Comparison study of EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To evaluate EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder (ADHD) using the integrated visual and auditory integration continuous performance test (IVA-CPT).Methods:Children with ADHD who completed more than 60 times of EEG biofeedback training in Hangzhou Seventh People's Hospital from July 2018 to September 2020 were selected as the research subjects. According to the results of IAV-CPT before treatment, all the children were divided into three subtypes: attention deficit type ( n=21), impulse hyperactivity type ( n=11), and mixed type ( n=30). The differences of symptom improvement between the three subtypes before and after training were compared by SPSS 23.0 software. Results:(1) In terms of response control (a total of 9 items), there was no statistical significance in the attention deficit group before and after treatment (all P>0.05). In the hyperactivity group, the scores of visual and auditory response control, full scale response control, auditory prudence and auditory consistency, visual focus quotient and visual consistency before treatment were significantly lower than those after treatment(all P<0.05). In the mixed group, the scores of visual and auditory response control, full scale response control, auditory prudence, visual consistency, and visual prudence before treatment were significantly lower than those after treatment(all P<0.05). In terms of attention (a total of 9 items), the scores of auditory vigilance, auditory attention, visual attention, full scale attention, visual vigilance and visual speed in the attention deficit group before treatment were significantly lower than those after treatment(all P<0.05). The scores of visual attention, full scale attention, visual focus quotient (all P<0.01), auditory attention and visual speed (all P<0.05) in hyperactivity group before treatment were significantly lower than those after treatment. In the mixed group, the scores of the other 8 items before treatment were significantly lower than those after treatment (all P<0.01, auditory focus quotient were P<0.05), except that the auditory speed had no statistical significance before and after treatment.(2)After EEG biofeedback training, the changes of IVA-CPT scores of the three groups before and after treatment(visual response control (-2.76±24.39), (19.55±19.94), (12.93±25.30), F=3.932, P=0.025), (full scale response control (2.38±20.77), (21.27±15.86), (15.43±25.69), F=3.158, P=0.050), (full scale attention (18.43±27.44), (11.36±11.40), (26.23±18.41), F=4.692, P=0.016), (auditory vigilance (20.23±42.65), (6.55±10.20), (33.63±36.30), F=7.160, P=0.002), (visual vigilance (19.48±28.55), (5.27±10.62), (33.27±28.26), F=10.876, P<0.001), (visual focus quotient (-2.24±23.67), (14.45±13.79), (12.83±21.91), F=3.669, P=0.031) were statistically significant. After LSD comparison, the changes of visual control and total control scores in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group (all P<0.05) and the mixed group (all P<0.05). In the three items of total attention score, auditory vigilance and visual vigilance, the changes of impulsivity hyperactivity group before and after treatment were significantly lower than those of mixed group ( P=0.050, P<0.05, P<0.01, respectively). The changes of visual attention quotient in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group and the mixed group (all P<0.05). Conclusion:EEG biofeedback has clinical efficacy in the three groups of subtypes of ADHD, but the efficacy is different, and individualized EEG training programs should be developed for different subtypes of children on the basis of standard TBR therapy protocol.

Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder: a prospective study / 中国当代儿科杂志

OBJECTIVES@#To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone.@*METHODS@#A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups.@*RESULTS@#Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (@*CONCLUSIONS@#Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.

Attention Deficit Hyperactivity Disorder in Neurofibromatosis Type 1: Evaluation with a Continuous Performance Test

BACKGROUND AND PURPOSE: The objective of this study was to determine if the MOXO visual- and vocal-distractors-based continuous performance test distinguishes patients with attention deficit hyperactivity disorder (ADHD) and neurofibromatosis type 1 (NF1) from those without NF1. METHODS: Thirty-five patients (16 males; mean age 9.91 years) attending a multidisciplinary NF1 clinic completed the MOXO test. The findings were compared to 532 healthy age-matched standardized control subjects (285 males) without ADHD. RESULTS: The overall performance in the MOXO text was significantly worse in the NF1 group than in controls (p < 0.01), but no group-specific pattern was identified. Impulsivity and hyperactivity were significantly more prominent in males than females (p < 0.01). Compared to controls, the NF1 group exhibited significantly more failures to respond to target stimuli in the presence of visual distractors. CONCLUSIONS: MOXO scores are abnormal in patients with NF1, but the test cannot differentiate between NF1 with ADHD characteristics and ADHD. The test highlights sex differences in ADHD characteristics in NF1. Overreactivity to visual distractors may form part of the attention deficit in NF1.

