeth N.; Lawrence, Michael A.

    2011-01-01

    Objective: This study evaluated the alerting, orienting, and executive attention abilities of children with ADHD and their typically developing (TD) peers using a modified version of the adult attention network test (ANT-I). Method: A total of 25 children with ADHD, Combined Type (ADHD-C, mean age = 9.20 years), 20 children with ADHD,…

  2. The Academic Experience of Male High School Students with ADHD

    ERIC Educational Resources Information Center

    Kent, Kristine M.; Pelham, William E.; Molina, Brooke S. G.; Sibley, Margaret H.; Waschbusch, Daniel A.; Yu, Jihnhee; Gnagy, Elizabeth M.; Biswas, Aparajita; Babinski, Dara E.; Karch, Kathryn M.

    2011-01-01

    This study compared the high school academic experience of adolescents with and without childhood ADHD using data from the Pittsburgh ADHD Longitudinal Study (PALS). Participants were 326 males with childhood ADHD and 213 demographically similar males without ADHD who were recruited at the start of the follow-up study. Data were collected yearly…

  3. Retrospective Reports of Childhood Trauma in Adults with ADHD

    ERIC Educational Resources Information Center

    Rucklidge, Julia J.; Brown, Deborah L.; Crawford, Susan; Kaplan, Bonnie J.

    2006-01-01

    Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of…

  4. Sustained and Focused Attention Deficits in Adult ADHD

    ERIC Educational Resources Information Center

    Marchetta, Natalie D. J.; Hurks, Petra P. M.; De Sonneville, Leo M. J.; Krabbendam, Lydia; Jolles, Jelle

    2008-01-01

    Objective: To examine the specificity of deficits in focused attention and sustained attention in adults with ADHD and to evaluate the effect of comorbidity. Method: Twenty-eight adults with ADHD without comorbidity were compared with 28 ADHD outpatients with comorbidity. Two control groups were used: 68 adults referred for ADHD but with another…

  5. Comorbidity and Phenomenology of Bipolar Disorder in Children with ADHD

    ERIC Educational Resources Information Center

    Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina

    2013-01-01

    Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…

  6. Iron and ADHD: Time to Move beyond Serum Ferritin Levels

    ERIC Educational Resources Information Center

    Donfrancesco, Renato; Parisi, Pasquale; Vanacore, Nicola; Martines, Francesca; Sargentini, Vittorio; Cortese, Samuele

    2013-01-01

    Objective: (a) To compare serum ferritin levels in a sample of stimulant-naive children with ADHD and matched controls and (b) to assess the association of serum ferritin to ADHD symptoms severity, ADHD subtypes, and IQ. Method: The ADHD and the control groups included 101 and 93 children, respectively. Serum ferritin levels were determined with…

  7. Do Hyperactive Symptoms Matter in ADHD-I Restricted Phenotype?

    ERIC Educational Resources Information Center

    Schmitz, Marcelo; Ludwig, Henrique; Rohde, Luis A.

    2010-01-01

    The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD).…

  8. Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents.

    PubMed

    Bello, Nicholas T

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is "added on" to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. PMID:26170637

  9. Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents

    PubMed Central

    Bello, Nicholas T

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric illness in children and adolescents. Several stimulant medications, such as methylphenidate and amphetamine derivatives, are available to treat ADHD in pediatric patients. Nonstimulant medications are more preferred by some parents, other caregivers, and patients because they lack the abuse potential of stimulant medications. In the US, one available nonstimulant option is guanfacine extended release (XR). As a selective α2A adrenergic receptor, guanfacine acts on the central noradrenergic pathways and cortical noradrenergic targets to improve working memory and attention. The XR formulation of guanfacine, compared with the immediate-release formulation, is more effective for the long-term management of ADHD and is associated with fewer adverse effects. Available data also indicate that guanfacine XR is superior to atomoxetine and is as effective as the nonselective α2 adrenergic receptor agonist, clonidine XR. The most common adverse effects associated with guanfacine XR are somnolence, fatigue, bradycardia, and hypotension. Somnolence is the most often cited reason for discontinuation. Guanfacine XR is also labeled for use as an adjuvant to stimulant treatment for ADHD. A similar profile of adverse effects as reported with monotherapy is reported when guanfacine XR is “added on” to stimulant therapy with somnolence as the most commonly reported adverse event. This review discusses the clinical efficacy and patient preference of guanfacine XR based on available published data on the safety, relative effectiveness, and tolerance of this medication to treat ADHD. PMID:26170637

  10. “I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD

    PubMed Central

    Mitchell, John T.; Sweitzer, Maggie M.; Tunno, Angela M.; Kollins, Scott H.; McClernon, F. Joseph

    2016-01-01

    Background Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources. Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as threads, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis. Methods A total of 268 separate forum threads were identified. Twenty percent (20%) were randomly selected, which yielded 55 separate forum threads (mean number of individual posts per forum thread = 17.53) scored by three raters (Cohen’s kappa = 0.74). A final sample of 401 posts in these forum threads received at least one endorsement on predetermined topics following qualitative coding procedures. Results Twenty-five (25%) percent of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other (non-ADHD) psychiatric conditions, or overall domains of daily life. Additional themes emerged (e.g., cannabis being considered sanctioned by healthcare providers). Conclusions Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD—this is the first study to identify such a trend. This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care

  11. Untreated ADHD in Adults: Are There Sex Differences in Symptoms, Comorbidity, and Impairment?

    ERIC Educational Resources Information Center

    Rasmussen, Kirsten; Levander, Sten

    2009-01-01

    Objective: To analyze sex differences among adult, never-treated patients referred for central stimulant treatment of ADHD. Method: Data for 600 consecutive patients from northern Norway referred for evaluation by an expert team during 7 years were analyzed. General background information, diagnostic and social history, and symptom profiles were…

  12. Towards an ICF core set for ADHD: a worldwide expert survey on ability and disability.

    PubMed

    de Schipper, Elles; Mahdi, Soheil; Coghill, David; de Vries, Petrus J; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Almodayfer, Omar; Rohde, Luis; Tannock, Rosemary; Bölte, Sven

    2015-12-01

    This is the second in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF and Children and Youth version, ICF-CY) core sets for attention deficit hyperactivity disorder (ADHD). The objective of this stage was to gather the opinions from international experts on which ability and disability concepts were considered relevant to functioning in ADHD. An email-based survey was carried out amongst international experts in ADHD. Relevant functional ability and disability concepts were extracted from their responses and linked to the ICF/-CY categories by two independent researchers using a standardised linking procedure. 174 experts from 11 different disciplines and 45 different countries completed the survey. Meaningful concepts identified in their responses were linked to 185 ICF/-CY categories. Of these, 83 categories were identified by at least 5 % of the experts and considered the most relevant to ADHD: 30 of these were related to Body functions (most identified: attention functions, 85 %), 30 to Activities and Participation (most identified: school education, 52 %), 20 to Environmental factors (most identified: support from immediate family, 61 %), and 3 to Body structures (most identified: structure of brain, 83 %). Experts also provided their views on particular abilities related to ADHD, naming characteristics such as high-energy levels, flexibility and resiliency. Gender differences in the expression of ADHD identified by experts pertained mainly to females showing more internalising (e.g. anxiety, low self-esteem) and less externalising behaviours (e.g. hyperactivity), leading to a risk of late- and under-diagnosis in females. Results indicate that the impact of ADHD extends beyond the core symptom domains, into all areas of life and across the lifespan. The current study in combination with three additional preparatory studies (comprehensive scoping review, focus groups, clinical study

  13. Justice and rejection sensitivity in children and adolescents with ADHD symptoms.

    PubMed

    Bondü, Rebecca; Esser, Günter

    2015-02-01

    Justice sensitivity captures individual differences in the frequency with which injustice is perceived and the intensity of emotional, cognitive, and behavioral reactions to it. Persons with ADHD have been reported to show high justice sensitivity, and a recent study provided evidence for this notion in an adult sample. In 1,235 German 10-to 19-year olds, we measured ADHD symptoms, justice sensitivity from the victim, observer, and perpetrator perspective, the frequency of perceptions of injustice, anxious and angry rejection sensitivity, depressive symptoms, conduct problems, and self-esteem. Participants with ADHD symptoms reported significantly higher victim justice sensitivity, more perceptions of injustice, and higher anxious and angry rejection sensitivity, but significantly lower perpetrator justice sensitivity than controls. In latent path analyses, justice sensitivity as well as rejection sensitivity partially mediated the link between ADHD symptoms and comorbid problems when considered simultaneously. Thus, both justice sensitivity and rejection sensitivity may contribute to explaining the emergence and maintenance of problems typically associated with ADHD symptoms, and should therefore be considered in ADHD therapy. PMID:24878677

