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.

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.

Early Intervention Facilitates Neuropsychological Development in Children with Autism and Attention Deficit Hyperactivity Disorder

Objective:This study aims to investigate the impact of early intervention on neuropsychological development in children with autism and attention deficit hyperactivity disorder(ADHD),providing effective intervention strategies for clinical practice.Methods:A total of 130 children with autism and ADHD who visited the hospital between June 2023 and June 2024 were selected as study subjects and randomly divided into an intervention group and a control group,with 65 children in each group.The intervention group received a one-year early comprehensive intervention,including behavioral therapy,cognitive training,and family guidance,while the control group only received routine medical care.The neuropsychological development assessment scale was used to evaluate both groups before and after the intervention to compare changes in their neuropsychological development levels.Results:Children in the intervention group showed significant improvements in cognitive function,social skills,language ability,and attention concentration,with an average improvement score of 23.5 points.Children in the control group did not show significant improvements in these areas,with an average improvement score of only 5.8 points.The difference between the two groups was statistically significant(P<0.05).Conclusion:Early comprehensive intervention has a significant promoting effect on the neuropsychological development of children with autism and ADHD.Targeted behavioral therapy,cognitive training,and family guidance can effectively enhance children’s cognitive,social,language,and attention abilities,laying a solid foundation for their future overall development.Therefore,it is recommended to actively promote and apply early intervention strategies in clinical practice.

A retrospective study on professor Gui-Qi Xuan’s experience in traditional Chinese medicine treatment on attention-deficit hyperactivity disorder: based on data mining and network pharmacology

Background:To investigate the clinical medication approach of Professor Guiqi Xuan(Prof.Xuan)in treating pediatric patients with attention-deficit hyperactivity disorder(ADHD)and the potential mechanism of the core herbal prescription.Methods:Following medical record information pretreatment,the Traditional Chinese Medicine(TCM)inheritance computing platform system V3.0 was utilized to analyze the standardized data.The associate rules were summarized to identify the core prescription for treating ADHD.The extracted core herbal prescription’s active compounds and potential targets were used to establish a protein-protein interaction network of active ingredient-disease targets.Cytoscape 3.9.1 software was used to analyze the network’s topological parameters to obtain the key active ingredients and their targets.The Bioconductor data package of R4.0.2 was used to analyze the gene ontology biological functions and Kyoto Encyclopedia of Genes and Genomes pathways of key targets.Results:Two hundred and twenty-seven entries derived from TCM record information were selected.Through data mining,it was found that 62.5%of pediatric patients had short-tempered behavior,nearly half had sleep problems,and 30%-40%had picky eating and polyphagia issues.The highest-frequency syndrome type was kidney deficiency and liver hyperactivity.Deficiency,fire,phlegm,and dyspeptic food were the main pathological factors for ADHD.Prof.Xuan’s treatment of ADHD mainly focused on replenishing kidney essence and subduing Yang(active,external,ascending,warm,bright,functional and excited pertain to Yang).The core herbal prescription for ADHD included Yuan-zhi,Yi-zhi,Gui-jia,Bai-shao,Long-chi,Ci-shi,Shi-chang-pu,Yu-jin,Fu-shen,and Huang-jing.The protein-protein interaction network showed that MAOA,ADRB2,FOS,MAOB,and SLC6A3 were the five key targets essential in treating ADHD with core herbal prescriptions.The gene ontology biological function of crucial targets mainly involved G protein-coupled amine receptor activity,catecholamine binding,and neurotransmitter transmembrane transporter activity.Analysis of Kyoto Encyclopedia of Genes and Genomes pathways showed that the dopaminergic synapse signaling and neuroactive ligand-receptor interaction pathways were significantly enriched and may be the primary routes for the main treatment of ADHD.Conclusion:Prof.Xuan’s treatment of ADHD has achieved satisfactory clinical effects by supplementing the kidney,replenishing the essence,opening the orifices,nourishing the Yin(static,internal,descending,cold,dim,organic,depressed and pertain to Yin),and subduing the Yang.The major prescription predominantly affects catecholamine binding,neuroactive ligand-receptor interaction,G protein-coupled amine receptor function,and signaling pathways for dopaminergic synapses.Our findings showed that the methodology and software used in this research could explore and analyze the mechanism behind Prof.Xuan’s clinical medication rule for treating ADHD in children.

Identification and treatment of individuals with attentiondeficit/ hyperactivity disorder and substance use disorder: An expert consensus statement

Attention-deficit/hyperactivity disorder(ADHD)often co-occurs with substance use(SU)and/or substance use disorder(SUD).Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment.This can be further complicated by the context in which services are delivered.Also,when working with young people and adults with co-existing ADHD and SU/SUD,there is uncertainty among healthcare practitioners on how best to meet their needs.In February 2022,the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues.Following presentations providing attendees with an overview of the literature,group discussions were held synthesizing research evidence and clinical experience.Topics included:(1)A review of substances and reasons for use/misuse;(2)identification,assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services;and(3)identification,assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services.Discussions highlighted inter-service barriers and fragmentation of care.It was concluded that a multimodal and multi-agency approach is needed.The consensus group generated a table of practice recommendations providing guidance on:identification and assessment;pharmacological and psychological treatment;and multi-agency interventions.

