Magnetic resonance imaging evaluation and nuclear receptor binding SET domain protein 1 mutation in the Sotos syndrome with attention-deficit/hyperactivity disorder

Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene.Attentiondeficit/hyperactivity disorder(ADHD)is considered a neurodevelopment and psychiatric disorder in childhood.Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD.Magnetic resonance imaging(MRI)has been used to assess medical images in Sotos syndrome and ADHD.The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial.In the future,genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.

Clinical and genetic characteristics of a child with Sotos syndrome and attention-deficit/hyperactivity disorder:A case report

BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.

Positive Effect of Transcranial Direct Current Stimulation on Visual Verbal Working Memory in Patients with Attention-Deficit/Hyperactivity Disorder

Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.

Attention-deficit/hyperactivity disorder and suicide:A systematic review

AIM To investigate suicidality and attention-deficit/hyperactivity disorder(ADHD), this paper aims to systematically review the literature as an extension of previous reviews.METHODS We searched five databases(Ovid MEDLINE, Psychinfo, PubM ed, Scopus, Web of Science) with two categories of search terms:(1) suicide; suicidal; suicide behavior; suicide attempt; suicidal thought; and(2) ADHD. RESULTS The search resulted 26 articles. There is a positive association between ADHD and suicidality in both sexes and in all age groups. Comorbid disorders mediate between suicidality and ADHD. CONCLUSION Recognizing ADHD, comorbid conditions and suicidality is important in prevention.

Alcohol and drug use disorders in adult attentiondeficit/hyperactivity disorder:Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation

BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

Generalized structural equation modeling:Symptom heterogeneity in attention-deficit/hyperactivity disorder leading to poor treatment efficacy

BACKGROUND Treatment efficacy for attention-deficit/hyperactivity disorder(ADHD)is reported to be poor,possibly due to heterogeneity of ADHD symptoms.Little is known about poor treatment efficacy owing to ADHD heterogeneity.AIM To use generalized structural equation modeling(GSEM)to show how the heterogeneous nature of hyperactivity/impulsivity(H/I)symptoms in ADHD,irritable oppositional defiant disorder(ODD),and the presentation of aggression in children interferes with treatment responses in ADHD.METHODS A total of 231 children and adolescents completed ADHD inattention and H/I tests.ODD scores from the Swanson,Nolan,and Pelham,version IV scale were obtained.The child behavior checklist(CBCL)and parent’s satisfaction questionnaire were completed.The relationships were analyzed by GSEM.RESULTS GSEM revealed that the chance of ADHD remission was lower in children with a combination of H/I symptoms of ADHD,ODD symptoms,and childhood aggressive behavior.ODD directly mediated ADHD symptom severity.The chance of reaching remission based on H/I symptoms of ADHD was reduced by 13.494%[=exp(2.602)]in children with comorbid ADHD and ODD[odds ratio(OR)=2.602,95%confidence interval(CI):1.832-3.373,P=0.000]after adjusting for the effects of other factors.Childhood aggression mediated ODD symptom severity.The chance of reaching remission based on ODD symptoms was lowered by 11.000%[=1-exp(-0.117)]in children with more severe baseline symptoms of aggression based on the CBCL score at study entry[OR=-0.117,95%CI:(-0.190)-(-0.044),P=0.002].CONCLUSION Mediation through ODD symptoms and aggression may influence treatment effects in ADHD after adjusting for the effects of baseline ADHD symptom severity.More attention could be directed to the early recognition of risks leading to ineffective ADHD treatment,e.g.,symptoms of ODD and the presentation of aggressive or delinquent behaviors and thought problems in children with ADHD.