  14. Health, Dietary Habits, and Achievement Motivation in College Students with Self-Reported ADHD Diagnosis.

    PubMed

    Merkt, Julia; Gawrilow, Caterina

    2014-02-19

    Objective: The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD. Method: Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation. Results: College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis. Conclusion: College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24554297

  15. Attention Deficit Hyper Activity Disorder (ADHD) and Stress: A Mutual Relationship between Children and Mothers

    PubMed Central

    Samiei, Mercedeh; Daneshmand, Reza; Keramatfar, Rasul; Khooshabi, Katayoon; Amiri, Nasrin; Farhadi, Yadollah; Farzadfard, Seyedeh Zeinab; Kachooi, Hamid; Samadi, Roya

    2015-01-01

    Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by high levels of inattention, hyperactivity and impulsivity which may result in mothers' stress. The current study aims to compare stress among 45 mothers of ADHD children who had referred to “Rofeydeh psychiatric center” with 45 mothers of normal children. Methods: Brief demographic researcher-made questionnaire, Child Symptom Inventory-4 (CSI-4), the Child Behavior Checklist (CBCL), and Parental Stress Index-Short Form (PSI/SF) were completed for each mother and child. Results: The results showed that except the component of acceptance, ADHD children had more problems in the field of attention compared with normal children. Mothers of ADHD children had also more stress compared with mothers of normal children. Discussion: ADHD can impair mothers' mental health by inducing stress and this issue has important clinical and treatment implications. Specific treatment programs should be designed and implemented in Iran for the mothers of ADHD children to reduce stress among them and therefore, improve their mental health status. PMID:27307956

  16. A lack of default network suppression is linked to increased distractibility in ADHD

    PubMed Central

    Fassbender, Catherine; Zhang, Hao; Buzy, Wendy M.; Cortes, Carlos R.; Mizuiri, Danielle; Beckett, Laurel; Schweitzer, Julie B.

    2015-01-01

    Heightened distractibility in participants with ADHD as indexed by increased reaction time (RT) variability has been hypothesized to be due to a failure to sufficiently suppress activation in the default attention network during cognitively demanding situations. The present study utilized fMRI to examine the relationship between intra-individual variability (IIV) in task RT and suppression of BOLD response in regions of the default network, using a working memory paradigm and two levels of control tasks. IIV was calculated separately for thirteen healthy control and twelve children with ADHD, Combined Type. Children with ADHD displayed significantly more RT variability than controls. Neural measures showed that although both groups displayed a pattern of increasing deactivation of the medial prefrontal cortex (PFC) with increasing task difficulty, the ADHD group was significantly less deactive than controls. Correlations between IIV and brain activation suggested that greater variability was associated with a failure to deactivate ventromedial PFC with increasing task difficulty. T-tests on brain activation between participants with ADHD with low versus high IIV implicated a similar region so that high variability was associated with greater activity in this region. These data provide support for the theory that increased distractibility in at least some participants with ADHD may be due to an inability to sufficiently suppress activity in the default attention network in response to increasing task difficulty. PMID:19281801

  17. High mobility group A1 expression shows negative correlation with recurrence time in patients with glioblastoma multiforme.

    PubMed

    Liu, Bin; Pang, Bo; Liu, Huajie; Arakawa, Yoshiki; Zhang, Rui; Feng, Bin; Zhong, Peng; Murata, Daiki; Fan, Haitao; Xin, Tao; Zhao, Guangyu; Liu, Wei; Guo, Hua; Luan, Liming; Xu, Shangchen; Miyamoto, Susumu; Pang, Qi

    2015-08-01

    The aim of this study was to explore the difference in high mobility group A1 (HMGA1) expression and isocitrate dehydrogenase (IDH) 1 R132H point mutation in initial and recurrent glioblastoma multiforme (GBM), and to further identify whether the expression of HMGA1 has a role in the malignant progression of GBM. Paired initial and recurrent GBM specimens from the same patient were evaluated using immunohistochemical analysis. The association between HMGA1 expression and progression-free survival time (PFST) was analyzed. Three patients were confirmed with IDH-1 R132H mutations in both initial and recurrent groups (3/25, 12%). There was a significant difference in HMGA1 expression between initial and recurrent GBM (P=0.002), and patients with tumors expressing HMGA1 at higher level had a significantly shorter PFST (7.3 months versus 11.1months; P=0.044). Our study indicates that recurrent GBM express HMGA1 at a higher level and that HMGA1 overexpressoin is associated with shorter PFST in patients with GBM. These findings suggest that HMGA1 potentially plays an important role in the treatment of GBM. PMID:26092597

  18. Hospitals In ‘Magnet’ Program Show Better Patient Outcomes On Mortality Measures Compared To Non-‘Magnet’ Hospitals

    PubMed Central

    Friese, Christopher R.; Xia, Rong; Ghaferi, Amir A.; Birkmeyer, John D.; Banerjee, Mousumi

    2015-01-01

    Hospital executives pursue external recognition to improve market share and demonstrate institutional commitment to quality of care. The Magnet Recognition Program of the American Nurses Credentialing Center identifies hospitals that epitomize nursing excellence, but it is not clear that receiving Magnet recognition improves patient outcomes. Using Medicare data on patients hospitalized for coronary artery bypass graft surgery, colectomy, or lower extremity bypass in 1998–2010, we compared rates of risk-adjusted thirty-day mortality and failure to rescue (death after a postoperative complication) between Magnet hospitals and non-Magnet hospitals matched on hospital characteristics. Surgical patients treated in Magnet hospitals, compared to those treated in non-Magnet hospitals, were 7.7 percent less likely to die within thirty days and 8.6 percent less likely to die after a postoperative complication. Across the thirteen–year study period, patient outcomes were significantly better in Magnet hospitals than in non-Magnet hospitals. However, outcomes did not improve for hospitals after they received Magnet recognition, which suggests that the Magnet program recognizes existing excellence and does not lead to additional improvements in surgical outcomes. PMID:26056204

  19. Mutation analysis in Duchenne and Becker muscular dystrophy patients from Bulgaria shows a peculiar distribution of breakpoints by intron

    SciTech Connect

    Todorova, A.; Bronzova, J.; Kremensky, I.

    1996-10-02

    For the first time in Bulgaria, a deletion/duplication screening was performed on a group of 84 unrelated Duchenne/Becker muscular dystrophy patients, and the breakpoint distribution in the dystrophin gene was analyzed. Intragenic deletions were detected in 67.8% of patients, and intragenic duplications in 2.4%. A peculiar distribution of deletion breakpoints was found. Only 13.2% of the deletion breakpoints fell in the {open_quotes}classical{close_quotes} hot spot in intron 44, whereas the majority (> 54%) were located within the segment encompassing introns 45-51, which includes intron 50, the richest in breakpoints (16%) in the Bulgarian sample. Comparison with data from Greece and Turkey points at the probable existence of a deletion hot spot within intron 50, which might be a characteristic of populations of the Balkan region. 17 refs., 2 figs.

  20. IBS Patients Show Frequent Fluctuations between Loose/Watery and Hard/Lumpy Stools: Implications for Treatment

    PubMed Central

    Palsson, Olafur S.; Baggish, Jeffrey S.; Turner, Marsha J.; Whitehead, William E.

