Sleep-Dependent Consolidation of Rewarded Behavior Is Diminished in Children with Attention Deficit Hyperactivity Disorder and a Comorbid Disorder of Social Behavior.

Children suffering from attention-deficit hyperactivity disorder (ADHD) often also display impaired learning and memory. Previous research has documented aberrant reward processing in ADHD as well as impaired sleep-dependent consolidation of declarative memory. We investigated whether sleep also fosters the consolidation of behavior learned by probabilistic reward and whether ADHD patients with a comorbid disorder of social behavior show deficits in this memory domain, too. A group of 17 ADHD patients with comorbid disorders of social behavior aged 8-12 years and healthy controls matched for age, IQ, and handedness took part in the experiment. During the encoding task, children worked on a probabilistic learning task acquiring behavioral preferences for stimuli rewarded most often. After a 12-hr retention interval of either sleep at night or wakefulness during the day, a reversal task was presented where the contingencies were reversed. Consolidation of rewarded behavior is indicated by greater resistance to reversal learning. We found that healthy children consolidate rewarded behavior better during a night of sleep than during a day awake and that the sleep-dependent consolidation of rewarded behavior by trend correlates with non-REM sleep but not with REM sleep. In contrast, children with ADHD and comorbid disorders of social behavior do not show sleep-dependent consolidation of rewarded behavior. Moreover, their consolidation of rewarded behavior does not correlate with sleep. The results indicate that dysfunctional sleep in children suffering from ADHD and disorders of social behavior might be a crucial factor in the consolidation of behavior learned by reward.

Memory consolidation of socially relevant stimuli during sleep in healthy children and children with attention-deficit/hyperactivity disorder and oppositional defiant disorder: What you can see in their eyes.

Children with attention-deficit/hyperactivity disorder (ADHD) display deficits in sleep-dependent memory consolidation, and being comorbid with oppositional defiant disorder (ODD), results in deficits in face processing. The aim of the present study was to investigate the role of sleep in recognizing faces in children with ADHD+ODD. Sixteen healthy children and 16 children diagnosed with ADHD+ODD participated in a sleep and a wake condition. During encoding (sleep condition at 8p.m.; wake condition at 8a.m.) pictures of faces were rated according to their emotional content; the retrieval session (12h after encoding session) contained a recognition task including pupillometry. Pupillometry and behavioral data revealed that healthy children benefited from sleep compared to wake with respect to face picture recognition; in contrast recognition performance in patients with ADHD+ODD was not improved after sleep compared to wake. It is discussed whether in patients with ADHD+ODD social stimuli are preferentially consolidated during daytime.

Sleep promotes consolidation of emotional memory in healthy children but not in children with attention-deficit hyperactivity disorder.

Fronto-limbic brain activity during sleep is believed to support the consolidation of emotional memories in healthy adults. Attention deficit-hyperactivity disorder (ADHD) is accompanied by emotional deficits coincidently caused by dysfunctional interplay of fronto-limbic circuits. This study aimed to examine the role of sleep in the consolidation of emotional memory in ADHD in the context of healthy development. 16 children with ADHD, 16 healthy children, and 20 healthy adults participated in this study. Participants completed an emotional picture recognition paradigm in sleep and wake control conditions. Each condition had an immediate (baseline) and delayed (target) retrieval session. The emotional memory bias was baseline-corrected, and groups were compared in terms of sleep-dependent memory consolidation (sleep vs. wake). We observed an increased sleep-dependent emotional memory bias in healthy children compared to children with ADHD and healthy adults. Frontal oscillatory EEG activity (slow oscillations, theta) during sleep correlated negatively with emotional memory performance in children with ADHD. When combining data of healthy children and adults, correlation coefficients were positive and differed from those in children with ADHD. Since children displayed a higher frontal EEG activity than adults these data indicate a decline in sleep-related consolidation of emotional memory in healthy development. In addition, it is suggested that deficits in sleep-related selection between emotional and non-emotional memories in ADHD exacerbate emotional problems during daytime as they are often reported in ADHD.