Decision Making in Children with Attention-Deficit/Hyperactivity Disorder

Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for children with developmental disorders who show attention or similar problems. This study quantitatively evaluated the decision-making ability of these children using the Wechsler Intelligence Scale for Children-III (WISC-III) as a preliminary study for a multi-faceted investigation that would also use physiological indices. Methods: Participants were 11 children with Attention Deficit/Hyperactivity Disorder (AD/HD). The WISC-III was used for quantitative evaluation of their decision-making ability. Results of intelligence quotients (IQs), group indices, and subtest scores were analyzed. Results: The mean Performance IQ was four points lower than the mean Verbal IQ. The mean score for the Processing Speed index was lower by more than one standard deviation (SD). The mean scores for the Coding and Object Assembly subtests were lower by more than two SDs. Conclusion: The WISC-III results for IQ and group indices suggested the efficacy of auditory explanations. In addition, the subtest results suggested the necessity to pay sufficient attention to risk-benefit weighting in explanations. These findings suggested that the decision-making ability of children with AD/HD could be assessed using the WISC-III.

Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

A Preliminary Near-Infrared Spectroscopy Study in Adolescent and Adult Patients with Attention-Deficit/Hyperactivity Disorder Symptoms

Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.

Comparison of adults with attention-deficit/hyperactivity disorder versus Asperger’s disorder using the WAIS-R

Objective: The present study compared results on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) among adult patients with attention-deficit/hyperactivity disorder (AD/HD) and those with Asperger’s disorder (AD). Method: WAIS-R results were compared between 16 adults with AD/HD (8 men and 8 women;mean age, 33.81 years;mean full-scale IQ, 101.5) and 15 adults with AD (12 men and 3 women;mean age, 30.93 years;mean full-scale IQ, 104.6). Results: Verbal IQ was significantly higher than performance IQ in the AD group. Among various subtests, scores were the highest for similarities in the AD/HD group and for block design in the AD group. Picture completion test scores were the lowest scores obtained in both groups. A comparison of subtest scores between the AD/HD and AD groups showed scores for information to be significantly higher in the AD group than in the AD/HD group. Conclusions: Our results suggest that there are no differences in verbal IQ, performance IQ, and full-scale IQ scores (except for scores on the information subtest) among adult patients with AD/HD compared with adult patients with AD.

Basic Study Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder

BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly prescribed for children with ADHD and are considered effective in 70%of the cases.Furthermore,only a handful of studies have investigated the long-term impact of MPH medication on EF and behaviour.AIM To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time points.METHODS Thirty-seven children with ADHD completed a stimulant medication trial to study the short-and long-term impact of medication.Children with ADHD completed three neuropsychological assessments[Continuous Performance Test(CPT)-II,Digit Span Backwards and Spatial Span Backwards].Parents of children with ADHD completed behaviour rating scales[Behaviour Rating Inventory of Executive Functioning(BRIEF)and Behaviour Assessment System for Children-Second Edition(BASC-2)].Participants were evaluated at:(1)Baseline(no medication);and(2)Best-dose(BD;following four-week MPH treatment).Additionally,18 participants returned for a long-term naturalistic follow up(FU;up to two years following BD).RESULTS Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of BASC-2.Neuropsychological assessments showed some improvement,but not on all tasks following the medication trial.These improvements did not sustain at FU,with increases in EF and behaviour challenges,and a decline in performance on the CPT-II task being observed.CONCLUSION Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at FU.Combining screening tools and neuropsychological assessments may be useful for monitoring medication responses.

Food intolerance and the few-foods(or oligoantigenic)diet in children with attention-deficit hyperactivity disorder

The hypothesis that some children with attention-deficit hyperactivity disorder(ADHD)may show sensitivity or allergic reactions to various food items has led to the development of the the few-foods(or oligoantigenic)diet.The rationale of the diet is to eliminate certain foods from the diet in order to exclude potential allergens contained either naturally in food or in artificial ingredients with allergenic properties.The oligoantigenic diet attempts to identify individual foods to which a person might be sensitive.First,ADHD symptoms are monitored while multiple foods are excluded from the diet.Subsequently,if symptoms remit,foods are re-introduced,while observing the individual for the return of symptoms.An advantage of the oligoantigenic diet is that it can be tailored to the individual.A growing body of evidence suggests that behavioral symptoms of subgroups of children with ADHD may benefit from the elimination of certain foods.The effect sizes of an oligoantigenic diet regarding improvement of ADHD symptoms have been found to be medium to large.Available evidence suggests that the investigation of the role of food hypersensitivities in ADHD is a promising avenue worthy of further exploration.Further large-scale,randomized controlled studies including assessment of long-term outcome are therefore warranted.

Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder

BACKGROUND Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder(ADHD)in children,which can easily have adverse effects on children’s learning and social interactions.Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD.Compared with children with ADHD alone,children with asthma and ADHD are more likely to show high levels of hyperactivity,hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization.AIM To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors.METHODS This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023.Children diagnosed with ADHD at this hospital were selected as the ADHD group,while healthy children without ADHD who underwent physical examinations during the same period served as the control group.Clinical and parental data were collected for all participating children,and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD.RESULTSSignificant differences were detected between the ADHD group and the control group in terms of family history ofasthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergymedications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationshipstatus (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidityrate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the controlgroup. The difference in the asthma comorbidity rate between the two groups was statistically significant (P <0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergicdiseases, maternal complications during pregnancy, maternal use of asthma and allergy medications duringpregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independentrisk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05).CONCLUSIONChildren with ADHD were more likely to have comorbid asthma than healthy control children were. A familyhistory of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified asrisk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions basedon these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for resultssections of abstracts in scientific articles.

Impact of educational interventions on mothers’ awareness and communication with their attention-deficit hyperactivity disorder children

Objective:The objectives of this study are to evaluate the effects of the educational intervention on mothers’knowledge,awareness,and communication difficulties experienced with their children and mothers’capacity to successfully interact with their affected child before and after the intervention.Materials and Methods:A quasi-experimental research design was used.A total of 30 mothers and their children complaining of attention-deficit hyperactivity disorder from four Dawadmi primary schools were included.Data were collected through a self-developed questionnaire from September 2023 to January 2024 after study acceptance by Shaqra University’s scientific deanship.Intervention prepared according to subjects’needs and current scientific base and demonstrated in 10 sessions in schools.Results:Regarding mothers’age,more than one-fourth of them(26.7%)ranged from 31 to 35 year old,and about a third(36.7%)had secondary education.Regarding mother’s job,about 76.7%do not work,and the majority of affected children(66.6%)were male,there were significant improvements in mothers’knowledge pre-and postintervention also a significant improvement in mothers’awareness about symptoms of poor attention,hyperactivity,and impulsivity pre-and postintervention was found.Significant differences were found before and after the intervention regarding the impact of the intervention in decreasing mothers’challenges.Conclusion:The study hypothesis was accepted,and the intervention improved mothers;knowledge,awareness,and communication challenges.The intervention should be conducted and followed up for a long period of time to manage all mother’s and children’s daily challenges,improve children’s daily activities,and stabilize effective communication patterns between children and their family members.

Inattentiveness in attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder （ADHD） is a neurodevelopmental disorder with a long-term impact on functioning, productivity and quality of life of patients. This impact is largely due to the symptoms of inattentiveness. However, despite its impairing role in the lives of ADHD patients, inattentiveness has been studied relatively less frequently than have symptoms of impulsivity/hyperactivity and problems with executive function. This review therefore seeks to integrate the neuropsychological theories and current findings in the research fields of neuropsychology, neurophysiology, and neuroimaging, in an attempt to gain a more complete understanding of the role that inattentiveness plays in ADHD, as well as to suggest directions for future studies. The need for a more comprehensive understanding of inattentiveness and ADHD, which integrates findings from each of the three disciplines mentioned above, is emphasized.