    2013-01-01

    Aims To determine how variable stool consistency is in patients with irritable bowel (IBS) and assess the relationship between stool consistency and gastrointestinal symptoms. Methods Individuals with a physician diagnosis of IBS were recruited by advertisement. Enrollment questionnaires included the Rome III Diagnostic Questionnaire and IBS Symptom Severity Scale. Then 185 patients meeting Rome criteria for IBS rated the consistency (using the Bristol Stool Scale) of each bowel movement (BM) for 90 days and whether the BM was accompanied by pain, urgency, or soiling. Each night they transferred BM ratings from a paper diary to an internet form and also reported the average daily intensity of abdominal pain, bloating, bowel habit dissatisfaction, and life interference of bowel symptoms. Only the longest sequence of consecutive days of diary data was used in analysis (average of 73 days). Results Patients were 89% female with average age 36.6 years. 78% had both loose/watery and hard/lumpy stools; the average was 3 fluctuations between these extremes per month. The proportion of loose/watery stools correlated r=.78 between the first and second months and the proportion of hard/lumpy stools correlated r=.85 between months. Loose/watery stools were associated with more BM-related pain, urgency, and soiling than hard/lumpy or normal stools; however, IBS-C patients had significantly more BM-unrelated abdominal pain, bloating, dissatisfaction with bowel habits, and life interference than IBS-D. Questionnaires overestimated the frequency of abnormal stool consistency and gastrointestinal symptoms compared to diaries. Conclusions Stool consistency varies greatly within individuals. However, stool patterns are stable within an individual from month to month. The paradoxical findings of greater symptom severity after individual loose/watery BMs vs. greater overall symptom severity in IBS-C implies different physiological mechanisms for symptoms in constipation compared to

  1. Single-trial fMRI Shows Contralesional Activity Linked to Overt Naming Errors in Chronic Aphasic Patients

    PubMed Central

    Postman-Caucheteux, Whitney Anne; Birn, Rasmus M.; Pursley, Randall H.; Butman, John A.; Solomon, Jeffrey M.; Picchioni, Dante; McArdle, Joe; Braun, Allen R.

    2016-01-01

    We used fMRI to investigate the roles played by perilesional and contralesional cortical regions during language production in stroke patients with chronic aphasia. We applied comprehensive psycholinguistic analyses based on well-established models of lexical access to overt picture-naming responses, which were evaluated using a single trial design that permitted distinction between correct and incorrect responses on a trial-by-trial basis. Although both correct and incorrect naming responses were associated with left-sided perilesional activation, incorrect responses were selectively associated with robust right-sided contralesional activity. Most notably, incorrect responses elicited overactivation in the right inferior frontal gyrus that was not observed in the contrasts for patients’ correct responses or for responses of age-matched control subjects. Errors were produced at slightly later onsets than accurate responses and comprised predominantly semantic paraphasias and omissions. Both types of errors were induced by pictures with greater numbers of alternative names, and omissions were also induced by pictures with late acquired names. These two factors, number of alternative names per picture and age of acquisition, were positively correlated with activation in left and right inferior frontal gyri in patients as well as control subjects. These results support the hypothesis that some right frontal activation may normally be associated with increasing naming difficulty, but in patients with aphasia, right frontal overactivation may reflect ineffective effort when left hemisphere perilesional resources are insufficient. They also suggest that contralesional areas continue to play a role—dysfunctional rather than compensatory—in chronic aphasic patients who have experienced a significant degree of recovery. PMID:19413476

  2. Efficacy of Muscle Exercise in Patients with Muscular Dystrophy: A Systematic Review Showing a Missed Opportunity to Improve Outcomes

    PubMed Central

    Gianola, Silvia; Pecoraro, Valentina; Lambiase, Simone; Gatti, Roberto; Banfi, Giuseppe; Moja, Lorenzo

    2013-01-01

    Background Although muscular dystrophy causes muscle weakness and muscle loss, the role of exercise in the management of this disease remains controversial. Objective The purpose of this systematic review is to evaluate the role of exercise interventions on muscle strength in patients with muscular dystrophy. Methods We performed systematic electronic searches in Medline, Embase, Web of Science, Scopus and Pedro as well as a list of reference literature. We included trials assessing muscle exercise in patients with muscular dystrophy. Two reviewers independently abstracted data and appraised risk of bias. Results We identified five small (two controlled and three randomized clinical) trials comprising 242 patients and two ongoing randomized controlled trials. We were able to perform two meta-analyses. We found an absence of evidence for a difference in muscle strength (MD 4.18, 95% CIs - 2.03 to 10.39; p = 0.91) and in endurance (MD −0.53, 95% CIs –1.11 to 0.05; p = 0.26). In both, the direction of effects favored muscle exercise. Conclusions The first included trial about the efficacy of muscular exercise was published in 1978. Even though some benefits of muscle exercise were consistently reported across studies, the benefits might be due to the small size of studies and other biases. Detrimental effects are still possible. After several decades of research, doctors cannot give advice and patients are, thus, denied basic information. A multi-center randomized trial investigating the strength of muscles, fatigue, and functional limitations is needed. PMID:23894268

  3. Horizon's patient-centered medical home program shows practices need much more than payment changes to transform.

    PubMed

    Patel, Urvashi B; Rathjen, Carl; Rubin, Elizabeth

    2012-09-01

    Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs. PMID:22949451

  4. What can ADHD without comorbidity teach us about comorbidity?

    PubMed

    Takeda, Toshinobu; Ambrosini, Paul J; deBerardinis, Rachel; Elia, Josephine

    2012-01-01

    Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age, gender, IQ, SES and ADHD symptoms were compared among ADHD comorbid free subjects and ADHD with internalizing and externalizing disorders. Logistic regression analyses were also carried out to investigate the relationship between comorbidity and parental psychiatric status. Age range was younger in the ADHD without comorbidity and older in ADHD+internalizing disorders. No significant difference in IQ or SES was found among ADHD comorbid and comorbid-free groups. ADHD with internalizing disorder has a significantly greater association with paternal psychiatric conditions. After matching by age, gender, IQ and SES, ADHD with externalizing disorders had significantly higher total ADHD, hyperactivity/impulsivity score and single item score of difficulty awaiting turn than ADHD without comorbidity and ADHD with internalizing disorders. Older age ranges, ADHD symptom severity and parental psychopathology may be risk factors for comorbidity. PMID:22119689

  5. Symbolic dynamics of heart rate variability - a promising tool to investigate cardiac sympathovagal control in attention deficit/hyperactivity disorder (ADHD)?

    PubMed

    Tonhajzerova, Ingrid; Farsky, Ivan; Mestanik, Michal; Visnovcova, Zuzana; Mestanikova, Andrea; Hrtanek, Igor; Ondrejka, Igor

    2016-06-01

    We aimed to evaluate complex cardiac sympathovagal control in attention deficit/hyperactivity disorder (ADHD) by using heart rate variability (HRV) nonlinear analysis - symbolic dynamics. We examined 29 boys with untreated ADHD and 25 healthy boys (age 8-13 years). ADHD symptoms were evaluated by ADHD-RS-IV scale. ECG was recorded in 3 positions: baseline supine position, orthostasis, and clinostasis. Symbolic dynamics indices were used for the assessment of complex cardiac sympathovagal regulation: normalised complexity index (NCI), normalised unpredictability index (NUPI), and pattern classification measures (0V%, 1V%, 2LV%, 2UV%). The results showed that HRV complexity was significantly reduced at rest (NUPI) and during standing position (NCI, NUPI) in ADHD group compared to controls. Cardiac-linked sympathetic index 0V% was significantly higher during all posture positions and cardiovagal index 2LV% was significantly lower to standing in boys suffering from ADHD. Importantly, ADHD symptom inattention positively correlated with 0V%, and negatively correlated with NCI, NUPI. Concluding, symbolic dynamics revealed impaired complex neurocardiac control characterised by potential cardiac beta-adrenergic overactivity and vagal deficiency at rest and to posture changes in boys suffering from ADHD that is correlated with inattention. We suggest that symbolic dynamics indices could represent promising cardiac biomarkers in ADHD. PMID:26963175

  6. Are There Executive Dysfunction Subtypes Within ADHD?

    PubMed

    Roberts, Bethan A; Martel, Michelle M; Nigg, Joel T

    2013-11-01

    Objective: Children with ADHD have heterogeneous behavioral and neuropsychological profiles. The aim of this study was to examine the possible utility of executive function (EF) subtypes within ADHD. Method: Participants were 357 children aged 6 through 13 with a diagnosis of ADHD. Children completed a brief laboratory battery measuring EF, including response inhibition, response variability, speed, and set-shifting. Children also completed standardized intelligence and achievement testing. Results: Two-way cluster analysis of EF profiles of children with ADHD produced a three-cluster solution, labeled poor inhibitory control, poor set-shifting/speed, and intact task performance. Clusters significantly differed in measures of intelligence, academic achievement, and other disruptive behavior and anxiety/mood symptoms. Conclusion: These findings further support the idea that children with ADHD have heterogeneous EF profiles and suggest that the theory of ADHD should consider these individual differences in EF profiles within the ADHD diagnostic category. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24214969

