[Neuropsychological assessment of memory in attention deficit hyperactivity disorder: the role of executive functions]. / Evaluación neuropsicológica de la memoria en el trastorno pordéficit de atención/hiperactividad: papel de las funciones ejecutivas.

INTRODUCTION: There is an important agreement on the consideration of attention deficit hyperactivity disorder (ADHD) as a condition characterized by neurodevelopmental dysfunction of fronto-striatal dopaminergic and noradrenergic circuits with resultant executive deficits in cognitive functioning. AIM: To assess the existence of memory deficits in children with ADHD associated with a poor performance executive. SUBJECTS AND METHODS: We assess 14 children diagnosed with ADHD combined type and 14 controls matched on intellectual coefficient, age and level of schooling, in a neuropsychological evaluation protocol designed to assess executive functions and memory skills using Auditory Verbal Learning Test, Memory for Stories Test -Test of Memory and Learning (TOMAL)-, Complex Figure Text, Visual Selective Reminding Test (TOMAL), Tower of Hanoi, Memory Phrases Test (Siegel and Ryan), Digit Span (Wechsler Intelligence Scale for Children-Revised) and Tapping Test (Wechsler Memory Scale III). RESULTS: The ADHD group showed deficits in the learning and free recall of verbal material, in procedural and working memory. No group differences were observed in the visual memory tasks. CONCLUSIONS: The results are analyzed in terms of difficulty in coding strategies, storage and search of information previously stored in the group with ADHD, at least for the kind of verbal information. These difficulties are associated with deficits in executive functioning.

Evaluación neuropsicológica de la memoria en el trastorno por déficit de atención/hiperactividad: papel de las funciones ejecutivas / Neuropsycological assessment of memory in attention deficit hyperactivity disorder: The role of executive functions

Introducción. Existe un acuerdo importante en la consideración del trastorno por déficit de atención/hiperactividad (TDAH) como una patología del neurodesarrollo caracterizada por déficit dopaminérgicos y noradrenérgicos de los circuitos frontoestriados que afectan al funcionamiento ejecutivo en el rendimiento cognitivo. Objetivo. Evaluar la existencia de déficit en memoria en niños con TDAH asociados a un deficiente rendimiento ejecutivo. Sujetos y métodos. Administramos a 14 niños diagnosticados de TDAH tipo combinado y a 14 controles equiparados en cociente intelectual, edad y nivel de escolarización, un protocolo de evaluación neuropsicológica destinado a evaluar funciones ejecutivas y habilidades de memoria, mediante las pruebas Auditory Verbal Learning Test, test de memoria de historias –test de memoria y aprendizaje (TOMAL)–,figura compleja de Rey, recuerdo selectivo visual (TOMAL), torre de Hanoi, test de memoria de frases (Siegel y Ryan), test de dígitos (escala de inteligencia para niños de Wechsler revisada) y test de tapping visual (escala de memoria de Wechsler III).Resultados. Se encontró que los niños con TDAH presentan déficit en el aprendizaje y en el recuerdo libre del material verbal descontextualizado y contextualizado, en la memoria de trabajo y en la memoria procedimental. Por el contrario, no se encontraron diferencias significativas entre los grupos en las pruebas de memoria de naturaleza visuoespacial y visuoperceptiva.Conclusiones. Los resultados obtenidos se analizan en términos de dificultades en las estrategias de codificación, almacenamiento y búsqueda de la información previamente almacenada en el grupo con TDAH, al menos para la información de naturaleza verbal. Estas dificultades están asociadas a déficit en el funcionamiento ejecutivo

Introduction. There is an important agreement on the consideration of attention deficit hyperactivity disorder(ADHD) as a condition characterized by neurodevelopmental dysfunction of fronto-striatal dopaminergic and noradrenergic circuits with resultant executive deficits in cognitive functioning. Aim. To assess the existence of memory deficits in children with ADHD associated with a poor performance executive. Subjects and methods. We assess 14 children diagnosed with ADHD combined type and 14 controls matched on intellectual coefficient, age and level of schooling, in a neuropsychological evaluation protocol designed to assess executive functions and memory skills using Auditory Verbal Learning Test, Memoryfor Stories Test –Test of Memory and Learning (TOMAL)–, Complex Figure Text, Visual Selective Reminding Test (TOMAL), Tower of Hanoi, Memory Phrases Test (Siegel and Ryan), Digit Span (Wechsler Intelligence Scale for Children-Revised) and Tapping Test (Wechsler Memory Scale III). Results. The ADHD group showed deficits in the learning and free recall of verbal material, in procedural and working memory. No group differences were observed in the visual memory tasks. Conclusions. The results are analyzed in terms of difficulty in coding strategies, storage and search of information previously stored in the group with ADHD, at least for the kind of verbal information. These difficulties are associated with deficits in executivefunctioning

[Neuropsychological assessment of the effectiveness of OROS-methylphenidate in attention deficit hyperactivity disorder]. / Evaluación neuropsicológica de la eficacia del metilfenidato-OROS en el trastorno por deficit de atención/hiperactividad.