Local synchronization and amplitude of the fluctuation of spontaneous brain activity in attention-deficit/hyperactivity disorder:a resting-state fMRI study

Regional homogeneity（ReHo）and the amplitude of low-frequency fluctuation（ALFF）are two approaches to depicting different regional characteristics of resting-state functional magnetic resonance imaging（RS-fMRI）data.Whether they can complementarily reveal brain regional functional abnormalities in attention-deficit/hyperactivity disorder（ADHD）remains unknown.In this study,we applied ReHo and ALFF to 23 medication-na ve boys diagnosed with ADHD and 25 age-matched healthy male controls using whole-brain voxel-wise analysis.Correlation analyses were conducted in the ADHD group to investigate the relationship between the regional spontaneous brain activity measured by the two approaches and the clinical symptoms of ADHD.We found that the ReHo method showed widely-distributed differences between the two groups in the fronto-cingulo-occipitocerebellar circuitry,while the ALFF method showed a difference only in the right occipital area.When a larger smoothing kernel and a more lenient threshold were used for ALFF,more overlapped regions were found between ALFF and ReHo,and ALFF even found some new regions with group differences.The ADHD symptom scores were correlated with the ReHo values in the right cerebellum,dorsal anterior cingulate cortex and left lingual gyrus in the ADHD group,while no correlation was detected between ALFF and ADHD symptoms.In conclusion,ReHo may be more sensitive to regional abnormalities,at least in boys with ADHD,than ALFF.And ALFF may be complementary to ReHo in measuring local spontaneous activity.Combination of the two may yield a more comprehensive pathophy-siological framework for ADHD.

Study on drug retention of methylphenidate and atomoxetine in children with attention-deficit/hyperactivity disorder

This study retrospectively analyzed the medication prescriptions of children diagnosed with attention-deficit/hyperactivity disorder(ADHD) in Ningbo Psychiatric Hospital and Ningbo Women and Children’s Hospital from March 2018 to September 2020 and compared the drug retention rate of methylphenidate hydrochloride and atomoxetine hydrochloride. The prescription automatic screening system was used to screen the prescriptions in children with ADHD. Kaplan-Meier regression analysis was used to compare prescription retention rates between the two regimens after adjusting for gender, age, body weight, and prescription cost. The mean age of the methylphenidate hydrochloride group was 8.75 ± 2.16 years, and the monthly prescription cost was 327.37 ± 146.64 RMB. The average age of the atomoxetine group was 8.33 ± 1.73 years, and the monthly prescription cost was 363.15 ± 154.90 ￥. There were some differences in the age of enrollment and the monthly prescription cost between the two regimens(all P < 0.01). Moreover, the retention rate of methylphenidate hydrochloride was higher compared with atomoxetine hydrochloride within 18 months. Kaplan-Meier regression analysis showed that this trend was significant(Tarone-ware, Chi-square value = 14.893, P < 0.001). Prescription costs might be a factor affecting drug retention. This study found that the retention rates were decreased month by month in children with ADHD, and after 5 months, the retention rates were 52.20% and 41.22%, respectively, far below the recommended levels of the guidelines.

Neuropsychological Profile Related with Executive Function of Chinese Preschoolers with Attention-Deficit/Hyperactivity Disorder： Neuropsychological Measures and Behavior Rating Scale of Executive Function-Preschool Version