  7. Global consensus on ADHD/HKD.

    PubMed

    Remschmidt, Helmut

    2005-05-01

    A Global ADHD Working Group of experienced clinicians and researchers was gathered to review the latest evidence, discuss current best practice in the treatment of attention-deficit/hyperactivity disorder (ADHD), and make a statement based on consensus. The statement aims to re-affirm ADHD as a valid disorder that exists across different cultures, has a significant global impact, and should be diagnosed and effectively treated wherever it occurs. ADHD is one of the most common neurobehavioural disorders of childhood and impacts on many aspects of development, including social, emotional and cognitive functioning, in the home and school environment. Although these findings are from developed countries, the impact in developing countries is likely to be similar. There is strong supportive evidence for the validity of ADHD as a syndrome with neurobiological aspects, and complex genetic factors are primarily implicated in the aetiology. Accurate diagnosis and measurement of impairment is important to enable appropriate and successful management of symptoms. ADHD is a persistent condition that needs to be treated and monitored over time. The evidence supporting medication-based interventions (such as methylphenidate) is strong and consensus treatment algorithms to guide the multimodal treatment of ADHD, alone and in combination with common comorbidities, are suggested. PMID:15959658

  8. Gambling behaviors and psychopathology related to Attention-Deficit/Hyperactivity Disorder (ADHD) in problem and non-problem adult gamblers.

    PubMed

    Fatseas, Melina; Alexandre, Jean-Marc; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Guilleux, Alice; Groupe Jeu; Challet-Bouju, Gaëlle; Grall-Bronnec, Marie

    2016-05-30

    Previous studies showed that Pathological Gambling and Attention Deficit/Hyperactivity Disorder (ADHD) often co-occur. The aim of this study was to examine whether ADHD is associated with specific severity patterns in terms of gambling behavior, psychopathology and personality traits. 599 problem and non-problem-gamblers were recruited in addiction clinics and gambling places in France. Subjects were assessed with the Wender-Utah Rating Scale-Child, the Adult ADHD Self-Report Scale, the Mini International Neuropsychiatric Interview, the Temperament and Character Inventory, the South Oaks Gambling Screen and questionnaires assessing gambling related cognitive distortions and gambling habits. 20.7% (n=124) of gamblers were screened positive for lifetime or current ADHD. Results from the multivariate analysis showed that ADHD was associated with a higher severity of gambling-related problems and with more psychiatric comorbidity. Among problem gamblers, subjects with history of ADHD were also at higher risk for unemployment, psychiatric comorbidity and specific dysfunctional personality traits. This study supports the link between gambling related problems and ADHD in a large sample of problem and non-problem gamblers, including problem-gamblers not seeking treatment. This points out the necessity to consider this disorder in the prevention and in the treatment of pathological gambling. PMID:27031593

  9. Perioperative dexamethasone administration in tonsillectomy patients: A three-cycle audit showing improvement using printed theatre lists.

    PubMed

    Bola, Summy; Bartlett, Annie; Williams, Richard

    2015-01-01

    Dexamethasone administration prior to tonsillectomy has been shown to reduce morbidity and is part of SIGN guideline 117. We conducted a three-cycle audit of 149 patients to ascertain how well guidelines were being met and introduce a sustainable method to improve compliance. A 3-month audit was conducted to ascertain how many tonsillectomy patients didn't receive pre-operative dexamethasone. ENT secretaries were requested to add 'Dex Please' to tonsillectomy theatre lists. A 3-month re-audit was conducted; the intervention was only implemented in half of cases and so a reminding tool for the secretarial staff was administered before a third cycle. Initially, there was 73% compliance to SIGN guidelines, this improved to 87% in the second cycle. After the second intervention, all tonsillectomy theatre lists had the 'Dex Please' note and compliance to SIGN guidelines was 100%. There were five readmissions in the first cycle, three in the second and two in the third cycle. All readmissions were underdosed according to guidelines. Understanding there are regular staff rotations throughout many U.K. hospitals, we implemented a reliable method to increase compliance to guidelines which helped reduce post-operative readmission after tonsillectomy. This can be easily introduced to other institutions and for other perioperative requirements. PMID:26734456

  10. EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials

    PubMed Central

    Micoulaud-Franchi, Jean-Arthur; Geoffroy, Pierre Alexis; Fond, Guillaume; Lopez, Régis; Bioulac, Stéphanie; Philip, Pierre

    2014-01-01

    Objective: We undertook a meta-analysis of published Randomized Controlled Trials (RCT) with semi-active control and sham-NF groups to determine whether Electroencephalogram-neurofeedback (EEG-NF) significantly improves the overall symptoms, inattention and hyperactivity/impulsivity dimensions for probably unblinded assessment (parent assessment) and probably blinded assessment (teacher assessment) in children with Attention Deficit Hyperactivity Disorder (ADHD). Data sources: A systematic review identified independent studies that were eligible for inclusion in a random effects meta-analysis. Data extraction: Effect sizes for ADHD symptoms were expressed as standardized mean differences (SMD) with 95% confidence intervals. Results: Five identified studies met eligibility criteria, 263 patients with ADHD were included, 146 patients were trained with EEG-NF. On parent assessment (probably unblinded assessment), the overall ADHD score (SMD = −0.49 [−0.74, −0.24]), the inattention score (SMD = −0.46 [−0.76, −0.15]) and the hyperactivity/impulsivity score (SMD = −0.34 [−0.59, −0.09]) were significantly improved in patients receiving EEG-NF compared to controls. On teacher assessment (probably blinded assessment), only the inattention score was significantly improved in patients receiving EEG-NF compared to controls (SMD = −0.30 [−0.58, −0.03]). Conclusions: This meta-analysis of EEG-NF in children with ADHD highlights improvement in the inattention dimension of ADHD symptoms. Future investigations should pay greater attention to adequately blinded studies and EEG-NF protocols that carefully control the implementation and embedding of training. PMID:25431555

  11. Effect of Backward Walking on Attention: Possible Application on ADHD

    PubMed Central

    Viggiano, Davide; Travaglio, Michele; Cacciola, Giovanna; Di Costanzo, Alfonso

    2015-01-01

    The human requires attentive effort as assessed in dual-task experiments. Consistently, an attentive task can modify the walking pattern and a attention deficit and hyperactivity disorder (ADHD) is accompanied by gait modifications. Here we investigated the relationships between backward walking and attentive performances in ADHD children (n=13) and healthy age-, height and weight matched controls (n=17). We evaluated the attentive/impulsive profile by means of a Go/No-Go task and the backward and forward gait parameters by step length, cadence and Froude number. Moreover, to test the causal relationship between attention and gait parameters, we trained children to walk backward. The training program consisted of 10 min backward walking session, thrice a week for two months. Results showed a significant negative correlation between Froude number during backward walking and reaction time in the Go/No-Go test. Besides, after training with backward walking control children increased their cadence by 9.3% and their Froude number by 17% during backward walking. Conversely, ADHD children did not modify their walking parameters after training, and showed a significant reduction in their number of errors in the Go/No-Go task (−49%) compared to the score before the training. These data suggest that specific physical training with attention-demanding tasks may improve attentive performance. PMID:25674550

  12. Effect of backward walking on attention: possible application on ADHD.

    PubMed

    Viggiano, Davide; Travaglio, Michele; Cacciola, Giovanna; Di Costanzo, Alfonso

    2015-01-01

    The human requires attentive effort as assessed in dual-task experiments. Consistently, an attentive task can modify the walking pattern and a attention deficit and hyperactivity disorder (ADHD) is accompanied by gait modifications. Here we investigated the relationships between backward walking and attentive performances in ADHD children (n=13) and healthy age-, height and weight matched controls (n=17). We evaluated the attentive/impulsive profile by means of a Go/No-Go task and the backward and forward gait parameters by step length, cadence and Froude number. Moreover, to test the causal relationship between attention and gait parameters, we trained children to walk backward. The training program consisted of 10 min backward walking session, thrice a week for two months. Results showed a significant negative correlation between Froude number during backward walking and reaction time in the Go/No-Go test. Besides, after training with backward walking control children increased their cadence by 9.3% and their Froude number by 17% during backward walking. Conversely, ADHD children did not modify their walking parameters after training, and showed a significant reduction in their number of errors in the Go/No-Go task (-49%) compared to the score before the training. These data suggest that specific physical training with attention-demanding tasks may improve attentive performance. PMID:25674550