Study on event related potentials and behavioral characteristics in Go/Nogo task in children with sleep disordered breathing and normal children / 中华行为医学与脑科学杂志

Objective To compare and analyze the event related potential ( ERP ) and behavioral characteristics of sleep disordered breathing ( SDB ) and normal children by the persistent operating test ( CPT-AX) task,and to explore the characteristics and neural mechanism of the cognitive deficits in the left and right brain of school age SDB children. Methods SDB children( n=20) and normal children( n=20) aged 6-8 were selected. All subjects were tested by CPT-AX ( Go/Nogo task) . The ERP behavior of SDB and normal children was recorded,and the N2,P3 amplitude and latency of F3,Fz,F4 lead were compared. Re-sults ( 1) There was no significant difference between SDB group and normal group in behavioral correct number (36. 45±4. 69 vs 35. 00±3. 46),the reaction time ((516. 84±54. 14)ms vs (496. 94±78. 89)ms) and false alarm number( 1. 0 ( 0. 25,3. 75) vs 0. 5 ( 0. 00,3. 00) ) ( all P>0. 05) . ( 2) Comparison of F3,Fz and F4 lead:(1) SDB group:there was no significant difference in Go-N2 amplitude (-7. 75(-12. 03,-1. 09)μV vs (-8. 69±5. 72) μV vs ( -7. 12±4,68)μV) and Nogo-N2 amplitude((-10. 72±4. 49)μV vs (-12. 16±4. 60) μV vs (-11. 78±4. 44) μV) in the left,middle,and right of frontal regions. (2) Control group:there was no statistical difference between F3 and Fz ((-7. 26±3. 18)μV vs (-9. 09±3. 11)μV)(P>0. 05) in N2 amplitude and there was no statistical difference between F3 and F4((-7. 26±3. 18) μV vs (-6. 10±3. 36)μV) in N2 amplitude (P>0. 05). The N2 amplitude difference of Fz and F4 ((-9. 09± 3. 11) μV vs (-6. 10±3. 36)μV ) was statistically significant (P<0. 05). The Nogo-N2 amplitude differ-ence between F3 and Fz((-14. 05±3. 31) μV vs (-15. 50±3. 52) μV) was no statistically significant (P>0. 05) . The left frontal lobe Nogo-N2 amplitude was significantly higher than that of the right frontal lobe ((-14. 05±3. 31) μV vs-11. 75(-12. 68,-10. 43) μV) (P<0. 05),and the center of the frontal lobe No-go-N2 was significantly higher than that in the right frontal lobe((-15. 50±3. 52) μV vs -11. 75(-12. 68,-10. 43) ) ,and the difference was statistically significant (P<0. 05) . ( 3) There was no significant difference in N2 latency,P3 amplitude and latency between F3,Fz and F4 leads (P>0. 05). Conclusion Compared with normal children,SDB children showed no left dominant brain region while dealing with the same conflict monitoring tasks. It is suggested that left hemisphere activation is poor and function is incompatible. Left fron-tal lobe injury in SDB is more obvious than that in the right side.

The Relationship between the SNAP-25 Polymorphism and Omission Errors in Korean Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE: This study aimed to investigate the association between the synaptosomal-associated protein 25 kDa (SNAP-25) genotype and performance on the continuous performance test (CPT) in Korean children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Eighty-seven children with ADHD (mean age, 9.23±1.99 years) participated in this study. Omission errors, commission errors, reaction time, and reaction time variability on the CPT were analyzed. The single-nucleotide polymorphism (SNP) rs3746544 (1065 T>G) of SNAP-25 was genotyped to examine the association with CPT performance. RESULTS: We found significantly more omission errors on the CPT among children with the TT genotype of SNAP-25 (t=2.56, p=0.012) after correcting for multiple testing. CONCLUSION: Our results suggest the possible involvement of the SNAP-25 1065 T>G polymorphism in the inattention phenotype in children with ADHD. Further studies with more refined neuropsychological measures and much larger sample sizes are needed to confirm our findings.