Sleep restores daytime deficits in procedural memory in children with attention-deficit/hyperactivity disorder.

Sleep supports the consolidation of declarative and procedural memory. While prefrontal cortex (PFC) activity supports the consolidation of declarative memory during sleep, opposite effects of PFC activity are reported with respect to the consolidation of procedural memory during sleep. Patients with attention-deficit/hyperactivity disorder (ADHD) are characterised by a prefrontal hypoactivity. Therefore, we hypothesised that children with ADHD benefit from sleep with respect to procedural memory more than healthy children. Sixteen children with ADHD and 16 healthy controls (aged 9-12) participated in this study. A modification of the serial-reaction-time task was conducted. In the sleep condition, learning took place in the evening and retrieval after a night of sleep, whereas in the wake condition learning took place in the morning and retrieval in the evening without sleep. Children with ADHD showed an improvement in motor skills after sleep compared to the wake condition. Sleep-associated gain in reaction times was positively correlated with the amount of sleep stage 4 and REM-density in ADHD. As expected, sleep did not benefit motor performance in the group of healthy children. These data suggest that sleep in ADHD normalizes deficits in procedural memory observed during daytime. It is discussed whether in patients with ADHD attenuated prefrontal control enables sleep-dependent gains in motor skills by reducing the competitive interference between explicit and implicit components within a motor task.

Sleep selectively enhances memory expected to be of future relevance.

The brain encodes huge amounts of information, but only a small fraction is stored for a longer time. There is now compelling evidence that the long-term storage of memories preferentially occurs during sleep. However, the factors mediating the selectivity of sleep-associated memory consolidation are poorly understood. Here, we show that the mere expectancy that a memory will be used in a future test determines whether or not sleep significantly benefits consolidation of this memory. Human subjects learned declarative memories (word paired associates) before retention periods of sleep or wakefulness. Postlearning sleep compared with wakefulness produced a strong improvement at delayed retrieval only if the subjects had been informed about the retrieval test after the learning period. If they had not been informed, retrieval after retention sleep did not differ from that after the wake retention interval. Retention during the wake intervals was not affected by retrieval expectancy. Retrieval expectancy also enhanced sleep-associated consolidation of visuospatial (two-dimensional object location task) and procedural motor memories (finger sequence tapping). Subjects expecting the retrieval displayed a robust increase in slow oscillation activity and sleep spindle count during postlearning slow-wave sleep (SWS). Sleep-associated consolidation of declarative memory was strongly correlated to slow oscillation activity and spindle count, but only if the subjects expected the retrieval test. In conclusion, our work shows that sleep preferentially benefits consolidation of memories that are relevant for future behavior, presumably through a SWS-dependent reprocessing of these memories.

Virtual social interactions in social anxiety--the impact of sex, gaze, and interpersonal distance.

In social interactions, interpersonal distance between interaction partners plays an important role in determining the status of the relationship. Interpersonal distance is an important nonverbal behavior, and is used to regulate personal space in a complex interplay with other nonverbal behaviors such as eye gaze. In social anxiety, studies regarding the impact of interpersonal distance on within-situation avoidance behavior are so far rare. Thus the present study aimed to scrutinize the relationship between gaze direction, sex, interpersonal distance, and social anxiety in social interactions. Social interactions were modeled in a virtual-reality (VR) environment, where 20 low and 19 high socially anxious women were confronted with approaching male and female characters, who stopped in front of the participant, either some distance away or close to them, and displayed either a direct or an averted gaze. Gaze and head movements, as well as heart rate, were measured as indices of avoidance behavior and fear reactions. High socially anxious participants showed a complex pattern of avoidance behavior: when the avatar was standing farther away, high socially anxious women avoided gaze contact with male avatars showing a direct gaze. Furthermore, they showed avoidance behavior (backward head movements) in response to male avatars showing a direct gaze, regardless of the interpersonal distance. Overall, the current study proved that VR social interactions might be a very useful tool for investigating avoidance behavior of socially anxious individuals in highly controlled situations. This might also be the first step in using VR social interactions in clinical protocols for the therapy of social anxiety disorder.