  13. Summer treatment programs for youth with ADHD.

    PubMed

    Fabiano, Gregory A; Schatz, Nicole K; Pelham, William E

    2014-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) require intensive treatments to remediate functional impairments and promote the development of adaptive skills. The summer treatment program (STP) is an exemplar of intensive treatment of ADHD. STP intervention components include a reward and response-cost point system, time-out, use of antecedent control (clear commands, establishment of rules and routines), and liberal praise and rewards for appropriate behavior. Parents also participate in parent management training programming to learn how to implement similar procedures within the home setting. There is strong evidence supporting the efficacy of the STP as an intervention for ADHD. PMID:25220085

  14. "The Show"

    ERIC Educational Resources Information Center

    Gehring, John

    2004-01-01

    For the past 16 years, the blue-collar city of Huntington, West Virginia, has rolled out the red carpet to welcome young wrestlers and their families as old friends. They have come to town chasing the same dream for a spot in what many of them call "The Show". For three days, under the lights of an arena packed with 5,000 fans, the state's best…

  15. In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps

    PubMed Central

    Das, Jishnu; Holla, Alaka; Das, Veena; Mohanan, Manoj; Tabak, Diana; Chan, Brian

    2013-01-01

    This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers. We found low overall levels of medical training among health care providers; in rural Madhya Pradesh, for example, 67 percent of health care providers who were sampled reported no medical qualifications at all. What’s more, we found only small differences between trained and untrained doctors in such areas as adherence to clinical checklists. Correct diagnoses were rare, incorrect treatments were widely prescribed, and adherence to clinical checklists was higher in private than in public clinics. Our results suggest an urgent need to measure the quality of health care services systematically and to improve the quality of medical education and continuing education programs, among other policy changes. PMID:23213162

  16. Topological organization of the “small-world” visual attention network in children with attention deficit/hyperactivity disorder (ADHD)

    PubMed Central

    Xia, Shugao; Foxe, John J.; Sroubek, Ariane E.; Branch, Craig; Li, Xiaobo

    2013-01-01

    Background: Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed childhood psychiatric disorder. Disrupted sustained attention is one of the most significant behavioral impairments in this disorder. We mapped systems-level topological properties of the neural network responsible for sustained attention during a visual sustained task, on the premise that strong associations between anomalies in network features and clinical measures of ADHD would emerge. Methods: Graph theoretic techniques (GTT) and bivariate network-based statistics (NBS) were applied to fMRI data from 22 children with ADHD combined-type and 22 age-matched neurotypicals, to evaluate the topological and nodal-pairing features in the functional brain networks. Correlation testing for relationships between network properties and clinical measures were then performed. Results: The visual attention network showed significantly reduced local-efficiency and nodal-efficiency in frontal and occipital regions in ADHD. Measures of degree and between-centrality pointed to hyper-functioning in anterior cingulate cortex and hypo-functioning in orbito-frontal, middle-occipital, superior-temporal, supra-central, and supra-marginal gyri in ADHD. NBS demonstrated significantly reduced pair-wise connectivity in an inner-network, encompassing right parietal and temporal lobes and left occipital lobe, in the ADHD group. Conclusions: These data suggest that atypical topological features of the visual attention network contribute to classic ADHD symptomatology, and may underlie the inattentiveness and hyperactivity/impulsivity that are characteristics of this syndrome. PMID:24688465

  17. Abnormal Parietal Brain Function in ADHD: Replication and Extension of Previous EEG Beta Asymmetry Findings

    PubMed Central

    Hale, T. Sigi; Kane, Andrea M.; Tung, Kelly L.; Kaminsky, Olivia; McGough, James J.; Hanada, Grant; Loo, Sandra K.

    2014-01-01

    Background: Abundant work indicates ADHD abnormal posterior brain structure and function, including abnormal structural and functional asymmetries and reduced corpus callosum size. However, this literature has attracted considerably less research interest than fronto-striatal findings. Objective: To help address this imbalance, the current study replicates and extends our previous work showing abnormal parietal brain function in ADHD adults during the Conner’s Continuous Performance Test (CPT). Method: Our previous study found that ADHD adults had increased rightward EEG beta (16–21 Hz) asymmetry in inferior parietal brain regions during the CPT (p = 0.00001), and that this metric exhibited a lack of normal correlation (i.e., observed in controls) with beta asymmetry at temporal–parietal regions. We re-tested these effects in a new ADHD sample and with both new and old samples combined. We additionally examined: (a) EEG asymmetry in multiple frequency bands, (b) unilateral effects for all asymmetry findings, and (c) the association between EEG asymmetry and a battery of cognitive tests. Results: We replicated our original findings by demonstrating abnormal rightward inferior parietal beta asymmetry in adults with ADHD during the CPT, and again this metric exhibited abnormal reduced correlation to temporal–parietal beta asymmetry. Novel analyses also demonstrated a broader pattern of rightward beta and theta asymmetry across inferior, superior, and temporal–parietal brain regions, and showed that rightward parietal asymmetry in ADHD was atypically associated with multiple cognitive tests. Conclusion: Abnormal increased rightward parietal EEG beta asymmetry is an important feature of ADHD. We speculate that this phenotype may occur with any form of impaired capacity for top-down task-directed control over sensory encoding functions, and that it may reflect associated increase of attentional shifting and compensatory sustained/selective attention. PMID

  18. Steroid-dependent sensorineural hearing loss in a patient with Charcot-Marie-Tooth disease showing auditory neuropathy.

    PubMed

    Maeda, Yukihide; Kataoka, Yuko; Sugaya, Akiko; Kariya, Shin; Kobayashi, Katsuhiro; Nishizaki, Kazunori

    2015-06-01

    Charcot-Marie-Tooth disease (CMT) is the most common form of hereditary sensorimotor neuropathy and sometimes involves disorders of the peripheral auditory system. We present a case of steroid-dependent auditory neuropathy associated with CMT, in which the patient experienced 3 episodes of acute exacerbation of hearing loss and successful rescue of hearing by prednisolone. An 8-year-old boy was referred to the otolaryngology department at the University Hospital. He had been diagnosed with CMT type 1 (demyelinating type) at the Child Neurology Department and was suffering from mild hearing loss due to auditory neuropathy. An audiological diagnosis of auditory neuropathy was confirmed by auditory brainstem response and distortion-product otoacoustic emissions. At 9 years and 0 months old, 9 years and 2 months old, and 10 years and 0 months old, he had experienced acute exacerbations of hearing loss, each of which was successfully rescued by intravenous or oral prednisolone within 2 weeks. Steroid-responsive cases of CMT have been reported, but this is the first case report of steroid-responsive sensorineural hearing loss in CMT. The present case may have implications for the mechanisms of action of glucocorticoids in the treatment of sensorineural hearing loss. PMID:25440412

  19. First evidence of HERV-H transcriptional activity reduction after methylphenidate treatment in a young boy with ADHD.