Study on relationship among pulsatility index, sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery / 临床神经病学杂志

Objective To investigate the relationship among pulsatility index ( PI) , sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery .Methods One hundred and thirty-five patients with severe stenosis or occlusion of internal carotid artery were examined by DSA and were divided into different groups according to the type of collateral circulation .Meanwhile, 30 healthy aged people were selected as a control group .The peak systolic velocity ( Vs) , and diastolic velocity ( Vd) , mean velocity ( Vm) and PI of bilateral middle cerebral artery were obtained by TCD .Sustained attention was evaluated by missed and mistaken scores as well as average reaction time of continuous performance test .The results were compared and analyzed.Results (1)According to the type of collateral circulation , 135 patients with severe stenosis or occlusion of internal carotid artery were divided into groups with patency of anterior communicating artery (AcoA)(31 cases),posterior communicating artery (PcoA)(20 cases), AcoA+PcoA (19 cases), primary collateral circulation (with AcoA, PcoA and AcoA +PcoA) (70 cases), secondary collateral circulation (including ophthalmic artery, leptomeningeal collateral vessel and new blood vessels ) ( 15 cases ) , primary+secondary collateral circulation ( 13 cases) and group without collateral circulation (37 cases).(2)Compared with control group, Vs,Vd,Vm and PI all decreased significantly in every other group ( all P<0.05 ) .Compared with group without collateral circulation , Vd of group with AcoA or primary collateral circulation , Vd and Vm of group with AcoA +PcoA all increased significantly;PI of groups with AcoA , AcoA+PcoA, primary collateral circulation and primary +secondary collateral circulation all decreased (all P<0.05).Compared with group with PcoA, PI of groups with AcoA and AcoA +PcoA both decresed significantly (all P<0.05).Compared with group with secondary collateral circulation , Vs,Vd and Vm of group with primary collateral circulation , Vd and Vm of group with primary +secondary collateral circulation all increased significantly; PI of groups with primary collateral circulation and primary +secondary collateral circulation both decreased (all P<0.05).(3) Compared with control group, the missed, mistaken scores and average reaction time of CPT in every other group increased significantly ( all P<0.05 ) .Compared with group without collateral circulation , the missed, mistaken scores and average reaction time in groups with AcoA , AcoA+PcoA and primary collateral circulation all decreased significantly; the missed and mistaken scores of group with primary+secondary collateral circulation decreased significanly ( all P<0.05) .Compared with group with PcoA , the missed and mistaken scores of group with AcoA decreased significantly while the missed , mistaken scores and average reaction time of group with AcoA +PcoA all decreased significantly ( all P<0.05 ) .Compared with group with AcoA+PcoA, the missed, mistaken scores and average reaction time in group with AcoA increased sinificantly ( all P<0.05).Compared with group with secondary collateral circulation , the missed, mistaken scores and average reaction time in group with primary collateral circulation all decreased significantly ;the missed and mistaken scores in primary+secondary collateral circulation both decreased significantly ( all P<0.05 ) .( 4 ) PI positively related to average reaction time in groups with AcoA , primary and secondary collateral circulation ( r=0.441, r=0.364, r=0.552; all P<0.05 ) .PI positively related to missed scores in group with PcoA and group without collateral circulation (r=0.668, r=0.397;all P<0.05).PI also positively related to mistaken scores in the above groups (r=0.509,r=0.480;all P<0.05).Conclusion High PI on the affected side of patients with severe stenosis or occlusion of internal carotid artery may reflect impairment of sustained attention function .

Study on relationship among pulsatility index, sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery / 临床神经病学杂志