INTRODUCTION: There is wide evidence about dopaminergic and noradrenergic mechanisms in fronto-striatal circuits which are thought to be related with attention deficit hyperactivity disorder (ADHD) neurobiology. That dysfunction may explain core symptoms and part of executive deficits in cognitive functioning. Methylphenidate is effective in alleviating core symptoms, enhancing dopaminergic and noradrenergic biodisponibility. Less evidence in improving executive functions, specially working memory is found. AIMS: To assess if methylphenidate-OROS has a potential effect increasing working memory and attention parameters in ADHD children, and to determine if initial working memory and attention differences between ADHD and control group disappear after one month of daily methylphenidate-OROS treatment. SUBJECTS AND METHODS: Eleven children with ADHD were selected and as control group was chosen eleven children compared in age, intelligence quotient, school grade, and social-demographic status. Neuropsychological battery was administered in naive ADHD patients at three times, before treatment, after the first methylphenidate-OROS dose, and after one month of daily treatment. Simultaneously neuropsychological battery was administered to control group. RESULTS. Statistically significant differences were found in neuropsychological variables of working memory after one month daily treatment with methylphenidate-OROS and attention parameters after only one dose in ADHD group. Differences between naive ADHD and control group in terms of working memory were statistically significant before treatment but not after one month daily treatment. CONCLUSION: Methylphenidate-OROS improves attention achievement after the first dose and working memory after one month of daily treatment.

Evaluación neuropsicológica de la eficacia del metilfenidato-OROS en el trastorno por déficit de atención/hiperactividad / Neuropsychological assessment of the effectiveness of oros-methylphenidate in attention deficit hyperactivity disorder

El déficit dopaminérgico y noradrenérgico en los circuitos frontoestriatales es considerado como labase bioquímica del trastorno por déficit de atención/hiperactividad (TDAH). Estas alteraciones parecen explicar parte de sus déficit cognitivos, entre los cuales están las funciones ejecutivas. El metilfenidato incrementa la biodisponibilidad dopaminérgica y noradrenérgica en la corteza prefrontal y los ganglios basales. Este hecho supone beneficios inmediatos en el incremento de la atención y un descenso de la impulsividad. Menos documentado está el efecto del metilfenidato sobre las funciones ejecutivas y, en concreto, sobre la memoria de trabajo. Objetivos. Evaluar si el metilfenidato-OROS incrementa el rendimiento de los TDAH en diversos parámetros atencionales y en tareas de memoria de trabajo, y estudiar si las diferencias entre el grupo con TDAH y el grupo control desaparecen tras un mes de tratamiento con metilfenidato-OROS. Sujetos y métodos.Se seleccionaron 11 pacientes con TDAH y 11 sujetos control equiparados en edad, cociente intelectual, años de escolaridad y nivel socioeconómico. Se administró un protocolo neuropsicológico en tres momentos: antes del tratamiento, tras una sola dosis y tras un mes de tratamiento con metilfenidato-OROS. Se administró el mismo protocolo neuropsicológico al grupocontrol. Resultados. Se encontraron diferencias en memoria de trabajo tras un mes de tratamiento y en parámetros atencionales tras una sola toma en el grupo con TDAH. Las diferencias iniciales entre el grupo con TDAH y el grupo control en memoria de trabajo dejaron de ser significativas tras un mes de tratamiento. Conclusión. El metilfenidato-OROS mejora elrendimiento atencional desde la primera dosis y la memoria de trabajo verbal tras un mes de administración diaria

There is wide evidence about dopaminergic and noradrenergic mechanisms in fronto-striatal circuitswhich are thought to be related with attention deficit hyperactivity disorder (ADHD) neurobiology. That dysfunction may explain core symptoms and part of executive deficits in cognitive functioning. Methylphenidate is effective in alleviating coresymptoms, enhancing dopaminergic and noradrenergic biodisponibility. Less evidence in improving executive functions, specially working memory is found. Aims. To assess if methylphenidate-OROS has a potential effect increasing working memory and attention parameters in ADHD children, and to determine if initial working memory and attention differences between ADHD and control group disappear after one month of daily methylphenidate-OROS treatment. Subjects andmethods. Eleven children with ADHD were selected and as control group was chosen eleven children compared in age,intelligence quotient, school grade, and social-demographic status. Neuropsychological battery was administered in naive ADHD patients at three times, before treatment, after the first methylphenidate-OROS dose, and after one month of daily treatment. Simultaneously neuropsychological battery was administered to control group. Results. Statistically significant differences were found in neuropsychological variables of working memory after one month daily treatment with methylphenidate-OROS and attention parameters after only one dose in ADHD group. Differences between naive ADHD and controlgroup in terms of working memory were statistically significant before treatment but not after one month daily treatment. Conclusion. Methylphenidate-OROS improves attention achievement after the first dose and working memory after one month of daily treatment