Association of premature birth and maternal education level on attention deficit hyperactivity disorder in children:A meta-analysis

BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in childhood.There is growing evidence that both preterm birth and maternal education levels substantially affect the likelihood of ADHD in children.However,there are limited systematic reviews and meta-analyses examining these associations.AIM To systematically review and conduct a meta-analysis on the association of preterm birth and maternal education level on the risk of ADHD in children.METHODS We conducted a comprehensive literature search across MEDLINE(PubMed),Web of Science,Embase,and the Cochrane Library,including studies published up to June 17,2024.Data synthesis was performed using random-effect models,and the quality of studies was assessed using the Newcastle-Ottawa Scale.RESULTS This study included twelve studies,which revealed a significant association between premature delivery and an increased risk of ADHD in children[odds ratio(OR)=2.76,95%confidence interval(CI):2.52-3.04,P<0.001,I^(2)=1.9%).Conversely,higher maternal education levels were significantly associated with a reduced risk of ADHD in children(OR=0.59,95%CI:0.48-0.73,P<0.001,I^(2)=47.1%).Subgroup analysis further indicated that maternal education levels significantly influenced ADHD risk,particularly in studies conducted in China(OR=0.59,95%CI:0.46-0.75,P<0.001,I^(2)=81.2%),while no significant association was observed in studies from other regions(OR=1.25,95%CI:0.66-2.40,P=0.495,I^(2)=92.3%).The sensitivity analysis confirmed the robustness of our findings,showing no significant publication bias.CONCLUSION This study found that preterm birth significantly increases the risk of ADHD in children,while a higher maternal education level serves as a protective factor against ADHD.To reduce the incidence of ADHD in children,public health policies should focus on early intervention for preterm infants and improving maternal education levels.

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.

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.

Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder

BACKGROUND Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations,creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder(ADHD).Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream,and the severity of their symptoms correlates with the heavy metal levels measured in their blood.Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.AIM To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.METHODS The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD.Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test(n=11)or control(n=11)group.The test group participated in the six-week online nutritional epigenetics tutorial,while the control group did not.The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods.Diet intake scores were derived for both ultra-processed and whole/organic foods.Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.RESULTS There was a significant difference in the diet scores of the test group between the pre-and post-intervention periods.The parents in the test group significantly reduced their intake of ultra-processed foods with a preintervention diet score of 70(mean=5.385,SD=2.534)and a post-intervention diet score of 113(mean=8.692,SD=1.750)and the paired t-test analysis showing a significance of P<0.001.The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100(mean=5.882,SD=2.472)and post-intervention diet score of 121(mean=7.118,SD=2.390)and the paired t-test analysis showing a significance of P<0.05.CONCLUSION Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.

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.

Association of Serotonin Receptors with Attention Deficit Hyperactivity Disorder： A Systematic Review and Meta-analysis

Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have reported the association between the serotonin receptor family （5-HTR） gene polymorphisms and ADHD, but the results are still controversial. In this study, we conducted a meta-analysis of the association between 5-HTRIB, 5-HTR2A, and 5-HTR2C genetic variants and ADHD. The results showed that the 861G allele of 5-HTRIB SNP rs6296 could significantly increase the risk of ADHD （OR= 1.09, 95% CI： 1.01-1.18）; the 5-HTR2C gene rs518147 （OR=1.69, 95% CI： 1.38-2.07） and rs3813929 （OR = 1.57, 95% CI： 1.25-1.97） were all associated with the risk of ADHD. In addition, we also carried on a case- control study to explore the relevance between potential candidate genes 5-HTR1A, 5-HTRIE, 5-HTR3A and ADHD. The results indicated that 5-HTRIA rs6295 genotype （CC＋CG vs. GG OR=Z00, 95% CI： 1.23-3.27） and allele （OR=1.77, 95% CI： 1.16-2.72） models were statistically significantly different between case group and control group. This study is the first comprehensive exploration and summary of the association between serotonin receptor family genetic variations and ADHD, and it also provides more evidence for the etiology of ADHD.

Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.

How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder?

AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.

Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.

Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain

Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.

Visual-Motor Perceptual and Reading Processes of Schoolchildren With Attention Deficit Hyperactivity Disorder

Objectives:Compare and relate the performance of schoolchildren with Attention Deficit Hyperactivity Disorder(ADHD)and with good academic performance in the visual-motor perceptual and reading processes.Method:Twenty schoolchildren,of both genders,aged between nine and 11 years old,participated in this study.They were divided into two groups:Group I(GI):comprising 10 students diagnosed with ADHD;and Group II(GII):10 students with good academic performance paired according to gender,age group,and educational level with GI.All students were submitted to the Developmental Test of Visual Perception(DTVP 3)and Reading Processes Assessment Protocol(PROLEC).Results:There was lower performance of GI compared to GII in the subtests of copying,eye-hand coordination,and figure-ground in the standard score of general visual perception and visual-motor integration.GI presented lower performance in all reading processes except for the punctuation marks test.There was a statistically significant difference in the comparison between GI and GII regarding the classification of reading processes.A relationship was identified between the reading and visual perception subtests in the GI students,demonstrating a relationship between the visual perceptual motor skills and the reading processes in the group of students with ADHD.Conclusion:Schoolchildren with ADHD performed less well than their peers with good academic performance in the visual-motor perceptual and reading skills;such that the worse their performance in the visual-motor perceptual processes,the worse their performance in the reading processes.

Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder

BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.

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.

Age-related connectivity differences between attention deficit and hyperactivity disorder patients and typically developing subjects：a resting-state functional MRI study

Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.

Comparison of horse and cow milk on sleep disorders in children with attention deficit hyperactivity disorder:a double-blind randomized clinical trial study

Approximately 25%–50%of children with attention deficit hyperactivity disorder have sleep problems.The aim of this study is to compare the effect of horse milk with conventionally-fed cow’s milk on sleep disorders in children with attention deficit hyperactivity disorder.In this randomized double-blind crossover study,30 patients with attention deficit hyperactivity disorder were randomly selected and divided into two groups.All patients underwent a 45-day period of horse milk consumption and a 45-day period of cow milk consumption and they continued their drug treatment.A one-week interval between two periods of milk consumption was considered as the washout period.The severity of sleep disorder in the studied patients was determined based on the short form of the Children’s Sleep Habits Questionnaire(CSHQ).Twenty-two(73.3%)male and eight(26.7%)female patients were included in this study.The mean age of the patients was 8.9 years.Our results showed that horse milk consumption improved the CSHQ score.For the group of patients consuming horse milk prior to cow milk,reductions of total CSHQ(P-value=0.001)and subscale 1(P-value<0.001)scores were significant.For the group of patients consuming cow milk first,in addition to the total CSHQ(P-value<0.001),subscale 3(P-value=0.001)and 4(P-value=0.009)dropped significantly.On the other hand,the results indicated that cow milk consumption increased the CSHQ score.Specifically,for the group of patients consuming horse milk first,the total CSHQ(P-value=0.001),subscale 3(P-value=0.016),and subscale 4(P-value=0.010)increased significantly.The mean values of the first,second,third,and fourth subscales of CSHQ before and after the washout period were not significantly different between the two groups.According to the study,consuming horse milk was significantly better than cow milk in improving the total score of CSHQ in children with attention deficit hyperactivity disorder.

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.

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.