Objective To investigate the relationship among pulsatility index ( PI) , sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery .Methods One hundred and thirty-five patients with severe stenosis or occlusion of internal carotid artery were examined by DSA and were divided into different groups according to the type of collateral circulation .Meanwhile, 30 healthy aged people were selected as a control group .The peak systolic velocity ( Vs) , and diastolic velocity ( Vd) , mean velocity ( Vm) and PI of bilateral middle cerebral artery were obtained by TCD .Sustained attention was evaluated by missed and mistaken scores as well as average reaction time of continuous performance test .The results were compared and analyzed.Results (1)According to the type of collateral circulation , 135 patients with severe stenosis or occlusion of internal carotid artery were divided into groups with patency of anterior communicating artery (AcoA)(31 cases),posterior communicating artery (PcoA)(20 cases), AcoA+PcoA (19 cases), primary collateral circulation (with AcoA, PcoA and AcoA +PcoA) (70 cases), secondary collateral circulation (including ophthalmic artery, leptomeningeal collateral vessel and new blood vessels ) ( 15 cases ) , primary+secondary collateral circulation ( 13 cases) and group without collateral circulation (37 cases).(2)Compared with control group, Vs,Vd,Vm and PI all decreased significantly in every other group ( all P<0.05 ) .Compared with group without collateral circulation , Vd of group with AcoA or primary collateral circulation , Vd and Vm of group with AcoA +PcoA all increased significantly;PI of groups with AcoA , AcoA+PcoA, primary collateral circulation and primary +secondary collateral circulation all decreased (all P<0.05).Compared with group with PcoA, PI of groups with AcoA and AcoA +PcoA both decresed significantly (all P<0.05).Compared with group with secondary collateral circulation , Vs,Vd and Vm of group with primary collateral circulation , Vd and Vm of group with primary +secondary collateral circulation all increased significantly; PI of groups with primary collateral circulation and primary +secondary collateral circulation both decreased (all P<0.05).(3) Compared with control group, the missed, mistaken scores and average reaction time of CPT in every other group increased significantly ( all P<0.05 ) .Compared with group without collateral circulation , the missed, mistaken scores and average reaction time in groups with AcoA , AcoA+PcoA and primary collateral circulation all decreased significantly; the missed and mistaken scores of group with primary+secondary collateral circulation decreased significanly ( all P<0.05) .Compared with group with PcoA , the missed and mistaken scores of group with AcoA decreased significantly while the missed , mistaken scores and average reaction time of group with AcoA +PcoA all decreased significantly ( all P<0.05 ) .Compared with group with AcoA+PcoA, the missed, mistaken scores and average reaction time in group with AcoA increased sinificantly ( all P<0.05).Compared with group with secondary collateral circulation , the missed, mistaken scores and average reaction time in group with primary collateral circulation all decreased significantly ;the missed and mistaken scores in primary+secondary collateral circulation both decreased significantly ( all P<0.05 ) .( 4 ) PI positively related to average reaction time in groups with AcoA , primary and secondary collateral circulation ( r=0.441, r=0.364, r=0.552; all P<0.05 ) .PI positively related to missed scores in group with PcoA and group without collateral circulation (r=0.668, r=0.397;all P<0.05).PI also positively related to mistaken scores in the above groups (r=0.509,r=0.480;all P<0.05).Conclusion High PI on the affected side of patients with severe stenosis or occlusion of internal carotid artery may reflect impairment of sustained attention function .

The Behavior Rating Inventory of Executive Function and Continuous Performance Test in Preschoolers with Attention Deficit Hyperactivity Disorder

OBJECTIVE: The aim of this study is to examine performance-based measures and behavioral ratings of executive functions (EF) as a component of preschool attention deficit hyperactivity disorder (ADHD). METHODS: Twenty-one 4-to-6-year-old children with ADHD and 52 children with no psychopathology, matched on age, gender, socioeconomic status, and parental education, were enrolled. Parents were interviewed with the use of The Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version. The Conners' Kiddie Continuous Performance Test (K-CPT) was administered to the children, and the Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P) and the Conners' Parent Rating Scale-Revised/Short Form (CPRS-R/S) were filled out by the parents. RESULTS: All BRIEF-P and CPRS-R/S scores, the K-CPT measures of inattention and impulsivity were higher in the ADHD group. The CPRS-R/S ADHD index was strongly correlated with inhibition and related indexes in the BRIEF-P and was moderately correlated with inattention measures in the K-CPT. CONCLUSION: The current study is one of the few to investigate the features of preschool ADHD with the use of behavioral ratings of EF and a performance-based measure. Our results suggest that the BRIEF-P was able to identify behavioral difficulties in inhibition and working memory and that the K-CPT identified difficulties indicating inattention. The findings of this study support the use of a combination of methods for a complete evaluation of preschoolers with inattentive and hyperactive/impulsive behavior, the application of rating scales for screening ADHD symptoms, and the measurement of behavioral correlates of EF, along with performance-based measures.

