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.

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.

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.

Behavioral and Neural Enhancing Effects of a Summer Treatment Program in Children with Attention Deficit Hyperactivity Disorder

Deficiency in executive functioning is a core symptom of attention deficit hyperactivity disorder (ADHD). The brain part responsible for executive functions is the prefrontal cortex (PFC). Although drug-based interventions can improve PFC activity, reports on PFC activity being improved by behavioral treatment are lacking. We evaluated whether a summer treatment program (STP) administering comprehensive behavioral treatment would increase PFC activity in children with ADHD. We examined behavioral and neural changes in 20 children before and after the STP, conducted over a 2-week period. We asked the parents/guardians to complete the Swanson, Nolan, and Pelham IV scale to assess severity of ADHD. The main task evaluating executive control was the reverse Stroop task. To examine changes in physiological indices, we used near-infrared spectroscopy to measure changes in PFC activity. Subjective assessments by parents/guardians indicated that ADHD symptoms improved significantly. There was also significant improvement in the number of correct responses and interference rates in the reverse Stroop task. Furthermore, post-intervention PFC activity was significantly higher. These results suggest that the STP improved inhibitory control in executive function, which is considered as a key symptom of ADHD. The increase in PFC activity further suggests that the STP improves cognition through neural function.

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.

ADHD in Children and Adolescents: Barriers to Ethical and Successful Treatment

This review provides a comprehensive analysis of attention deficit hyperactivity disorder (ADHD), a neurodevelopmental disorder characterized by inattention, hyperactivity, or impulsivity. The global prevalence of the disorder ranges from 2% to 7%, with an average of around 5%. ADHD affects individuals of all ages, with symptoms typically becoming visible as early as 3 years. The symptoms range from mild to severe and may persist into adulthood. The disorder affects a variety of demographic groups, including differences in age, gender, race, and ethnicity, with varying effects, prevalence, and treatment options among these groups. Treatment options for ADHD range from behavioral interventions to prescription medication, with a number of medications available on the market for treating ADHD. The review also highlights the issues of relapse and safety concerns associated with the use of medication, as well as the challenges associated with diversity and socioeconomic barriers in the diagnosis and treatment of the disorder.

Frequency-specific abnormalities in regional homogeneity among children with attention deficit hyperactivity disorder: a resting-state f MRI study

Although many functional magnetic resonance imaging(f MRI) studies have investigated the neurophysiology of attention deficit hyperactivity disorder(ADHD),the existing studies have not yielded consistent findings.This may be related to the different properties of different frequency bands. To investigate the frequency-specific regional homogeneity(Re Ho) of spontaneous neural activities in ADHD, the current study used resting-state f MRI to explore the Re Ho properties of five frequency bands, slow-5(0.01–0.027 Hz), slow-4(0.027–0.073 Hz),slow-3(0.073–0.198 Hz), slow-2(0.198–0.25 Hz) and the extra-low frequency(0–0.01 Hz), in 30 drug-naive boys with ADHD and 30 healthy controls. Compared with controls, the ADHD group showed decreased Re Ho in the default mode network(DMN) including the medial prefrontal cortex and precuneus, middle frontal gyrus and angular gyrus. ADHD patients also showed increased Re Ho in the posterior cerebellum. Significant interactions between frequency band and group were observed predominantly in the dorsolateral prefrontal and parietal cortices, orbital frontal cortex, supplementary motor area,inferior occipital gyrus, thalamus and anterior cerebellum.In particular, we found that the between-group difference in the extra-low frequency band(0–0.01 Hz) seemed to be greater than that in the other frequency bands for most brain regions. The findings suggest that ADHD children display widespread abnormalities in regional brain activity,particularly in the DMN and attention network, and these abnormalities show frequency specificity.

