ABSTRACT
We studied error-related negativity (ERN) and error positivity (Pe) during a discrimination task in 319 unmedicated children divided into subtypes of ADHD (Not-ADHD/inattentive/combined), learning disorder (Not-LD/reading/math/reading+math), and oppositional defiant disorder. Response-locked ERPs contained a frontocentral ERN and posterior Pe. Error-related negativity and positivity exhibited larger amplitude and later latency than corresponding waves for correct responses matched on reaction time. ADHD did not affect performance on the task. The ADHD/combined sample exceeded controls in ERN amplitude, perhaps reflecting patients' adaptive monitoring efforts. Compared with controls, subjects with reading disorder and reading+math disorder performed worse on the task and had marginally more negative correct-related negativities. In contrast, Pe/Pc was smaller in children with reading+math disorder than among subjects with reading disorder and Not-LD participants; this nonspecific finding is not attributable to error processing. The results reflect anomalies in error processing in these disorders but further research is needed to address inconsistencies in the literature.
Subject(s)
Attention Deficit Disorder with Hyperactivity/physiopathology , Attention Deficit and Disruptive Behavior Disorders/physiopathology , Contingent Negative Variation , Dyslexia/physiopathology , Evoked Potentials/physiology , Learning Disabilities/physiopathology , Mathematics , Adolescent , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/psychology , Cerebral Cortex/physiopathology , Child , Discrimination Learning/physiology , Dyslexia/diagnosis , Dyslexia/psychology , Female , Functional Laterality/physiology , Humans , Learning Disabilities/diagnosis , Learning Disabilities/psychology , Male , Pattern Recognition, Visual/physiology , Probability Learning , Psychomotor Performance/physiology , Reaction Time/physiologyABSTRACT
OBJECTIVE: To compare the effects of methylphenidate on attention-deficit/hyperactivity disorder (ADHD) subtypes. METHOD: Nineteen ADHD/inattentive (ADHD/I) and 22 ADHD/combined (ADHD/C) 6- to 12-year-old children entered a 6-week, double-blind trial of placebo and methylphenidate in divided doses (0.94 +/- 0.02 mg/kg/day = 33.06 +/- 1.40 mg/day). ADHD children received a restricted arithmetic task without medication before the trial and after their noon dose on the last day of each phase. Thirty-four unmedicated controls were tested at comparable time points. Parents and teachers rated ADHD children before and after each phase of the trial; parents rated controls before the study. RESULTS: Controls had marginally better arithmetic performance than children with ADHD/C who outperformed ADHD/I children. Unmedicated children with ADHD exceeded controls in task-incompatible behaviors during restricted arithmetic. Under methylphenidate, both ADHD subtypes reached control levels of arithmetic performance and task-incompatible behavior. Before the trial, parents rated children with both ADHD subtypes higher than controls on inattention, hyperactivity, and oppositionality/aggression and parents and teachers rated ADHD/C children higher than ADHD/I children on hyperactivity and oppositionality/aggression but not inattention. Methylphenidate lowered parent and teacher ratings of inattention and hyperactivity for those with both ADHD subtypes, but ratings of children with ADHD/C decreased more in hyperactivity and aggression. CONCLUSIONS: Methylphenidate ameliorated task-incompatible behavior, arithmetic performance, and inattention comparably in both ADHD subtypes, whereas medication reduced hyperactivity and aggression largely in children with ADHD/C.
Subject(s)
Attention Deficit Disorder with Hyperactivity/classification , Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/therapeutic use , Methylphenidate/therapeutic use , Aggression/psychology , Attention/drug effects , Child , Double-Blind Method , Female , Humans , Male , Treatment OutcomeABSTRACT
We administered the Tower of Hanoi to demographically comparable samples of control participants (n = 34) and children with the Combined (n = 22) and Inattentive subtypes (n = 19) of Attention-Deficit/Hyperactivity Disorder (ADHD). Controls excelled over children with the Inattentive subtype, who outperformed patients with the Combined subtype. These results replicated findings of greater executive deficits in the Combined than in the Inattentive type of ADHD. Double-blind administration of methylphenidate improved task performance only for patients with the Inattentive subtype. In a drug-free Baseline session, children with both subtypes of ADHD made more private verbalizations than controls, particularly when failing puzzles. In later sessions, regardless of drug condition, the inattentive sample exhibited a smaller increase in self-regulatory utterances under failure. In contrast, the combined sample decreased self-regulatory verbalizations under failure only under methylphenidate. The results support some differences between the two subtypes of ADHD in executive functioning and in their response to stimulant therapy.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/drug therapy , Central Nervous System Stimulants/therapeutic use , Methylphenidate/therapeutic use , Neuropsychological Tests , Speech , Verbal Behavior , Child , Double-Blind Method , Female , Humans , MaleABSTRACT
We investigated the eyeblink component of acoustic startle reactions in maltreated children. Previous research indicates that acoustic startle is enhanced in adult males with posttraumatic stress disorders (PTSD) whereas findings on women with PTSD have been inconsistent. In accord with the only previous report for children with PTSD, we found that maltreated boys, particularly those who had been physically abused, responded to increases in startle probe loudness with smaller increments in amplitude of startle eyeblink and smaller reductions in blink latency than did comparison boys. Results for girls were inconsistent: younger maltreated girls had smaller startle amplitude and slower onset latency than controls, whereas older maltreated girls exhibited the opposite pattern.
Subject(s)
Child Abuse/psychology , Noise/adverse effects , Reflex, Startle , Stress Disorders, Post-Traumatic/etiology , Child , Child Abuse/statistics & numerical data , Electromyography , Female , Humans , Male , Sex Factors , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiologyABSTRACT
BACKGROUND: We investigated the impact of stimulus probability and sequence on performance and event-related potentials of 310 children classified into 12 combinations of attention-deficit/hyperactivity disorder (Not-attention-deficit/hyperactivity disorder, Inattentive and Combined subtypes) with presence/absence of reading disorder and math disorder. METHODS: Subjects pressed buttons to displays of the letters O and X, which were presented with probabilities of either .17/.83 or .50/.50. Greater response selection was required in the .17/.83 condition. RESULTS: Stimulus probability had comparable effects on all diagnostic groups. The extent of mismatch between a stimulus and preceding events elicited less systematic increases in errors, P3b latency, and P3b amplitude among both attention-deficit/hyperactivity disorder subtypes than controls. Mismatch with preceding trials more greatly reduced math disorder and reading disorder + math disorder children's speed in the Rare task and accuracy in both conditions. Math disorder and reading disorder + math disorder subjects also registered less the effects of alternations of the infrequent O on N2 amplitude and on P3b latency. CONCLUSIONS: Math disorder and reading disorder + math disorder youngsters' lower sensitivity to sequence irregularity in their event-related potentials along with greater disruption of performance suggest working memory deficits that adversely affected response selection. Comorbidity of attention-deficit/hyperactivity disorder and reading disorder did not affect the results.