Clinical application of the integrated visual and auditory continuous performance test on Tourette syndrome children with attention deficit hyperactivity disorder / 中华实用儿科临床杂志

Objective To explore the value of the integrated visual and audio continuous performance test (IVA-CPT) in the diagnosis of Tourette syndrome(TS) patients who have comorbid attention deficit hyperactivity disorder(ADHD).Methods IVA-CPT was performed in 519 TS patients with comorbid ADHD (observation group)and 857 patients with pure ADHD (control group).The gold standard for the diagnosis of ADHD was based on the Diagnostic and Statistical Manual of Mental Disorders (4th version,USA) (DSM-Ⅳ).Results (1) When DSM-Ⅳ was used as the gold standard,the sensitivity,specificity and coincidence rate of IVA-CPT were 62.4％,81.9％ and 75.7％,respectively.(2) IVA-CPT misdiagnosed 62 cases in TS + ADHD group,including 30.3％ (10/33 cases) inattentive subtype (ADHD-I),51.4％ (37/72 cases) hyperactive subtype (ADHD-H) and 25.0％ (15/60 cases) combined subtype (ADHD-C).Significant difference in misdiagnosis rate was found among ADHD-H and ADHD-I and ADHD-C (x2=10.646,P＜0.05).(3) There were 449 cases in which 2 diagnostic methods were both positive in both observation group and control group,including 103 cases in observation group and 346 cases in control group.The full scale response control quotient,visual reaction control,auditory reaction control in observation group and control group were 89.0±19.5/77.4±18.2,92.4±19.0/84.3±18.9,89.6±16.8/77.4±19.7,and there were significant differences between 2 groups (t=-5.024,-3.533,-5.255,all P＜0.05).The full scale response control quotient,visual response control quotient,full scale attention quotient and visual attention quotient between the 2 groups were statistically significant (t=2.510,-2.836,-1.402,-2.501,all P＜0.05).Conclusions (1) IVA-CPT can be used as an effective and objective tool for the diagnosis of TS children with comorbid ADHD.(2)Comparcd with TS childrcn with comorbid ADHD,pure ADHD children have a higher attention and control impairment.

Values of the integrated visual and auditory continuous performance test in diagnosing children with attention deficit hyperactivity disorder in clinic and school in China / 中华行为医学与脑科学杂志

Objective To explore the psychometric properties of the Chinese version of integrated visual and auditory continuous performance test (IVA-CPT) ,and to assess the diagnosis value of the Chinese version of IVA-CPT in two samples of children with attention deficit hyperactivity disorder (ADHD) in clinic and school.Methods 112 participants were divided into 4 groups:clinic group, clinic control group, school group and control group from school.The participants were measured by IVA-CPT and the results were compared.Results ①The integrated quotients of IVA-CPT had concordance with the dimensions of the DSM-ⅣV and ASRS.Each integrated quotients of IVA-CPT and each dimension of the DSM-ⅣV and ASRS were negatively correlated(school: r=-0.277, P＜0.05;clinic: r=-0.423, P＜0.05).The score of HI dimension was negatively correlated with integrated attention quotient and integrated inhibition quotient of IVA-CPT (r=-0.480, P＜0.01;r=-0.452, P＜0.01).② The results of the IVA-CPT and the comprehensive assessment had consistency for diagnosis of children with ADHD from the total subjects,the clinic ,and the school.And there were no difference between the sensitivity, the specificity, the coincidence rate, the missed diagnosis rate and the misdiagnosis rate of IVA-CPT when used to diagnose children with ADHD in clinic and school(x2=3.396, P＞0.05).③The IVA-CPT evaluation system had good stability according to the retest of a random sample of 25 subjects(P＜0.01).The pretest and posttest results of each full quotients of IVA-CPT were significantly correlated (P＜0.01).Conclusion The IVA-CPT not only can be used as auxiliary diagnostic tools to diagnose children with ADHD in clinic,it can be used as auxiliary diagnostic tools to diagnose children with ADHD in the community.

Effects of age and gender on performance on Conners' Continuous Performance Test in Brazilian adolescents

The present study analyzed the effects of age and gender on performance on the Conners' Continuous Performance Test (CCPT II) in a sample of Brazilian adolescents aged 12-17 years. The sample consisted of 480 participants (210 boys) with a mean age of 14.34 years (SD ± 1.61 years) who were representative of the socioeconomic class distribution of the city of São Paulo, Brazil. The participants were prescreened for attention-deficit/hyperactivity disorder. The present results found effects of age and gender that were similar to other Brazilian age groups. Compared with males, female participants presented a lower rate of responding to non-target stimuli (i.e., commission errors), a greater ability to discriminate signals (d'), and fewer impulsive responses (i.e., less perseveration) but longer reaction times (Hit RT and Hit RT Std Error). A significant effect of age was found on RTs (Hit RT, Hit RT Sdt Error, Variability, Hit RT Block Change), commission errors, and perseveration. As age increased, the differences diminished. The present results may be useful for research and clinical studies with Brazilian adolescents.

