ABSTRACT
El sueño es uno de los actos fisiológicos más importantes para la estructuración funcional y anatómica de áreas del sistema nervioso central. Las alteraciones del sueño durante la infancia y su relación con trastornos del neurodesarrollo es compleja y sumam ente interesante, donde destaca la multiplicidad de causas de estos trastornos. Bajo esta premisa se realiza una revisión sobre las alteraciones del sueño en los trastornos del neurodesarrollo (TND), por déficit de atención e hiperactividad (TDAH) y del espectro autista (TEA). El sueño está presente desde la etapa fetal y va modificando su expresión en sintonía con la madurez del sistema nervioso central. Los trastornos del sueño y su relación con TDAH, TEA y otros TND son complejos, pero existen avances sobre la etiología de los mismos. Una mayor compresión de las funciones pleiotrópicas de los genes implicados en los trastornos del ciclo vigilia-sueño y en las desviaciones del desarrollo neurológico podría conducir a nuevas estrategias diagnósticas y terapéuticas de manera precoz con el fin de mejorar la calidad de vida del paciente, familiares y cuidadores.
The development and establishment of the normal sleep patterns are very important processes in the final anatomical and physiological architecture of the central nervous system. The relationship between sleep disturbances during childhood with neurodevelopmental disorders is complex and potentially synergistic. Sleep patterns are present since the fetal period but their structure and physiology is modified according with the maturation of the central nervous system. Sleep disorders and their relationship with attention deficit hyperactivity disorders(ADHD), autism spectrum disorders(ASD) and other neurodevelopmental disorders (TDN) are not well understood yet, but significant progresses have been made in understanding associations and potential etiological correlations. We reviewed sleep disturbances in NDT, in ADHD and in ASD. A greater understanding of the pleiotropic functions of the genes involved in sleep-wake cycle disorders and deviations from neurological developme nt could lead to new diagnostic and therapeut ic strategies in an early stage in order to improve the quality of life of the patient, relatives and caregivers.
Subject(s)
Humans , Child, Preschool , Attention Deficit Disorder with Hyperactivity/complications , Sleep Wake Disorders/complications , Autism Spectrum Disorder/complications , Attention Deficit Disorder with Hyperactivity/genetics , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/genetics , Circadian Rhythm , Autism Spectrum Disorder/geneticsABSTRACT
OBJECTIVE: Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity. METHODS: 650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics. RESULTS: We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU. CONCLUSION: The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.
Subject(s)
Adolescent , Humans , Attention Deficit Disorder with Hyperactivity , Internet , Longitudinal Studies , Prospective Studies , Risk FactorsABSTRACT
OBJECTIVES: It is known that adolescents with autism spectrum disorder (ASD) often concurrently exhibit attention-deficit hyperactivity disorder (ADHD). The objective of this study is to investigate how ADHD symptoms modify clinical characteristics in adolescents with ASD. METHODS: Subjects were recruited from the Program for the Education Enrichment of Relational Skills program, which is a program for adolescents with ASD to promote and train social skills. The study participants and their parents completed the study questionnaires, such as the ADHD rating scale, Autism Diagnostic Observation Schedule, and Korean version of Child Behavior Checklist. RESULTS: Adolescents with ASD and ADHD (N=19) were found to have more impaired sociality, less open communication with their parents, and more behavioral and emotional problems compared with adolescents with ASD, and without ADHD (N=28). CONCLUSION: Although further research is needed, the results of our study suggest that adolescents with ASD present different clinical characteristics when comorbid with ADHD.
Subject(s)
Adolescent , Child , Humans , Appointments and Schedules , Autistic Disorder , Checklist , Child Behavior , Autism Spectrum Disorder , Comorbidity , Education , Parents , Surveys and QuestionnairesABSTRACT
PURPOSE: The purpose of this study was to explore factors related to the medication compliance by severity levels of children on Attention Deficit Hyperactive Disorder (ADHD) medication. METHODS: The method employed in this study was a descriptive correlational and cross-sectional survey design using face-to-face interviews. The survey was conducted from September, to October, 25, 2010 through a self-report questionnaire following consent of 143 mothers. Interview instruments, which were used in the study were CARS, PAI, ADHD knowledge instrument, BDI, a maternal behavior instrument, TAQ, and TAB instrument. Descriptive statistics, t-test, analysis of variance, and Pearson' correlation were used for data analysis. RESULTS: Mothers who perceived their children as not hyperactive were significantly higher in accepting medication and positive maternal behaviors than mothers who perceived their children as hyperactive. The mother perceived their children as not hyperactive showed positive correlation to adherence with ADHD medication and ADHD knowledge but a negative correlation with depression and children's ADHD symptoms. There was, however, no correlation between medication adherence and any other variables in the mothers of children with hyperactivity. CONCLUSION: The results of this study indicate that different approaches are needed according to the severity of ADHD in children on medication and children's medication adherence.
Subject(s)
Child , Humans , Attention Deficit Disorder with Hyperactivity , Cross-Sectional Studies , Depression , Maternal Behavior , Medication Adherence , Mothers , Surveys and QuestionnairesABSTRACT
The frontal lobe, the most human part of the brain (Goldberg), has been intensely studied, particularly in the last decades. This region is crucial for the control of behavior, cognition, planning, and working memory. Both behavior and higher cognitive abilities depend importantly on the arousal level, and on the autonomic responses that anticipate and accompany behaviors. In this review we will discuss the role played by the medial prefrontal cortex in controlling the level of vigilance and the autonomic and endocrine responses that are crucial for normal behavior. We will also discuss how dysfunctions of the medial prefrontal cortex resulting in the loss of the cortical control over arousal (both behavioral and vegetative) can help to explain the behavioral alterations observed in patients with posttraumatic stress, schizophrenia, attentional deficit and hyperactivity disorder and antisocial and aggressive behavior. Additionally we will discuss how studies in rats may give us valuable information about of the mechanisms by which the medial prefrontal cortex is capable of controlling the arousal state, autonomic and emotional responses in humans.
El lóbulo frontal, la parte más humana del cerebro, como lo propone E. Goldberg, ha llamado intensamente la atención de los investigadores en las últimas décadas. Esta región es clave en el control de la conducta, la personalidad, la memoria de trabajo, y en funciones cognitivas superiores. Sin embargo, tanto la conducta como las habilidades cognitivas superiores dependen de manera importante del estado de alerta, y de las respuestas autonómicas y emocionales asociadas. En esta revisión discutiremos acerca del papel que la corteza prefrontal medial juega en el control del alerta, y cómo alteraciones en la actividad de la corteza prefrontal medial, al afectar dicho control cortical, pueden explicar las alteraciones conductuales observadas en pacientes con estrés postraumático, esquizofrenia, déficit atencional y conductas antisociales y agresivas. Adicionalmente discutiremos cómo los estudios en la rata pueden darnos valiosa información sobre los mecanismos por los cuales la corteza prefrontal medial es capaz de manejar el alerta, el control autonómico y el control emocional.