Multimodal integrated intervention for children with attentiondeficit/hyperactivity disorder

BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20 years,effective treatments are still lacking.Instead,the concept of ADHD seems to have become broader and more heterogeneous.Therefore,the diagnosis and treatment of ADHD remains challenging for clinicians.AIM To investigate the effects of a multimodal integrated intervention for children with ADHD.METHODS Between March 2019 and September 2020,a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility,two of whom revoked their consent.A case-control study was conducted in which the children were equally assigned,using a randomized number table,to either a medication group(methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets)or a multimodal integrated intervention group(medication+parent training+behavior modification+sensory integration therapy+sand tray therapy),with 49 patients in each group.The clinical endpoint was the efficacy of the different intervention modalities.RESULTS The two groups of children with ADHD had comparable patient characteristics(P>0.05).Multimodal integrated intervention resulted in a significantly higher treatment efficacy(91.84%)than medication alone(75.51%)(P<0.05).Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone(P<0.05).The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group(P<0.05).Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone(P<0.05).CONCLUSION Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children.It enhanced their memory and attention with high safety and parental satisfaction,demonstrating good potential for clinical promotion.

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.

Deficiency of transmembrane AMPA receptor regulatory protein γ-8 leads to attention-deficit hyperactivity disorder-like behavior in mice

Attention-deficit hyperactivity disorder(ADHD) is a neurodevelopmental disorder prevalent in schoolage children. At present, however, its etiologies and risk factors are unknown. Transmembrane α-amino-3-hydroxy-5-methyl-4-isoxazolepropionicacid(AMPA) receptor regulatory protein γ-8(TARP γ-8,also known as calcium voltage-gated channel auxiliary subunit gamma 8(CACNG8)) is an auxiliary AMPA receptor(AMPAR) subunit. Here, we report an association between TARP γ-8 and ADHD,whereby adolescent TARP γ-8 knockout(KO) mice exhibitedADHD-likebehaviors,including hyperactivity, impulsivity, anxiety, impaired cognition,and memory deficits. Human single-nucleotide polymorphism(SNP) analysis also revealed strong associations between intronic alleles in CACNG8genes and ADHD susceptibility. In addition,synaptosomal proteomic analysis revealed dysfunction of the AMPA glutamate receptor complex in the hippocampi of TARP γ-8 KO mice.Proteomic analysis also revealed dysregulation of dopaminergic and glutamatergic transmissions in the prefrontal cortices of TARP γ-8 KO mice.Methylphenidate(MPH), which is commonly used to treat ADHD, significantly rescued the major behavioral deficits and abnormal synaptosomal proteins in TARP γ-8 KO mice. Notably, MPH significantly reversed the up-regulation of Grik2 and Slc6a3 in the prefrontal cortex. MPH also significantly improved synaptic AMPAR complex function by up-regulating other AMPAR auxiliary proteins in hippocampal synaptosomes. Taken together, our results suggest that TARP γ-8 is involved in the development of ADHD in humans.This study provides a useful alternative animal model with ADHD-like phenotypes related to TARP γ-8deficiency, which has great potential for the development of new therapies.

Whole Exome Sequencing: Novel Genetic Polymorphisms in Saudi Arabian Attention Deficit Hyperactivity Disorder (ADHD) Children

Background: Attention-deficit hyperactivity disorder (ADHD) is a widespread and debilitating disorder with relatively high prevalence in Saudi Arabia. Neuropsychological and radiological investigations have revealed that there are some differences in the components of the brain regions in children with and without ADHD. In this study we have performed whole exome sequencing (WES) in four non-familial cases of ADHD from Makkah Region to identify the genetic polymorphisms associated with the disease in our Saudi population. Methods: Exome sequencing was carried out using Ion Proton with AmpliSeq Exome library methods, and the data were analysed by Ion Reporter 5.6 software. Results: A total of 33 variants were identified from 222 genes selected from the GWAS catalogue for ADHD associated genes. However, the SNPs we identified in these genes were not reported to be associated with ADHD in previous studies. We have identified 2 novel missense variants;one in c.3451G > T;p. (Ala1151Ser) in ITGA1 gene and another is c.988G > A;p. (Ala330Thr) in SPATA13 genes. The variants rs928661, rs11150370 and rs386792899 were the only three variants that appeared on all the 4 patients studied. Six missense variants, rs16841277, rs2228209, rs2230283, rs3741883, rs1716 and rs2272606, were found in 3 different patients, respectively. However, the three documented variants are rs13166360 with bipolar disorder, rs920829 with neuropathic pain, and rs6558702 with schizophrenia. Conclusion: We have identified 2 novel variants in ADHD children. SIFT score of all variants indicates that these substitutions have damaging effects on the protein function. Further screening studies are recommended for confirmation.

Voxel-based statistical analysis of regional cerebral glucose metabolism in children with attention-deficit hyperactivity disorder

The technique of region of interest-based positron emission tomography is limited by its poor reli-ability and relatively few examined brain regions. In the present study, we compared brain metabo-lism assessed using fluorine-18-fluorodeoxyglucose positron emission tomography between 14 at-tention-deficit hyperactivity disorder （ADHD） patients and 15 normal controls with scoliosis at resting state by statistical parametric mapping. Glucose metabolism was decreased in the left parahippo-campal gyrus, left hippocampus, left anterior cingulate gyrus, right anterior and posterior lobes of the cerebellum, left superior temporal gyrus, left insula, left medial and middle frontal gyri, right medial frontal gyrus, and left basal ganglia （putamen, amygdala, and caudate nucleus） in children with ADHD. These data suggest that children with ADHD exhibit hypometabolism in various brain regions compared to controls, indicating that ADHD symptoms are unlikely the result of abnormalities in specific areas.

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.

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.

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.