Performance patterns in Conners' CPT among children with attention deficit hyperactivity disorder and dyslexia / Padrão de desempenho no Conners' CPT em crianças com transtorno do déficit de atenção e hiperatividade e dislexia

This study investigated the performance of children with attention deficit hyperactivity disorder (ADHD) and dyslexia using Conners' Continuous Performance Test (CCPT). The clinical groups were composed of 52 children with ADHD and 32 children with dyslexia. Performance in the CCPT was evaluated using ANCOVA to compare the clinical groups with the normative Brazilian sample. The ADHD group performed worse than the normative sample in almost all of the measurements, except for reaction time and response style. The dyslexia group scored higher on commissions, variability, perseverations and inconsistency in the reaction time over the six time blocks (Hit SE Block Change) than the children in the normative Brazilian sample. The ADHD and dyslexia groups differed in omission measurements, Hit RT SE, variability, perseverations, Hit RT Interstimulus Intervals (ISI) Change and Hit SE ISI Change. We thus found that the dyslexia group had specific deficit patterns, with greater response to non-target stimuli, greater perseveration and response variability, and difficulties in hit reaction time as the test progressed.

O presente estudo investigou o desempenho de crianças com transtorno do déficit de atenção e hiperatividade (TDAH) e dislexia no Teste de Desempenho Contínuo de Conner (do inglês Conners' Continnuous Performance Test). Foram considerados dois grupos clínicos: 52 crianças com TDAH e 32 com dislexia. O desempenho no CCPT foi analisado por meio do teste ANCOVA, comparando os grupos clínicos com a amostra de normatização brasileira. O grupo TDAH teve pior desempenho que os controles em quase todas as medidas, exceto em medidas de tempo de reação e estilo de resposta. Já o grupo dislexia teve maiores escores em comissões, variabilidade, perseverações e inconsistência nas mudanças de tempo de reação no decorrer dos seis blocos de tempo (Hit SE Block Change). Os grupos TDAH e disléxicos diferiram entre si nas medidas de omissões, variabilidade do tempo de reação, perseverações, mudança de tempo de reação por intervalos interstimulus. Verificou-se assim que as crianças com dislexia apresentam padrões específicos de déficits, com maior resposta aos estímulos não alvos, maior perseveração e variabilidade de respostas, assim como dificuldades no tempo de reação conforme o desenvolvimento do teste.

Diagnostic Significance of Comprehensive Attention Test in Children and Adolescents with Attention-Deficit Hyperactivity Disorder

BACKGROUND: The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). METHOD: A total of 110 children and adolescents with ADHD (mean age : 11.2+/-2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0+/-2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. RESULTS: The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). CONCLUSIONS: The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

Diagnostic Significance of Comprehensive Attention Test in Children and Adolescents with Attention-Deficit Hyperactivity Disorder

BACKGROUND: The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). METHOD: A total of 110 children and adolescents with ADHD (mean age : 11.2+/-2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0+/-2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. RESULTS: The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). CONCLUSIONS: The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.

Differences in Performance of ADHD Children on a Visual and Auditory Continuous Performance Test according to IQ

OBJECTIVE: Continuous performance tests (CPTs) are frequently used in clinical practice to assess the attentiveness of ADHD children. Although most CPTs do not categorize T scores by intelligence, there is great diversity of opinion regarding the interrelation between intelligence and CPT performance. This study aimed to determine if ADHD children with superior IQs would perform better than ADHD children with average IQs. Additionally, we aimed to examine the need for CPTs' to categorize according to IQ. METHODS: Participants were 326 outpatients, aged 5-15 years, diagnosed with ADHD. All participants completed the Wechsler Intelligence Scale for Children-Revised and a CPT. After excluding those who meet exclusion criteria, we had 266 patients for our analysis. RESULTS: The "Highly Intelligent Group" (HIG), patients with IQs 120 and above, performed superiorly to the "Normally Intelligent Group" (NIG) patients, with IQs between 70 and 120, with regard to omission and commission errors on the visual-auditory CPT, even after controlling for age and gender. The HIG had higher ratios of subjects with T scores <65 on the visual and auditory CPT variables than the NIG did. CONCLUSION: The results of this study suggest this CPT is not sensitive for discerning ADHD in children with superior IQs; thus, there is a need to standardize the variables based on IQ, as well as on age and gender. Moreover, clinicians need to pay attention to the effect of IQ in interpreting CPT scores; that is, a "normal" score does not rule out a diagnosis of ADHD.