Nicotinic Acetylcholine Receptor α4 Subunit Gene Variation Associated with Attention Deficit Hyperactivity Disorder

Previous pharmacological, human genetics, and animal models have implicated the nicotinic ace- tylcholine receptor α4 subunit （CHRNA4） gene in the pathogenesis of attention deficit/hyperactivity disorder （ADHD）. The objective of this study is to examine the genetic association between single nucleotide poly- morphisms in the CHRNA4 gene （rs2273502, rs1044396, rs1044397, and rs3827020 loci） and ADHD. Both case-control and family-based designs are used. Children aged 6 to 16 years were interviewed and assessed with the children behavior checklist and the revised conner＇ parent rating scale to identify probands. No significant differences in the frequency distribution of genotypes or alleles were found between the case and control groups. However, further haplotype analyses showed the CCGG haplotype on risk for ADHD in 164 case-control samples and the standard transmission disequilibrium test analyses suggest that the allele C of rs2273502 was over-trensferred in 98 ADHD parent-offspring trios. These findings suggest that the CHRNA4 gene may play a role in the pathogenesis of ADHD.

Ascorbic acid derived carbon dots promote circadian rhythm and contribute to attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder(ADHD)is one of the most prevalent psychiatric disorders in children,and ADHD patients always display circadian abnormalities.While,the ADHD drugs currently used in clinic have strong side effects,such as psychosis,allergic reactions,and heart problems.Here,we demonstrated carbon dots derived from the ascorbic acid(VCDs)could strongly rescue the hyperactive and impulsive behaviour of a zebrafish ADHD disease model caused by per1b mutation.VCDs prolonged the circadian period of zebrafish for more than half an hour.In addition,the amplitude and circadian phase were also changed.The dopamine level was specifically increased,which may be caused by stimulation of the dopaminergic neuron development in the midbrain.Notably,it was found that the serotonin level was not altered by VCDs treatments.Also,the gene transcriptome effects of VCDs were discussed in present work.Our results provided the dynamic interactions of carbon dots with circadian system and dopamine signaling pathway,which illustrates a potential application of degradable and bio-safe VCDs for the treatment of the attention deficient and hyperactive disorder through circadian intervention.

ADHD儿童在钟表绘画测验中的执行功能特征

目的研究ADHD儿童在钟表绘画(CDT)测试中体现出的执行功能特征。方法对60例ADHD儿童和60例正常对照儿童进行CDT测试,综合分析两组儿童的大脑额叶执行功能的差异。结果ADHD儿童在CDT测试中的时间总分和构造总分低于对照组(3.23±1.40/4.15±0.78,11.2±1.48/11.90±0.76,t=7.742、5.073,P<0.01)。在给定十字位相标定点(3、6、9、12点)后ADHD儿童的钟面构造得分高于给定标定点之前(11.93±0.95/11.19±1.48,t=5.645,P<0.001),但时间设置评分却没有明显的提高(P>0.05)。结论ADHD儿童CDT测试得分偏低体现了其存在计划性、注意调控功能和工作记忆的缺陷,这些缺陷的核心问题是执行功能的缺陷。

盐酸哌甲酯控释剂治疗儿童ADHD临床疗效影响因素分析

目的观察中枢神经兴奋剂盐酸哌甲酯控释剂治疗注意缺陷多动障碍(ADHD)患儿临床疗效的影响因素。方法采取自身对照研究方法,选取2014年1月至2015年12月在上海市儿童医院儿保门诊就诊被诊断为ADHD并需要进行治疗的患儿711例;经过盐酸哌甲酯控释剂治疗后,分别于6周、6个月后采用斯诺佩评估量表(SNAP-Ⅳ)的家长使用量表、联合型瑞文测验(CRT)等相关测试,进行治疗前后疗效评估。结果盐酸哌甲酯控释剂对注意力缺陷型和混合型的ADHD患儿治疗效果明显优于多动型/冲动型(χ~2=73.109,P<0.01);对认知功能好的ADHD患儿疗效优于合并认知障碍者(χ~2=100.225,P<0.01)。结论盐酸哌甲酯控释剂治疗儿童不同类型ADHD疗效肯定;疗效受到ADHD类型、患儿智力、药物剂量等的影响。

