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Objective@#Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents. The present study investigated the cortical morphology features and their relationship with working memory (WM). @*Methods@#In the present study, a total of 36 medication naïve children with ADHD (aged from 8 to 15 years) and 36 age- and gendermatched healthy control (HC) children were included. The digit span test was used to evaluate WM. The magnetic resonance imaging (MRI) was used to examine the characteristics of cortical morphology. Firstly, we compared the cortical morphology features between two groups to identify the potential structural alterations of cortical volume, surface, thickness, and curvature in children with ADHD. Then, the correlation between the brain structural abnormalities and WM was further explored in children with ADHD. @*Results@#Compared with the HC children, the children with ADHD showed reduced cortical volumes in the left lateral superior temporal gyrus (STG) (p=6.67×10-6) and left anterior cingulate cortex (ACC) (p=3.88×10-4). In addition, the cortical volume of left lateral STG was positively correlated with WM (r=0.36, p=0.029). @*Conclusion@#Though preliminary, these findings suggest that the reduced cortical volumes of left lateral STG may contribute to the pathogenesis of ADHD and correlate with WM in children with ADHD.
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Objective@#Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents. The present study investigated the cortical morphology features and their relationship with working memory (WM). @*Methods@#In the present study, a total of 36 medication naïve children with ADHD (aged from 8 to 15 years) and 36 age- and gendermatched healthy control (HC) children were included. The digit span test was used to evaluate WM. The magnetic resonance imaging (MRI) was used to examine the characteristics of cortical morphology. Firstly, we compared the cortical morphology features between two groups to identify the potential structural alterations of cortical volume, surface, thickness, and curvature in children with ADHD. Then, the correlation between the brain structural abnormalities and WM was further explored in children with ADHD. @*Results@#Compared with the HC children, the children with ADHD showed reduced cortical volumes in the left lateral superior temporal gyrus (STG) (p=6.67×10-6) and left anterior cingulate cortex (ACC) (p=3.88×10-4). In addition, the cortical volume of left lateral STG was positively correlated with WM (r=0.36, p=0.029). @*Conclusion@#Though preliminary, these findings suggest that the reduced cortical volumes of left lateral STG may contribute to the pathogenesis of ADHD and correlate with WM in children with ADHD.
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Objective:To explore the related factors to the effect of cognitive behavior therapy (CBT) for adults with attention-deficit/hyperactivity disorder(ADHD).Methods:A prospective and open-label,self-control study was designed.Eighty-five adult patients from outpatient department with ADHD diagnosed with the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ).All the patients received 12 weeks of CBT,the ADHD Rating Scale (ADHD-RS) was used to evaluate ADHD core symptoms,and according to the post-treat ADHD-RS reduction ratio,41 patients were divided into responders(ADHD-RS reduction ratio≥25％)and 44 patients were divided into non-responders(ADHD-RS reduction ratio ＜ 25％).The t-test and chi-square test were used to analyze the differences of sociodemographic variables,clinical variables and early efficacy (ADHD-RS reduction ratio≥25％ in the fourth week) between the two groups,and logistics regression was used to analysis the related factors.Results:Comparing with the group of non-responders,there was more cases with early efficacy (P ＜ 0.05)in the group of responders.Logistic models indicated that higher scores of BIS-motor (OR =1.27),early efficacy (OR =11.87) were associated with better CBT efficacy.Conclusion:It suggests that ADHD adults with more sever motor impulsiveness symptom,and early efficacy may get favorable response to CBT.
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Objective:To find out the difference between children with attention-deficit/hyperactivity disorder and normal control,and the difference between boys and girls with ADHD in resting-state.Methods:There were 38 children with ADHD in this study including 31 boys and 7 girls,meanwhile,42 normal controls whose age and gen der were matched with children with ADHD were involved too,including 29 boys and 13 girls.Total scores of ADHD rating scale (ADHD-RS) were used to measure the severity of symptom for both ADHD and normal control.Magnetic resonance imaging was used to collect the resting-state functional magnetic resonance imaging data,and the fractional amplitude of low frequency fluctuation (fALFF) was measured for each child.Analysis of covariance (ANCOVA) was used to find out the difference between the group and the sex.Results:Children with ADHD showed a higher fALFF in the right medial superior frontal gyrus and right supplementary motor area,and a lower fALFF in the left putamen,bilateral cerebellum and bilateral precuneus than controls (all corrected P ＜0.05).ADHD boys showed a lower fALFF in the left cerebellum and a higher fALFF in the bilateral medial superior frontal gyrus than boys without ADHD (all corrected P ＜0.05).ADHD girls showed a higher fALFF in the bilateral cerebellum and in the thalamus than girls without ADHD,and a lower fALFF in the insula than girls without ADHD (all corrected P ＜ 0.05).There was a negative relationship between the fALFF of the left cerebellum of ADHD girls and the scores of inattention symptoms.Conclusion:The fALFF difference exist between ADHD and normal controls,and between boys and girls with ADHD.