Videogame e sua influência em teste de atenção / Videogame impact in attention test / Videojuegos y su influencia en la atención

Esta pesquisa objetivou investigar a performance em cinco variáveis do Continuous Performance Test (CPT-II), um teste de atenção sustentada. Dela participaram 30 indivíduos, com idades entre 10 e 16 anos, envolvidos nas atividades de uma organização não governamental (ONG) para crianças carentes, organizados em dois grupos: um grupo de jogadores de videogame (JVGs) e um de não jogadores de videogame (NJVGs). Todos eles foram testados no CPT-II e o grupo de NJVGs foi treinado por 20 sessões em dois jogos de videogame. Os NJVGs foram retestados no CPT-II. Verificou-se que, inicialmente, o grupo de JVGs apresentou um desempenho melhor do que o grupo de NJVGs. Após a intervenção experimental constatou-se que este último grupo apresentou uma melhor performance nas variáveis avaliadas do teste. Os resultados mostraram que o regime de treinamento e os jogos de videogame utilizados foram eficientes para melhorar o desempenho de adolescentes NJVGs no CPT II.

The present research aimed to investigate the performance in five variables of Continuous Performance Test, a maintained attention test. Participants included 30 individuals, aged between 10 and 16 years old, involved in the activities of a Non-governmental Organization (NGO) for poor children, organized in two groups: one of videogame players (VGP) and another with no-players videogame (NVGP). All of them were examined in the CPT-II and the group of NJVG was trained for 20 sessions in two videogames. The NJVG were re-examined in the CPT-II. It could be verified that the group of JVG showed a better performance than the group of NJVG before experimental intervention. After experimental intervention it could be noted that this last group presented a better performance in the test variables evaluated. The results showed that the training conduction and the videogames used were efficient for improving the NVGP adolescents' performance in the CPT-II.

Este estudio tuvo como objetivo investigar la actuación de cinco variables en Continuous Performance Test (CPT-II), una prueba de atención sostenida. Participaron 30 individuos con edades entre 10 y 16 anos, envueltos en las actividades de una Organización no Gubernamental (ONG) para niños carentes, organizados en dos grupos: uno para los jugadores de videojuegos (JV) y otros con no jugadores de videojuegos (NJV). Todos se pusieron a prueba en el CPT-II y el grupo de NJV se formó por 20 sesiones en dos videojuegos. El NJV fueron re-probado en la CPT-II. Se encontró que en principio, el grupo JV mostraron mejor rendimiento que el grupo de NJV. Después de la intervención ensayo encontró que este último grupo mostró un mejor desempeño en las variables de la prueba. Los resultados mostraron que el sistema de formación y los videojuegos utilizados son eficaces para mejorar el rendimiento de los adolescentes NJV en CPT II.

Therapeutic evaluation of biofeedback treatment on ADHD with IVA-CPT multi-quotients / 中华行为医学与脑科学杂志

Objective To investigate the curative effect of biofeedback treatment on attention-deficit/hyperactivity disorder ( ADHD ) patients using integrated visual and auditory continuous performance test ( IVA-CPT).Methods 23 ADHD patients undertaked 20 times of EEG biofeedback treatment using VBFB-3000A facility.Their executive and attention quotients were measured before and after treatment by IVA-CPT.Results The pre-therapy full scale of response control and attention quotients of ADHD were 58.26 ± 32.9 and 54.43 ±34.01 respectively.After the therapy, all the quotients got improved (response control 99.3 ± 12.6, attention 84.1 ± 15.9 ) except for stamina and speed quotients both in visual and in auditory.Conclusion Shortterm EEG biofeedback treatment is one of effective methods for ADHD patients,especially for hyperactive cases.