正念疗法联合Omega-3治疗儿童ADHD疗效观察

目的评估正念疗法及服用Omega-3作为辅助措施治疗儿童注意力缺陷多动障碍(ADHD)的疗效。方法本研究为随机双盲临床试验,研究对象为2010年7月至2016年7月在深圳市南山区妇幼保健院就诊的60名ADHD患儿,年龄在5~12岁。所有研究对象均被评估8周,均服用利他林,分为对照组、Omega-3组、正念疗法组及联合治疗组,每组15例患儿。使用Conners父母和教师评定量表评价治疗0周、2周、4周、8周时临床症状改善情况。结果治疗开始时(0周)及治疗2周四组Conners评分比较均无明显差异(均P>0.05),治疗4周时联合治疗组较对照组及Omega-3组Conners评分明显降低(t值分别为3.00、2.85,均P<0.01),治疗8周时正念疗法组较对照组及Omega-3组Conners评分明显降低(t值分别为2.76、2.94,均P<0.01),联合治疗组较对照组及服用Omega-3组Conners评分明显降低(t值分别为2.91、2.89,均P<0.01)。结论在服用利他林的基础上,正念疗法联合服用Omega-3可有效改善ADHD患儿的症状。正念疗法联合服用Omega-3较对照组及服用Omega-3有更好的治疗效果。

应用SPECT评价HANS数码针刺治疗ADHD的疗效

目的:应用SPECT评价韩氏穴位神经刺激仪(Han's a cupoint nerve stimulat or,HANS)治疗ADHD的疗效。方法:分别在33例ADHD患儿HANS治疗前和≥12个月治疗后,进行SPECT脑灌注显像,并应用视觉分析和血流功能变化率(BFCR%)生理数学模型定量分析HANS治疗疗效。结果:HANS治疗前SPECT显示33例患儿共有128处局部脑血流灌注及功能低下病灶,主要位于双侧额前区、眶额、颞极,其次为双侧Rolandic区、枕叶次级视皮质区。HANS治疗≥12个月后视觉分析示,128处病灶有107处消失或缩小;定量分析显示,有91处BFCR%≥15%,10处15%>BFCR%≥10%,合计101处。显效率为71.09%,有效率为7.81%,总有效率为78.91%。结论:HANS治疗ADHD疗效肯定。

基于时空双稀疏表示的成人ADHD脑网络检测与分析

注意力缺陷多动障碍(Attention deficit hyperactivity disorder,ADHD)主要表现为注意力分散、多动和冲动,是一种常见的精神障碍疾病.作为一种流行的脑功能成像技术,静息态功能核磁共振成像(Resting-state functional magnetic resonance imaging,rsfMRI)常应用于探索ADHD的神经机制.然而,由于rsfMRI数据的高维和少样本特性,采用传统的独立成分分析方法从rsfMRI数据中获得脑网络后,大多用基于体素级的方法进行推断,这难以检测出可靠的、与ADHD相关的脑网络.针对上述问题,本文提出了一种新颖的基于时空双稀疏表示(Dual temporal and spatial sparse representation,DTSSR)的方法和指标,以22名成人ADHD患者为研究对象,从大尺度脑网络级的角度检测出与ADHD相关的脑网络.首先采用DTSSR从ADHD的rsfMRI数据中提取出组脑网络及相应的耦合参数;然后将耦合参数均值池化作为网络的活跃度指标;最后,将活跃度指标与ADHD的量表分进行Spearman相关性分析,检测出与ADHD相关的脑网络.实验结果表明,背侧注意网络、执行控制网络的活跃度与ADHD量表分具有显著相关性.该结果在脑科学角度有合理的解释,且在不同字典尺寸下具有较高稳定性.本文所提方法,为探讨ADHD的潜在神经机制提供了一种新思路.

ADHD儿童脑电生物反馈治疗前后IVA-CPT的变化

【目的】对34名ADHD儿童进行生物反馈治疗,通过治疗前后视听整合持续操作测试(integrated visualand auditory continuous performance test,IVA-CPT)测试的变化,探讨其疗效及临床意义。【方法】34名ADHD儿童行脑电生物反馈治疗前后均未投用利他林类兴奋剂,仅予每周2～3次脑电生物反馈治疗,每一疗程20次,每例均完成一个以上疗程的治疗,对治疗前后IVA-CPT测试结果进行统计分析。【结果】ADHD患儿总反应控制商数、总注意力商数在治疗前后差异有显著性(P<0.01)。其中总反应控制商数(包括谨慎商数、一致性商数)、总注意力商数(包括警醒商数、注意力集中商数、速度商数)均较治疗前有明显提高,而总反应控制商数中的毅力商数在治疗前后差异无显著性。【结论】脑电生物反馈治疗可提高儿童注意力集中水平,改善控制能力,减少多动冲动,是治疗儿童ADHD的强有力的手段之一。