    PubMed

    D'Agati, Elisa; Pitzianti, Mariabernarda; Balestrieri, Emanuela; Matteucci, Claudia; Sinibaldi Vallebona, Paola; Pasini, Augusto

    2016-09-01

    Human endogenous retroviruses (HERVs) have been associated with many complex diseases including neuropsychiatric diseases, such as attention deficit hyperactivity disorder (ADHD). In ADHD an over-expression of HERV-H family in peripheral blood mononuclear cells has been documented. It has been hypothesized that HERVs may represent the link between genetic and environmental risk factors, contributing to the clinical onset and/or to the progression of the neurodevelopmental disease. The effect of pharmacological treatment on HERV transcriptional activity in psychiatric disorders has been attracting attention. Using a real-time RT-PCR we investigated the influence of methylphenidate on HERV transcription in peripheral blood mononuclear cells of a young patient with ADHD. In this clinical case we describe for the first time the reduction of HERV-H expression and the significant improvement of ADHD symptoms after 6 months of methylphenidate treatment. PMID:27602426

  20. Qualitative Treatment-Subgroup Interactions in a Randomized Clinical Trial of Treatments for Adolescents with ADHD: Exploring What Cognitive-Behavioral Treatment Works for Whom

    PubMed Central

    Geurts, Hilde M.; Prins, Pier J. M.; Van Mechelen, Iven; Van der Oord, Saskia

    2016-01-01

    Objective This study explored qualitative treatment-subgroup interactions within data of a RCT with two cognitive behavioral treatments (CBT) for adolescents with ADHD: a planning-focused (PML) and a solution-focused CBT (SFT). Qualitative interactions imply that which treatment is best differs across subgroups of patients, and are therefore most relevant for personalized medicine. Methods Adolescents with ADHD (N = 159) received either PML or SFT. Pre-, post- and three-month follow-up data were gathered on parent-rated ADHD symptoms and planning problems. Pretreatment characteristics were explored as potential qualitative moderators of pretest to follow-up treatment effects, using an innovative analyses technique (QUINT; Dusseldorp & Van Mechelen, 2014). In addition, qualitative treatment-subgroup interactions for the therapeutic changes from pre- to posttest and from post- to follow-up test were investigated. Results For the entire time span from pretest to follow-up only a quantitative interaction was found, while from posttest to follow-up qualitative interactions were found: Adolescents with less depressive symptoms but more anxiety symptoms showed more improvement when receiving PML than SFT, while for other adolescents the effects of PML and SFT were comparable. Discussion Whereas subgroups in both treatments followed different trajectories, no subgroup was found for which SFT outperformed PML in terms of the global change in symptoms from pretest to three months after treatment. This implies that, based on this exploratory study, there is no need for personalized treatment allocation with regard to the CBTs under study for adolescents with ADHD. However, for a subgroup with comorbid anxiety symptoms but low depression PML clearly appears the treatment of preference. Trial Registration Nederlands Trial Register NTR2142 PMID:26977602

  1. Characterization of Fibromyalgia Symptoms in Patients 55 to 95 Years Old: a Longitudinal Study Showing Symptom Persistence with Suboptimal Treatment

    PubMed Central

    Jacobson, Sandra A.; Simpson, Rachel G.; Lubahn, Cheri; Hu, Chengcheng; Belden, Christine M.; Davis, Kathryn J.; Nicholson, Lisa R.; Long, Kathy E.; Osredkar, Tracy; Lorton, Dianne

    2014-01-01

    BACKGROUND Fibromyalgia (FM) has been understudied in the elderly population, a group with particular vulnerabilities to pain, reduced mobility, and sleep disruption. AIMS To characterize FM symptoms and treatments in a cohort of older subjects examined over time to determine the extent to which current, community-based treatment for older FM patients is in accord with published guidelines, and effective in reducing symptoms. METHODS A longitudinal, observational study of 51 subjects with FM (range 55 to 95 years) and 81 control subjects (58 to 95 years) performed at Banner Sun Health Research Institute in Sun City, AZ. Serial history and examination data were obtained over a 6-year period. FM data included medical history, medications, physical examination, tender point examination, neuropsychological testing, sleep and pain ratings, the Physical Function Subscale of the Fibromyalgia Impact Questionnaire, and other standardized scales to evaluate depression and other psychiatric symptoms, and cognitive and functional impairment. RESULTS Pain and stiffness that interfered with physical activity, sleep, and mood were reported by 80% or more of subjects. Over time, pain involved an increasing number of body areas. Over half of subjects were treated with NSAIDs, one-quarter with opioids, and one-quarter with estrogen. Few were treated with dual-acting antidepressants or pregabalin. DISCUSSION In this cohort of elders with suboptimally treated FM, substantial persistence of symptoms was seen over time. In general, recommended treatments were either not used or not tolerated. CONCLUSIONS Age-appropriate treatments as well as education of primary care providers are needed to improve treatment of FM in the older population. PMID:24859821

  2. Managing the risks of ADHD treatments.

    PubMed

    Schneider, Benjamin N; Enenbach, Michael

    2014-10-01

    Pharmacotherapy of attention deficit-hyperactivity disorder (ADHD) is a well-established and effective treatment modality. However, ADHD medications are not without side effects. Understanding the prevalence of adverse events and effective management of risks associated with stimulants and other medications used to treat ADHD is central to broad applicability and effective treatment. This review discusses the literature on the prevalence of adverse events and management strategies employed. We searched online MEDLINE/PubMed and Cochrane databases for articles using several keywords relating to adverse events associated with ADHD medication management. We discuss the relevant data on the significance and prevalence of side effects and adverse events, highlight recent updates in the field, and suggest approaches to clinical management. PMID:25135779

  3. Future Directions in ADHD Etiology Research

    PubMed Central

    Nigg, Joel T.

    2015-01-01

    Reviews salient emerging themes in the scientific literature related to identifying etiology and pathophysiology of ADHD. While bypassing the need for new treatment research, the review highlights three themes. First, recognition of the epigenetic effects is expected to revitalize the search for and mapping of early environmental influences on the development of ADHD. Second, neurobiological findings will have limited impact if not examined in the context of significant race and cultural variation in ADHD-related developmental processes, and in the context of rapidly changing social and technological contexts of children’s development worldwide. Third, further examination of the phenotype and characterization of its dimensional and categorical structure remains a major need. Overall, the coming decades of etiology research on ADHD will be expected to capitalize on new scientific tools. The hope in the field is that new insights into fundamental prevention can emerge. PMID:22642834

  4. Risk of Tics with Psychostimulants for ADHD.

    PubMed

    Millichap, J Gordon

    2015-12-01

    Investigators at Yale University, New Haven, CT, conducted a meta-analysis to examine the risk of new onset or worsening of tics caused by psychostimulants used in the treatment of children with ADHD. PMID:26933551

  5. Focusing on ADHD - Attention Deficit Hyperactivity Disorder

    MedlinePlus

    ... on ADHD Health Capsules Genetic Sites Tied to Schizophrenia Helping Older Adults Talk With Their Doctors Featured ... and child mental health expert at NIH. “The diagnosis is made because the level of hyperactivity or ...

  6. Neurofeedback in ADHD and insomnia: vigilance stabilization through sleep spindles and circadian networks.

    PubMed

    Arns, Martijn; Kenemans, J Leon

    2014-07-01

    In this review article an overview of the history and current status of neurofeedback for the treatment of ADHD and insomnia is provided. Recent insights suggest a central role of circadian phase delay, resulting in sleep onset insomnia (SOI) in a sub-group of ADHD patients. Chronobiological treatments, such as melatonin and early morning bright light, affect the suprachiasmatic nucleus. This nucleus has been shown to project to the noradrenergic locus coeruleus (LC) thereby explaining the vigilance stabilizing effects of such treatments in ADHD. It is hypothesized that both Sensori-Motor Rhythm (SMR) and Slow-Cortical Potential (SCP) neurofeedback impact on the sleep spindle circuitry resulting in increased sleep spindle density, normalization of SOI and thereby affect the noradrenergic LC, resulting in vigilance stabilization. After SOI is normalized, improvements on ADHD symptoms will occur with a delayed onset of effect. Therefore, clinical trials investigating new treatments in ADHD should include assessments at follow-up as their primary endpoint rather than assessments at outtake. Furthermore, an implication requiring further study is that neurofeedback could be stopped when SOI is normalized, which might result in fewer sessions. PMID:23099283

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

    PubMed

    Mesquita, Cintia; Nazar, Bruno P; Pinna, Camilla M S; Rabelo, Beatriz; Serra-Pinheiro, Maria Antonia; Sergeant, Joseph; Mattos, Paulo

    2016-09-30

    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. PMID:27434202

  8. Correlation of a set of gene variants, life events and personality features on adult ADHD severity.

    PubMed

    Müller, Daniel J; Chiesa, Alberto; Mandelli, Laura; De Luca, Vincenzo; De Ronchi, Diana; Jain, Umesh; Serretti, Alessandro; Kennedy, James L