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Objective:To explore whether executive function (EF) deficits are specific to attention-deficit/hyperactivity disorder (ADHD) or whether such deficits are also associated with tics disorder (TD).Methods:A total of 112 ADHD comorbid TD (ADHD +TD) children,112 pure ADHD children and 112 normal controls were selected.The diagnosis was according to the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ).The groups were matched by sex,age (less than 6 months) and IQ.The Rey-Osterrieth complex Figure Test,the Trail Making Test,and Stroop Color Word Test were administered to assess working memory,shifting and inhibitory function respectively.The results of the comparison between groups used multivariate analysis of variance,and the statistically significant indicators were conducted with apost-test comparison.Results:Both pure ADHD group and ADHD + TD group performed worse (P ＜ 0.05) in the aspects of the delay recalling structure score,the immediate memory detail score,delay recalling detail score of Rey complex figure test,time of numberletter part and shifting time of trail making test,the time of Stroops2,4,the errors of Stroop 4 and word interference than normal controls.In the aspects of the score of the structure and detail forgetting,the pure ADHD group performed worse (P ＜0.05) than normal controls,but the ADHD + TD group didn't.The differences were significant (P ＜ 0.05).The other differences all weren't significant (P ＞ 0.05).Conclusion:It suggests that children with ADHD have executive function deficit,particular in the tests assessing working memory,shifting and inhibitory function,whether or not comorbid tics disorder.Comorbid tics disorders may not be the factor of aggravation.
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<p><b>BACKGROUND</b>The cognitive function of children with either attention deficit hyperactivity disorder (ADHD) or learning disabilities (LDs) is known to be impaired. However, little is known about the cognitive function of children with comorbid ADHD and LD. The present study aimed to explore the cognitive function of children and adolescents with ADHD and learning difficulties in comparison with children with ADHD and healthy controls in different age groups in a large Chinese sample.</p><p><b>METHODS</b>Totally, 1043 participants with ADHD and learning difficulties (the ADHD + learning difficulties group), 870 with pure ADHD (the pure ADHD group), and 496 healthy controls were recruited. To investigate the difference in cognitive impairment using a developmental approach, all participants were divided into three age groups (6-8, 9-11, and 12-14 years old). Measurements were the Chinese-Wechsler Intelligence Scale for Children, the Stroop Color-Word Test, the Trail-Making Test, and the Behavior Rating Inventory of Executive Function-Parents (BRIEF). Multivariate analysis of variance was used.</p><p><b>RESULTS</b>The results showed that after controlling for the effect of ADHD symptoms, the ADHD + learning difficulties group was still significantly worse than the pure ADHD group, which was, in turn, worse than the control group on full intelligence quotient (98.66 ± 13.87 vs. 105.17 ± 14.36 vs. 112.93 ± 13.87, P < 0.001). The same relationship was also evident for shift function (shifting time of the Trail-Making Test, 122.50 [62.00, 194.25] s vs. 122.00 [73.00, 201.50] s vs. 66.00 [45.00, 108.00] s, P< 0.001) and everyday life executive function (BRIEF total score, 145.71 ± 19.35 vs. 138.96 ± 18.00 vs. 122.71 ± 20.45, P < 0.001) after controlling for the effect of the severity of ADHD symptoms, intelligence quotient, age, and gender. As for the age groups, the differences among groups became nonsignificant in the 12-14 years old group for inhibition (meaning interference of the Stroop Color-Word Test, 18.00 [13.00, 25.00] s vs. 17.00 [15.00, 26.00] s vs. 17.00 [10.50, 20.00] s , P = 0.704) and shift function (shifting time of the Trail-Making Test, 62.00 [43.00, 97.00] s vs. 53.00 [38.00, 81.00] s vs. 101.00 [88.00, 114.00] s, P = 0.778).</p><p><b>CONCLUSIONS</b>Children and adolescents with ADHD and learning difficulties have more severe cognitive impairment than pure ADHD patients even after controlling for the effect of ADHD symptoms. However, the differences in impairment in inhibition and shift function are no longer significant when these individuals were 12-14 years old.</p>
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Adolescent , Child , Female , Humans , Male , Attention Deficit Disorder with Hyperactivity , Cognition , Physiology , Cross-Sectional Studies , Executive Function , Physiology , Intelligence Tests , Learning DisabilitiesABSTRACT
Objective:To investigate association of the new polymorphism G352A in the dopaminetransporter gene(DAT1)exon 15 with attention deficit hyperactivity disorder(ADHD)in Han Chinesechildren.Methods:The new mutant polymorphism G352A in the dopamine transporter gene(DAT1)ex-on 15 was found by the fluorescently-labeled dye-terminators assay.The study samples were comprised of337 ADHD children,207 unrelated controls and 201 integrated ADHD trios(included proband and bio-logical parents).Associations of polymorphisms with ADHD and its subtypes were examined by:(i)comparing cases and controls;and(ii)using family-based association study in transmission-disequilibri-um test(TDT).Results:The allele frequencies at the DAT1 G352A locus in the control samples were79.5% for 352G and 20.5% for 352A respectively.Association studies revealed no association betweenG352A in exon 15 of DAT1 and ADHD.But after a stratification by gender,there was possible associationbetween G352A and ADHD girls:the 352G allele had a tendency to be preferentially transmitted toADHD girls.Conclusion:There is no association between G352A,the new polymorphism,in exon 15 ofDAT1 and ADHD.The 352G allele has a tendency to be preferentially transmitted to ADHD girls,but thefindings require replication before drawing a definitive conclusion.