COMT基因多态性与ADHD患儿青春期预后的关联分析

目的:探讨儿茶酚-O-甲基转移酶(COMT)基因Val108/158Met(rs4680)多态性对中国汉族男性注意缺陷多动障碍(Attention deficit hyperactivity disorder,ADHD)患儿青春期预后的影响。方法:对77名基线时符合美国《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的中国汉族ADHD男性患儿进行青春期的随访,以定式访谈方法按同样诊断标准对随访组确定诊断,并检测COMT基因Val158Met多态性。采用卡方检验对ADHD不同预后结局进行COMT基因Val158Met多态性等位基因频率的比较。结果:77名患者中,41人(53.2%)ADHD无缓解,36人(46.8%)达到不同程度的缓解,缓解组中16人(20.8%)满足功能缓解,7人(9.1%)症状缓解,13人(16.9%)综合征缓解。各种缓解表型与无缓解型的COMT基因Val158Met等位基因频率差异无统计学意义。结论:COMT基因Val158Met多态性对ADHD男性患儿青春期预后无关联,但尚需进一步扩大样本量进行验证。

Conners父母症状量表在ADHD患儿中的应用

目的了解儿童注意缺陷多动障碍患者合并其他行为问题的情况。方法采用Conners儿童行为问卷（父母用），对符合美国精神病协会《精神障碍诊断和统计手册》第4版（DSM—Ⅳ）注意缺陷多动障碍诊断标准的1006例患者进行了合并行为问题的研究，分析不同性别、不同亚型患儿Conners量表测试结果，以分析注意缺陷多动障碍合并其他行为障碍的特点。结果多动／冲动为主型、注意缺陷为主型和混合型行为问题各占18．3％、55．9％和25．9％，其分布经比较有显著性差异（X2=9．054，P〈0．05）；1006例患者主要分布在7～11岁之间，占总人次的78．1％，其中以9岁组为最多；合并学习问题者占57．6％、品行问题占50．1％，焦虑占36．2％，心身障碍占17．3％；女性患儿各因子异常率和总分异常率均高于男性，除心身障碍因子外，其余因子异常率性别间经比较差异有统计学意义（X2=11．148，P〈0．01）；多动／冲动为主型行为问题发生率由高到低为品行问题、学习问题、焦虑和心身障碍；注意缺陷为主型和混合型行为问题发生率顺序均为学习问题、品行问题、焦虑和心身障碍；以上4种障碍发生率均以混合型行为问题最高，不同亚型各因子异常率经比较均存在显著性的差异。结论注意缺陷多动障碍患儿合并行为问题较多，性别和亚型间存在差异；症状愈严重，合并障碍比例愈高。

学龄前儿童ADHD与儿童忽视关系的调查研究

目的对学龄前儿童注意缺陷多动障碍（ADHD）的发生情况、学龄前儿童忽视情况进行调查，探讨儿童忽视与学龄前儿童ADHD发生的关系，促进儿童健康发展。方法采用Conners父母问卷和专家访谈相结合的方式，对无锡市604名3～6岁儿童进行ADHD的患病情况调查；应用“中国3—6岁城区儿童忽视状况评价问卷”对上述儿童进行问卷调查。结果无锡市学龄前儿童ADHD患病率为5．0％（30／604）；无锡市3～6岁儿童的总忽视率为27．5％（166／604），忽视总分值为151．4，总忽视度为41．6（151．4／364×100）；学龄前ADHD儿童受忽视率、忽视度显著高于正常儿童（X2=10．584，P〈0．01；t=2．634，P〈0．05）；两组儿童在身体、情感、教育、医疗层面的忽视具有显著性差异（t值分别为2．309、2．373、2．142、3．202，均P〈0．05）；情感、教育、医疗层面的忽视为学龄前儿童ADHD产生的危险因素。结论学龄前ADHD儿童的忽视状况较正常儿童更为严重，情感、教育、医疗层面的忽视在学龄前儿童ADHD的发生中起一定作用。