    2010-07-01

    Increasing evidence suggests that symptoms of attention deficit hyperactivity disorder (ADHD) could persist into adult life in a substantial proportion of cases. The aim of the present study was to investigate the impact of (1) adverse events, (2) personality traits and (3) genetic variants chosen on the basis of previous findings and (4) their possible interactions on adult ADHD severity. One hundred and ten individuals diagnosed with adult ADHD were evaluated for occurrence of adverse events in childhood and adulthood, and personality traits by the Temperament and Character Inventory (TCI). Common polymorphisms within a set of nine important candidate genes (SLC6A3, DBH, DRD4, DRD5, HTR2A, CHRNA7, BDNF, PRKG1 and TAAR9) were genotyped for each subject. Life events, personality traits and genetic variations were analyzed in relationship to severity of current symptoms, according to the Brown Attention Deficit Disorder Scale (BADDS). Genetic variations were not significantly associated with severity of ADHD symptoms. Life stressors displayed only a minor effect as compared to personality traits. Indeed, symptoms' severity was significantly correlated with the temperamental trait of Harm avoidance and the character trait of Self directedness. The results of the present work are in line with previous evidence of a significant correlation between some personality traits and adult ADHD. However, several limitations such as the small sample size and the exclusion of patients with other severe comorbid psychiatric disorders could have influenced the significance of present findings. PMID:20006992

  9. Skills training groups for men with ADHD in compulsory care due to substance use disorder: a feasibility study.

    PubMed

    Bihlar Muld, B; Jokinen, J; Bölte, S; Hirvikoski, T

    2016-09-01

    Dialectical behavior therapy (DBT)-based skills training has been developed and previously evaluated for adults with ADHD in a psychiatric outpatient context. The aim of the present study was to evaluate the feasibility of DBT-based skills training as a voluntary intervention for men with ADHD in compulsory care due to severe substance abuse. Forty sufficiently detoxified men with ADHD in compulsory care due to life-threatening substance use disorder (SUD) were included in DBT-based skills training groups. Self- and staff-rating scales were administered before and after the treatment. The refusal rate was 42.9 %. Of those who started the DBT-based skills training, 70 % completed the treatment (attendance at ≥75 % of the sessions). The treatment acceptability was good. Both ADHD and psychiatric symptoms decreased from pre- to post-intervention in self-ratings, but not in staff ratings. The patients reported improved general well-being. The correlation between self- and staff ratings was poor. Motivation for voluntary nonpharmacological treatment was low in a compulsory care context. However, the results indicate that a DBT-based skills training program for adults with ADHD may be feasible for some patients with ADHD in combination with SUD in compulsory care, provided that considerable resources are allocated with adjustments to the target group and compulsory care context. PMID:27059489

  10. iPSC-derived neurons from GBA1-associated Parkinson's disease patients show autophagic defects and impaired calcium homeostasis.

    PubMed

    Schöndorf, David C; Aureli, Massimo; McAllister, Fiona E; Hindley, Christopher J; Mayer, Florian; Schmid, Benjamin; Sardi, S Pablo; Valsecchi, Manuela; Hoffmann, Susanna; Schwarz, Lukas Kristoffer; Hedrich, Ulrike; Berg, Daniela; Shihabuddin, Lamya S; Hu, Jing; Pruszak, Jan; Gygi, Steven P; Sonnino, Sandro; Gasser, Thomas; Deleidi, Michela

    2014-01-01

    Mutations in the acid β-glucocerebrosidase (GBA1) gene, responsible for the lysosomal storage disorder Gaucher's disease (GD), are the strongest genetic risk factor for Parkinson's disease (PD) known to date. Here we generate induced pluripotent stem cells from subjects with GD and PD harbouring GBA1 mutations, and differentiate them into midbrain dopaminergic neurons followed by enrichment using fluorescence-activated cell sorting. Neurons show a reduction in glucocerebrosidase activity and protein levels, increase in glucosylceramide and α-synuclein levels as well as autophagic and lysosomal defects. Quantitative proteomic profiling reveals an increase of the neuronal calcium-binding protein 2 (NECAB2) in diseased neurons. Mutant neurons show a dysregulation of calcium homeostasis and increased vulnerability to stress responses involving elevation of cytosolic calcium. Importantly, correction of the mutations rescues such pathological phenotypes. These findings provide evidence for a link between GBA1 mutations and complex changes in the autophagic/lysosomal system and intracellular calcium homeostasis, which underlie vulnerability to neurodegeneration. PMID:24905578

  11. The attention network test: a characteristic pattern of deficits in children with ADHD

    PubMed Central

    Adólfsdóttir, Steinunn; Sørensen, Lin; Lundervold, Astri J

    2008-01-01

    Background The Attention Network test (ANT) gives measures of different aspects of the complex process of attention. We ask if children with Attention Deficit Hyperactivity Disorder (ADHD) will show a characteristic pattern of deficits on this test. Methods The sample included 157 children (M = 10 years) who performed the child version of ANT as participants of the Bergen Child Study. Children with an ADHD diagnosis (N = 45) were compared to a group of children with other diagnoses (N = 55) and a group of children without any diagnosis (N = 57). Results The group of children with ADHD showed low accuracy scores and a variable response set, indicating an inattentive response style. No differences were found between the groups on RT and accuracy measures of the alerting, orienting, and conflict networks. A high correlation between full scale IQ (FSIQ) and ANT measures was only found in the ADHD group. When FSIQ score was included as a covariate, the group differences were not statistically significant on any ANT measure. Conclusion The present study showed that accuracy and variability measures rather than measures of the three attention networks conveyed the characteristic pattern of deficits in children with ADHD. The results emphasized the importance of including these measures to extend the sensitivity of the ANT, and the importance of reporting results both with and without FSIQ as a covariate. PMID:18269768

  12. ADHD: A Crash-Free Course

    ERIC Educational Resources Information Center

    Gigout-Hues, Lisa

    2006-01-01

    Richard Restak asserts in "The New Brain" (Rodale Books, 2003) that "ADD/ADHD isn't so much a disorder as it is a cognitive style." With this in mind, and through much trial and error, the author of this article, a second-grade teacher at Hood-Case Elementary School in Alvin, Texas, provides suggestions to keep in mind when one has ADHD children…

  13. Attention deficits revealed by passive auditory change detection for pure tones and lexical tones in ADHD children

    PubMed Central

    Yang, Ming-Tao; Hsu, Chun-Hsien; Yeh, Pei-Wen; Lee, Wang-Tso; Liang, Jao-Shwann; Fu, Wen-Mei; Lee, Chia-Ying

    2015-01-01

    Inattention (IA) has been a major problem in children with attention deficit/hyperactivity disorder (ADHD), accounting for their behavioral and cognitive dysfunctions. However, there are at least three processing steps underlying attentional control for auditory change detection, namely pre-attentive change detection, involuntary attention orienting, and attention reorienting for further evaluation. This study aimed to examine whether children with ADHD would show deficits in any of these subcomponents by using mismatch negativity (MMN), P3a, and late discriminative negativity (LDN) as event-related potential (ERP) markers, under the passive auditory oddball paradigm. Two types of stimuli—pure tones and Mandarin lexical tones—were used to examine if the deficits were general across linguistic and non-linguistic domains. Participants included 15 native Mandarin-speaking children with ADHD and 16 age-matched controls (across groups, age ranged between 6 and 15 years). Two passive auditory oddball paradigms (lexical tones and pure tones) were applied. The pure tone oddball paradigm included a standard stimulus (1000 Hz, 80%) and two deviant stimuli (1015 and 1090 Hz, 10% each). The Mandarin lexical tone oddball paradigm’s standard stimulus was /yi3/ (80%) and two deviant stimuli were /yi1/ and /yi2/ (10% each). The results showed no MMN difference, but did show attenuated P3a and enhanced LDN to the large deviants for both pure and lexical tone changes in the ADHD group. Correlation analysis showed that children with higher ADHD tendency, as indexed by parents’ and teachers’ ratings on ADHD symptoms, showed less positive P3a amplitudes when responding to large lexical tone deviants. Thus, children with ADHD showed impaired auditory change detection for both pure tones and lexical tones in both involuntary attention switching, and attention reorienting for further evaluation. These ERP markers may therefore be used for the evaluation of anti-ADHD drugs that

  14. Attention deficits revealed by passive auditory change detection for pure tones and lexical tones in ADHD children.

    PubMed

    Yang, Ming-Tao; Hsu, Chun-Hsien; Yeh, Pei-Wen; Lee, Wang-Tso; Liang, Jao-Shwann; Fu, Wen-Mei; Lee, Chia-Ying