Previous studies have found that schoolchildren with attention-deficit/hyperactivity disorder （ADHD） showed difficulties in neuropsychologicat function. This study aimed to assess neuropsychological function in Chinese preschoolers with ADHD using broad neuropsychological measures and rating scales and to test whether the pattern and severity of neuropsyehological weakness differed among ADH D presentations in preschool children. Methods： The 226 preschoolers （163 with ADHD and 63 controls） with the age of 4-5 years were included and assessed using the Behavior Rating Scale of Executive Function-Preschool Version （BRIEF-P） and a series of tests to investigate neuropsychological function. Results： Preschoolers with ADHD showed higher scorns in all domains of the BRIEF-P （inhibition： 30.64 ± 5.78 vs.20.69 ± 3.86, P 〈 0.001; shift： 13.40 ±3.03 vs. 12.41 ±2.79, P = 0.039; emotional control：15.10 ±3.53 vs.12.20 ±2.46, P 〈 0.001; working memory： 28.41± 4.99 vs.20.95± 4.60, P 〈 0.001 ; plan/organize： 17.04 ±3.30 vs. 13.29± 2.40, P 〈 0.001 ） and lower scores of Statue （23.18± 7.84 vs.28.27 ± 3.18, P = 0.001 ）, Word Generation （ 15.22 ± 6.52 vs. 19.53 ± 7.69, P = 0.025）, Comprehension of Instructions （ 14.00 ±4.44 vs. 17.02± 3.39, P = 0.016）, Visuomotor Precision （P 〈 0.050）, Toy delay （P = 0.048）, and Matrices tasks （P = 0.011）, compared with normal control. In terms of the differences among ADHD subtypes, all ADHD presentations had higher scores in several domains of the BRIEF-P （P 〈 0.001 ）, and the ADHD-combined symptoms （ADHD-C） group had the poorest ratings on inhibition and the ability to Plan/Organize. For neuropsychological measures, the results suggested that the ADHD-C group had poorer pertbrmances than the ADHD-predominantly inattentive symptoms （ADHD-I） group on Statue tasks （F = 7.34, η2= 0.12, P 〈 0.001 ）. Furthermore, the ADHD-hyperactive/impulsive symptoms group had significantly poorer perforulances compared to the ADHD-C group in the Block Construction task （F = 4.89, η2 = 0.067, P = 0.003）. However, no significant group differences were found between the ADHD-I group and normal control. Conclusion： Based on the combined evaluation of performance-based neuropsychological tests and the BRIEF-P, preschoolers with ADHD show difficulties of neuropsychological function in many aspects.

MicroRNAs as potential biomarkers for diagnosis of attention deficit hyperactivity disorder

Inappropriate levels of hyperactivity,impulsivity,and inattention characterize attention deficit hyperactivity disorder,a common childhood-onset neuropsychiatric disorder.The cognitive function and learning ability of children with attention deficit hyperactivity disorder are affected,and these symptoms may persist to adulthood if they are not treated.The diagnosis of attention deficit hyperactivity disorder is only based on symptoms and objective tests for attention deficit hyperactivity disorder are missing.Treatments for attention deficit hyperactivity disorder in children include medications,behavior therapy,counseling,and education services which can relieve many of the symptoms of attention deficit hyperactivity disorder but cannot cure it.There is a need for a molecular biomarker to distinguish attention deficit hyperactivity disorder from healthy subjects and other neurological conditions,which would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of attention deficit hyperactivity disorder.The recent studies reviewed had performed microRNA profiling in whole blood,white blood cells,blood plasma,and blood serum of children with attention deficit hyperactivity disorder.A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies.From the studies that had included a validation set of patients and controls,potential candidate biomarkers for attention deficit hyperactivity disorder in children could be miR-140-3p,let-7g-5p,-30e-5p,-223-3p,-142-5p,-486-5p,-151a-3p,-151a-5p,and-126-5p in total white blood cells,and miR-4516,-6090,-4763-3p,-4281,-4466,-101-3p,-130a-3p,-138-5p,-195-5p,and-106b-5p in blood serum.Further studies are warranted with children and adults with attention deficit hyperactivity disorder,and consideration should be given to utilizing rat models of attention deficit hyperactivity disorder.Animal studies could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.

Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a common mental and behavioral disorder among children.AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old(16.6%)and poor academic performance for children over 7 years old(12.1%).We employed a two-stage experiment to diagnose ADHD.Among the 5683 children evaluated from 2018 to 2021,360 met the DSM-5 criteria.Those diagnosed with ADHD underwent assessments for letter,number,and figure attention.Following the exclusion of ADHD-H diagnoses,the detection rate rose to 96.0%,with 310 out of 323 cases identified.RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test,offering valuable guidance for directing ADHD treatment,facilitating early detection,and enabling timely intervention.Our research delved into the predominant worries of parents across various age groups.Furthermore,we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children.CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.