Gender-Specific Association of the Brain-Derived Neurotrophic Factor Gene with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder with a strong genetic component. Brain-derived neurotrophic factor (BDNF), which participates in the differentiation and survival of dopaminergic and noradrenergic neurons, could play a role in ADHD development. We aimed to explore the relationships between ADHD and BDNF gene polymorphism. METHODS: We conducted a case-control analysis of 202 ADHD subjects and 159 controls, performed a transmission disequilibrium test on 151 trios, and compared the results of a continuous performance test (CPT) according to the genotype of the three single nucleotide polymorphisms (rs11030101, rs6265, rs16917204) in the BDNF gene. RESULTS: In the case-control analysis, the AA genotype of the BDNF rs11030101 polymorphism was significantly associated with ADHD only in girls (p=0.024, odds ratio=3.00). The T-G-G haplotype was significantly less frequent (p=0.005) and A-G-G was more frequent (p=0.048) in girls with ADHD than in control girls (global p=0.027). A multivariate analysis of variance for commission errors on the CPT showed a significant main effect for the rs11030101 genotype (p=0.026) and an interaction effect of the rs11030101 genotype and gender (p=0.032) in ADHD probands. CONCLUSION: These results provide preliminary evidence for a gender-specific association between BDNF and ADHD in the Korean population.

Attention characteristics of children with comorbid attention deficit hyperactivity disorder and tic disorder / 中华行为医学与脑科学杂志

Objective To investigate the characteristics of attention in children with comorbid attention deficit hyperactivity disorder (ADHD) and tic disorder (TD) (CAT). Methods 60 children with comorbid ADHD and TD (CAT), 79 children with ADHD, 60 children with TD and 71 normal control children (NG) were collected. All of those cases were evaluated with the integrated visual and auditory continuous performance test (IVA-CPT). Results It was slightly higher for visual response control quotient (VRCQ) in CAT group(85.15 ±21.10) than those in ADHD group(78.52 ± 21.85) (P ＜ 0.05), there was no significant different in the other five scores between CAT group and ADHD group (P＞0.05). It was significantly lower for the full response control quotient (FRCQ), auditory response control quotient (ARCQ) ,visual response control quotient (VRCQ), full attention quotient (FAQ), auditory attention quotient (AAQ) and visual attention Quotient (VAQ) in CAT group (83.43 ± 20.98,86.12 ± 19.88,85.15 ± 21. 10,64.88 ± 16.88,67.92 ± 17. 11 ,67.97 ± 20.04) than those in TD group(96.47 ± 17.83,97.50 ± 17.62,95.72 ± 18.87,85.37 ± 18.54,86.47 ± 17.32,87.43 ± 19.89) and those in normal control group(98.42 ± 12.67,101.50 ± 15.39,95.92 ± 11.79,99.33 ± 12.98,98.50 ± 12.09,100.00 ± 16.12) (P＜0.01). Conclusion There have serious reduced control ability and attention deficit in children with CAT. The attention deficit is attributed to the existence of ADHD.

O K-CPT em uma amostra brasileira: descrição do desempenho e comparação com as normas norte-americanas / K-CPT in a Brazilian sample: description of performance and comparison with North American norms

INTRODUÇÃO: O presente estudo investigou o desempenho de uma amostra de crianças brasileiras de 4 a 5 anos de idade no Conners' Kiddie CPT (K-CPT), uma tarefa computadorizada utilizada na avaliação da atenção e do controle inibitório em crianças. MÉTODO: Os escores de crianças brasileiras, que passaram por uma triagem para excluir déficit de atenção, foram comparados com as normas norte-americanas. RESULTADOS: Os efeitos de gênero e idade na nossa amostra foram similares aos descritos na literatura. Entretanto, a falta de triagem para déficit de atenção pode ter distorcido os dados normativos norte-americanos, pois meninos e meninas brasileiros tiveram melhores escores em quase todas as medidas. CONCLUSÕES: Os procedimentos de triagem aqui empregados, juntamente com a obtenção dos efeitos de idade e gênero previamente descritos, confirmam a adequação dos escores obtidos como referência local de desempenho, que podem ser úteis na avaliação de crianças pré-escolares no Brasil até que normas nacionais sejam estabelecidas.

INTRODUCTION: This study investigated the performance of a sample of Brazilian children aged 4-5 years on the Conners' Kiddie CPT (K-CPT), a computer-based task used to assess attention and inhibitory control in children. METHODS: Scores of Brazilian children pre-screened for attention disorders were obtained using the K-CPT, and data were compared with North American norms. RESULTS: Age and gender effects on the Brazilian sample were similar to those previously described. However, the lack of screening for attention deficits might have distorted normative scores of the K-CPT in the USA because Brazilian boys and girls had better scores than the North American children in almost all measures. CONCLUSION: The screening procedures used in Brazil, in addition to the previously described age and gender effects on sustained attention, indicate that the results described in the present study constitute appropriate local performance scores and, as such, are useful in the evaluation of pre-school children in Brazil until national norms are established.