    2015-01-01

    Inattention (IA) has been a major problem in children with attention deficit/hyperactivity disorder (ADHD), accounting for their behavioral and cognitive dysfunctions. However, there are at least three processing steps underlying attentional control for auditory change detection, namely pre-attentive change detection, involuntary attention orienting, and attention reorienting for further evaluation. This study aimed to examine whether children with ADHD would show deficits in any of these subcomponents by using mismatch negativity (MMN), P3a, and late discriminative negativity (LDN) as event-related potential (ERP) markers, under the passive auditory oddball paradigm. Two types of stimuli-pure tones and Mandarin lexical tones-were used to examine if the deficits were general across linguistic and non-linguistic domains. Participants included 15 native Mandarin-speaking children with ADHD and 16 age-matched controls (across groups, age ranged between 6 and 15 years). Two passive auditory oddball paradigms (lexical tones and pure tones) were applied. The pure tone oddball paradigm included a standard stimulus (1000 Hz, 80%) and two deviant stimuli (1015 and 1090 Hz, 10% each). The Mandarin lexical tone oddball paradigm's standard stimulus was /yi3/ (80%) and two deviant stimuli were /yi1/ and /yi2/ (10% each). The results showed no MMN difference, but did show attenuated P3a and enhanced LDN to the large deviants for both pure and lexical tone changes in the ADHD group. Correlation analysis showed that children with higher ADHD tendency, as indexed by parents' and teachers' ratings on ADHD symptoms, showed less positive P3a amplitudes when responding to large lexical tone deviants. Thus, children with ADHD showed impaired auditory change detection for both pure tones and lexical tones in both involuntary attention switching, and attention reorienting for further evaluation. These ERP markers may therefore be used for the evaluation of anti-ADHD drugs that aim to

  15. The co-occurrence of reading disorder and ADHD: epidemiology, treatment, psychosocial impact, and economic burden.

    PubMed

    Sexton, Chris C; Gelhorn, Heather L; Bell, Jill A; Classi, Peter M

    2012-01-01

    The co-occurrence of reading disorder (RD) and attention-deficit/hyperactivity disorder (ADHD) has received increasing attention. This review summarizes the epidemiology, treatment strategies, psychosocial impact, and economic burden associated with the co-occurrence of these conditions. Common genetic and neuropsychological deficits may partially explain the high degree of overlap between RD and ADHD. Children who face the additive problems of both disorders are at greater risk for academic failure, psychosocial consequences, and poor long-term outcomes that persist into adulthood. However, few studies have evaluated interventions targeted to this patient population, underscoring the importance of identifying effective multimodal treatments that address the neuropsychological deficits of RD and ADHD through carefully planned clinical research. PMID:21757683

  16. ADHD and delinquency--a developmental perspective.

    PubMed

    von Polier, G G; Vloet, T D; Herpertz-Dahlmann, B

    2012-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood and adolescence. Until now, it has been unclear whether ADHD by itself constitutes a risk factor for later delinquency or does so only in combination with other disruptive symptoms. This article seeks to give a comprehensive account of the literature to shed light on the developmental pathway from childhood ADHD to adult criminality. Comorbid ADHD and conduct disorder (CD) are significantly related to a range of biological and environmental risk factors such as neurocognitive impairment, high parental psychopathology, poor social functioning, and other comorbid mental disorders, particularly substance abuse, that are described in this review. In addition, the results of treatment studies are presented, with a special focus on the results of the Multimodal Treatment Study of Children with ADHD (MTA). Although treatment programs, including medication and psychosocial treatment, can be very effective in improving the functioning of children with ADHD in the social and academic domains in the short term, there is no conclusive evidence that such treatments lower the risk for developing delinquency in adulthood. PMID:22371085

  17. Increased ongoing neural variability in ADHD.

    PubMed

    Gonen-Yaacovi, Gil; Arazi, Ayelet; Shahar, Nitzan; Karmon, Anat; Haar, Shlomi; Meiran, Nachshon; Dinstein, Ilan

    2016-08-01

    Attention Deficit Hyperactivity Disorder (ADHD) has been described as a disorder where frequent lapses of attention impair the ability of an individual to focus/attend in a sustained manner, thereby generating abnormally large intra-individual behavioral variability across trials. Indeed, increased reaction time (RT) variability is a fundamental behavioral characteristic of individuals with ADHD found across a large number of cognitive tasks. But what is the underlying neurophysiology that might generate such behavioral instability? Here, we examined trial-by-trial EEG response variability to visual and auditory stimuli while subjects' attention was diverted to an unrelated task at the fixation cross. Comparisons between adult ADHD and control participants revealed that neural response variability was significantly larger in the ADHD group as compared with the control group in both sensory modalities. Importantly, larger trial-by-trial variability in ADHD was apparent before and after stimulus presentation as well as in trials where the stimulus was omitted, suggesting that ongoing (rather than stimulus-evoked) neural activity is continuously more variable (noisier) in ADHD. While the patho-physiological mechanisms causing this increased neural variability remain unknown, they appear to act continuously rather than being tied to a specific sensory or cognitive process. PMID:27179150

  18. Cognitive enhancers for the treatment of ADHD

    PubMed Central

    Bidwell, L. Cinnamon; McClernon, F. Joseph; Kollins, Scott H.

    2012-01-01

    Attention-deficit hyperactivity disorder (ADHD) is associated with multiple cognition-related phenotypic features in both children and adults. This review aims to clarify the role of cognition in ADHD and how prevailing treatments, which are often highly effective at reducing the clinical symptoms of the disorder, fare in modulating ADHD-related cognitive processes. First, we consider how the broad construct of cognition can be conceptualized in the context of ADHD. Second, we review the available evidence for how a range of both pharmacological and non-pharmacological interventions have fared with respect to enhancing cognition in individuals affected by this pervasive disorder. Findings from the literature suggest that the effects across a broad range of pharmacological and non-pharmacological interventions on the characteristic symptoms of ADHD can be distinguished from their effects on cognitive impairments. As such the direct clinical relevance of cognition enhancing effects of different interventions is somewhat limited. Recommendations for future research are discussed, including the identification of cognition-related end ophenotypes, the refinement of the ADHD clinical phenotype, and studying the difference between acute and chronic treatment regimens. PMID:21596055

  19. Pharmacotherapy of inattention and ADHD in adolescents.

    PubMed

    McBurnett, Keith; Swetye, Michael; Muhr, Heather; Hendren, Robert L

    2013-08-01

    This article reviews the current use of stimulants in adolescents. The evidence base for treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescents is meager compared with that of ADHD in children, and much recent research of older populations with ADHD has been directed toward adults rather than adolescents. The structure of psychosocial treatment of ADHD differs across developmental ranges. For example, in children, treatment of ADHD uses direct behavior modification via parents and teachers. Treatment approaches then change toward contracting in adolescents (acknowledging the emerging independence common at this age) and toward self-management and coaching in adults. Medication for ADHD, however, does not substantially differ across developmental epochs. In supplementation of data, specifically on adolescence, much of our understanding of treating adolescents comes from upward or downward extension of the child and adult data. Symptomatic treatment (treatment for inattention, hyperactivity, or impulsive behavior) has always been a parallel approach to diagnostic and developmentally specific selection of treatment based on an incomplete literature. In recognition, this article assumes that inference from children or adults to adolescents, in the absence of adolescent-specific data, is commonplace and often confirmed with clinical experience. Such inferences, in the face of literature gaps, in no way obviate the need for continued research focused on adolescence. PMID:24298754

  20. A developmental examination of story recall and coherence among children with ADHD.

    PubMed

    Lorch, Elizabeth P; Milich, Richard; Flake, Rebecca A; Ohlendorf, Joanna; Little, Summer

    2010-04-01

    This study investigated developmental differences in story recall in children with attention-deficit/hyperactivity disorder (ADHD), N = 57 (77.2% male) and their comparison peers, N = 98 (61.2% male). Children at the ages of 4-6 or 7-9 completed a free recall immediately after viewing each of two televised stories, once in the presence of toys during viewing and once in their absence. This procedure was repeated with new stories 21 months later. Comparison children recalled more story events and showed a greater sensitivity to the thematic importance of the story events than did children with ADHD, a pattern that remained stable over time. Older comparison children showed a dramatic increase over time in the global coherence of their narrations, whereas the older children with ADHD showed limited improvement over time. The implications of these findings for academic performance and the possible need for remediation are discussed. PMID:20024672